Cardiovascular Research Foundation, New York, New York.
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.
血管内影像学和生理学技术正在超越研究框架，为临床决策提供信息。目前可用的技术和方法包括：血流储备分数、灰阶血管内超声（IVUS）、IVUS 射频组织特征分析、光学相干断层扫描（IVUS 的光模拟）和近红外光谱，后者可检测血管壁内的脂质，最近已与灰阶 IVUS 结合在同一导管中作为首个联合成像设备。这些工具可用于回答日常实践中出现的问题，包括：这个狭窄是否有意义？罪犯病变在哪里？这是易损斑块吗？支架植入过程中远端栓塞或围手术期心肌梗死的可能性有多大？如何优化急性支架结果？为什么这个支架会发生血栓形成或再狭窄？冠状动脉造影的一个遗留问题是假定一种技术可以回答所有这些问题；然而，在当代实践中，这经常被证明是不准确的。
