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Strategies to break the chain link between plaque vulnerability and adverse clinical events include optimized pharmacologic prevention and potentially also preemptive percutaneous coronary interventions (previously defined as \u201cplaque sealing\u201d or \u201cplaque passivation\u201d). Various morphologic features of the vulnerable plaques have been described, including aspects regarding the large necrotic lipid content, the thin fibrous cap, the presence and extent of the presence of calcifications with small size and calcification angle, and as well as the large macrophage infiltration within the plaque. The detection of these features of plaque vulnerability is possible with intravascular imaging modalities such as intravascular ultrasound (IVUS), near\u2010infrared spectroscopy (NIRS), and optical coherence tomography (OCT). This review explores the peculiarities of these three imaging modalities for the detection of vulnerable coronary plaque features.<\/jats:p>","DOI":"10.1111\/echo.70035","type":"journal-article","created":{"date-parts":[[2024,11,22]],"date-time":"2024-11-22T09:36:17Z","timestamp":1732268177000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Multimodal Intravascular Imaging of the Vulnerable Coronary Plaque"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7580-8029","authenticated-orcid":false,"given":"Andrea","family":"Milzi","sequence":"first","affiliation":[{"name":"Cardiocentro Ticino Institute Ente Ospedaliero Cantonale (EOC)  Lugano Switzerland"},{"name":"Faculty of Biomedical Sciences University of Italian Switzerland  Lugano 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