Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 May;11(1):11-16.
doi: 10.15420/icr.2016:6:1.

Choice of Intracoronary Imaging: When to use Intravascular Ultrasound or Optical Coherence Tomography

Sudheer Koganti  1   2 , Tushar Kotecha  2   3 , Roby D Rakhit  2   3
Affiliations

Choice of Intracoronary Imaging: When to use Intravascular Ultrasound or Optical Coherence Tomography

Sudheer Koganti et al. Interv Cardiol. 2016 May.

Abstract

Intracoronary imaging has the capability of accurately measuring vessel and stenosis dimensions, assessing vessel integrity, characterising lesion morphology and guiding optimal percutaneous coronary intervention (PCI). Coronary angiography used to detect and assess coronary stenosis severity has limitations. The 2D nature of fluoroscopic imaging provides lumen profile only and the assessment of coronary stenosis by visual estimation is subjective and prone to error. Performing PCI based on coronary angiography alone is inadequate for determining key metrics of the vessel such as dimension, extent of disease, and plaque distribution and composition. The advent of intracoronary imaging has offset the limitations of angiography and has shifted the paradigm to allow a detailed, objective appreciation of disease extent and morphology, vessel diameter, stent size and deployment and healing after PCI. It has become an essential tool in complex PCI, including rotational atherectomy, in follow-up of novel drug-eluting stent platforms and understanding the pathophysiology of stent failure after PCI (e.g. following stent thrombosis or in-stent restenosis). In this review we look at the two currently available and commonly used intracoronary imaging tools - intravascular ultrasound and optical coherence tomography - and the merits of each.

Keywords: Intracoronary imaging; intravascular ultrasound; optical coherence tomography.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. IVUS (A) and OCT (B) Showing a Normal Segment of Coronary Artery
Figure 2:
Figure 2:. IVUS Showing a Circumferential Calcified Lesion (A) and Eccentric Mixed Plaque (B)
Figure 3:
Figure 3:. OCT Showing a Well-opposed Stent (A) and Malapposed Stent (B); IVUS Showing a Well-opposed Stent (C) and Malapposed Stent (D)
Figure 4:
Figure 4:. OCT Showing a Thin-walled Plaque (A), Ruptured Plaque (B) and In-stent Restenosis (C)
Figure 5:
Figure 5:. OCT Showing Red Thrombus Resulting in Image Dropout (A) and White Thrombus Within a Previously Implanted Stent With no Image Dropout (B)
See this image and copyright information in PMC

References

    1. Garcia-Garcia HM, Gogas BD, Serruys PW, Bruining N. IVUS-based imaging modalities for tissue characterization: similarities and differences. Int J Cardiovasc Imaging. 2011;27:215–24. 10.1007/s10554-010-9789-7 - DOI - PMC - PubMed
    1. Gogas BD, Farooq V, Serruys PW, Garcia-Garcia HM. Assessment of coronary atherosclerosis by IVUS and IVUSbased imaging modalities: progression and regression studies, tissue composition and beyond. Int J Cardiovasc Imaging. 2011;27:225–37. 10.1007/s10554-010-9791-0 - DOI - PMC - PubMed
    1. Mintz GS, Nissen SE, Anderson WD et al. American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol. 2001;37:1478–92. - PubMed
    1. Prati F, Guagliumi G, Mintz GS et al. Expert review document part 2: methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures. Eur Heart J. 2012;33:2513–20. 10.1093/eurheartj/ehs095 - DOI - PMC - PubMed
    1. Terashima M, Kaneda H, Suzuki T. The role of optical coherence tomography in coronary intervention. Korean J Intern Med. 2012;27:1–12. 10.3904/kjim.2012.27.1.1 epub ahead of press. - DOI - PMC - PubMed

LinkOut - more resources