Intracoronary optical coherence tomography: state of the art and future directions

Optical coherence tomography (OCT) has been increasingly utilised to guide percutaneous coronary inter-vention (PCI). Despite the diagnostic utility of OCT, facilitated by its high resolution, the impact of intra-coronary OCT on clinical practice has thus far been limited. Difficulty in transitioning from intravascular ultrasound (IVUS), complex image interpretation, lack of a standardised algorithm for PCI guidance, and paucity of data from prospective clinical trials have contributed to the modest adoption. Herein, we provide a comprehensive up-do-date overview on the utility of OCT in coronary artery disease, including techni-cal details, device set-up, simplified OCT image interpretation, recognition of the imaging artefacts, and an algorithmic approach for using OCT in PCI guidance. We discuss the utility of OCT in acute coronary syndromes, provide a summary of the clinical trial data, list the work in progress, and discuss the future directions.