Intravascular Optical Coherence Tomography - Opening a Window into Coronary Artery Disease

Over one million people are diagnosed with coronary heart disease (CHD) annually. Recent postmortem analyses have suggested that sudden cardiac deaths are caused by the rupture of vulnerable plaque, as opposed to stable plaque occlusion. Optical coherence tomography (OCT) is a high-resolution imaging technique that offers microscopic visualisation of biological tissues. When used as an intravenous realtime imaging technique, OCT provides researchers and physicians with the ability to visualise the composition of stenoses (fibrous, lipid-rich or calcified), as well as thin-capped lesions that may be more prone to rupture. OCT can therefore aid in determining the appropriate treatment and later follow-up examinations. Furthermore, the high resolution gives physicians more information regarding new therapies, such as atherectomy devices and drug-eluting stents (DES). Beginning in the early years of life, atherosclerosis damages the lining of the coronary arteries and makes the arteries susceptible to the formation of blood clots or stenoses that restrict blood flow to the heart. Atherosclerotic plaque can build up for years before vessel narrowing becomes apparent - a debilitating or fatal heart attack is often the first indication of underlying disease. In spite of the availability of effective drug therapies and other remarkable therapeutic advances in interventional cardiology, more than 650,000 Americans die every year of heart attacks related to CAD. Diagnostic methods have not kept pace with the demand to select and apply therapies more effectively. Better imaging methods may help bridge this diagnostic gap.