Optical Coherence Tomography Imaging: Novel Insights into the Vascular Response After Coronary Stent Implantation |
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Authors: | Milosz Jaguszewski Ulf Landmesser |
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Institution: | (1) Cardiology, Cardiovascular Center, University Hospital of Zurich, Raemistrassse 100, 8091 Zurich, Switzerland; |
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Abstract: | Optical coherence tomography (OCT) is a high-resolution imaging technique that is increasingly used for intracoronary imaging
to characterize coronary atherosclerotic plaques and vascular responses after coronary stent implantation. Introduction of
optical frequency-domain imaging (OFDI; second generation OCT) has simplified practical use of this novel imaging modality
resulting in a more widespread availability in interventional cardiology. Here we highlight recent insights into the acute
and chronic vascular response after coronary stent implantation by OCT imaging. OCT provides cross-sectional images with approximately
10-fold higher resolution as compared to intravascular-ultrasound (IVUS), allowing for precise evaluation of tissue coverage
and malapposition of coronary stent struts. More than 30 studies using OCT to compare vascular responses to different stents
have now been reported. Recent studies have examined the relation between OCT-image characteristics and tissue composition
around stent struts. OCT is used for evaluation of novel stent concepts, such as bioengineered stents and bioabsorbable stents,
where it provides more accurate information than IVUS. While intracoronary OCT imaging is further developed, including faster
3D-OCT-image-reconstruction, larger OCT studies/registries with standardized analysis will provide more insights into clinical
implications of observations from OCT-imaging after coronary stent implantation. |
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