Optical coherence tomography in coronary atherosclerosis assessment and intervention

Area of Science:

• Cardiovascular Imaging and Interventions
• Medical Technology and Diagnostics

Background:

• Optical coherence tomography (OCT) has been utilized in humans for two decades, becoming integral to coronary atherosclerosis research.
• Significant advancements in understanding in vivo vascular biology via OCT have occurred over the last ten years.
• OCT is crucial for optimizing percutaneous coronary intervention (PCI) and diagnosing various cardiovascular conditions.

Purpose of the Study:

• To review the current state-of-the-art in cardiac OCT applications.
• To facilitate standardized use of OCT in coronary atherosclerosis research and clinical practice.
• To serve as a reference for future OCT research and applications.

Main Methods:

• Comprehensive review of existing literature and clinical applications of OCT in cardiology.
• Synthesis of global contributions from experienced clinicians and investigators in the field of cardiac OCT.
• Focus on the interpretation and clinical significance of OCT findings.

Main Results:

• OCT enables identification of culprit plaque pathology, potentially altering acute coronary syndrome management.
• OCT aids in understanding plaque healing, destabilization, and atherosclerosis progression.
• OCT detects post-PCI sequelae and is vital for diagnosing myocardial infarction with non-obstructive coronary arteries.

Conclusions:

• OCT provides critical insights into neoatherosclerosis and very late stent thrombosis mechanisms.
• Accurate interpretation of OCT findings is essential for optimal clinical outcomes.
• This review aims to establish a standard reference for the uniform application of cardiac OCT.