ABSTRACT
Effective in vivo identification of a vulnerable plaque requires an intravascular imaging modality that is portable, uses a catheter of less than 1 mm in diameter, ideally has a resolution 50 µm, and can differentiate a lipid-rich core. Furthermore, the imaging equipment and disposable parts (i.e., catheters) have to be fairly inexpensive if this technology is to be used widely. Optical coherence tomography (OCT) has all of these components (1, 2). OCT has already demonstrated the ability to image in vivo intravascular structures with a resolution of less than 20 µm with a 2.9F catheter (3). OCT’s exceptional resolution can identify the fine structural details in the artery, including a thin fibrous cap, fissures, and lipid cores (2). This chapter will review the applications of OCT technology to the assessment of cardiovascular microstructure. Although OCT has the potential to accurately, reliably, and inexpensively identify vulnerable plaques in humans, technical challenges to initiating clinical trials will also be discussed.
