Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Intravascular imaging has advanced our understanding of coronary artery disease and facilitated decision-making in percutaneous coronary intervention (PCI). In particular, intravascular ultrasound (IVUS) has contributed significantly to modern PCI techniques. The recent introduction of optical coherence tomography (OCT) has further expanded this field due to its higher resolution and rapid image acquisition as compared with IVUS. Furthermore, OCT allows detailed planning of interventional strategies and optimisation before stent deployment, particularly with complex lesions. However, to date it is unclear whether OCT is superior to IVUS as an intracoronary imaging modality with limited data supporting OCT use in routine clinical practice. This review aims to compare these two intracoronary imaging techniques and the recent evidence for their use in this ever-changing field within interventional cardiology.