The Rise of Optical Coherent Tomography in Intracoronary Imaging: An Overview of Current Technology, Limitations, and Future Perspectives.

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Reviews in cardiovascular medicine Pub Date : 2025-08-29 eCollection Date: 2025-08-01 DOI:10.31083/RCM38123
Gianluca Castaldi, Georgios Zormpas, Pascal Frederiks, Tom Adriaenssens, Johan Bennett
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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.

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光学相干断层成像在冠状动脉内成像中的兴起:当前技术、局限性和未来展望的概述。
血管内光学相干断层扫描(OCT)代表了一种革命性的侵入性成像方法,提供了人体冠状动脉的体内高分辨率横断面视图,从而促进了对急性和慢性冠状动脉病变血管生物学理解的重大进化。自20世纪90年代早期OCT发展以来,该技术提供了血管生物学的详细见解,使冠状动脉疾病(CAD)和经皮冠状动脉介入治疗(PCI)的影响能够更彻底地评估。此外,最近的一系列临床试验一致证明了血管内成像(IVI)和oct引导的PCI的临床益处,与血管造影引导的手术相比,显示出更好的结果,特别是在复杂冠状动脉病理的情况下。然而,尽管OCT具有优势,但仍然存在一些局限性,包括渗透深度有限和需要额外的造影剂管理,这可能会限制OCT的广泛采用。此外,经济和后勤方面的挑战仍然存在,包括介入性心脏病专家的培训水平不一,这导致OCT在西方世界的利用不足。与此同时,新兴技术以及机器学习和基于人工智能的算法的整合将提高日常实践中的诊断准确性。未来的研究有必要解决现有的局限性并研究下一代设备,进一步推动介入心脏病学领域朝着最佳成像引导的PCI和改善的结果发展。
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来源期刊
Reviews in cardiovascular medicine
Reviews in cardiovascular medicine 医学-心血管系统
CiteScore
2.70
自引率
3.70%
发文量
377
审稿时长
1 months
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.
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