Optical coherence tomography (OCT) is the 'new kid on the block' in coronary imaging. This technology offers clinicians a high resolution (approximately 15 μm), that is ten times higher than the currently accepted gold standard of intravascular ultrasound and has emerged as the ideal imaging tool for the assessment of superficial components of coronary plaques and stent struts. Novel OCT systems can perform quick and safe scanning of coronary arteries with a non-occlusive technique. A brief summary containing the key physical principles of OCT technology with particular attention to the novel Fourier domain system is presented. This review will focus on clinical and research applications of OCT in interventional cardiology. The two main fields of OCT in vivo: coronary atherosclerosis assessment and the study of vessel wall response to stent implantation in terms of strut coverage and apposition will be delineated. Limitations and future perspectives of the technique are presented.
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