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The basics of intravascular optical coherence tomography.

Roleder T, Jąkała J, Kałuża GL, Partyka Ł, Proniewska K, Pociask E, Zasada W, Wojakowski W, Gąsior Z, Dudek D - Postepy Kardiol Interwencyjnej (2015)

Bottom Line: It identifies stent malapposition, dissections, and thrombosis with unprecedented precision.Furthermore, OCT helps to monitor vessel healing after stenting.The following review presents the technical background, basics of OCT image interpretation, and practical tips for adequate OCT imaging, and outlines its established and potential clinical application.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Medical University of Silesia, Katowice, Poland ; KCRI, Krakow, Poland.

ABSTRACT
Optical coherence tomography (OCT) has opened new horizons for intravascular coronary imaging. It utilizes near-infrared light to provide a microscopic insight into the pathology of coronary arteries in vivo. Optical coherence tomography is also capable of identifying the chemical composition of atherosclerotic plaques and detecting traits of their vulnerability. At present it is the only tool to measure the thickness of the fibrous cap covering the lipid core of the atheroma, and thus it is an exceptional modality to detect plaques that are prone to rupture (thin fibrous cap atheromas). Moreover, it facilitates distinguishing between plaque rupture and plaque erosion as a cause of acute intracoronary thrombosis. Optical coherence tomography is applied to guide angioplasties of coronary lesions and to assess outcomes of percutaneous coronary interventions broadly. It identifies stent malapposition, dissections, and thrombosis with unprecedented precision. Furthermore, OCT helps to monitor vessel healing after stenting. It evaluates the coverage of stent struts by the neointima and detects in-stent neoatherosclerosis. With so much potential, new studies are warranted to determine OCT's clinical impact. The following review presents the technical background, basics of OCT image interpretation, and practical tips for adequate OCT imaging, and outlines its established and potential clinical application.

No MeSH data available.


Related in: MedlinePlus

Representative OCT images of a healthy vessel and fibrotic, calcified, lipid-rich and thin fibrous cap atheroma. A – Healthy vessel: lumen (L), vessel wall (W), and adventitia (AD) with vasa vasorum (V). B – Three layers of the vessel: internal elastic lamina (IEL), media (M) and external elastic lamina (EEL). C – Fibrotic atheroma (Fi). D – Lipid-rich plaque (LR) with lipid arc = 190° and bright spots (BS). E – Calcified atheroma (Ca) with calcium arc = 93°. F – Lipid-rich plaque with cholesterol clefts (Ch)
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Figure 0002: Representative OCT images of a healthy vessel and fibrotic, calcified, lipid-rich and thin fibrous cap atheroma. A – Healthy vessel: lumen (L), vessel wall (W), and adventitia (AD) with vasa vasorum (V). B – Three layers of the vessel: internal elastic lamina (IEL), media (M) and external elastic lamina (EEL). C – Fibrotic atheroma (Fi). D – Lipid-rich plaque (LR) with lipid arc = 190° and bright spots (BS). E – Calcified atheroma (Ca) with calcium arc = 93°. F – Lipid-rich plaque with cholesterol clefts (Ch)

Mentions: In a healthy vessel OCT visualizes three layers of the artery: an internal elastic lamina (an abluminal bright, high reflective line), a media (a dark, low-reflective line) and an external elastic lamina (an adluminal high reflective zone). Beyond the external elastic lamina, OCT exposes an adventitia with its vasa vasorum (Figure 2).


The basics of intravascular optical coherence tomography.

Roleder T, Jąkała J, Kałuża GL, Partyka Ł, Proniewska K, Pociask E, Zasada W, Wojakowski W, Gąsior Z, Dudek D - Postepy Kardiol Interwencyjnej (2015)

Representative OCT images of a healthy vessel and fibrotic, calcified, lipid-rich and thin fibrous cap atheroma. A – Healthy vessel: lumen (L), vessel wall (W), and adventitia (AD) with vasa vasorum (V). B – Three layers of the vessel: internal elastic lamina (IEL), media (M) and external elastic lamina (EEL). C – Fibrotic atheroma (Fi). D – Lipid-rich plaque (LR) with lipid arc = 190° and bright spots (BS). E – Calcified atheroma (Ca) with calcium arc = 93°. F – Lipid-rich plaque with cholesterol clefts (Ch)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4495121&req=5

Figure 0002: Representative OCT images of a healthy vessel and fibrotic, calcified, lipid-rich and thin fibrous cap atheroma. A – Healthy vessel: lumen (L), vessel wall (W), and adventitia (AD) with vasa vasorum (V). B – Three layers of the vessel: internal elastic lamina (IEL), media (M) and external elastic lamina (EEL). C – Fibrotic atheroma (Fi). D – Lipid-rich plaque (LR) with lipid arc = 190° and bright spots (BS). E – Calcified atheroma (Ca) with calcium arc = 93°. F – Lipid-rich plaque with cholesterol clefts (Ch)
Mentions: In a healthy vessel OCT visualizes three layers of the artery: an internal elastic lamina (an abluminal bright, high reflective line), a media (a dark, low-reflective line) and an external elastic lamina (an adluminal high reflective zone). Beyond the external elastic lamina, OCT exposes an adventitia with its vasa vasorum (Figure 2).

Bottom Line: It identifies stent malapposition, dissections, and thrombosis with unprecedented precision.Furthermore, OCT helps to monitor vessel healing after stenting.The following review presents the technical background, basics of OCT image interpretation, and practical tips for adequate OCT imaging, and outlines its established and potential clinical application.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Medical University of Silesia, Katowice, Poland ; KCRI, Krakow, Poland.

ABSTRACT
Optical coherence tomography (OCT) has opened new horizons for intravascular coronary imaging. It utilizes near-infrared light to provide a microscopic insight into the pathology of coronary arteries in vivo. Optical coherence tomography is also capable of identifying the chemical composition of atherosclerotic plaques and detecting traits of their vulnerability. At present it is the only tool to measure the thickness of the fibrous cap covering the lipid core of the atheroma, and thus it is an exceptional modality to detect plaques that are prone to rupture (thin fibrous cap atheromas). Moreover, it facilitates distinguishing between plaque rupture and plaque erosion as a cause of acute intracoronary thrombosis. Optical coherence tomography is applied to guide angioplasties of coronary lesions and to assess outcomes of percutaneous coronary interventions broadly. It identifies stent malapposition, dissections, and thrombosis with unprecedented precision. Furthermore, OCT helps to monitor vessel healing after stenting. It evaluates the coverage of stent struts by the neointima and detects in-stent neoatherosclerosis. With so much potential, new studies are warranted to determine OCT's clinical impact. The following review presents the technical background, basics of OCT image interpretation, and practical tips for adequate OCT imaging, and outlines its established and potential clinical application.

No MeSH data available.


Related in: MedlinePlus