View source for Imaging to optimise stent deployment

[[File:Intracoronary Imaging Modalities.png|thumb|Advantages and disadvantages of different intracoronary imaging and haemodynamic modalities<ref>Mayo Clinic Interventional Cardiology Review Board 2017.</ref>.]]
Fractional flow reserve (FFR), intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have different roles in assessing different coronary segments.

===Definitions<ref>JACC 2014;64:207.</ref>===

*Malapposition: occurs when a stent (or portion of a stent) does not make contact with the vessel wall
*Under expansion: occurs when the stent (or a portion of the stent) is not at nominal diameter
*Under deployment is an imprecise term and should not be used.

[[File:Mechanical Causes of Stent Thrombosis OCT.png|thumb|Some mechanical causes of stent thrombosis identified on OCT.<ref>JACC 2014;64:207.</ref>]]

===Causes of stent thrombosis<ref>Circ Cardiovascular Interv 2011;4:239.</ref>===

*In cases of stent thrombosis, intravascular imaging with IVUS or OCT should be performed after initial aspiration or PCI to restore flow.
*Possible mechanical causes of stent thrombosis include:
**Malapposition
**Underexpansion
**Protrusion
**Edge dissection
*Factors associated with stent thrombosis in the HORIZONS-AMI Trial<ref>Circ Cardiovasc Interv 2011;4:239.</ref>:
**Under expansion (CSA < 5 mm<sup>2)</sup>
**Protrusion
**Dissection
**Malapposition was not associated with stent thrombosis.

*IVUS guided stent placement compared to no IVUS is associated with less stent thrombosis<ref>Roy Our Heart J 2008;29:1851.</ref>

===References===
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[[Category:Intracoronary Imaging]]