Reviewing imaging modalities for the assessment of plaque erosion

Carlos Collet, Edoardo Conte, Saima Mushtaq, Sofie Brouwers, Toshiro Shinke, Ahmet Umit Coskun, Zhongyue Pu, Diaa Hakim, Peter Howard Stone, Daniele Andreini

Research output: Contribution to journalReview articlepeer-review


Plaque rupture followed by intracoronary thrombus formation is recognized as the most common pathophysiological mechanism in acute coronary syndromes (ACS). The second most common underlying substrate for ACS is plaque erosion whose hallmark is thrombus formation without cap disruption. Invasive and non-invasive methods have emerged as a promising tool for evaluation of plaque features that either predict or detect plaque erosion. Optical coherence tomography (OCT), high-definition intravascular ultrasound (IVUS), near-infrared spectroscopy (NIRS), and near-infrared autofluorescence (NIRF) have been used to study plaque erosion. The detection of plaque erosion in the clinical setting, mainly facilitated by OCT, has shed light upon the complex pathophysiology underlying ACS not related to plaque rupture. Coronary computed tomography angiography (CCTA), which is to date the most commonly used non-invasive technique for coronary plaque evaluation, may also have a role in the evaluation of patients predisposed to erosion. Also, computational models enabling quantification of endothelial shear stress may pave the way to new research in coronary plaque pathophysiology. This review focuses on the recent imaging techniques for the evaluation of plaque erosion including invasive and non-invasive assessment.

Original languageEnglish
Pages (from-to)52-59
Number of pages8
Publication statusPublished - Feb 2021


  • Coronary computed tomography
  • Intravascular ultrasound
  • Optical computed tomography
  • Plaque erosion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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