High-speed multimodal intravascular ultrasound and photoacoustic imaging system for atherosclerosis characterization.

Current intravascular multimodality imaging systems are constrained by imaging speed, catheter size, and system stability, limiting their practical use in dynamic or vessel assessments. Although significant progress has been made in multimodality intravascular imaging, most existing implementations typically operate at rotational speeds in the low-hertz range (approximately 1-15 Hz), which restricts both clinical translation and biologically relevant investigation. Here, we present a next-generation multimodality intravascular imaging system implemented in a 3-French catheter that achieves high-speed rotational imaging at 30 Hz, representing a 2-fold increase in rotational imaging speed compared to typical multimodality intravascular implementations, while maintaining stable, co-registered IVUS and IVPA imaging. This increase in imaging speed enables reliable visualization of lipid-rich plaques over extended vascular segments with reduced motion artifacts, facilitating more consistent assessment of plaque distribution under cardiac-induced vascular motion. Instead of introducing a new imaging mechanism, this study demonstrates how system-level optimization can enable more robust investigation of plaque development and progression in biologically relevant intravascular environments.