Clinical utility of intravascular imaging and physiology in coronary artery disease

J Am Coll Cardiol. 2014 Jul 15;64(2):207-22. doi: 10.1016/j.jacc.2014.01.015. Epub 2014 Feb 12.


Intravascular imaging and physiology techniques and technologies are moving beyond the framework of research to inform clinical decision making. Currently available technologies and techniques include fractional flow reserve; grayscale intravascular ultrasound (IVUS); IVUS radiofrequency tissue characterization; optical coherence tomography, the light analogue of IVUS; and near-infrared spectroscopy that detects lipid within the vessel wall and that has recently been combined with grayscale IVUS in a single catheter as the first combined imaging device. These tools can be used to answer questions that occur during daily practice, including: Is this stenosis significant? Where is the culprit lesion? Is this a vulnerable plaque? What is the likelihood of distal embolization or periprocedural myocardial infarction during stent implantation? How do I optimize acute stent results? Why did thrombosis or restenosis occur in this stent? One of the legacies of coronary angiography is to presume that one technique will answer all of these questions; however, that often has been proved inaccurate in contemporary practice.

Keywords: fractional flow reserve; intravascular ultrasound; near-infrared spectroscopy; optical coherence tomography; radiofrequency IVUS.

Publication types

  • Review

MeSH terms

  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / physiopathology*
  • Diagnostic Imaging / statistics & numerical data*
  • Fractional Flow Reserve, Myocardial / physiology*
  • Humans
  • Reproducibility of Results
  • Severity of Illness Index
  • Spectroscopy, Near-Infrared / statistics & numerical data
  • Tomography, Optical Coherence / statistics & numerical data
  • Ultrasonography, Interventional / statistics & numerical data