Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Interventions

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  • Thomas W Johnson
    Department of Cardiology, Bristol Heart Institute, University Hospitals Bristol NHSFT & University of Bristol, Bristol, UK
  • Lorenz Räber
    Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
  • Carlo di Mario
    Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy
  • Christos Bourantas
    Department of Cardiology, Barts Heart Centre, Barts Health NHS & Queen Mary University, London, UK
  • Haibo Jia
    Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China
  • Alessio Mattesini
    Department of Cardiology, Barts Heart Centre, Barts Health NHS & Queen Mary University, London, UK
  • Nieves Gonzalo
    Department of Cardiology, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain
  • Jose M de la Torre Hernandez
    Department of Cardiology, Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Spain
  • Francesco Prati
    Department of Cardiology, San Giovanni Hospital, Rome, Italy & CLI Foundation Rome, Italy
  • Konstantinos Koskinas
    Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
  • Michael Joner
    Deutsches Herzzentrum München, DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Technische Universität München, Munich, Germany
  • Maria D Radu
    Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
  • David Erlinge
    Department of Cardiology, Lund University, Skane University Hospital, Lund, Sweden
  • Evelyn Regar
    Department of Cardiovascular Surgery, Zürich University Hospital, Zürich, Switzerland
  • Vijay Kunadian
    Institute of Cellular Medicine, Newcastle University and Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
  • Akiko Maehara
    Cardiovascular Research Foundation, Columbia University, New York, NY, USA
  • Robert A Byrne
    Deutsches Herzzentrum München, DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Technische Universität München, Munich, Germany
  • Davide Capodanno
    Division of Cardiology, Cardio-Thoraco-Vascular and Transplant Department, CAST, Rodolico Hospital, AOU “Policlinico-Vittorio Emanuele”, University of Catania, Catania, Italy
  • Takashi Akasaka
    Wakayama Medical University, Wakayama, Japan
  • William Wijns
    The Lambe Institute for Translational Medicine and Curam, National University of Ireland Galway, Saolta University Healthcare Group, Galway, Ireland
  • Gary S Mintz
    Cardiovascular Research Foundation, Columbia University, New York, NY, USA
  • Giulio Guagliumi
    Cardiovascular Department, Ospedale Papa Giovanni XXIII, Bergamo, Italy

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<jats:title>Abstract</jats:title> <jats:p>This consensus document is the second of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near infrared spectroscopy (NIRS)-IVUS. Beyond guidance of stent selection and optimization of deployment, invasive imaging facilitates angiographic interpretation and may guide treatment in acute coronary syndrome. Intravascular imaging can provide additional important diagnostic information when confronted with angiographically ambiguous lesions and allows assessment of plaque morphology enabling identification of vulnerability characteristics. This second document focuses on useful imaging features to identify culprit and vulnerable coronary plaque, which offers the interventional cardiologist guidance on when to adopt an intracoronary imaging-guided approach to the treatment of coronary artery disease and provides an appraisal of intravascular imaging-derived metrics to define the haemodynamic significance of coronary lesions.</jats:p>

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