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  1. 1. Optical Coherence Tomography : Unstable Plaque Morphology I.K. Jang, MD Massachusetts General Hospital Harvard Medical School VP.ORG Symposium November 16, 2002
  2. 2. OCT Charateristics  Fibrous - Echodense, homogenous  Lipid - Echolucent with diffuse border  Calcific - Echolucent with sharp border
  3. 3. Plaque Morphology: Stable vs Unstable Coronary Syndromes
  4. 4. Stable Angina Pectoris
  5. 5. f A B f i m a 2x * * Fibrous Plaque
  6. 6. A * C B * D Calcified Plaque
  7. 7. A B f f * Lipid-rich Plaque
  8. 8. A B 2x * Lipid-rich Plaque
  9. 9. Post AMI
  10. 10. Post-AMI L L T
  11. 11. Post-AMI Stent A B
  12. 12. Post-AMI Results  High incidence of lipid-rich plaque  Frequent disruption of plaque  High incidence of residual thrombus  Frequent prolapse post stenting
  13. 13. Acknowledgements Massachusetts General Hospital Cardiology Division H. Yabushita, M. Takano, B. MacNeill, D. DeJoseph Wellman Laboratories of Photomedicine B.E. Bouma, M. Shishkov, C. Kauffman, N. Iftima, G.J. Tearney Dept. of Pathology S. Houser, H.T. Aretz CIMIT T. Brady, J. Rosen Guidant Corporation D. Kilpatrick, J. Ellis, R. Jones, T. Linnemeier