Intracoronary imaging of coronary atherosclerosis: validation for diagnosis, prognosis and treatment.

Koskinas, Konstantinos C; Ughi, Giovanni J; Windecker, Stephan; Tearney, Guillermo J; Räber, Lorenz (2015). Intracoronary imaging of coronary atherosclerosis: validation for diagnosis, prognosis and treatment. European Heart Journal, 37(6), pp. 524-535. Oxford University Press 10.1093/eurheartj/ehv642

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While coronary atherosclerosis is a leading cause of mortality, evaluation of coronary lesions was previously limited to either indirect angiographic assessment of the lumen silhouette or post mortem investigations. Intracoronary (IC) imaging modalities have been developed that allow for visualization and characterization of coronary atheroma in living patients. Used alone or in combination, these modalities have enhanced our understanding of pathobiological mechanisms of atherosclerosis, identified factors responsible for disease progression, and documented the ability of various medications to reverse the processes of plaque growth and destabilization. These methodologies have established a link between in vivo plaque characteristics and subsequent coronary events, thereby improving individual risk stratification, paving the way for risk-tailored systemic therapies and raising the option for pre-emptive interventions. Moreover, IC imaging is increasingly used during coronary interventions to support therapeutic decision-making in angiographically inconclusive disease, guide and optimize procedural results in selected lesion and patient subsets, and unravel mechanisms underlying stent failure. This review aims to summarize current evidence regarding the role of IC imaging for diagnosis and risk stratification of coronary atherosclerosis, and to describe its clinical role for guiding percutaneous coronary interventions. Future perspectives for in-depth plaque characterization using novel techniques and multimodality imaging approaches are also discussed.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Windecker, Stephan and Räber, Lorenz

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0195-668X

Publisher:

Oxford University Press

Language:

English

Submitter:

Judith Liniger

Date Deposited:

02 Mar 2016 15:04

Last Modified:

02 Mar 2016 15:04

Publisher DOI:

10.1093/eurheartj/ehv642

PubMed ID:

26655874

Uncontrolled Keywords:

Atherosclerosis; Coronary interventions; Intracoronary imaging; Vulnerable plaque

BORIS DOI:

10.7892/boris.75892

URI:

https://boris.unibe.ch/id/eprint/75892

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