Evaluation of coronary plaques and atherosclerosis using optical coherence tomography

Expert Rev Cardiovasc Ther. 2021 Apr 7. doi: 10.1080/14779072.2021.1914588. Online ahead of print.ABSTRACTINTRODUCTION: Coronary angiography (CAG) is the standard modality for assessing coronary stenosis; however, it has limitations in assessing coronary plaque morphology. Optical coherence tomography (OCT) is a high-resolution (10-20μm) light-based intravascular imaging technique that can identify more detailed coronary plaque morphology compared to other intravascular imaging modalities. OCT is remarkable for characterizing fibrous, fibrocalcific, and lipid-rich plaques. The capabilities of OCT are well suited for discriminating three types of unstable plaque morphologies underlying coronary thrombosis, such as plaque rupture, erosion, and calcified nodules. The high resolution of OCT makes it possible to identify important features of vulnerable plaques, such as thin-cap (<65μm thick) fibroatheroma, macrophages, vasa vasorum, and cholesterol crystals.AREA COVERED: This review summarizes the clinical impact of OCT and its efficacy in identifying plaque components and morphological features associated with plaque vulnerability.The unique properties of OCT as a tool for investigating high-risk lesions have greatly contributed to a better understanding of plaque vulnerability. Consequently, OCT has led to significant changes in medical treatment and percutaneous coronary intervention (PCI) strategies for acute coronary syndrome (ACS). Further development and investigation...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Authors: Source Type: research