ABSTRACT
This chapter discusses the usefulness of optical coherence tomography (OCT) in planning and guiding coronary stenting, using a practical, case-oriented approach, whenever applicable. Intravascular OCT pre-PCI allows accurate quantification of stenosis severity and extension, and characterization of the underlying plaque components and morphometry, helps locate adequate landing zones for the stent to be implanted, and provides accurate vessel sizing for selection of the stent length and diameter. The chapter also discusses The role of OCT to assess the quality of stent implantation and optimize the percutaneous coronary intervention (PCI) results. The main goal of PCI is to eliminate myocardial ischemia by optimizing the gain of lumen dimensions without complications. Stent underexpansion has long been identified as an important predictor of early stent thrombosis and mid- to long-term in-stent restenosis (ISR) of both bare-metal stent (BMS) and DES. Plaque fracture and dissection of the arterial wall are the key mechanisms of lumen enlargement during PCI.
