Role of Optical Coherence Tomography in Coronary Interventions

Optical coherence tomography (OCT) is an optical analog of intravascular ultrasound (IVUS) used to examine the coronary arteries with a higher resolution. Based on polarization properties, OCT can differentiate tissue characteristics (fibrous, calcified, or lipid-rich plaque) and identify vulnerable plaque. Because of the strong attenuation of light by blood, OCT requires a field of view that is free of blood. OCT can provide detailed information on coronary intervention such as dissection, tissue prolapse, thrombus stent malapposition, and under expansion. Despite the diagnostic utility of OCT, facilitated by its high resolution, the impact of intracoronary OCT on clinical practice has thus far been limited for various reasons. Herein, we provide a comprehensive up-to-date overview on the utility of OCT in coronary artery disease, specifically acute coronary syndromes along with a summary of the evidence, work in progress, and future directions.