Perspective on the use of true vessel characterization imaging in interventional cardiology clinical practice

Intracoronary near infrared spectroscopy (NIRS), incorporated in the True Vessel Characterization (TVC) Imaging System™, is a novel method for the identification and quantification of lipid composition in coronary plaques. The main advantage of NIRS over other plaque characterisation methods is its ability to directly identify chemical composition - the primary use of spectroscopy for other applications. NIRS by itself does not display structures, but a combination device with co-registered intravascular ultrasound (IVUS) has been developed to give simultaneous and complementary structural and compositional information. Identification of lipid core plaque with NIRS hypothetically has the potential to optimise the length of vessel to stent and to lead to effective utilisation of embolic protection devices in the native coronaries, identifying the exact location of lipid-core lesions at high risk of distal embolisation. The NIRS-IVUS device also has promise in the identification of vulnerable plaque, which may lead to strategies to prevent future coronary events.