Intracoronary imaging, in support of secondary prevention of coronary artery disease

Introduction: Intravascular imaging is one of the hot-test subjects of debate in cardiology, especially in inter-ventional cardiology. The ESC/EACTS Guidelines on myocardial revascularization offer Optical Coherence Tomography (OCT) a IIa class of indication. Near In-frared Spectroscopy (NIRS) is another intracoronary technique to identify the vulnerable plaques.
Methods: We examined the coronary vessels with OCT and NIRS, two catheter-based intracoronary techniqu-es, that employs near-infrared light to probe micro-meter-scale structures inside biological tissues. The intracoronary pull backs were used to assess in vivo co-ronary artery microstructure, as an additional tool to angiography, to assess the stenosis characteristics, but also to evaluate the results of stent deployment, and the apposition of the struts to the vessel wall.
Results: OCT and NIRS were useful in plaque and tissue characterization. Because OCT has a far grea-ter resolution than any other intravascular technique and was initially introduced to study superficial plaque components, OCT proved a good tool in thin cap fibro-atheroma assessment, with a high level of evidence in delineating the necrotic core. NIRS proved to be a good tool to assess the lipid rich plaque.
Conclusions: OCT is one of the intravascular imaging technique on a raise among other intracoronary techniques, superior in edge dissection or struts appositi-on. As about vulnerable plaque, although data are fa-vorable to OCT, more research is needed to confirm its usefulness in identifying the plaques at risk. Although NIRS is a good technique to identify lipid rich plaque, it is not clear it can predict acute coronary syndromes.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)