Hybrid intravascular imaging in the study of atherosclerosis

Recent evidence from large-scale clinical trials has not only underscored the potential value of intravascular imaging in detecting plaque characteristics that are associated with disease progression but also demonstrated the poor predictive accuracy of intravascular imaging in identifying the lesions that will evolve and cause a future event. This limitation has been attributed to the fact that all the available intravascular imaging techniques are unable to provide a detailed and complete visualization of plaque pathology and identify features that are related with increased vulnerability. To overcome these drawbacks, fusion of intravascular imaging modalities with different strengths and weaknesses has been proposed. In this chapter we describe the available intravascular imaging techniques, discuss their limitations in the study of atherosclerosis, and present the hybrid intravascular approaches that have been developed for more complete and precise assessment of plaque pathology.