Abstract
Optical coherence tomography (OCT) is a high-resolution intravascular imaging technique using near infrared light. This technique is useful for guiding percutaneous coronary intervention (PCI). OCT can predict peri-procedure complications. OCT-derived thin-cap fibroatheroma, which is characterized by large lipid-core and thin fibrous cap < 65 μm, has high risks for PCI-related no-reflow, distal embolization, microvascular obstruction and peri-procedure myocardial infarction. In bifurcation PCI, 3-dimensional OCT imaging is helpful to understand complex morphology of carina, distribution of jailing stent strut at side branch ostium and location of guide wire selecting the side branch through the struts. OCT-estimated long carina tip and small branching angle are predictors of side branch occlusion after main vessel stenting. The near infrared light in OCT penetrates coronary calcium and delineates its shape, size and distribution. OCT can describe calcium fracture induced by high pressure ballooning and cutting surface after rotational atherectomy. Bioresorbable vascular scaffold (BVS) struts are more clearly visualized by OCT than X-ray angiography and intravascular ultrasound. OCT allows us to detect inadequate BVS appearance such as underexpansion, malapposition and fracture. Online co-registration of OCT with angiography will be available soon. The co-registration technology might reduce errors in corresponding OCT findings to the angiogram and then prevent longitudinal geographic miss of PCI. By providing precise information of vessel morphologies and stent architectures, OCT contributes to guidance for PCI.
