Optical coherence tomography oct is a highresolution imaging technique with great versatility of applications. Cardiac interventions today optical coherence tomography. Pdf use of optical coherence tomography in interventional. The summary of basic physics, engineering solutions, preclinical and clinical application covers all relevant aspects and will be a valuable reference source. Acute coronary syndromes acs are a major cause of morbidity and mortality in the developed world. Oct and ivus are modern tools that contribute to the understanding of coronary artery disease and percu taneous coronary intervention pci. To evaluate optical coherence tomography, a new technique for highresolution crosssectional imaging of the retina, for quantitative assessment of retinal thickness in patients with macular edema. Radiofrequency ablation lesion assessment using optical. Optical coherence tomography oct is an optical analog of intravascular ultrasound ivus that can be used to examine the coronary arteries and has 10fold higher resolution than ivus. Optical coherence tomography oct is an imaging technique that uses low coherence light to capture micrometerresolution, two and threedimensional images from within optical scattering media e. Avinger receives fda clearance of nextgeneration pantheris device. Optical coherence tomography oct findings and coronary. This paper provides an overview of the principles and current uses of oct in diagnosing and guiding the treatment of atherosclerotic coronary artery disease. Apr 22, 2017 i read with great interest the results of the ilumien iii trial by ziad ali and colleagues nov 26, p 261828,1 which did not show superiority for optical coherence tomography octguided percutaneous coronary intervention pci compared with angiographyguided pci.
Intravascular oct in pci american college of cardiology. Optical coherence tomography is also capable of identifying the chemical composition of atherosclerotic plaques and detecting traits of their vulnerability. The role of optical coherence tomography in coronary. Around 1990, oct was independently developed by two japanese researchers, naohiro tanno of yamagata university, japan, and james g. Eyes with cnv in the differential diagnosis were imaged with the avanti rtvue xr hd optovue, fremont, ca. Optical coherence tomography market share analysis, growth. It utilizes nearinfrared light to provide a microscopic insight into the pathology of coronary arteries in vivo. Optical coherence tomography has become established as an imaging modality in clinical ophthalmology and is finding applications in even gastrointestinal and dermatological arenas.
Optical coherence tomography is based on lowcoherence interferometry, typically employing near. In bifurcated lesions, it is particularly helpful in guiding several steps. Optical coherence tomography of the human retina jama. Optical coherence tomography oct is a method of obtaining tomographic images of a human organ based on the coherence of light. Oct can perform an optical biopsy, imaging pathology in situ and in real time without the need for excisional biopsy. Nadir m 2017 letter by nadir regarding article, optical coherence tomography to optimize results of percutaneous coronary intervention in patients with nonstelevation acute coronary syndrome. Optical coherence tomographyprinciples and applications. Next article interpretation of optical coherence tomography images authors reply optical coherence tomography oct is a powerful diagnostic method to assess the underlying plaque in acute coronary syndromesits high resolution enables plaque composition characterisation and accurate identification of fibrous cap rupture and thrombus. Optical coherence tomography an overview sciencedirect topics. Use of optical coherence tomography in interventional cardiology article pdf available in interventional cardiology 11. A novel approach for quantitative analysis of intracoronary optical coherence tomography.
However, its value in the diagnosis of scad remains unsettled. Cardiovascular optical coherence tomography oct is a catheterbased invasive imaging system. Optical coherence tomography oct is a noninvasive diagnostic technique providing crosssectional images of biologic structures based on the differences in tissue optical properties. The development of optical coherence tomography springerlink. At present it is the only tool to measure the thickness of the fibrous cap covering the lipid core of the atheroma, and thus it is an exceptional modality to detect plaques that are prone. Bifurcated lesions and optical coherence tomography. For oct imaging, lowcoherence, nearinfrared light with a wavelength of approximately 0 nm is used since it minimizes the energy absorption in the light beam caused by protein, water, hemoglobin and lipid. Diagnosis of spontaneous coronary artery dissection by.
Optical coherence tomography is an optical analog of ultrasound using light rather than sound to produce an image 15. Optical coherence tomography guided percutaneous coronary interventions. View the article pdf and any associated supplements and figures for a period of 48 hours. In cardiology, oct has remained hitherto as a research tool for characterization of vulnerable plaques and evaluation of neointimal healing after stenting. Use of optical coherence tomography in interventional.
