Current Applications and New Perspectives in Optical Coherence Tomography (OCT) Coronary Atherosclerotic Plaque Assessment: From PCI Optimization to Pharmacological Treatment Guidance
Michele Mattia Viscusi,
Ylenia La Porta,
Giuseppe Migliaro,
Gian Marco Gargano,
Annunziata Nusca,
Laura Gatto,
Simone Budassi,
Luca Paolucci,
Fabio Mangiacapra,
Elisabetta Ricottini,
Rosetta Melfi,
Raffaele Rinaldi,
Francesco Prati,
Gian Paolo Ussia,
Francesco Grigioni
Affiliations
Michele Mattia Viscusi
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy
Ylenia La Porta
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy
Giuseppe Migliaro
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy
Gian Marco Gargano
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy
Annunziata Nusca
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy
Laura Gatto
San Giovanni Addolorata Hospital, Cardiology Department, 00184 Rome, Italy
Simone Budassi
San Giovanni Addolorata Hospital, Cardiology Department, 00184 Rome, Italy
Luca Paolucci
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy
Fabio Mangiacapra
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy
Elisabetta Ricottini
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy
Rosetta Melfi
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy
Raffaele Rinaldi
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy
Francesco Prati
San Giovanni Addolorata Hospital, Cardiology Department, 00184 Rome, Italy
Gian Paolo Ussia
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy
Francesco Grigioni
Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, 00128 Rome, Italy
Since its ability to precisely characterized atherosclerotic plaque phenotypes, to tailor stent implantation, as well as to guide both complex percutaneous coronary interventions (PCI) and invasive diagnostic work-ups (e.g., spontaneous coronary dissections or myocardial infarction with non-obstructive arteries), the adoption of optical coherence tomography (OCT) was raised in the past decades in order to provide complementary information to the traditional angiography and to overcome its limitations. However, the impact of OCT on daily clinical practice is currently modest, firstly because of the lack of both standardized algorithms of PCI guidance and data from prospective clinical trials. Therefore, the aim of our narrative review is to provide a comprehensive overview of the basic OCT interpretation, to summarize the evidence supporting the OCT guidance procedures and applications, to discuss its current limitations, and to highlight the knowledge gaps that need to be filled with more robust evidence.
