OCT Coronary Imaging in Hyderabad — Optical Coherence Tomography at AIG Hospitals, Gachibowli
OCT (Optical Coherence Tomography) is the highest-resolution intravascular imaging technology available in coronary intervention — providing detailed cross-sectional images of coronary artery walls and stents with 10 times greater resolution than IVUS. Using infrared light rather than sound waves, OCT reveals the microscopic architecture of coronary plaques and stent struts with extraordinary precision. Dr. Bhishma Chowdary uses OCT-guided angioplasty at AIG Hospitals, Gachibowli for patients from Gachibowli, Hitech City, Manikonda, Kondapur, and across Hyderabad.
At a glance
| What it is | Infrared light-based intravascular imaging technology that provides the highest-resolution images currently available for coronary artery assessment. |
| Also known as | Optical Coherence Tomography (OCT), Coronary OCT, OCT-guided PCI. |
| Resolution | Approximately 10 to 20 micrometres, offering image resolution up to 10 times higher than Intravascular Ultrasound (IVUS). |
| Used during | Coronary angioplasty procedures for pre-stent lesion assessment, procedural planning, and post-stent optimisation. |
| Key Advantage | Provides exceptional visualisation of individual stent struts, thin fibrous caps, plaque microstructures, stent apposition, and subtle vessel abnormalities that may be invisible with other imaging modalities. |
| Key Limitation | Requires temporary blood clearance using a contrast flush during image acquisition. This may limit its use in certain situations, including some ostial lesions and patients with severely reduced left ventricular function. |
| Available at | AIG Hospitals, Gachibowli, Hyderabad, serving patients from Hitech City, Manikonda, Kondapur, Madhapur, and surrounding regions. |
| Performed by | Dr. Bhishma Chowdary, DM Cardiology, Interventional Cardiologist. |
What does OCT show that other tests cannot?
OCT operates on the same principle as ultrasound — but uses light instead of sound. Because light has a much shorter wavelength than ultrasound, OCT produces images of extraordinarily fine detail. As the OCT catheter is pulled back through the artery, it captures a helical series of cross-sectional images at 100 frames per second — creating a detailed three-dimensional reconstruction of the vessel.
| Thin-Cap Fibroatheroma (TCFA) | A lipid-rich plaque covered by a fibrous cap thinner than 65 micrometres, considered one of the most vulnerable coronary plaque types. Plaque rupture from TCFA is responsible for many acute heart attacks. OCT is uniquely capable of identifying TCFA and detecting high-risk plaques before rupture. |
| Individual Stent Struts | OCT can visualise individual metallic stent struts, typically measuring 70–100 micrometres in thickness, along with the surrounding tissue response. This enables detailed assessment of stent apposition, neointimal coverage, and neoatherosclerosis. |
| Stent Edge Dissections | Very small dissections at the edges of a stent, including those less than 200 micrometres in size, can be detected by OCT even when invisible on angiography or difficult to appreciate with IVUS. Early identification allows prompt corrective treatment. |
| Calcium Morphology | OCT characterises calcium distribution in detail, including superficial calcium sheets, calcium nodules, and calcium fractures following balloon predilatation. These findings help determine whether additional plaque-modification techniques such as laser atherectomy or rotational atherectomy may be beneficial. |
| In-Stent Restenosis Mechanism | OCT differentiates between restenosis caused by neointimal hyperplasia, neoatherosclerosis, and stent underexpansion. Identifying the exact mechanism helps guide the most appropriate treatment strategy. |
| Plaque Erosion vs Plaque Rupture | In patients presenting with acute coronary syndromes, OCT can help distinguish plaque rupture from plaque erosion. This information may influence treatment decisions, as selected cases of plaque erosion may be managed differently from plaque rupture. |