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J. Pers. Med. 2019, 9(1), 8; https://doi.org/10.3390/jpm9010008

Personalized Assessment of the Coronary Atherosclerotic Arteries by Intravascular Ultrasound Imaging: Hunting the Vulnerable Plaque

1
Biomedical Engineering Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
2
Fourth Department of Internal Medicine, “Attikon” Hospital, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece
3
Third Department of Cardiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
*
Author to whom correspondence should be addressed.
Equal first authorship.
Current address: Biomedical Engineering Unit, First University Department of Cardiology, Hippokration Hospital, 114 Vas. Sophias ave., 11527 Athens, Greece.
Received: 25 November 2018 / Revised: 3 January 2019 / Accepted: 21 January 2019 / Published: 24 January 2019
(This article belongs to the Special Issue Personalized and Targeted Atherosclerosis Treatments)
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Abstract

The term “vulnerable plaque” is commonly used to refer to an atherosclerotic plaque that is prone to rupture and the formation of thrombosis, which can lead to several cardiovascular and cerebrovascular events. Coronary artery atherosclerosis has a wide variety of different phenotypes among patients who may have a substantially variable risk for plaque rupture and cardiovascular events. Mounting evidence has proposed three distinctive histopathological mechanisms: plaque rupture, plaque erosion and calcified nodules. Studies have demonstrated the characteristics of plaques with high vulnerability such as the presence of a thin fibrous cap, a necrotic lipid-rich core, abundant infiltrating macrophages and neovascularization. However, traditional coronary angiographic imaging fails to determine plaque vulnerability features, and its ability to individualize treatment strategies is limited. In recent decades, catheter-based intravascular ultrasound imaging (IVUS) modalities have been developed to identify vulnerable plaques and ultimately vulnerable patients. The aim is to individualize prediction, prevention and treatment of acute coronary events based on the identification of specific features of high-risk atherosclerotic plaques, and to identify the most appropriate interventional procedures for their treatment. In this context, the aim of this review is to discuss how personalized assessment of coronary atherosclerotic arteries can be achieved by intravascular ultrasound imaging focusing on vulnerable plaque detection. View Full-Text
Keywords: coronary arteries; atherosclerosis; precision medicine; interventional cardiology coronary arteries; atherosclerosis; precision medicine; interventional cardiology
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Papaioannou, T.G.; Kalantzis, C.; Katsianos, E.; Sanoudou, D.; Vavuranakis, M.; Tousoulis, D. Personalized Assessment of the Coronary Atherosclerotic Arteries by Intravascular Ultrasound Imaging: Hunting the Vulnerable Plaque. J. Pers. Med. 2019, 9, 8.

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