Korean J Intern Med.  2012 Mar;27(1):1-12. 10.3904/kjim.2012.27.1.1.

The Role of Optical Coherence Tomography in Coronary Intervention

Affiliations
  • 1Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan. mterashima-circ@umin.ac.jp
  • 2Okinaka Memorial Institute for Medical Research, Tokyo, Japan.

Abstract

Optical coherence tomography (OCT) is an optical analog of intravascular ultrasound (IVUS) that can be used to examine the coronary arteries and has 10-fold higher resolution than IVUS. Based on polarization properties, OCT can differentiate tissue characteristics (fibrous, calcified, or lipid-rich plaque) and identify thin-cap fibroatheroma. Because of the strong attenuation of light by blood, OCT systems required the removal of blood during OCT examinations. A recently developed frequency-domain OCT system has a faster frame rate and pullback speed, making the OCT procedure more user-friendly and not requiring proximal balloon occlusion. During percutaneous coronary intervention (PCI), OCT can provide detailed information (dissection, tissue prolapse, thrombi, and incomplete stent apposition [ISA]). At follow-up examinations after stent implantation, stent strut coverage and ISA can be assessed. Several OCT studies have demonstrated delayed neointimal coverage following drug-eluting stent (DES) implantation vs. bare metal stent (BMS) placement. While newer DESs promote more favorable vascular healing, the clinical implications remain unknown. Recent OCT studies have provided insights into restenotic tissue characteristics; DES restenotic morphologies differ from those with BMSs. OCT is a novel, promising imaging modality; with more in-depth assessments of its use, it may impact clinical outcomes in patients with symptomatic coronary artery disease.

Keyword

Tomography, optical coherence; Ultrasonography, interventional; Angioplasty; Stents; Coronary disease

MeSH Terms

*Angioplasty, Balloon, Coronary/adverse effects/instrumentation
Coronary Angiography
Coronary Artery Disease/*pathology/radiography/*therapy/ultrasonography
Coronary Restenosis/etiology/pathology
Coronary Vessels/*pathology/ultrasonography
Humans
Predictive Value of Tests
Severity of Illness Index
Stents
*Tomography, Optical Coherence
Treatment Outcome
Ultrasonography, Interventional
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