ABSTRACT
The first-generation time-domain OCT systems had a relatively narrow field of view and required proximal vessel occlusion for image acquisition, precluding its application in unprotected left main (ULM). Conversely, frequency-domain optical coherence tomography (FD-OCT) technology allows pullback speeds up to 25 mm/s, which obviates the need for proximal vessel occlusion. FD-OCT also offers a larger (10 mm) field of view, enabling visualization of large vessels, such as the ULM. This chapter evaluates the safety and feasibility of FD-OCT for ULM disease based on our data and representative cases. It also evaluates the coronary artery stent thrombosis (ST) changes, dissections, arrhythmias, slow flow, and spasms pre-PCI (pre-percutaneous coronary intervention) and post-PCI. Great advantage of FD-OCT for ULM was the larger field of view compared with the first-generation time-domain OCT systems. FD-OCT assessment during ULM PCI was safe and feasible. The safety of FD-OCT during non-ULM PCI was reported increasingly; however, there are no data evaluating the safety during ULM PCI.
