Citation: Expert Review of Cardiovascular Therapy. 19(2):141-149, 2021 Feb.; .Journal: Expert review of cardiovascular therapy.Published: 2021; ; ; ISSN: 1477-9072.Full author list: Barriola R; Ben-Dor I; Beyene SS; Bourantas C; Campos CM; Case BC; Chezar-Azerrad C; Dan K; De Maria GL; Forrestal BJ; Garcia-Garcia HM; Hashim H; Kuku KO; Medranda GA; Melaku GD; Shlofmitz E; Waksman R; Yerasi C.UI/PMID: 33261531.Subject(s): *Acute Coronary Syndrome/th [Therapy] | *Plaque, Atherosclerotic/th [Therapy] | *Tomography, Optical Coherence/mt [Methods] | Coronary Angiography | Humans | Percutaneous Coronary Intervention | Thrombosis/et [Etiology]Institution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1080/14779072.2021.1857732 (Click here)Abbreviated citation: Expert Rev Cardiovasc Ther. 19(2):141-149, 2021 Feb; .Abstract: AREAS COVERED: In this review, we outline the underlying causes of acute coronary syndrome (ACS) as evaluated by optical coherence tomography (OCT). We report both the definitions of each mechanism and its frequency as reported in the literature to date. Finally, we present an algorithm based on the findings in the review that gives an outlined approach to perform intervention on ACS patients.Abstract: EXPERT OPINION: Although the most common and most accepted intervention in ACS cases is stent implantation, data suggest a stentless approach in cases of plaque erosion, which generally occurs in younger patients presenting with an acute coronary syndrome that have TIMI flow of 2/3 and either a small or large burden of thrombus and underlying stenosis of less than 50%.