Intracoronary Imaging (OCT, IVUS)

Intracoronary Imaging techniques such as OCT (Optical Coherence Tomography) and IVUS (Intravascular Ultrasound) are advanced tools that allow cardiologists to look inside the heart’s arteries in great detail during an angiogram or angioplasty. These technologies help in precisely diagnosing coronary artery disease, guiding accurate stent placement, and ensuring superior outcomes for patients undergoing coronary interventions.

Dr. Jaydutt B Tekani is skilled in the use of OCT and IVUS for advanced coronary imaging, combining cutting-edge technology with clinical expertise to deliver precise and personalized cardiac care.

What Is Intracoronary Imaging?

While a coronary angiogram shows the outline of heart arteries using X-rays and contrast dye, it cannot always reveal the true structure or composition of the blockage. Intracoronary imaging provides a cross-sectional, inside view of the artery, showing detailed information about plaque type, thickness, and exact location.

Two Main Modalities of Intracoronary Imaging:

IVUS (Intravascular Ultrasound): Uses high-frequency sound waves from a tiny ultrasound probe mounted on a catheter to generate real-time images of the artery wall. It helps visualize vessel size, plaque burden, and stent expansion.
OCT (Optical Coherence Tomography): Uses near-infrared light instead of sound waves to create ultra-high-resolution images (10x finer than IVUS), allowing detailed visualization of the inner layers of the artery, stent placement, and tissue coverage.

Together, OCT and IVUS help cardiologists make data-driven, highly accurate decisions during coronary procedures.

Why Intracoronary Imaging Is Recommended?

Intracoronary imaging is recommended when standard angiography doesn’t provide sufficient detail or when complex blockages or stent-related concerns are suspected.

Common Reasons to Use OCT / IVUS

To assess borderline or ambiguous lesions on angiography
To determine the size and composition of plaque before angioplasty
To guide accurate stent selection and placement
To confirm proper stent expansion and apposition
To evaluate stent restenosis (re-narrowing) or thrombosis
To plan and optimize complex angioplasties (bifurcation, left main, CTO, calcified arteries)

Intracoronary imaging helps achieve the best possible results and reduces the risk of complications or repeat procedures.

How the Procedure Works

Intracoronary imaging is performed as part of a coronary angiography or angioplasty procedure in a Cardiac Catheterization Laboratory (Cath Lab).

Step-by-Step Process

A thin imaging catheter (OCT or IVUS) is inserted into the coronary artery via the wrist or groin.
The catheter is gently advanced across the area of interest.
For IVUS, ultrasound signals are emitted and reflected from the artery wall to create cross-sectional images.
For OCT, a contrast dye is briefly injected to clear blood from the vessel, allowing light waves to capture high-resolution images.
The images are displayed instantly on a monitor and analyzed in real-time.

The entire imaging process takes just a few minutes and adds minimal time to the angiography or angioplasty.

What the Test Shows

OCT and IVUS provide detailed visualization of:

Plaque type (soft, fibrous, calcified, or mixed)
Vessel size and diameter for accurate stent sizing
Plaque burden and distribution along the artery
Extent of calcium deposits (important for selecting atherectomy or IVL)
Stent expansion, apposition, and coverage
Causes of stent failure, such as underexpansion or edge dissection

This precision helps tailor treatment to each patient’s unique artery structure.

Benefits of Intracoronary Imaging

More accurate diagnosis than standard angiography alone
Optimized stent deployment for long-lasting results
Reduced risk of restenosis or stent thrombosis
Improved outcomes in complex angioplasty cases
Enhanced safety through real-time procedural guidance
Personalized treatment planning based on plaque characteristics

OCT and IVUS imaging are considered the gold standard for ensuring procedural success and minimizing complications.

Is it Safe?

Yes. Both OCT and IVUS are minimally invasive, safe, and well-tolerated techniques performed during routine coronary procedures.

Complications are extremely rare and may include:

Temporary chest discomfort
Mild dye-related reaction (in OCT)
Very small risk of vessel spasm

These risks are minimized under expert supervision and modern imaging systems.

When Intracoronary Imaging Is Especially Useful

During complex or high-risk angioplasties (CHIP PCI)
For left main, bifurcation, or calcified lesions
When stent results are uncertain, or there’s stent re-narrowing
For recurrent angina despite previous stenting
To guide the treatment strategy in multivessel disease

In these situations, OCT and IVUS provide unmatched accuracy and confidence in treatment outcomes.

Expert in Intracoronary Imaging – Dr. Jaydutt B Tekani

Dr. Jaydutt B Tekani is an accomplished Interventional Cardiologist with advanced expertise in Intracoronary Imaging using OCT and IVUS.

He routinely integrates these technologies into his angioplasty procedures to ensure:

Optimal stent expansion and placement
Improved procedural precision and safety
Personalized treatment tailored to each patient’s coronary anatomy

Dr. Tekani’s evidence-based and technology-driven approach ensures patients receive the most accurate diagnosis and the best possible long-term outcomes.

Book Your Consultation

If you’ve been advised an angiography or angioplasty, or if you have complex coronary artery disease, ask about Intracoronary Imaging with OCT/IVUS for precise and informed treatment.

Schedule your appointment with Dr. Jaydutt B Tekani to benefit from advanced cardiac imaging, expert care, and truly personalized heart treatment.