Optical coherence tomography and its use in detection of vulnerable plaque

Acute coronary syndromes and their associated complications related to coronary ischemia continue to be the leading cause of morbidity and mortality in the world. The most commonly encountered pathophysiologic cascade of events resulting in this picture is initiated by formation of a vulnerable plaque. Despite the widespread use of a variety of imaging technologies, high-resolution detection of the vulnerable plaque and designing a method to correlate the results of the imaging modality with disease severity and prognosis have proven to be an arduous task. The recent introduction of optical coherence tomography has proven to be an innovative contribution to the diagnostic armamentarium for the cardiologist. This article presents an overview of vulnerable plaque and methods for its imaging. It focuses on how optical coherence tomography comes into play and how it compares with other modalities in regard to plaque characterization.