Methods following a prospective protocol, oct was performed in 17 consecutive patients with a clinical and angiographic suspicion of scd from a. Optical coherence tomography oct is the optical analog of ultrasound imaging and is a powerful imaging technique that enables noninvasive, in vivo, high resolution, crosssectional imaging in biological tissue. Previous optical coherence tomography oct, intravascular ultrasound ivus and nearinfrared spectroscopy nirs studies presented their potential to detect vulnerable plaques, which is not possible by ffr assessment. Optical coherence tomography oct crosssections have shown limited ellipsoid zone ez improvement in mild hydroxychloroquine hcq retinopathy within a few years after drug cessation. Advantage of nextgeneration frequencydomain optical coherence tomography compared with conventional timedomain system in the assessment of coronary lesion. From the time of the first implantation of coronary stent in human in 1986, cardiologists were trying to find ways how to investigate coronary vessels in vivo from inside. Safety and feasibility of a new nonocclusive technique for facilitated intracoronary optical coherence tomography oct acquisition in various clinical and anatomical scenarios. Optical coherence tomography oct is a new intravascular imaging technique with high resolution and could provide accurate morphological information for plaques in coronary arteries. Open access editorial optical coherence tomography. The advent of intravascular imaging has been a significant advancement in visualization of coronary arteries, particularly with optical coherence tomography oct that allows for highresolution imaging of intraluminal and transmural coronary structures. Furthermore, oct is able to traverse many of the limitations of angiography and intravascular ultrasound when imaging coronary stents in vivo. Between 30 to 40 million oct imaging procedures are performed per year in ophthalmology. Principles of optical coherence tomography intravascular oct provides a method of obtaining crosssectional.
Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies. For more than 17 years, optical coherence tomography of ocular diseases has been the classic text on this. Radiofrequency ablation lesion assessment using optical coherence tomography a proof. Background scad is a rare but challenging clinical entity. From a research tool to clinical practice 385 thrombi can be readily detected which is not always true with ivus. I read with great interest the results of the ilumien iii trial by ziad ali and colleagues nov 26, p 261828,1 which did not show superiority for optical coherence tomography octguided percutaneous coronary intervention pci compared with angiographyguided pci. Since its introduction more than 2 decades ago, optical coherence tomography oct. Listing a study does not mean it has been evaluated by the u. Oct provides unique insights on coronary atherosclerosis and results of coronary interventions. Optical coherence tomography oct optical coherence tomography is a type of intravascular imaging that uses light waves to provide a crosssection view of the retina.
Optical coherence tomography market growth analysis, application and share by technology sdoct, sweptsource oct, application cardiology, ophthalmology, dermatology, others, type of devices handheld, tabletop, catheterbased oct devices global forecast till 2023. Survey optical coherence tomographic examination of the retina, including the macula and optic nerve head in normal human subjects. Optical tomographic techniques are of particular importance in the medical. Optical coherence tomography for coronary bioresorbable. Optical coherence tomography oct has opened new horizons for intravascular coronary imaging. Optical coherence tomography oct is the intravascular imaging method, that allows physicians to investigate structure of a vessel in a near to cellular level in vivo. Optical coherence tomography for intracoronary imaging. Feb 12, 20 in comparison to ivus, optical coherence tomography oct is a novel technology with the first in human studies performed in 2008. Optical coherence tomography oct, a technique for noninvasive imaging of living tissue at micrometer scales using lowcoherence light, has applications in a wide range of fields, including. Optical coherence tomography oct is a highresolution imaging technology that. However, the extent, functional significance, and stability of such changes over time remain unclear. The advent of intravascular imaging has been a significant advancement in visualization of coronary arteries, particularly with optical.
Intracoronary optical coherence tomography 2018 jacc. Oct 12, 2019 optical coherence tomography oct enables crosssectional, volumetric, and functional imaging of internal microstructure and pathology in biological tissues. No difference was found in the primary endpointminimum stent area after pcibetween the two strategies p012. The role of optical coherence tomography in coronary intervention. Its biggest application in cardiovascular medicine currently is in the coronary vasculature and to a lesser extent coronary graft assessment. Fractional flow reserve ffr assesses a functional impact of the atheroma on the myocardial ischemia, but it does not take into account the morphology of the lesion. Optical coherence tomography to optimize results of. Optical coherence tomography angiography octa is a recent developed and effective technique to evaluate retinal microcirculation. That is because of the vacancy of technologies capable to perform images with. Optical coherence tomography oct is a new technique that provides accurate visualization of the coronary artery wall with an unprecedented resolution 15. Results of the multicenter, randomized doctors study does optical coherence tomography optimize results of stenting, circulation, 5.
In diagnostic terms, it is essential to separate two very distinct populations. It is used for medical imaging and industrial nondestructive testing ndt. Optical coherence tomography assessment of culprit lesions in acute coronary syndrome oct is a promising tool to assess patients with acs because it can detect plaques at high risk for rupture and provide additional information about plaque composition, thickness of the fibrous cap, the presence of thrombi and collagen composition. Sep, 2018 optical coherence tomography oct optical coherence tomography is a type of intravascular imaging that uses light waves to provide a crosssection view of the retina.
