Emerging Hybrid Intracoronary Imaging Technologies and Their Applications in Clinical Practice and Research

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology
• Biomedical Engineering

Background:

• Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are crucial for diagnosing and managing coronary artery disease.
• These standalone imaging modalities have limitations in fully characterizing plaque and guiding interventions.
• The need for comprehensive intracoronary assessment has driven the development of advanced imaging solutions.

Purpose of the Study:

• To review the evolution and current state of hybrid intracoronary imaging technologies.
• To present available multimodality intracoronary imaging catheters.
• To discuss the clinical applications and future potential of these hybrid systems.

Main Methods:

• Review of scientific literature on intracoronary imaging, focusing on multimodality and hybrid catheter development.
• Analysis of studies utilizing combined imaging probes (e.g., NIRS-IVUS).
• Discussion of postmortem histology findings comparing hybrid imaging to standalone methods.

Main Results:

• Development of prototype catheters integrating 2-3 imaging probes with complementary functions.
• Clinical use of multimodality systems, with NIRS-IVUS showing promise in identifying high-risk plaques.
• Histological evidence confirming superior plaque characterization by hybrid imaging compared to individual modalities.

Conclusions:

• Hybrid intracoronary imaging offers enhanced capabilities for assessing vessel wall pathology and guiding percutaneous coronary intervention (PCI).
• These advanced catheters show significant potential in detecting vulnerable plaques and evaluating atherosclerotic disease.
• Future applications include improved PCI guidance, risk stratification, and assessment of novel therapies.