BEGIN:VCALENDAR VERSION:2.0 PRODID:-//Talks.cam//talks.cam.ac.uk// X-WR-CALNAME:Talks.cam BEGIN:VEVENT SUMMARY:Intravascular imaging of atherosclerosis - Prof.Dr.Ir. Ton van der Steen DTSTART:20121107T170000Z DTEND:20121107T180000Z UID:TALK41081@talks.cam.ac.uk CONTACT:Sri Aitken DESCRIPTION:INTRAVASCULAR IMAGING OF ATHEROSCLEROSIS\n\nProf.dr.ir. Ton va n der Steen1\,2\n\n1 Thoraxcenter Biomedical Engineering\, Erasmus MC Rott erdam\, the Netherlands\;\n2 Interuniversity Cardiology Institute of the N etherlands\, Utrecht\, The Netherlands.\nCorresponding e-mail: a.vanderste en@erasmusmc.nl\n\n\n \nIntravascular ultrasound (IVUS) is a technology th at uses an ultrasound element on the tip of a catheter[1\, 2]. This cathet er is advanced through the groin into the coronary arteries. In this way a tomographic image of the vascular wall and atherosclerotic plaques can be produced. The steering of the ultrasound beam can be done by mechanically rotating a single ultrasound transducer\, or electronically\, using an ar ray of 64 elements in the tip. \nHistorically is has been used to assess the level of occlusion\, the atherosclerotic plaque burden and the native size of the vessel. This information can be used to decide to treat or not and to determine the diameter and length of the stent to be used for trea tment. It has also been used extensively to determine if the stent was wel l deployed.\nThe composition and morphology of an atherosclerotic lesion a re currently considered more important determinants of acute coronary isch emic syndromes that the degree of stenosis[3]. When a lesion is unstable\, it can rupture and cause an acute thrombotic reaction. An unstable plaque can be characterized by a lipid core that is covered by a thin fibrous ca p\, which has been locally weakened by inflammatory cells.\nThe last decad e serious effort has been put in developing IVUS towards identifying these unstable plaques. This lecture will focus on the development of measuring the elastic properties of the plaque as a marker for plaque instability[4 ] and measuring the vascularization in the plaque[5]\, which plays an impo rtant role in the pathogenesis of unstable plaque. Furthermore the role of combined ultrasound/light catheters will be discussed[6\, 7]. These will allow to image the luminal plaque at a resolution of around 10 µm\, while maintaining the full overview. Furthermore photoacoustics and combination of NIR spectroscopy and imaging will be possible. \nTechnology developmen t in the elements\, the echomachines and the signal processing will be pre sented as well as their validation and the role of IVUS to provide imaging biomarkers in natural history studies and trials for the development of n ew cardiovascular drugs[8\, 9].\n\nREFERENCES\n\n[1] A. F. W. van der Stee n\, E. I. Cespedes\, C. L. de Korte\, S. G. Carlier\, W. Li\, F. Mastik\, C. T. Lancee\, J. Borsboom\, F. Lupotti\, R. Krams\, P. W. Serruys\, and N . Bom\, "Novel developments in intravascular imaging\," in Proceedings 199 8 IEEE Ultrasonics Symposium\, pp. 1733-1742.\n[2] Vascular Ultrasound. A. F.W. van der Steen\, Y. Saijo eds. Tokio: Springer\, 2004.\n[3] J. A. Scha ar\, J. E. Muller\, E. Falk\, R. Virmani\, V. Fuster\, P. W. Serruys\, A. Colombo\, C. Stefanadis\, W. S. Casscells\, P. R. Moreno\, A. Maseri\, and A. F. W. van der Steen\, "Terminology for high-risk and vulnerable corona ry artery plaques\," European Heart Journal\, vol. 25\, pp. 1077-1082\, 20 04.\n[4] C. L. de Korte\, M. J. Sierevogel\, F. Mastik\, C. Strijder\, J. A. Schaar\, E. Velema\, G. Pasterkamp\, P. W. Serruys\, and A. F. W. van d er Steen\, "Identification of atherosclerotic plaque components with intra vascular ultrasound elastography in vivo - A Yucatan pig study\," Circulat ion\, vol. 105\, pp. 1627-1630\, 2002.\n[5] D. E. Goertz\, M. E. Frijlink\ , D. Tempel\, L. C. van Damme\, R. Krams\, J. A. Schaar\, F. J. Ten Cate\, P. W. Serruys\, N. de Jong\, and A. F. van der Steen\, "Contrast harmonic intravascular ultrasound: a feasibility study for vasa vasorum imaging\," Invest Radiol\, vol. 41\, pp. 631-8\, 2006.\n[6] A. F. van der Steen\, R. A. Baldewsing\, F. Levent Degertekin\, S. Emelianov\, M. E. Frijlink\, Y. Furukawa\, D. Goertz\, M. Karaman\, P. T. Khuri-Yakub\, K. Kim\, F. Masti k\, T. Moriya\, O. Oralkan\, Y. Saijo\, J. A. Schaar\, P. W. Serruys\, S. Sethuraman\, A. Tanaka\, H. J. Vos\, R. Witte\, and M. O'Donnell\, "IVUS b eyond the horizon\," EuroIntervention\, vol. 2\, pp. 132-42\, 2006.\n[7] S . Garg\, P. Serruys\, M. v. d. Ent\, C. Schultz\, F. Mastik\, G. v. Soest\ , A. v. d. Steen\, M. Wilder\, J. Muller\, and E. Regar\, "First use in pa tients of a combined near infra-red spectroscopy and intra-vascular ultras ound catheter to identify composition and structure of coronary plaque\," EuroIntervention\, vol. 5\, pp. 755-756\, 2010.\n[8] P. W. Serruys\, H. M. Garcia-Garcia\, P. Buszman\, P. Erne\, S. Verheye\, M. Aschermann\, H. Du ckers\, O. Bleie\, D. Dudek\, H. E. Botker\, C. von Birgelen\, D. D'Amico\ , T. Hutchinson\, A. Zambanini\, F. Mastik\, G. A. van Es\, A. F. van der Steen\, D. G. Vince\, P. Ganz\, C. W. Hamm\, W. Wijns\, and A. Zalewski\, "Effects of the direct lipoprotein-associated phospholipase A(2) inhibitor darapladib on human coronary atherosclerotic plaque\," Circulation\, vol. 118\, pp. 1172-82\, 2008.\n[9] C. A. G. Van Mieghem\, E. P. McFadden\, P. J. de Feyter\, N. Bruining\, J. A. Schaar\, N. R. Mollet\, F. Cademartiri \, D. Goedhart\, S. de Winter\, G. R. Granillo\, M. Valgimigli\, F. Mastik \, A. F. van der Steen\, W. J. van der Giessen\, G. Sianos\, B. Backx\, M. A. M. Morel\, G. A. van Es\, A. Zalewski\, and P. W. Serruys\, "Noninvasi ve detection of subclinical coronary atherosclerosis coupled with assessme nt of changes in plaque characteristics using novel invasive imaging modal ities\," Journal of the American College Of Cardiology\, vol. 47\, pp. 113 4-1142\, 2006.\n\n\n LOCATION:Berridge Room\, Level 5\, Addenbrookes Hospital\, University Dept of Radiology\,Cambridge CB2 0QQ END:VEVENT END:VCALENDAR