Gianluca Castaldi, Georgios Zormpas, Pascal Frederiks, Tom Adriaenssens, Johan Bennett
{"title":"The Rise of Optical Coherent Tomography in Intracoronary Imaging: An Overview of Current Technology, Limitations, and Future Perspectives.","authors":"Gianluca Castaldi, Georgios Zormpas, Pascal Frederiks, Tom Adriaenssens, Johan Bennett","doi":"10.31083/RCM38123","DOIUrl":null,"url":null,"abstract":"<p><p>Intravascular optical coherence tomography (OCT) has represented a revolutionary invasive imaging method, offering <i>in vivo</i> high-resolution cross-sectional views of human coronary arteries, thereby promoting a significant evolution in the understanding of vascular biology in both acute and chronic coronary pathologies. Since the development of OCT in the early 1990s, this technique has provided detailed insights into vascular biology, enabling a more thorough assessment of coronary artery disease (CAD) and the impact of percutaneous coronary intervention (PCI). Moreover, a series of recent clinical trials has consistently demonstrated the clinical benefits of intravascular imaging (IVI) and OCT-guided PCI, showing improved outcomes compared to angiography-guided procedures, particularly in cases of complex coronary pathology. Nonetheless, despite the advantages of OCT, several limitations remain, including limited penetration depth and the necessity for additional contrast agent administration, which may potentially constrain the widespread adoption of OCT. Moreover, economic and logistical challenges remain, including heterogeneous levels of training among interventional cardiologists, which leads to the underutilization of OCT in the Western world. Meanwhile, emerging technologies and the integration of machine learning and artificial intelligence-based algorithms are set to enhance diagnostic accuracy in daily practice. Future research is necessary to address existing limitations and investigate next-generation devices, further advancing the field of interventional cardiology toward optimal imaging-guided PCI and improved outcomes.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"26 8","pages":"38123"},"PeriodicalIF":1.3000,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415738/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reviews in cardiovascular medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.31083/RCM38123","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/8/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Intravascular optical coherence tomography (OCT) has represented a revolutionary invasive imaging method, offering in vivo high-resolution cross-sectional views of human coronary arteries, thereby promoting a significant evolution in the understanding of vascular biology in both acute and chronic coronary pathologies. Since the development of OCT in the early 1990s, this technique has provided detailed insights into vascular biology, enabling a more thorough assessment of coronary artery disease (CAD) and the impact of percutaneous coronary intervention (PCI). Moreover, a series of recent clinical trials has consistently demonstrated the clinical benefits of intravascular imaging (IVI) and OCT-guided PCI, showing improved outcomes compared to angiography-guided procedures, particularly in cases of complex coronary pathology. Nonetheless, despite the advantages of OCT, several limitations remain, including limited penetration depth and the necessity for additional contrast agent administration, which may potentially constrain the widespread adoption of OCT. Moreover, economic and logistical challenges remain, including heterogeneous levels of training among interventional cardiologists, which leads to the underutilization of OCT in the Western world. Meanwhile, emerging technologies and the integration of machine learning and artificial intelligence-based algorithms are set to enhance diagnostic accuracy in daily practice. Future research is necessary to address existing limitations and investigate next-generation devices, further advancing the field of interventional cardiology toward optimal imaging-guided PCI and improved outcomes.
期刊介绍:
RCM is an international, peer-reviewed, open access journal. RCM publishes research articles, review papers and short communications on cardiovascular medicine as well as research on cardiovascular disease. We aim to provide a forum for publishing papers which explore the pathogenesis and promote the progression of cardiac and vascular diseases. We also seek to establish an interdisciplinary platform, focusing on translational issues, to facilitate the advancement of research, clinical treatment and diagnostic procedures. Heart surgery, cardiovascular imaging, risk factors and various clinical cardiac & vascular research will be considered.