Intravascular optical coherence tomography european. Optical coherence tomography oct is an imaging technique that uses light to capture high. Optical coherence tomography guidance optical coherence tomography oct is a high resolution intravascular imaging tool used to assess coronary lesions and evaluate the results of stenting. Cardiovascular optical coherence tomography oct explained. Optical coherence tomography is an officebased device that uses the reflection of infrared light from an exogenous source directed through the pupil off the back of the eye to quantify the thickness of retinal tissues, including the retinal nerve fiber layer and macula. Optical coherence tomography in cardiovascular research.
Fractional flow reserve and optical coherence tomography. Intravascular optical coherence tomography european heart. Yet, much of the early motivation for the development of ivoct was the detection of the vulnerable plaquepatient. Oct is already commonly used in ophthalmology to noninvasively create a topography map of the retina. The limitations of angiography and ivus in identifying intermediate lesions able to produce ischemia have led contemporary interventional cardiology to call for. The early detection of capillary abnormality is crucial for the clinical evaluation of hypertensionrelated microvascular rarefaction, however, the current approaches are still limited. Optical coherence tomography is a new imaging technique analogous to ultrasound b scan that can provide crosssectional images of the retina with micrometerscale resolution. Attizzani from university hospitals in cleveland explains oct cardiovascular optical coherence tomography which is a catheterbased invasive imaging system. Intravascular ultrasound intracoronary imaging icr journal. Fujimoto of the massachusetts institute of technology mit in the united states, and patent applications were submitted.
Optical coherence tomographyprinciples and applications 241 contents page 1. Bioresorbable vascular scaffold treatment induces the formation of neointimal cap that seals the underlying plaque without compromising the luminal dimensions. Pdf the basics of intravascular optical coherence tomography. Pdf optical coherence tomography oct has opened new horizons for intravascular coronary.
Optical coherence tomography oct enables crosssectional, volumetric, and functional imaging of internal microstructure and pathology in biological tissues. Optical coherence tomography oct is an imaging technique that uses lowcoherence light to capture micrometerresolution, two and threedimensional images from within optical scattering media e. A multicenter evaluation of the safety of intracoronary optical coherence tomography. Based on polarization properties, oct can differentiate tissue characteristics fibrous, calcified, or lipidrich plaque and identify thincap fibroatheroma. Oct functions as an optical analog to ivus detecting the back scatter of light to generate an image. Optical coherence tomography the cardiology advisor. Intravascular optical coherence tomography quickly found a sizeable niche in assessing tissue response to stents through the measurement of stent strut coverage. Development and applications 411 organizing this data by areas of knowledge and looking only for the most expressive ones, fig. Optical coherence tomography is based on low coherence interferometry, typically employing near. Accumulating data support a clinical role for oct in a multitude of clinical scenarios, including assessing the natural history of. Optical coherence tomography of ocular diseases pdf author joel s. Nowadays, optical coherent tomography oct as the most precise morphologic technique is used in the increasing number of cases, both in routine clinical. Introduction tomographic techniques generate slice images of threedimensional objects.
Use of optical coherence tomography in interventional cardiology. Jun, 2016 intravascular optical coherence tomography oct can add value to angiography as a diagnostic andor intervention tool for percutaneous coronary intervention pci guidance. The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Optical coherence tomography in coronary atherosclerosis. Stable coronary artery disease cad and acute coronary syndromes acs. Survey examination with optical coherence tomography of patients with macular edema. Optical coherence tomography oct findings and coronary bifurcation lesions. In comparison to ivus, optical coherence tomography oct is a novel technology with the first inhuman studies performed in 2008. The risk of future acute coronary events appears to be largely dependent on the presence of morphologically distinct, atherosclerotic plaques,1 rather than the presence of severely stenotic lesions as assessed by angiography. The basics of intravascular optical coherence tomography.
Jun 20, 2015 optical coherence tomography is also capable of identifying the chemical composition of atherosclerotic plaques and detecting traits of their vulnerability. Optical coherence tomographyprinciples and applications 243 1. Goldmans cecil medicine twenty fourth edition, 2012. Optical coherence tomography of ocular diseases pdf. Jan, 2016 the role of optical coherence tomography in coronary intervention. Optical coherence tomography an overview sciencedirect. The handbook of optical coherence tomography in cardiovascular research targets researchers and clinicians involved in the field of atherosclerosis. Optical coherence tomography in interventional cardiology. The tech nique was performed using an occlusion balloon in 256 54. Interpretation of optical coherence tomography images. Mar 18, 2019 optical coherence tomography oct is an imaging technique that uses light to capture high. Quantitative assessment of macular edema with optical.
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