Utilidad de técnicas de imagen en la valoración de la enfermedad coronaria - Tomografía de coherencia óptica

Abstract

Optic coherence tomography is a high resolution imaging technique that enables the lumen and the walls of the structures of the coronary vessel to be examined. It offers a tissue penetration on a millimetre scale (1-2mm) and a longitudinal and lateral spatial resolution on a micrometre scale. The resolution is in the order of 10-20μm, approximately 10 times superior to the resolution of intravascular ultrasound, which is in the order of 100-150μm, and is another intra-coronary imaging technique widely used in current clinical practice.Since its introduction more than 20 years ago, it has been increasingly used in research, as well as in clinical practice. It has been especially useful in the evaluation of the natural history of atherosclerosis, the description of the mechanisms of acute coronary syndrome, and the optimisation of coronary interventions. It currently has a special use in the diagnosis of culprit lesions in cases where angiograph is limited, in the planning of complex percutaneous catheterisation (diffuse diseases, bifurcations, and calcified lesions), and in cases of stent failures (thrombosis and re-stenosis). The latter is probably one of the par excellence indications, with the aim of understanding the pathophysiology and to provide the appropriate percutaneous treatment.In this review, emphasis will be made on the considerations for using optic coherence tomography as an intracoronary imaging technique in the diagnosis and classification of atherosclerotic disease.