Imaging of vulnerable plaques using near-infrared spectroscopy for risk stratification of atherosclerosis

Although the prevalent approach in cardiology is largely "stenosis-centric," it has been long known that most acute coronary events are caused by apparently angiographically nonsignificant stenosis. This has led to a gradual paradigm shift from detection of significant stenosis to detection of lesion instability. A number of imaging modalities have been developed that help in this quest; however, none have been as promising as near-infrared spectroscopy used for detection of coronary plaque characteristics. In this article we discuss the various invasive imaging tools available to the interventional cardiologist, with special emphasis on near-infrared spectroscopy as a key emerging imaging technology.