Utility of optical coherence tomography in acute coronary syndromes

Catheter Cardiovasc Interv. 2023 Jul;102(1):46-55. doi: 10.1002/ccd.30656. Epub 2023 May 28.

Abstract

Studies utilizing intravascular imaging have replicated the findings of histopathological studies, identifying the most common substrates for acute coronary syndromes (ACS) as plaque rupture, erosion, and calcified nodule, with spontaneous coronary artery dissection, coronary artery spasm, and coronary embolism constituting the less common etiologies. The purpose of this review is to summarize the data from clinical studies that have used high-resolution intravascular optical coherence tomography (OCT) to assess culprit plaque morphology in ACS. In addition, we discuss the utility of intravascular OCT for effective treatment of patients presenting with ACS, including the possibility of culprit lesion-based treatment by percutaneous coronary intervention.

Keywords: acute coronary syndromes; calcified nodule; optical coherence tomography; percutaneous coronary intervention; plaque erosion; plaque rupture.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome* / diagnostic imaging
  • Acute Coronary Syndrome* / etiology
  • Acute Coronary Syndrome* / therapy
  • Coronary Angiography / adverse effects
  • Coronary Artery Disease* / complications
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / therapy
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / pathology
  • Humans
  • Plaque, Atherosclerotic*
  • Rupture, Spontaneous / complications
  • Rupture, Spontaneous / pathology
  • Tomography, Optical Coherence / methods
  • Treatment Outcome