Optical coherence tomography

Summary

Optical coherence tomography (OCT) is a light-based imaging modality which shows tremendous potential in the setting of coronary imaging. Compared to intravascular ultrasound (IVUS), OCT has a ten-fold higher image resolution. OCT is able to characterise the structure and extent of coronary artery disease in unprecedented detail as the various components of atherosclerotic plaques have different optical properties. Typically, calcified, fibrous and lipid-rich plaque components can be distinguished, as well as the presence of dense macrophage infiltration, neovascularisation and mural or intraluminal thrombi. These diagnostic capabilities are being applied to study patients with coronary artery disease (CAD), especially acute coronary syndrome (ACS) and ST-elevation myocardial infarction (STEMI), to improve our understanding of the pathophysiology and progression of atherosclerosis. In patients with ACS, the use of OCT has emerged as instrumental in recognising and characterising the lesions responsible for the acute event, as well as in identifying the atherosclerotic plaque composition of non-culprit lesions. Several studies have also shed light on the role of OCT as an instrumental tool for studying the severity and extension of calcific components and for selecting the most appropriate interventional device to perform PCI in such complex lesions. Likewise, OCT allows the detailed analysis of...