Fundamentals of Optical Coherence Tomography

Atherosclerotic plaque components such as thin cap fibroatheroma (TCFA), fibrous cap, macrophage infiltration, large necrotic core, and thrombus are the microstructural plaque components that can be detected with only high-resolution imaging modalities such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Light-based OCT provides better visualization of plaque tissue layers of coronary vessel walls as compared to IVUS. Three dominant paradigms have been identified to characterize atherosclerotic plaque components based on optical attenuation coefficients, machine learning algorithms, and deep learning techniques. This review (condensation of 126 papers after downloading 150 articles) presents a detailed comparison among various methodologies utilized for plaque tissue characterization, classification, and arterial measurements in OCT. Furthermore, this review presents the different ways to predict and stratify the risk associated with the CVD based on plaque characterization and measurements in OCT. Moreover, this review discovers three different paradigms for plaque characterization and their pros and cons. Among all of the techniques, a combination of machine learning and deep learning techniques is a best possible solution that provides improved OCT-based risk stratification.

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A Survey on Coronary Atherosclerotic Plaque Tissue Characterization in Intravascular Optical Coherence Tomography

Boi

Jamthikar

Saba

et al. 2018

Curr Atheroscler Rep

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Spontaneous Coronary Artery Dissection: Diagnosis and Management

Yeo

Feldman

Kim

2018

Curr Treat Options Cardio Med

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Coronary angiography is the first-line diagnostic modality for SCAD, with three angiographic features commonly observed in SCAD: type 1 (pathognomonic angiographic appearance with contrast staining of the arterial wall), type 2 (long coronary stenosis), and type 3 (focal tubular stenosis). In addition, adjunctive intracoronary imaging can aid in identifying coronary dissections. Conservative management with beta-blockers and aspirin remains the mainstay of therapy. However, patients with high-risk features and recurrent symptoms may require revascularization. Several techniques have been reported, such as long stents to seal the entire length of the dissection, stepwise stenting starting at the distal edge followed by proximal edge stenting, use of bioabsorbable stents, and cutting balloon angioplasty. Furthermore, cardiac rehabilitation appears to be safe and offers significant benefits for patients with SCAD. Coronary angiographic classification contributed to the increased recognition of SCAD in recent years. Selecting the most suitable and appropriate therapy based on accurate diagnosis is the cornerstone of management in SCAD. Further studies are needed to establish optimal treatment of SCAD depending on anatomical and/or clinical features.

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Efficacy of Zotarolimus-Eluting Stents in Treating Diabetic Coronary Lesions: An Optical Coherence Tomography Study

Zhu

et al. 2020

Adv Ther

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Fundamentals of Optical Coherence Tomography

Cited by 3 publications

References 58 publications

A Survey on Coronary Atherosclerotic Plaque Tissue Characterization in Intravascular Optical Coherence Tomography

A Survey on Coronary Atherosclerotic Plaque Tissue Characterization in Intravascular Optical Coherence Tomography

Spontaneous Coronary Artery Dissection: Diagnosis and Management

Efficacy of Zotarolimus-Eluting Stents in Treating Diabetic Coronary Lesions: An Optical Coherence Tomography Study

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