Efficacy and Safety of High-Frequency Optical Coherence Tomography (HF-OCT) for Coronary Imaging: A Multicenter Study

Optical coherence tomography (OCT) has emerged as an essential tool in coronary atherosclerosis research and has shown clinical value in optimizing percutaneous coronary intervention. Its capability to identify coronary plaque pathology and accurately detect intervention results, often overlooked by angiography, serves as a guide in managing patients with acute coronary syndromes, myocardial infarction due to nonobstructing coronary artery disease, calcified arteries, and in-stent restenosis, thus contributing to improved clinical outcomes. However, the current technology of intracoronary imaging catheters has a size approaching 3F, limiting its adoption preintervention. Furthermore, the image field of view of current OCT technologies cannot consistently offer complete visualization of coronary arteries ≥5 mm.

In this multicenter, single-arm study, we evaluated the efficacy and safety of a novel imaging catheter and system called high-frequency optical coherence tomography (HF-OCT). This system features a reduced-size, rapid-exchange imaging catheter with a diameter of 1.8F. HF-OCT captures 100 mm long segments of coronary arteries in just 1 second. In addition, HF-OCT provides an expanded field of view greater than 14 mm in diameter, enabling complete imaging of large coronary arteries.

After conducting 143 imaging acquisitions in 81 unique coronary arteries across 75 patients at 3 institutions, we obtained an average clear image length of 68.8 ± 18.8 mm. Coronary arteries of varying sizes, including cases with severe stenosis, were evaluated. Comparing preintervention HF-OCT acquisitions-taken prior to any arterial manipulation-to postintervention acquisitions, no significant difference in image quality was observed (t test, P = .901).

The results of this study illustrate that a lower HF-OCT catheter profile, larger field of view, and faster pullback capabilities provide reliable imaging of coronary arteries in an all-comers, multicenter population.