Recent Patents in Imaging of the Vulnerable Atherosclerotic Plaque: the Search for the Holy Grail
Alessandro Lupi, Andrea Rognoni, Maurizio Lazzero, Rossella Fattori, Mauro De Benedictis, Imad Sheiban, Angelo Sante Bongo and Gioel Gabrio SeccoAffiliation:
Hospital Cardiology, "Maggiore della Carita" Hospital, Novara, Italy.
AbstractCoronary obstruction by thrombus, triggered by ruptureprone atherosclerotic plaques, is the leading cause of myocardial infarction and accounts for millions of deaths and invasive coronary revascularization procedures. Coronary plaques became vulnerable far before any hemorheological effects, thus conventional diagnostic techniques based on angiographic assessment of the coronary vessels or the induction of myocardial perfusion defects or ischemia failed to identify lesions with adverse clinical evolution. In this review we report about the currently available imaging methods used to investigate atherosclerotic plaques. Different coronary vessel imaging modalities such as coronary angiography, coronary ultrasound, nuclear imaging, magnetic resonance (MRI), computed tomography and other novel currently investigated methods are discussed. Virtual histology IVUS, elastography, palpography, are ultrasound-based methods used to characterize different tissues on the basis of their harmonic properties or their deformability. Optical coherence tomography, near infrared spectroscopy and fluorescence use infrared light to obtain high definition images of the vessel wall or tissue characterization. Intravascular MRI is a promising tool coupling high tissue-specificity imaging of MRI and high definition of intravascular techniques. Moreover recent advances in plaque-specific contrast media for magnetic resonance and positron emission tomography are described highlighting their strength and pitfalls and future direction of research in the field. This article presents the current status in the technical background of intravascular ultrasound and nuclear tomographic imaging in the areas of clinical practice, and focuses on future developments of related patent forms.
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