Institution: | 1. Adelaide Medical School, University of Adelaide, Adelaide, Australia;2. Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, Australia;3. Institute for Photonics and Advanced Sensing, The University of Adelaide, Adelaide, Australia;4. Department of Cardiology, Central Adelaide Local Health Network, Adelaide, Australia;5. Vascular Research Centre, Heart and Vascular Program, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia;6. Baker Heart and Diabetes Institute, Melbourne, Australia;7. Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University, Melbourne, Australia |
Abstract: | The majority of coronary atherothrombotic events presenting as myocardial infarction (MI) occur as a result of plaque rupture or erosion. Understanding the evolution from a stable plaque into a life-threatening, high-risk plaque is required for advancing clinical approaches to predict atherothrombotic events, and better treat coronary atherosclerosis. Unfortunately, none of the coronary imaging approaches used in clinical practice can reliably predict which plaques will cause an MI. Currently used imaging techniques mostly identify morphological features of plaques, but are not capable of detecting essential molecular characteristics known to be important drivers of future risk. To address this challenge, engineers, scientists, and clinicians have been working hand-in-hand to advance a variety of multimodality intravascular imaging techniques, whereby 2 or more complementary modalities are integrated into the same imaging catheter. Some of these have already been tested in early clinical studies, with other next-generation techniques also in development. This review examines these emerging hybrid intracoronary imaging techniques and discusses their strengths, limitations, and potential for clinical translation from both an engineering and clinical perspective. |