Current applications of optical coherence tomography for coronary intervention

Department of Interventional Cardiology, Istituto Clinico Humanitas IRCCS, Rozzano, Milan, Italy.
International journal of cardiology (Impact Factor: 4.04). 03/2012; 165(1). DOI: 10.1016/j.ijcard.2012.02.013
Source: PubMed


Optical coherence tomography (OCT) is the 'new kid on the block' in coronary imaging. This technology offers clinicians a high resolution (approximately 15μm), that is ten times higher than the currently accepted gold standard of intravascular ultrasound and has emerged as the ideal imaging tool for the assessment of superficial components of coronary plaques and stent struts. Novel OCT systems can perform quick and safe scanning of coronary arteries with a non-occlusive technique. A brief summary containing the key physical principles of OCT technology with particular attention to the novel Fourier domain system is presented. This review will focus on clinical and research applications of OCT in interventional cardiology. The two main fields of OCT in vivo: coronary atherosclerosis assessment and the study of vessel wall response to stent implantation in terms of strut coverage and apposition will be delineated. Limitations and future perspectives of the technique are presented.

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Available from: Peter Barlis, Oct 20, 2014
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    • "In clinical applications, OCT has been frequently used in ophthalmology to quickly assess the retina in a noninvasive setting and may have potential as a guidance tool during eye surgery (Drexler and Fujimoto, 2008b; Fernandez et al., 2008; Ide et al., 2010; Tao et al., 2010; Sohrab and Fawzi, 2013). In addition, intravascular OCT (IVOCT) is used by interventional cardiologists to analyze the coronaries for inflammation and atherosclerosis, as well as guide and verify stent placement (Prati et al., 2011; Tearney et al., 2012; Asrar Ul Haq et al., 2013; Ferrante et al., 2013; Vignali et al., 2014). We, as well as others, have customized OCT technology to investigate the structure and function of the embryonic heart (Gu et al., 2011; Jenkins et al., 2012). "
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    ABSTRACT: Background: The most commonly used method to analyze congenital heart defects involves serial sectioning and histology. However, this is often a time-consuming process where the quantification of cardiac defects can be difficult due to problems with accurate section registration. Here we demonstrate the advantages of using optical coherence tomography, a comparatively new and rising technology, to phenotype avian embryo hearts in a model of fetal alcohol syndrome where a binge-like quantity of alcohol/ethanol was introduced at gastrulation. Results: The rapid, consistent imaging protocols allowed for the immediate identification of cardiac anomalies, including ventricular septal defects and misaligned/missing vessels. Interventricular septum thicknesses and vessel diameters for three of the five outflow arteries were also significantly reduced. Outflow and atrioventricular valves were segmented using image processing software and had significantly reduced volumes compared to controls. This is the first study to our knowledge that has 3D reconstructed the late-stage cardiac valves in precise detail to examine their morphology and dimensions. Conclusions: We believe, therefore, that optical coherence tomography, with its ability to rapidly image and quantify tiny embryonic structures in high resolution, will serve as an excellent and cost-effective preliminary screening tool for developmental biologists working with a variety of experimental/disease models.
    Developmental Dynamics 12/2014; 244(4). DOI:10.1002/dvdy.24246 · 2.38 Impact Factor
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    • "Intravascular OCT (IVOCT) is also being used in the adult cardiology setting to detect the state of coronary vessel walls via a catheter. With further testing, IVOCT may become useful to assess plaque formation , detect the accumulation of macrophages, identify stent struts, and detect vessel wall dissections (Prati et al., 2011; Tahara et al., 2012; Tearney et al., 2012; Ferrante et al., 2013; Saw et al., 2013). OCT techniques have been and are being developed and adapted by our group and others to study the structure and function of the developing heart (reviewed in Gu et al., 2011; Jenkins et al., 2012). "
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    ABSTRACT: Disturbed cardiac function at an early stage of development has been shown to correlate with cellular/molecular, structural as well as functional cardiac anomalies at later stages culminating in the congenital heart defects (CHDs) that present at birth. While our knowledge of cellular and molecular steps in cardiac development is growing rapidly, our understanding of the role of cardiovascular function in the embryo is still in an early phase. One reason for the scanty information in this area is that the tools to study early cardiac function are limited. Recently developed and adapted biophotonic tools may overcome some of the challenges of studying the tiny fragile beating heart. In this chapter, we describe and discuss our experience in developing and implementing biophotonic tools to study the role of function in heart development with emphasis on optical coherence tomography (OCT). OCT can be used for detailed structural and functional studies of the tubular and looping embryo heart under physiological conditions. The same heart can be rapidly and quantitatively phenotyped at early and again at later stages using OCT. When combined with other tools such as optical mapping (OM) and optical pacing (OP), OCT has the potential to reveal in spatial and temporal detail the biophysical changes that can impact mechanotransduction pathways. This information may provide better explanations for the etiology of the CHDs when interwoven with our understanding of morphogenesis and the molecular pathways that have been described to be involved. Future directions for advances in the creation and use of biophotonic tools are discussed.
    Frontiers in Physiology 09/2014; 5:351. DOI:10.3389/fphys.2014.00351 · 3.53 Impact Factor
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    • "Its high-resolution is also able to detect individual stent struts and characterise their apposition to the vessel wall. OCT is therefore well positioned to investigate the causes of stent failure and provide insights to the pathophysiology and management of complications after PCI [6]. Guidelines on the standards for reporting these lesions are available [7]. "

    International Journal of Cardiology 08/2014; 177(1). DOI:10.1016/j.ijcard.2014.07.201 · 4.04 Impact Factor
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