[Intravascular imaging and its integration into coronary angiography]

Despite technical innovations of non-invasive coronary imaging modalities, coronary angiography still remains the standard of reference for the assessment of CAD.The advances in interventional cardiology require also increased imaging capabilities, which cannot be fully addressed by conventional coronary angiography. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) as well as near infrared spectroscopy (NIRS) are important developments and will be covered in this review article.IVUS was already around in interventional cardiology since the 90ies. It was the first to offer a high resolution tomographic image of the coronary arteries in vivo. Beyond that, it is also frequently used for peri- and postprocedural imaging. Furthermore, the radiofrequency information ("virtual histology") can be applied to perform a basic tissue characterization.Using near coherent light instead of ultrasound, optical coherence tomography (OCT) is able to deliver a 10 fold higher resolution compared to IVUS when imaging coronary plaques.This allows also for the detection of potential vulnerable lesions as well as for the detection of neo-intimal stent strut coverage following stent placement.Using near infrared spectroscopy (NIRS) even insights into the chemical composition of coronary plaques can be achieved.The development of advanced image acquisition technologies enables us to combine modern intravascular imaging technologies and conventional coronary angiography and hereby achieve additional benefit.