Imaging Coronary Artery Plaque Erosion by Optical CoherenceTomography: An Emerging Modality to Assess Morphological Featuresand Guide Clinical Treatment Strategy

Previous post-mortem pathological studies demonstrated that plaque rupture was the most common cause of acute coronary events. However, due to the limitation of current intravascular imaging modalities, plaque erosion, although also indeed take the role in the causes of acute coronary events failed to detected in vivo. Various intravascular imaging techniques such as Coronary Angiography (CAG), Intravascular Ultrasound (IVUS) and Computed Tomography (CT) have been employed to identify the plaque characteristic in an attempt to improve the management of the Acute Coronary Syndrome (ACS). Optical Coherence Tomography (OCT) is an emerging modality with high resolution to assess various stages of plaque morphology which might allow provide a priori knowledge of the mechanism of the ACS. In addition, the application of OCT at the time of intervention enable to instruct clinicians with appropriate therapeutic strategy based on the different culprit plaque morphologies. This paper systematically reviews the morphological characteristics of plaque erosion identified by OCT and discusses its current status in the clinical treatment of ACS events.