New techniques of intravessel imaging in coronary atherosclerosis

Abstract

Intravascular imaging modalities are currently adopted to circumvent angiographic limitations. The present overview is aimed at describing the principal techniques used by an interventional cardiologist to assess both coronary atherosclerotic plaques and stent deployment results. Optical coherence tomography (OCT), intravascular ultrasound (IVUS), and near-infrared spectroscopy are currently available to address these issues. These techniques are characterized by specific advantages and limitations, making each of those applicable for specific purposes. Offline software programmes have been developed to further characterize plaque tissue, highlighting the macrophage presence or unfold coronary stent in a three-dimensional view by a carpet view. Although IVUS and OCT have been largely used for research purposes, growing evidence is supporting a clinical impact of percutaneous coronary interventions guided by those intravascular techniques, especially in the setting of complex procedures. We will provide data supporting a favourable outcome in particular describing the results of the ADAPT-DES study and CLI-OPCI registry.