Optical coherent tomography in patients with unstable angina

Abstract

The article describes modern approaches to the study of atherosclerotic plaques characteristics using invasive imaging methods of the coronary arteries. We briefly highlighted the features of the so-called «vulnerable» atheroma. The features of the method of optical coherent tomography (OCT) in determining the thickness of the fibrous cap of a vulnerable plaque are considered. Factors limiting the possibilities of OCT and advantages over intravascular ultrasound before and after stenting are described. The clinical case is presented as a complex and uncertain one for the further tactics of treating a patient with non-Q myocardial infarction and a destroyed plaque in the LAD. The objective of this clinical case was to show the advantages of OCT as an additional method for assessing the structure of the vascular wall at the site of the destroyed plaque, the extent of the affected area, to assess the adequacy of stent implantation and the degree of pressure of stent branches, the possible dissection with an angio-graphically adequate result, which made it possible to identify malposition earlier. Also, the OCT method can be used in the remote period to visualize the degree of stent endothelization and determine the duration of double antiplatelet therapy in patients after stenting with drug-eluting stents.