Key result
Intracoronary OCT and IVUS provide superior visualization of ACS culprit plaques versus angiography.
Why the study?
Intravascular imaging provides superior visualization of culprit plaques for ACS compared with coronary angiography, enabling precision therapy.
Does intravascular imaging with OCT and IVUS improve the diagnosis and management of acute coronary syndromes compared with coronary angiography?
Does intravascular imaging with OCT and IVUS improve the diagnosis and management of acute coronary syndromes compared with coronary angiography?
Intravascular imaging with OCT and IVUS provides critical pathophysiological insights and superior visualization of culprit lesions in ACS, facilitating precision therapy and optimized PCI outcomes.
May refine ACS culprit assessment; leaves open whether routine OCT/IVUS improves outcomes or practice.
Intravascular imaging with optical coherence tomography (OCT) and intravascular ultrasound provides superior visualization of the culprit plaques for acute coronary syndromes (ACS) compared with coronary angiography. Combined with angiography, intravascular imaging can be used to instigate 'precision therapy' for ACS. Post-mortem histopathology identified atherothrombosis at the exposed surface of a ruptured fibrous cap as the main cause of ACS. Further histopathological studies identified intact fibrous caps and calcified nodules as other culprit lesions for ACS. These plaque types were subsequently also identified on intravascular imaging, particularly with the high-resolution OCT. The less-common non-atherothrombotic causes of ACS are coronary artery spasm, coronary artery dissection, and coronary embolism. In this review, the authors provide an overview of clinical studies using intravascular imaging with OCT in the diagnosis and management of ACS.
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Petrossian et al. (2022) conducted a review in Acute Coronary Syndromes. Intracoronary imaging (OCT and IVUS) vs. Coronary angiography was evaluated. Intracoronary imaging with optical coherence tomography and intravascular ultrasound provides superior visualization of culprit plaques for acute coronary syndromes compared with coronary angiography.
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