Intra-coronary imaging modalities.

Area of Science:

• Cardiovascular Imaging
• Interventional Cardiology

Background:

• Intracoronary imaging modalities have advanced significantly in quality and delivery systems.
• Current best practices include assessing lesions, optimizing stent placement (sizing, apposition, expansion), and excluding edge dissection.
• Intracoronary imaging is crucial for left main and bifurcation stenting, and for managing in-stent thrombosis.

Purpose of the Study:

• To discuss current intracoronary imaging modalities and their applications.
• To review supporting data for intravascular ultrasound (IVUS) and optical coherence tomography (OCT).
• To highlight the gap between clinical practice and guideline recommendations.

Main Methods:

• Review of current intracoronary imaging modalities: intravascular ultrasound (IVUS) and optical coherence tomography (OCT).
• Discussion of established indications and emerging applications in interventional cardiology.
• Analysis of clinical guideline recommendations versus contemporary practice patterns.

Main Results:

• Intracoronary imaging use has risen due to improved technology.
• Established indications cover pre-stent assessment, stent optimization, and in-stent thrombosis management.
• Guideline recommendations (e.g., Class IIa for IVUS) lag behind widespread clinical adoption.

Conclusions:

• Intracoronary imaging, particularly IVUS and OCT, is integral to modern interventional cardiology.
• There is a need to update clinical guidelines to align with advanced imaging practices.
• Further data review supports the expanded role of these imaging techniques.