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Optical Coherence Tomography in the Catheterization Laboratory

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Textbook of Catheter-Based Cardiovascular Interventions

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Abstract

X-ray coronary angiography remains the gold standard for assessment of atherosclerotic lesions of coronary arteries and for guidance of coronary intervention. However, angiography only depicts the luminal narrowings caused by coronary plaques, without showing the structures located beneath the endothelial surface within the vessel walls.

Intravascular imaging modalities are now available allowing direct visualization of coronary artery walls and thus overcoming angiographic limitations. Optical coherence tomography (OCT) is a novel imaging technique that uses infrared light to assess atherosclerotic plaques and stented segments with extreme accuracy. Compared with intravascular ultrasound (IVUS), OCT has better spatial resolution at the expense of the penetration depth.

This chapter reviews the current role of OCT in the assessment of coronary artery disease and the clinical outcome of OCT-guided percutaneous coronary intervention (PCI). Detailed visualization of the superficial lipid pool, thin fibrous cap, and inflammatory cells allows OCT to precisely identify vulnerable plaque with thin-cap fibroatheroma. Recent data support the emerging clinical role of OCT-guided PCI as a means to reduce the incidence of adverse coronary events.

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Authors and Affiliations

  1. Cardiology, San Giovanni-Addolorata Hospital, Rome, Italy

    Luca Di Vito, Laura Gatto & Francesco Prati MD

  2. CLI Foundation, Rome, Italy

    Luca Di Vito, Laura Gatto & Francesco Prati MD

Authors
  1. Luca Di Vito
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  2. Laura Gatto
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  3. Francesco Prati MD
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Correspondence to Francesco Prati MD .

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  1. Middle German Heart Center and Health Care Center Bitterfeld-Wolfen, gGmbH, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Di Vito, L., Gatto, L., Prati, F. (2018). Optical Coherence Tomography in the Catheterization Laboratory. In: Lanzer, P. (eds) Textbook of Catheter-Based Cardiovascular Interventions. Springer, Cham. https://doi.org/10.1007/978-3-319-55994-0_20

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