Ultrasonographic investigation of the mechanics of vulnerable atherosclerotic plaques: significance of the volume strain

The concept of vulnerable atherosclerotic plaque in defining the prognostic risk for plaque rupture and thromboembolic complications is an attempt to go beyond the concept of the risk as only related to the degree of the consequent stenosis. However, interventional trials still depend on the evaluation of the degree of stenosis, used as endpoint and do not use plaque characteristics such as aspect, morphology, structure, and mechanics. Unfortunately, no consensus has yet been reached about how to define objective criteria and methodologies for assessing plaque characteristics.