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Optical Coherence Tomography for the Assessment of Coronary Artery Disease

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PanVascular Medicine

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Abstract

Angiography remains the gold standard for assessment of atherosclerotic impairment of coronary arteries and for guidance of coronary intervention. Angiography, as a main limitation, only depicts the luminal narrowings caused by coronary plaques, without showing the structures located beneath, such as the atherosclerotic lesions or the vessel wall.

Intravascular imaging modalities are currently adopted to circumvent angiographic limitations. Optical coherence tomography (OCT)) is a novel imaging technique that uses infrared lights and can study atherosclerotic plaques and stented segments with extreme accuracy. Compared to intravascular ultrasound (IVUS) , OCT has a much higher resolution; this is at the expense of the penetration depth.

This chapter reviews the role of OCT in atherosclerotic plaque assessment and the clinical outcome of OCT-guided percutaneous coronary interventions (PCI). A detailed visualization of the superficial lipid pool, thin fibrous cap, and inflammatory cells allows OCT to precisely identify vulnerable plaque with thin-cap fibroatheroma . Recent data support the potential clinical role of an OCT-guided strategy of coronary interventions that may lead to a reduction in the incidence of acute coronary events.

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Abbreviations

Frequency-domain optical coherence tomography (FD-OCT):

The next-generation type of optical coherence tomography.

Hazy lesions:

Ambiguous lesions.

Intravascular ultrasound (IVUS):

Intravascular imaging system that uses sounds.

Malapposition:

Distance between stent strut and vessel wall.

Optical coherence tomography (OCT):

Intravascular imaging system that uses light.

Plaque erosion:

Type of vulnerable plaque.

Pullback:

OCT image acquisition procedure.

Sew-up artifacts:

Common OCT artifacts due to rapid OCT probe movements.

Thrombosis:

Thrombus formation.

Time-domain optical coherence tomography (TD-OCT):

The old generation of optical coherence tomography.

Underexpansion:

Imperfect stent deployment inside coronary artery.

Vulnerable plaque:

A plaque at increased risk of subsequent rupture.

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Further Reading

  • Jang I-K (ed) (2015) Cardiovascular OCT imaging. Springer, Cham, Heidelberg, New York, Dordrecht, London

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Authors and Affiliations

  1. Rome CLI Foundation, Interventional Cardiology, San Giovanni Addolorata Hospital, Rome, Italy

    Luca Di Vito, Laura Gatto & Francesco Prati

  2. CLI Foundation, Interventional Cardiology, San Giovanni Hospital, Rome, Italy

    Luca Di Vito, Laura Gatto & Francesco Prati

  3. Department of Interventional Cardiology, San Giovanni–Addolorata Hospital, Via Amba Aradam 9, IT-00184, Rome, Italy

    Francesco Prati

Authors
  1. Luca Di Vito
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  2. Laura Gatto
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  3. Francesco Prati
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Corresponding author

Correspondence to Francesco Prati .

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Editors and Affiliations

  1. Division of Cardiovascular Disease Department of Internal Medicine, Health Care Center Bitterfeld, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Di Vito, L., Gatto, L., Prati, F. (2015). Optical Coherence Tomography for the Assessment of Coronary Artery Disease. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_42

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  • DOI: https://doi.org/10.1007/978-3-642-37078-6_42

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