Coronary artery disease in systemic sclerosis not clinically apparent: findings from optical coherence tomography

Further insight into systemic sclerosis from the vasculopathy perspective

Systemic sclerosis (SSc) is an autoimmune disease characterized by immune dysfunction, vascular system dysfunction, and tissue fibrosis. Vascular injury, vascular remodeling, and endothelial dysfunction are the hallmark pathological changes of the disease. In the early stages of SSc development, endothelial cell injury and apoptosis can lead to vascular and perivascular inflammation, oxidative stress, and tissue hypoxia, which can cause clinical manifestations in various organs from the skin to the parenchymal organs. Early diagnosis and rational treatment can improve patient survival and quality of life. Ancillary examinations such as nailfold capillaroscopy as well as optical coherence tomography can help early detect vascular injury in SSc patients. Studies targeting the mechanisms of vascular lesions will provide new perspectives for treatment of SSc.

Percutaneous Coronary Intervention Planning and Optimization with Optical Coherence Tomography

Coronary angiography confirms or excludes coronary artery disease, assesses lesions severity, and helps to decide percutaneous coronary interventions (PCI). Coronary angiography has clear limitations. Intravascular imaging guides PCI. Frequency domain optical coherence tomography (OCT) gained attention for accurate planning and guidance of complex PCI. High-speed OCT image acquisition enables prompt vessel assessment in stable and unstable patients. The high-resolution images provide precise tissue characterization and a reliable quantitative assessment of the coronary pathology. Immediately after stent implantation, OCT allows accurate evaluation of stent expansion and symmetry. Real-time angio-OCT co-registration integrates OCT into the PCI workflow for accurate decision making.