Why the study?
Despite its high resolution, the clinical impact and adoption of intracoronary OCT in PCI guidance have been limited by transition difficulties from IVUS, complex interpretation, lack of standardised algorithms, and scarce prospective trial data.
Provides a comprehensive overview of the utility, technical details, and algorithmic approach for using intracoronary optical coherence tomography (OCT) in guiding percutaneous coronary intervention.
May inform OCT-guided PCI algorithms; extends technical synthesis but leaves open randomized outcome validation.
Optical coherence tomography (OCT) has been increasingly utilised to guide percutaneous coronary intervention (PCI). Despite the diagnostic utility of OCT, facilitated by its high resolution, the impact of intracoronary OCT on clinical practice has thus far been limited. 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. 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. 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.
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Ali et al. (2021) studied this question.
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