Optimization of Percutaneous Coronary Intervention Using Optical Coherence Tomography

Abstract

Compared to the luminogram obtained by angiography, intravascular modalities produce cross-sectional images of coronary arteries with a far greater spatial resolution. It is capable of accurately determining the vessel size and plaque morphology. It also eliminates some disadvantages such as contrast streaming, foreshortening, vessel overlap, and angle dependency inherent to angiography. Currently, the development of its system and the visualization of coronary arteries has shown significant advancement. Of those, optical coherence tomography (OCT) makes it possible to obtain high-resolution images of intraluminal and transmural coronary structures leading to navigation of the treatment strategy before and after stent implantations. The aim of this review is to summarize the published data on the clinical utility of OCT, focusing on the use of OCT in interventional cardiology practice to optimize percutaneous coronary intervention.

Optical coherence tomography versus intravascular ultrasound in patients with myocardial infarction: a diagnostic performance study of pre-percutaneous coronary interventions

“…The reasons behind such discriminations of results are the gap between clinical trials and studies based on diagnostic performance in clinical practice ( 16 ). FDOCT visualizes the true lumen dimensions ( 4 ) because it provides cross-sectional images with a high spatial resolution ( 17 ), whereas intravascular ultrasound detects lumen dimension that is influenced by blood temperature, blood flow velocity, the incidence angle of the echo signal, and eccentric catheter placement ( 18 ).…”

Successful Culotte Stenting for Unprotected Left Main Trifurcation Disease: Insights from Optical Coherence Tomography

“…The high resolution (10 µm) of OCT can provide detailed post-PCI information, including stent apposition and edge dissections, but there are limited data regarding the OCT-guided PCI with two-stent technique for the bifurcation lesion, especially ULMCA. 1) 2) This case highlights the feasibility of OCT-guided complex PCI and OCT images of successful culotte technique.…”

The Bioengineered Combo Dual-Therapy CD34 Antibody-Covered Sirolimus-Eluting Coronary Stent in Patients with Chronic Total Occlusion Evaluated by Clinical Outcome and Optical Coherence Tomography Imaging Analysis

“…Stent expansion and apposition were assessed by using stent asymmetry (minimum lumen diameter/maximum lumen diameter > 0.7), stent eccentricity ((maximum stent diameter minus minimum stent diameter)/maximum stent diameter > 0.7) and no significant residual stenosis causing minimal lumen area <4 mm 2 . Incomplete strut apposition (ISA) was defined as stent area minus lumen area [ 25 , 26 , 27 , 28 ].…”