Due to the fast speed of light, interferometry is required for backscatter detection: this involves splitting the light into signal and reference beams, with the intensity of interference calculated according to the frequency differences between the two beams. By measuring the amplitude and time delay of the backscattered light, OCT generates high-resolution, cross-sectional and three-dimensional volumetric images of the vessel microstructure. OCT utilises near-infrared light directed at the vessel wall through a rotating single optical fibre coupled with an imaging lens within a short-monorail imaging sheath. INTRAVASCULAR OCT: TECHNOLOGY, ADVANTAGES, LIMITATIONS, AND AVAILABLE IMAGING PLATFORMS Registries 1, 2, 3, randomised controlled trials 4, 5, and meta-analyses 6, 7 consistently support procedural and long-term benefits of intravascular imaging-guided PCI. Intravascular imaging thus aids in the selection of treatment strategies and guidance of percutaneous coronary intervention (PCI). Intravascular imaging – intravascular ultrasound (IVUS) and optical coherence tomography (OCT) – enables cross-sectional tomographic imaging of the coronary artery and provides additional information that is complementary to angiography. These inherent limitations arise from angiography providing a lumenogram, depicting planar projections of the three-dimensional coronary tree, rather than imaging the vessel wall where the process of atherosclerosis manifests. We discuss the utility of OCT in acute coronary syndromes, provide a summary of the clinical trial data, list the work in progress, and discuss the future directions.Īngiography, the cornerstone imaging modality in the cardiac catheterisation laboratory, has well-established limitations.

Herein, we provide a comprehensive up-do-date overview on the utility of OCT in coronary artery disease, including technical details, device set-up, simplified OCT image interpretation, recognition of the imaging artefacts, and an algorithmic approach for using OCT in PCI guidance. Difficulty in transitioning from intravascular ultrasound (IVUS), complex image interpretation, lack of a standardised algorithm for PCI guidance, and paucity of data from prospective clinical trials have contributed to the modest adoption. Despite the diagnostic utility of OCT, facilitated by its high resolution, the impact of intracoronary OCT on clinical practice has thus far been limited.

Optical coherence tomography (OCT) has been increasingly utilised to guide percutaneous coronary intervention (PCI).

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