Abstract
Coronary artery disease is characterized by atherosclerotic plaque formation. Despite impressive advances in intravascular imaging modalities, in vivo molecular plaque characterization remains challenging, and different multimodality imaging systems have been proposed. We validated an engineered bimodal intravascular ultrasound imaging (IVUS) / near-infrared fluorescence (NIRF) imaging catheter in vivo using a balloon injury atherosclerosis rabbit model. Rabbit aortas and right iliac arteries were scanned in vivo after indocyanine green (ICG) injection, and compared to corresponding ex vivo fluorescence and white light images. Areas of ICG accumulation were colocalized with macroscopic atherosclerotic plaque formation. In vivo imaging was performed with the bimodal catheter integrating ICG-induced fluorescence signals into cross-sectional IVUS imaging. In vivo ICG accumulation corresponded to ex vivo fluorescence signal intensity and IVUS identified plaques.
Highlights
Cardiovascular diseases are the leading cause of morbidity and mortality worldwide [1], and their burden is expected to rise in the near future given the aging of the population and the increasing rates of obesity and diabetes
Indocyanine green (ICG), given its ability to accumulate in lipid-loaded macrophages [14] and its established clinical applications [15,16], has been proposed as an attractive agent for molecular fluorescence imaging of cardiovascular diseases [14,17]
indocyanine green (ICG) is a near-infrared fluorochrome known to bind to albumin, which is ingested by macrophages [18]
Summary
Cardiovascular diseases are the leading cause of morbidity and mortality worldwide [1], and their burden is expected to rise in the near future given the aging of the population and the increasing rates of obesity and diabetes. Different imaging modalities including intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have been established to overcome these limitations [5,6,7] Such catheter-based technologies provide high-resolution cross-sectional images of the coronary artery wall, allowing for a detailed visualization of atherosclerotic plaques and corresponding vessel responses [8], information with regard to plaque composition and activity is limited. Indocyanine green (ICG), given its ability to accumulate in lipid-loaded macrophages [14] and its established clinical applications [15,16], has been proposed as an attractive agent for molecular fluorescence imaging of cardiovascular diseases [14,17]. Previous in vivo applications relied on balloon occlusion to remove blood from the field of view
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