Almagal Naeif, Leahy Niall, Alqahtani Foziyah, Alsubai Sara, Elzomor Hesham, Del Sole Paolo Alberto, Sharif Ruth, Sharif Faisal
College of Medicine, University of Galway, H91 TK33 Galway, Ireland.
Cardiology Department, Neom Hospital, Sharma 49626, Saudi Arabia.
J Cardiovasc Dev Dis. 2025 Jul 29;12(8):288. doi: 10.3390/jcdd12080288.
Optical Coherence Tomography (OCT) is a further light-based intravascular imaging modality and provides a high-resolution, cross-sectional view of coronary arteries. It has a useful anatomic and increasingly physiological evaluation in light of coronary artery disease (CAD). This review provides a critical examination of the increased application of the OCT in assessing coronary artery physiology, beyond its initial mainstay application in anatomical imaging. OCT provides precise information on plaque morphology, which can help identify vulnerable plaques, and is most important in informing percutaneous coronary interventions (PCIs), including implanting a stent and optimizing it. The combination of OCT and functional measurements, such as optical flow ratio and OCT-based fractional flow reserve (OCT-FFR), permits a more complete assessment of coronary stenoses, which may provide increased diagnostic accuracy and better revascularization decision-making. The recent developments in OCT technology have also enhanced the accuracy in the measurement of coronary functions. The innovations may support the optimal treatment of patients as they provide more personalized and individualized treatment options; however, it is critical to recognize the limitations of OCT and distinguish between the hypothetical advantages and empirical outcomes. This review evaluates the existing uses, technological solutions, and future trends in OCT-based physiological imaging and evaluation, and explains how such an advancement will be beneficial in the treatment of CAD and gives a fair representation concerning other imaging applications.
光学相干断层扫描（OCT）是另一种基于光的血管内成像模式，可提供冠状动脉的高分辨率横截面视图。鉴于冠状动脉疾病（CAD），它在解剖学和日益重要的生理学评估方面具有重要作用。本综述对OCT在评估冠状动脉生理学方面应用的增加进行了批判性审视，超越了其最初在解剖学成像中的主要应用。OCT可提供有关斑块形态的精确信息，有助于识别易损斑块，在指导经皮冠状动脉介入治疗（PCI）（包括植入支架和优化支架）方面最为重要。OCT与功能测量（如光学血流比和基于OCT的血流储备分数（OCT-FFR））相结合，能够对冠状动脉狭窄进行更全面的评估，这可能提高诊断准确性并改善血运重建决策。OCT技术的最新进展也提高了冠状动脉功能测量的准确性。这些创新可能为患者提供更个性化的治疗选择，从而支持对患者进行最佳治疗；然而，认识到OCT的局限性并区分假设的优势和实际结果至关重要。本综述评估了基于OCT的生理成像和评估的现有用途、技术解决方案及未来趋势，并解释了这种进展如何有利于CAD的治疗，以及对其他成像应用进行了合理介绍。
