IVUS (Intravascular Ultrasound) and OCT (Optical Coherence Tomography) are advanced imaging techniques used during coronary procedures to provide detailed views of the inside of coronary arteries. Here’s a summary:

IVUS (Intravascular Ultrasound):

  • Technology:
    • Uses ultrasound waves to create images of the coronary artery walls.
  • Capabilities:
    • Provides cross-sectional images of the artery.
    • Measures the size of the artery and plaque buildup.
    • Helps assess the extent of plaque and the presence of calcification.
    • Good for visualizing the overall structure of the vessel, including the external elastic membrane.
    • Has a greater depth of penetration into the vessel wall.
  • Clinical Use:
    • Guides stent placement and optimization.
    • Assesses complex lesions.
    • Useful for evaluating vessel size and plaque burden.

OCT (Optical Coherence Tomography):

  • Technology:
    • Uses near-infrared light to create high-resolution images of the coronary artery walls.
  • Capabilities:
    • Provides very detailed, high-resolution images of the inner lining of the artery.
    • Allows for precise visualization of plaque morphology and composition.
    • Excellent for detecting thin fibrous caps and subtle plaque features.
    • has a lower depth of penetration into the vessel wall than IVUS.
  • Clinical Use:
    • Helps assess plaque vulnerability.
    • Guides stent optimization with high precision.
    • Useful for detailed assessment of stent apposition.

Key Differences:

  • Resolution:
    • OCT offers significantly higher resolution than IVUS.
  • Penetration:
    • IVUS has greater penetration depth, allowing visualization of deeper vessel structures.
  • Imaging Mechanism:
    • IVUS uses ultrasound, while OCT uses light.

Clinical Significance:

  • Both IVUS and OCT provide valuable information that complements traditional angiography.
  • They help cardiologists make more informed decisions during percutaneous coronary intervention (PCI).
  • They aid in optimizing stent placement, and reducing complications.
  • There are also hybrid systems in development that use both IVUS and OCT technology.

In essence, these technologies provide a much more detailed view of the coronary arteries than traditional angiography alone, leading to improved patient outcomes.