Intracoronary Imaging-Can It Make Difference in State of the Art PCI?

Abstract

There is an anatomy and there is an anatomy. Angiography is a rough method used for estimating dimensions. By completing the intervention with intracoronary imaging, one can directly characterize lesion composition, elucidate pathophysiology, and luminal size measurement. This review describes patients and lesions where imaging may be most beneficial, along with up-to-date evidence of the impact induced on cardiovascular events by the intracoronary imaging. It summarizes the importance of organizing procedural strategies and the use of various imaging methods such as optical coherence tomography or intravascular ultrasound for percutaneous coronary intervention (PCI) to improve stent optimization. Further, various advantages and disadvantages are associated with the use of imaging methods OCT and IVUS in the management of PCI and the elucidation of the causes of stent failure are discussed. It also explains the use of OCT or IVUS in various severe pathological conditions such as severe kidney disease (CKD), left main disease, bifurcation lesion, acute coronary syndrome (ACS), and patients present with high bleeding risk. It also describes diagnostic imaging of patients with vulnerable plaques. We will also talk about various other advanced imaging methods such as investigational Micro-optical Coherence Tomography and near-infrared spectroscopy (NIRS).