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Evolution of antithrombotic therapy in patients undergoing percutaneous coronary intervention: a 40-year journey Trial Design Principles for Patients at High Bleeding Risk Undergoing PCI: JACC Scientific Expert Panel Consensus Document ANMCO/ANCE/ARCA/GICR-IACPR/GISE/SICOA: Long-term Antiplatelet Therapy in Patients with Coronary Artery Disease Dual-Antiplatelet Therapy Cessation and Cardiovascular Risk in Relation to Age: Analysis From the PARIS Registry Rivaroxaban Plus Aspirin Versus Aspirin in Relation to Vascular Risk in the COMPASS Trial The optimal duration of dual antiplatelet therapy after coronary stent implantation: to go too far is as bad as to fall short Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents A risk score to predict postdischarge bleeding among acute coronary syndrome patients undergoing percutaneous coronary intervention: BRIC-ACS study Efficacy and Safety of Ticagrelor Monotherapy in Patients Undergoing Multivessel PCI Ticagrelor Monotherapy Versus Dual-Antiplatelet Therapy After PCI: An Individual Patient-Level Meta-Analysis

LetterVolume 69, Issue 3, May 2017, Pages 407-410

JOURNAL:Indian Heart J. Article Link

Optical coherence tomography is a kid on the block: I would choose intravascular ultrasound

Dash D. Keywords: Percutaneous coronary intervention; Intravscular ultrasound; Optical coherence tomography; Vulnerable plaque; Biodegradable vascular scaffold

ABSTRACT

Intravascular imaging has improved our understanding of in vivo pathophysiology of coronary artery disease (CAD) and predicted decision-making in percutaneous coronary intervention (PCI). Intravascular ultrasound (IVUS) has emerged as the first clinical imaging method contributing significantly to modern PCI techniques. This modality has outlived many other intravascular techniques 26 years after its inception. It has assisted us in understanding dynamics of atherosclerosis and provides several unique insights into plaque burden, remodeling, and restenosis. It is useful as an imaging endpoint in large progression-regression trial and as workhorse in many catheterization laboratories. IVUS guidance appears to be most beneficial in complex lesion subsets that are being treated with drug-eluting stents. The recent introduction of optical coherence tomography (OCT), a light based imaging technique, has further expanded this field because of its higher resolution and faster image acquisition. The omnipresence of OCT raises the question: Does IVUS have a role in the era of OCT? Whether OCT is superior to IVUS in routine clinical practice? Even if OCT is currently gaining clinical significance in detailed planning of interventional strategies and stent optimization in complex lesion subsets, it is the much younger technique and has to prove its worth. Nevertheless, undoubtedly IVUS plays significant role in studies on coronary atherosclerosis and for guidance of PCI. In fact, both the methods are complementary rather than competitive.