Although the incidence of dissections was comparable between RA and OA cases, OA resulted in deeper tissue modifications (lacunae) as shown by OCT imaging. The finding might provide an explanation for a better stent apposition after OA as compared to RA. Their impact on long-term outcome needs to be determined.

Careful consideration of OCT features mimicking fibroatheroma lesions and imaging artifacts contributed to significantly higher levels of interobserver agreement. Interobserver variation can be partially resolved by development of standard interpretation algorithms.

OCT-based fibrous cap thickness is the most important predictor of periprocedural MI. In the absence of information about cap thickness, NIRS lipid core or IVUS plaque burden best determined the likelihood of the periprocedural event.