OCT plaque characterization: comparison to IVUS-VH

RODRIGUEZ-GRANILLO GA, SERRUYS PW

Handbook of Optical Coherence Tomography in Cardiovascular Research

INFORMA HEALTHCARE

Año: 2007; p. 95 - 102

Recently, a study including a large series of victims of sudden cardiac death suggested that ruptured thin-cap fibroatheroma (TCFA) lesions were the precipitating factor of 60 % of acute coronary thrombi. Furthermore, 70 % of those patients had other TCFAs in their coronary tree that had not ruptured 5. A large (avascular, hypocellular, lipid-rich) necrotic core, a thin fibrous cap with inflammatory infiltration and paucity of smooth muscle cells, and the presence of expansive (positive) remodeling have been identified as the major criteria to define TCFA lesions 6,7-10. Detection of these non-obstructive, lipid rich, high-risk plaques may have an important impact on the prevention of acute myocardial infarction and sudden death. Currently, there are several intravascular tools capable of locally evaluating the aforementioned determinants of plaque vulnerability. We will focus the chapter on the current status of optical coherence tomography (OCT) and spectral analysis of the radiofrequency data (IVUS-VH) and the potential of combining these intravascular diagnostic tools to enhance the prognostic value of invasive plaque characterization and vulnerable plaque imaging