Intravascular ICG-enhanced NIRF-IVUS imaging to assess progressive atherosclerotic lesions in excised human coronary arteries

Philipp Rauschendorfer, Tobias Lenz, Philipp Nicol, Léa Wild, Alicia Beele, Emina Sabic, Grace Klosterman, Karl-Ludwig Laugwitz, Farouc A. Jaffer, Dimitris Gorpas, Michael Joner, Vasilis Ntziachristos
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Abstract

Indocyanine green (ICG)-enhanced intravascular near-infrared fluorescence (NIRF) imaging enhances the information obtained with intravascular ultrasound (IVUS) by visualizing pathobiological characteristics of atherosclerotic plaques. To advance our understanding of this hybrid method, we aimed to assess the potential of NIRF-IVUS to identify different stages of atheroma progression by characterizing ICG uptake in human pathological specimens. After excision, 15 human coronary specimens from 13 adult patients were ICG-perfused and imaged with NIRF-IVUS. All specimens were then histopathologically and immunohistochemically assessed. NIRF-IVUS imaging revealed colocalization of ICG-deposition to plaque areas of lipid accumulation, endothelial disruption, neovascularization and inflammation. Moreover, ICG concentrations were significantly higher in advanced coronary artery disease stages (p < 0.05) and correlated significantly to plaque macrophage burden (r = 0.67). Current intravascular methods fail to detect plaque biology. Thus, we demonstrate how human coronary atheroma stage can be assessed based on pathobiological characteristics uniquely captured by ICG-enhanced intravascular NIRF.

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血管内 ICG 增强 NIRF-IVUS 成像评估切除人体冠状动脉中的进行性动脉粥样硬化病变
吲哚菁绿(ICG)增强血管内近红外荧光(NIRF)成像通过显示动脉粥样硬化斑块的病理生物学特征,增强了血管内超声(IVUS)获得的信息。为了加深我们对这种混合方法的理解,我们旨在通过评估人体病理标本中 ICG 摄取的特征,评估 NIRF-IVUS 识别动脉粥样斑块不同进展阶段的潜力。切除 13 名成年患者的 15 个人体冠状动脉标本后,对其进行 ICG 灌注,并用 NIRF-IVUS 进行成像。然后对所有标本进行组织病理学和免疫组化评估。NIRF-IVUS 成像显示,ICG 沉积与斑块的脂质堆积、内皮破坏、新生血管和炎症区域共定位。此外,冠状动脉疾病晚期的 ICG 浓度明显更高(p <0.05),并与斑块巨噬细胞负担显著相关(r = 0.67)。目前的血管内方法无法检测斑块的生物学特性。因此,我们展示了如何根据 ICG 增强血管内近红外荧光独特捕捉到的病理生物学特征来评估人类冠状动脉粥样斑块的分期。
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