The role of intracoronary imaging in acute coronary syndromes: OCT in focus

Optical coherence tomography (OCT) has emerged as a powerful intravascular imaging modality in recent years. The introduction of frequency-domain OCT has simplified the procedure and enabled its safe utilisation in different clinical settings including acute coronary syndromes, where it can determine the mechanism of plaque disruption, thrombus burden, and guide percutaneous coronary intervention. In patients presenting with stent failure (stent thrombosis and instent restenosis), OCT can also be very useful in determining the underlying mechanism and guiding therapy thereafter. This article aims to review the role of OCT in acute coronary syndromes as well as its potential clinical applications.