Preprocedural planning, procedural guidance and follow-up assessment in percutaneous coronary intervention using multimodality coronary imaging

In 2017, percutaneous coronary intervention (PCI) celebrates the 40th anniversary of the first procedure which was performed back in 1977. There has been considerable progress in this field especially coronary stent technology. Despite the therapeutic successes achieved by DES, there is still a considerable effort to develop the new stent platforms that would offer the better clinical outcomes than the current one. In parallel with the advent of stents, coronary imaging both invasive and non-invasive have also evolved to support the field. The catheter-based imaging modalities available to date examine the coronary artery using either acoustic-based or light-based signals. Each imaging technique has individual strengths in supporting the operator for procedural planning, assessing the stent performance and monitoring the stent safety and efficacy at short- and long-term follow-up. However, the major drawback of the catheter-based imaging technique is its invasive nature. Therefore, multislices coronary computed tomography angiography (CCTA) is an alternative method to evaluate coronary anatomy. The challenge in this field has been to improve the ability of CCTA to provide assessment of coronary anatomy equivalent to the conventional coronary angiography. The aims of this thesis are 1) to demonstrate application of the multimodality imaging for planning and follow-up assessment in PCI from non-invasive coronary imaging to invasive intracoronary imaging; 2) to explore advanced OCT application for evaluating new stent technologies