Intracoronary Optical Coherence Tomography: Technological Innovations and Clinical Implications in Cardiology

Purpose of Review To provide the most up-to-date clinical evidence of intracoronary optical coherence tomography (OCT), and clinical implications to guide future imaging research in cardiology. Recent Findings Intracoronary OCT has demonstrated advanced system performance and high reproducibility in analyzing atherosclerotic lesions. It is an attractive tool due to its capability for functional classification and superior imaging resolution, enabling precise and reliable tissue assessments. Compared to traditional angiography, OCT has been associated with improved long-term clinical outcomes and serves as an effective tool for optimizing stent selection and post-intervention evaluation. The development of OCT variations and the combination of various intravascular imaging modalities further enhance its diagnostic capabilities, allowing a comprehensive assessment of complex vulnerable lesions and improving risk stratification for patients. Summary Current and evolving system development presents a hopeful path for treating coronary artery disease by addressing the challenges of the intracoronary OCT technique. Future studies focusing on utilizing OCT system extensions, integrated multimodality imaging systems, and Artificial Intelligence (AI) derived image analysis will improve clinical endpoints and streamline the process.