Intravascular sensors to assess unstable plaques and their compositions: a review

Area of Science:

• Cardiovascular Medicine
• Biomedical Engineering
• Materials Science

Background:

• Atherosclerosis and its thrombotic complications are major causes of cardiovascular events and sudden cardiac death.
• Vulnerable plaque rupture is a key driver of acute cardiovascular events.
• Coronary angiography is limited in characterizing plaque composition (lipid-rich, fibrotic, calcified).

Purpose of the Study:

• To review existing and emerging intravascular sensors for assessing vulnerable atherosclerotic plaques and their composition.
• To discuss the advantages, limitations, and clinical potential of these novel sensor technologies.
• To highlight the unmet need for real-time detection of vulnerable lesions in clinical trials.

Main Methods:

• Review of recent advances in multimodality catheters integrating technologies like intravascular ultrasound, photoacoustic microscopy, optical coherence tomography, and electrochemical impedance spectroscopy.
• Assessment of novel sensors utilizing stretchable electrodes and microfabrication techniques.
• Analysis of sensor capabilities for identifying plaque complexity, composition, stenosis severity, and plaque remodeling.

Main Results:

• Novel multimodality catheters enable detailed assessment of atherosclerotic plaque complexity and composition.
• Technologies like intravascular ultrasound, photoacoustic microscopy, OCT, and EIS provide enhanced plaque characterization.
• Real-time detection of vulnerable atherosclerotic lesions for clinical trials remains a significant challenge.

Conclusions:

• Emerging intravascular sensors offer improved capabilities for characterizing atherosclerotic plaques compared to traditional methods.
• Further development is needed to overcome limitations and realize the full clinical potential of these sensors.
• These advanced sensors hold promise for better management and treatment of atherosclerosis and its complications.