Why the study?
Guidance was needed on when to adopt intracoronary imaging to assess ambiguous lesions, plaque vulnerability, and haemodynamic significance in coronary artery disease.
This expert consensus document provides guidance on using intracoronary imaging (IVUS, OCT, NIRS-IVUS) to identify culprit and vulnerable plaques, assess ambiguous lesions, and guide interventional decision-making in acute coronary syndromes.
Supports imaging-guided PCI decisions in ACS; leaves open need for outcome trials validating plaque metrics.
This consensus document is the second of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near infrared spectroscopy (NIRS)-IVUS. Beyond guidance of stent selection and optimization of deployment, invasive imaging facilitates angiographic interpretation and may guide treatment in acute coronary syndrome. Intravascular imaging can provide additional important diagnostic information when confronted with angiographically ambiguous lesions and allows assessment of plaque morphology enabling identification of vulnerability characteristics. This second document focuses on useful imaging features to identify culprit and vulnerable coronary plaque, which offers the interventional cardiologist guidance on when to adopt an intracoronary imaging-guided approach to the treatment of coronary artery disease and provides an appraisal of intravascular imaging-derived metrics to define the haemodynamic significance of coronary lesions.
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Johnson et al. (2019) studied this question.
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