The recognition of the ubiquity of substantial but
non-" ow limiting lesions that may be at high risk
for subsequent plaque rupture and cannot be
identi! ed by coronary angiography has resulted
in a paradigm shift in thinking about the pathophysiology
of coronary artery disease, with the
focus no longer solely on the degree of arterial
luminal narrowing. This growing need for
more information about coronary atherosclerosis
in order to identify patients and lesions at risk for
complications during PCI and for future adverse
cardiac events has been the primary impetus for
the development of novel intra-coronary imaging
methods, able to detect plaque composition.
The introduction of intravascular ultrasound
(IVUS) initially allowed a detailed evaluation of coronary
atherosclerosis, but its limited resolution (axial
100-200 μm) precluded the visualization of certain
microstructure and its capability to characterize
coronary plaques, based on their greyscale-IVUS
appearance, is limited. For these reasons, some
other ultrasound and light based intra-coronary
imaging techniques have been developed in order
to provide tissue characterization of the coronary
plaques.
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