ABSTRACT
Every year approximately 1.5 million patients in the United States suffer acute coronary syndromes (ACS), such as sudden cardiac death, acute myocardial infarction (MI), and unstable angina. Spontaneous rupture or erosion of atherosclerotic plaques with subsequent thrombosis is the most frequent underlying cause of ACS. Autopsy studies have identified several histologic characteristics of plaques that are prone to disruption, the so-called vulnerable plaques. Pathologic characteristics of these vulnerable plaques are (i) a thin fibrous cap (<65 µm), (ii) a large lipid pool, and (iii) activated inflammatory cells, such as monocytes, macrophages, foam cells, lymphocytes and neutrophils near the fibrous cap.1-5
To date, a variety of diagnostic tools to detect structural abnormalities in vulnerable plaques have been developed. Intravascular optical coherence tomography (OCT) is a recently developed optical imaging tool that provides high-resolution, cross-sectional images of tissues in situ. In this chapter, an outline of the Massachusetts General Hospital (MGH) OCT system and the results of studies using this system are presented.
