
Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically to optimise percutaneous coronary intervention. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in managing patients with acute coronary syndromes. Accurate detection by OCT of sequelae from percutaneous coronary interventions that might be missed by angiography could improve clinical outcomes. The appropriate use of OCT depends on accurate interpretation and performance of the clinical significance of OCT findings. In this Review, summarised the state of the art in cardiac OCT and facilitate the uniform use of this modality in coronary atherosclerosis. Contributions have been made by clinicians and investigators worldwide with extensive experience in OCT.
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