Identifying stable coronary plaques with OCT technology

Abstract

This article discusses the current value of optical coherence tomography (OCT) for the assessment of stable coronary lesions. OCT generates intracoronary images with unprecedented image resolution, namely a 10‐fold higher image resolution compared to conventional intravascular ultrasound. OCT is able to visualize a variety of atherosclerotic plaques features that have been associated with rapid lesion progression and clinical events. There is broad agreement that the detailed, easy accessible, and interpretable information of OCT on the presence of atherosclerosis, its extent, lumen narrowing, as well as on the result of any interventional measure can be of clinical value, at least in individual patients and in specific clinical scenarios. Preliminary data indicate that OCT can change the operator's intention‐to‐treat and modify the overall revascularization strategy, potentially avoiding unnecessary interventional procedures. OCT might be efficient in complex interventions including treatment of long lesions, diffuse disease, bifurcations, as well as in all cases of angiographically ambiguous lesions. As such, OCT might emerge, next to its undisputed position in research, as tool of choice in all clinical scenarios where angiography is limited by its nature as two‐dimensional luminogram. Answer questions and earn CME: https://wileyhealthlearning.com/Activity2/4279893/Activity.aspx

An assessment of the quality of optical coherence tomography image acquisition

“…Based on the literature [2,13,[19][20][21][22][23][24][25][26][27][28], the best practices to avoid residual blood and to achieve excellent image quality include proper engagement of the guide catheter in the coronary artery, avoidance of guide catheters with side holes, optimal synchronization between flushing and OCT catheter pullback (the OCT pullback should not be started before the distal lumen is completely cleared of blood), use of power injections as they are more reliable in providing a blood-free lumen and use of higher-viscosity flush solutions as they provide superior imaging quality compared to the lower-viscosity ones.…”

All-optical dual photoacoustic and optical coherence tomography intravascular probe

“…The OCT catheter had a nominal axial resolution of 15 μm and a lateral resolution of ca . 25 μm [ 24 ]. The PA excitation light had a fluence ranging from 40 to 100 mJ/cm 2 across the wavelength range of the pulsed laser.…”