Abstract
Optical coherence tomography (OCT) has emerged as a high-resolution (10-20μm), light-based, intravascular imaging technique capable of investigating detailed coronary plaque morphology. OCT is highly sensitive and specific for characterizing fibrous, fibrocalcific, and lipid-rich plaque. OCT is capable of discriminating 3 types of unstable plaque morphologies underlying coronary thrombosis such as plaque rupture, erosion, and calcified nodules. The high resolution of OCT has a potential to identify important features of vulnerable plaques such as thin-cap (<65μm thick) fibroatheroma, macrophages, vasa vasorums, cholesterol crystals, and micro-calcifications. As compared with conventional intravascular ultrasound, OCT provides more accurate measurements of coronary lumen diameter and lesion length, which is useful in determining stent size. OCT is much more sensitive in detecting inadequate stent findings such as intrastent tissue protrusion, incomplete stent apposition, stent edge dissection, and intrastent thrombus, which is helpful in optimizing stent implantation. Recently developed new stent optimization software such as OCT/angiography co-registration and 3-dimentional view enhances ease of use, simplifies interpretation and allows us to literally visualize a better outcome of percutaneous coronary intervention (PCI). In conclusion, OCT is a promising technology to assess coronary atherosclerosis and to guide PCI.
