Abstract
Intravascular photoacoustic-ultrasound (IVPA-US) imaging and near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) are two hybrid modalities that detect arterial lipid, with comparison necessary to understand the relative advantages of each. We performed in vivo and ex vivo IVPA-US imaging of the iliac arteries of Ossabaw swine with metabolic syndrome (MetS) and lean swine to investigate sensitivity for early-stage atherosclerosis. We repeated imaging ex vivo with NIRS-IVUS for comparison to IVPA-US and histology. Both modalities showed significantly greater lipid in MetS vs. lean swine, but only IVPA-US localized the lipid as perivascular. To investigate late-stage atherosclerosis, we performed ex vivo IVPA-US imaging of a human coronary artery with comparison to NIRS-IVUS and histology. Two advanced fibroatheromas were identified, with agreement between IVPA-measured lipid area and NIRS-derived lipid content. As confirmed histologically, IVPA-US has sensitivity to detect lipid content similar to NIRS-IVUS and provides additional depth resolution, enabling quantification and localization of lipid cores within plaques.
Highlights
Over the past two decades, morphometric data from autopsy specimens have advanced our understanding of atherosclerotic plaque types and their progression to major adverse cardiovascular events [1, 2]
We show comparative quantification and localization of advanced atherosclerotic plaques in a fresh human coronary artery by ex vivo Intravascular photoacoustic-ultrasound (IVPA-US) compared to near-infrared spectroscopy (NIRS)-intravascular ultrasound (IVUS) and histopathology
Atherogenic diet developed the characteristics of metabolic syndrome (MetS), including significantly greater total cholesterol, triglycerides, and weight at sacrifice compared to swine in the lean control group (Table 1)
Summary
Over the past two decades, morphometric data from autopsy specimens have advanced our understanding of atherosclerotic plaque types and their progression to major adverse cardiovascular events [1, 2]. Development of intravascular imaging tools to detect vulnerable plaques has been the focus of intense investigation, yet none have been shown to reliably identify TCFAs. Detection of vulnerable plaques will be instrumental in elucidating the mechanisms underlying lesion progression, the development of preventive and therapeutic interventions, and reducing CAD-related morbidity and mortality [6,7,8,9]. NIRS-IVUS is limited by lack of depth (or radial) resolution, distinguishing only where vascular lipid is circumferentially. This modality cannot provide information about the dimensions of lipid deposition, which is necessary for optimally assessing vulnerability, monitoring lesion progression, and pathophysiological involvement of arterial lipids
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