Intravascular photoacoustics

Abstract

Of the 57 million global deaths in 2008, 17.3 million (30%) were due to cardiovascular disease, of which heart attacks were responsible for 7.3 million deaths1. This high mortality poses a great burden to society, both in terms of mortality and morbidity. The rupture of vulnerable atherosclerotic plaques is a major contributor to acute cardiovascular events and sudden cardiac deaths2. The vulnerability of an atherosclerotic plaque – its susceptibility to rupture – is known to be related to the composition of the plaque, the distribution of mechanical stress within it, and the presence and extent of associated inflammation3-5. One of the most common types of vulnerable plaques is the thin-cap fibroatheroma (TCFA). These lesions are characterized by a thin fibrous cap, weakened by the presence of macrophages, covering a lipid-rich necrotic core3. These and other known markers of plaque vulnerability are depicted in the schematic in Figure 1a. Figure 1b shows the gross morphology of a ruptured TCFA.