Optical coherence tomography in peripheral arterial disease: a systemic review

Abstract

Aim: The aim of this systematic review is to evaluate the role of OCT in the field of contemporary vascular surgery in terms of its utility in diagnostics and interventions in peripheral arterial disease (PAD). Methods: A systematic search of literature published from January 1, 2009 to June 13, 2019 was identified from Pubmed, Ovid and Cochrane library database with reference to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. The pre‐defined selection inclusion criteria was clinical applications of OCT in vascular surgery in relation to diagnostics and interventions. Keywords used included OCT, PAD, endovascular procedures and atherectomy. Results: From an initial search of 310 articles, twenty‐seven articles were included in this systematic review: fifteen articles were related to diagnostics: peripheral arterial disease was the most studied condition (n = 8), other conditions included in‐stent restenosis (n = 4), fibromuscular dysplasia (n = 2) and acute limb ischaemia (n = 1); twelve articles were related to intervention: an OCT‐guided crossing catheter was the most used assisting device (n = 10), with an OCT‐guided atherectomy device used in four of these studies. Conclusion: Although there is no level 1 evidence to suggest routine use of OCT in the diagnosis and treatment of PAD, current literature suggests that the use of OCT is safe and effective. The OCT real‐time vessel wall structural images clearly distinguish normal anatomy from plaque pathology, and is of great advantage both in the accurate diagnosis and treatment of target lesion, especially in reducing the amount of radiation in the endovascular procedure.