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Vulnerable plaque intervention: State of the art
Author(s) -
Young John J.,
Phillips Harry R.,
Marso Steven P.,
Granada Juan F.,
McPherson John A.,
Waksman Ron,
Steinhubl Steven R.,
Schwartz Robert S.,
Stone Gregg W.
Publication year - 2008
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.21354
Subject(s) - medicine , percutaneous coronary intervention , coronary artery disease , cardiology , coronary angiography , acute coronary syndrome , interventional cardiology , vulnerable plaque , intervention (counseling) , intensive care medicine , cardiac catheterization , vulnerability (computing) , myocardial infarction , computer security , psychiatry , computer science
Abstract Progressive atherosclerotic disease is responsible for many of the late adverse clinical events that detract from the high procedural and clinical success of percutaneous coronary intervention. Despite recent advances in catheter based technology for the treatment of obstructive coronary artery disease, the greater risk to the patient over time may in fact come from the significant rate of acute coronary events triggered by nonculprit and/or nonobstructive coronary artery lesions. These areas of vulnerability within the epicardial coronary tree have generated a great deal of interest surrounding the concepts of vulnerable plaque (VP), vulnerable blood and the vulnerable patient. This ‘state of the art’ review discusses the limitations of coronary angiography alone in providing risk assessment; reviews the underlying biological concepts of VP; discusses evolving noninvasive and invasive imaging technologies for the detection of VP; and finally provides a futuristic look at how the field of interventional cardiology may transcend the traditional angiogram and move toward a more comprehensive treatment approach that benefits the patients' overall coronary health. © 2008 Wiley‐Liss, Inc.