Petrossian Gregory, Ozdemir Denizhan, Galougahi Keyvan Karimi, Scheiner Jonathan, Thomas Susan V, Shlofmitz Richard, Shlofmitz Evan, Jeremias Allen, Ali Ziad A
Albany Medical College, Albany Medical Center Albany, NY.
Division of Cardiology, Columbia University Irving Medical Center/NewYork-Presbyterian Hospital New York, NY.
US Cardiol. 2022 Jun 23;16:e15. doi: 10.15420/usc.2022.03. eCollection 2022.
Intravascular imaging with optical coherence tomography (OCT) and intravascular ultrasound provides superior visualization of the culprit plaques for acute coronary syndromes (ACS) compared with coronary angiography. Combined with angiography, intravascular imaging can be used to instigate 'precision therapy' for ACS. Post-mortem histopathology identified atherothrombosis at the exposed surface of a ruptured fibrous cap as the main cause of ACS. Further histopathological studies identified intact fibrous caps and calcified nodules as other culprit lesions for ACS. These plaque types were subsequently also identified on intravascular imaging, particularly with the high-resolution OCT. The less-common non-atherothrombotic causes of ACS are coronary artery spasm, coronary artery dissection, and coronary embolism. In this review, the authors provide an overview of clinical studies using intravascular imaging with OCT in the diagnosis and management of ACS.
与冠状动脉造影相比，光学相干断层扫描（OCT）和血管内超声的血管内成像能更清晰地显示急性冠状动脉综合征（ACS）的罪犯斑块。血管内成像与血管造影相结合，可用于启动ACS的“精准治疗”。尸检组织病理学发现，纤维帽破裂暴露表面的动脉粥样硬化血栓形成是ACS的主要原因。进一步的组织病理学研究确定完整的纤维帽和钙化结节是ACS的其他罪犯病变。随后在血管内成像中也发现了这些斑块类型，尤其是高分辨率OCT。ACS较少见的非动脉粥样硬化血栓形成原因包括冠状动脉痉挛、冠状动脉夹层和冠状动脉栓塞。在这篇综述中，作者概述了使用OCT血管内成像诊断和管理ACS的临床研究。
