Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan.
Korean J Intern Med. 2012 Mar;27(1):1-12. doi: 10.3904/kjim.2012.27.1.1. Epub 2012 Feb 28.
Optical coherence tomography (OCT) is an optical analog of intravascular ultrasound (IVUS) that can be used to examine the coronary arteries and has 10-fold higher resolution than IVUS. Based on polarization properties, OCT can differentiate tissue characteristics (fibrous, calcified, or lipid-rich plaque) and identify thin-cap fibroatheroma. Because of the strong attenuation of light by blood, OCT systems required the removal of blood during OCT examinations. A recently developed frequency-domain OCT system has a faster frame rate and pullback speed, making the OCT procedure more user-friendly and not requiring proximal balloon occlusion. During percutaneous coronary intervention (PCI), OCT can provide detailed information (dissection, tissue prolapse, thrombi, and incomplete stent apposition [ISA]). At follow-up examinations after stent implantation, stent strut coverage and ISA can be assessed. Several OCT studies have demonstrated delayed neointimal coverage following drug-eluting stent (DES) implantation vs. bare metal stent (BMS) placement. While newer DESs promote more favorable vascular healing, the clinical implications remain unknown. Recent OCT studies have provided insights into restenotic tissue characteristics; DES restenotic morphologies differ from those with BMSs. OCT is a novel, promising imaging modality; with more in-depth assessments of its use, it may impact clinical outcomes in patients with symptomatic coronary artery disease.
光学相干断层扫描（OCT）是血管内超声（IVUS）的光学模拟，可以用于检查冠状动脉，其分辨率比 IVUS 高 10 倍。基于偏振特性，OCT 可以区分组织特征（纤维、钙化或富含脂质的斑块），并识别薄帽纤维粥样瘤。由于血液对光的强烈衰减，OCT 系统在 OCT 检查期间需要清除血液。最近开发的频域 OCT 系统具有更快的帧率和回撤速度，使 OCT 操作更加用户友好，并且不需要近端球囊闭塞。在经皮冠状动脉介入治疗（PCI）期间，OCT 可以提供详细信息（夹层、组织脱垂、血栓和支架贴壁不良[ISA]）。在支架植入后的随访检查中，可以评估支架支柱覆盖率和 ISA。几项 OCT 研究表明，与金属裸支架（BMS）相比，药物洗脱支架（DES）植入后新生内膜覆盖延迟。虽然更新的 DES 促进了更有利的血管愈合，但临床意义尚不清楚。最近的 OCT 研究提供了对再狭窄组织特征的深入了解；DES 再狭窄形态与 BMS 不同。OCT 是一种新颖、有前途的成像方式；随着对其使用的更深入评估，它可能会影响有症状的冠状动脉疾病患者的临床结果。
