Optical Coherence Tomography (OCT)- CATH LAB at Yashoda Hospital

At Yashoda hospital, we aim to achieve excellence in healthcare services by offering unique expertise, state of the art technology & patient care. We are committed to providing world class health care at an affordable cost. Our specialized team of top cardiologists & cardiothoracic surgeons are completely dedicated to treating you in the best possible way. Our trained, equipped, and professional team works in efforts towards the prevention & treatment of cardiac diseases, resulting in better results & improved quality of life for cardiac patients.

What is Optical Coherence Tomography?

During cardiac catheterization, Optical coherence tomography (OCT) is adopted, which is a diagnostic method. Unlike ultrasound, which employs sound waves to generate an image of the blood vessels, OCT uses light. With OCT, surgeons can retrieve images of the blood vessels that are about the same as if they were watching under a microscope.

OCT uses near-infrared light to construct images of the interior of the coronary arteries. The procedure delivers very high-resolution pictures. A beam of light is cast at the artery, and some of the light echoes from inside the artery tissue, and some of it distributes. This scattered light creates something called “glare.” Using OCT, the glare can be refined out. Even the slightest amount of reflected light that is not scattered can be distinguished and utilized to form the coronary artery's impression. In fact, OCT allows cardiologists to examine the inside of an artery in 10 times more detail than if they were using intravascular ultrasound.

OCT is utilized along with heart catheterization procedures, including angioplasty, in which cardiologists use a miniature balloon on the tip of a catheter to unclog a coronary artery. Most patients who undergo balloon angioplasty also obtain a stent—a narrow mesh-like device located inside the artery to keep it open. OCT images can help cardiologists see if a stent is keeping an artery open and whether the stent is arranged correctly against the artery wall. OCT also lets cardiologists clearly see the plaque inside an artery, find out how much fat or clot is inside an artery, and draw exact measurements before and after placing stents.

What are the indications for OCT in Cath lab?

The OCT in the cath lab is used for several purposes:

• Delineation of angiographically uncertain lesions
• Evaluation for allograft vasculopathy
• Lesion assessment pre-PCI
• Stent deployment post-PCI

OCT is promoted over IVUS for post-PCI stent evaluation as it makes clear images of stent strut apposition, inflation, and difficulties such as dissections.

What are the functions of the OCT in the Cath lab?

OCT's function in everyday clinical practice can help raise the outcomes for the patients and present an Optimal Percutaneous coronary Intervention. OCT can aid in guiding the physicians on precise clinical conditions and can help optimize physician treatment strategies.

Some of the day to day practical operations can be seen as below:

• In-stent Restenosis
• Assessment of Calcified Lesions
• Thrombosis
• Stent Deployment and Malapposition
• Stent Deployment and Edge Dissection
• Bifurcation Lesion Assessment
• Percutaneous Coronary Intervention
• Bioabsorbable Scaffold – OCT is the only imaging equipment that can visualize a BVS.
• OCT in ACS

OCT is especially helpful for conditions where fine tissue resolution is demanded – such as imaging edge dissections, tissue prolapse with stents, and thrombus.

How do OCT benefits patients?

Some of the benefits that OCT can provide to patients are:

• It presents detailed pictures of superficial coronary plaque components. OCT can accurately identify all types of plaques, such as fibrous, Fibro-calcific, and Lipid Rich.
• The high resolution of OCT identifies plaque characteristics that predispose to severe, including the thin fibrous caps, large lipid cores, and macrophages' build-up.
• OCT can produce crucial information to guide coronary interventions, in addition to characterizing atherosclerotic plaques.
• OCT can be employed to measure the minimal luminal diameter, reference vessel diameter, and length of the target lesion.
• OCT can be adopted to identify stent malapposition, tissue prolapse, and both in-stent and edge dissection with greater sensitivity than IVUS.
• It is of distinct benefit in assessing stent apposition with overlapping stents.