Intravascular ultrasound: Virtual histology IVUS, integrated backscatter IVUS, and palpography

The concept of the vulnerable plaque is the focus of much research, although our knowledge of the histology, pathobiology, natural history, and therapy of vulnerable plaque remains incomplete. The evolving intravascular ultrasound technologies of virtual histology, integrated backscatter, and palpography have yielded complementary information to traditional grayscale intravascular ultrasound, and advanced our understanding of vulnerable plaque. Although each of these techniques has enjoyed success in the academic arena, none of these techniques has been sufficiently validated to the extent that would allow it to play a part in clinical decision-making. Their future role, both in regard to risk stratification and identification of vulnerable plaque, will depend upon additional rigorous studies of the natural history and treatment of vulnerable plaque.