Optical Coherence Tomography based treatment approach for patients with Acute Coronary Syndrome. [Review]

MedStar author(s):
Citation: Expert Review of Cardiovascular Therapy. 19(2):141-149, 2021 Feb.PMID: 33261531Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Acute Coronary Syndrome/th [Therapy] | *Plaque, Atherosclerotic/th [Therapy] | *Tomography, Optical Coherence/mt [Methods] | Coronary Angiography | Humans | Percutaneous Coronary Intervention | Thrombosis/et [Etiology]Year: 2021ISSN:
  • 1477-9072
Name of journal: Expert review of cardiovascular therapyAbstract: 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.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%.All authors: 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 COriginally published: Expert Review of Cardiovascular Therapy. 2020 Dec 01Fiscal year: FY2021Digital Object Identifier: Date added to catalog: 2020-12-31
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Journal Article MedStar Authors Catalog Article 33261531 Available 33261531

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.

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%.

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