Imaging Coronary Atherosclerosis and Vulnerable Plaques with Optical Coherence Tomography

Abstract

Keywords Intravascular OCT • Atherosclerosis • Plaques • Fibroatheroma • Thin-capped fiberoatheroma • TCFA • Vunerable plaque • Macrophages • Stent deployment 69.1 Introduction Acute myocardial infarction (AMI) is the leading cause of death in the United States and industrialized countries [1, 2]. Research conducted over the past 15 years has demonstrated that several types of minimally or modestly stenotic atherosclerotic plaques, termed vulnerable plaques, are precursors to coronary thrombosis, myocardial ischemia, and sudden cardiac death. Postmortem studies have identified one type of vulnerable plaque, the thin-capped fibroatheroma (TCFA), as the culprit lesion in approximately 80 % of sudden cardiac deaths [3–7]. Over 90 % of TCFAs are found within the most proximal 5.0 cm segment of each of the main coronary arteries (left anterior descending, LAD; left circumflex, LCx; and right coronary artery, RCA) [3, 5].