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Thromb Haemost 2013; 110(04): 706-722
DOI: 10.1160/TH13-02-0121
Review Article
Schattauer GmbH

The vulnerable coronary plaque: update on imaging technologies

Gian Marco Rosa
1   Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, Genoa, Italy
,
Matteo Bauckneht
1   Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, Genoa, Italy
,
Giovanni Masoero
1   Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, Genoa, Italy
,
François Mach
2   Division of Cardiology, Department of Internal Medicine, Foundation for Medical researches, University of Geneva, Geneva, Switzerland
,
Alessandra Quercioli
2   Division of Cardiology, Department of Internal Medicine, Foundation for Medical researches, University of Geneva, Geneva, Switzerland
,
Sara Seitun
3   Interventional Radiology Department San Martino Hospital, University of Genova, Genoa, Italy
,
Manrico Balbi
1   Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, Genoa, Italy
,
Claudio Brunelli
1   Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, Genoa, Italy
,
Antonello Parodi
1   Clinic of Cardiovascular Diseases, Internal Medicine Department, San Martino Hospital and University of Genoa, Genoa, Italy
,
Alessio Nencioni
4   First Medical Clinic, Laboratory of Phagocyte Physiopathology and Inflammation, Department of Internal Medicine, University of Genoa, Genoa, Italy
,
Nicolas Vuilleumier
5   Division of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals, Switzerland
6   Department of Human Protein Science, Geneva Faculty of Medicine, Geneva, Switzerland
,
Fabrizio Montecucco
2   Division of Cardiology, Department of Internal Medicine, Foundation for Medical researches, University of Geneva, Geneva, Switzerland
4   First Medical Clinic, Laboratory of Phagocyte Physiopathology and Inflammation, Department of Internal Medicine, University of Genoa, Genoa, Italy
› Author Affiliations Financial Support: This research was funded by EU FP7, Grant number 201668, AtheroRemo to Dr. F. Mach. This work was also supported by the Swiss National Science Foundation Grants to Dr. F. Mach (#310030–118245), Dr. N. Vuilleumier (#310030–140736), and to Dr. F. Montecucco (#32003B-134963/1).
Further Information

Publication History

Received: 12 February 2013

Accepted after major revision: 01 June 2013

Publication Date:
01 December 2017 (online)

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Summary

Several studies have been carried out on vulnerable plaque as the main culprit for ischaemic cardiac events. Historically, the most important diagnostic technique for studying coronary atherosclerotic disease was to determine the residual luminal diameter by angiographic measurement of the stenosis. However, it has become clear that vulnerable plaque rupture as well as thrombosis, rather than stenosis, triggers most acute ischaemic events and that the quantification of risk based merely on severity of the arterial stenosis is not sufficient. In the last decades, substantial progresses have been made on optimisation of techniques detecting the arterial wall morphology, plaque composition and inflammation. To date, the use of a single technique is not recommended to precisely identify the progression of the atherosclerotic process in human beings. In contrast, the integration of data that can be derived from multiple methods might improve our knowledge about plaque destabilisation. The aim of this narrative review is to update evidence on the accuracy of the currently available non-invasive and invasive imaging techniques in identifying components and morphologic characteristics associated with coronary plaque vulnerability.

Keywords

Vulnerable plaque - atherosclerosis - imaging - nuclear medicine - coronary arteries
 

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