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Review
. 2022 May 9:17:e06.
doi: 10.15420/icr.2021.31. eCollection 2022 Jan.

Use of Optical Coherence Tomography in MI with Non-obstructive Coronary Arteries

Grigoris Karamasis  1 , Iosif Xenogiannis  1 , Charalampos Varlamos  1 , Spyridon Deftereos  1 , Dimitrios Alexopoulos  1
Affiliations
Review

Use of Optical Coherence Tomography in MI with Non-obstructive Coronary Arteries

Grigoris Karamasis et al. Interv Cardiol. .

Abstract

MI with non-obstructive coronary arteries (MINOCA) comprises an important minority of cases of acute MI. Many different causes have been implicated in the pathogenetic mechanism of MINOCA. Optical coherence tomography (OCT) is an indispensable tool for recognising the underlying pathogenetic mechanism when epicardial pathology is suspected. OCT can reliably identify coronary lesions not apparent on conventional coronary angiography and discriminate the various phenotypes. Plaque rupture and plaque erosion are the most frequently found atherosclerotic causes of MINOCA. Furthermore, OCT can contribute to the identification of ischaemic non-atherosclerotic causes of MINOCA, such as spontaneous coronary artery dissection, coronary spasm and lone thrombus. Recognition of the exact cause will enable therapeutic management to be tailored accordingly. The combination of OCT with cardiac magnetic resonance can set a definite diagnosis in the vast majority of MINOCA patients.

Keywords: MI with non-obstructive coronary arteries; calcified nodule; coronary spasm; optical coherence tomography; plaque erosion; plaque rupture; spontaneous coronary artery dissection.

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Conflict of interest statement

Disclosure: GK has received honoraria from Abbott Vascular. DA has received lecturing honoraria/advisory board fees from AstraZeneca, Bayer, Boehringer Ingelheim, Pfizer, Medtronic, Biotronik and Chiesi Hellas. All other authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Examples of MINOCA Caused by Plaque Rupture
Figure 2:
Figure 2:. Examples of MINOCA Caused by Plaque Erosion
Figure 3:
Figure 3:. Examples of MINOCA Caused by Coronary Spasm and Spontaneous Coronary Artery Dissection
Figure 4:
Figure 4:. Clinical Algorithm for the Use of Optical Coherence Tomography in MINOCA
See this image and copyright information in PMC

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