Is refined OCT guidance of stent implantation needed?

The development of optical coherence tomography (OCT) provides new opportunities for the evaluation of coronary stents. Having a much higher spatial resolution than intravascular ultrasound (IVUS), OCT is currently used for long-term assessment of stent implantation. In the immediate future, however, it is quite likely that OCT will be used synergically with IVUS to optimise stent deployment; the criteria for optimising stent implantation using OCT will be clearly indebted to the evidence gathered with IVUS, with an added value in contexts like ambiguous images presenting after stenting, or in complex percutaneous coronary interventions (PCI) procedures like bifurcation stenting. However, since OCT is capable of identifying, during PCI, findings of potential relevance beyond the resolution IVUS, such as thrombus or tissue protrusion, intra-stent or edge dissections, or specific patterns of hyperplasia in restenotic lesions, it is foreseeable that new OCT-specific recommendations for optimal stent implantation will be made in the near future.