Imaging the subcellular structure of human coronary atherosclerosis using micro-optical coherence tomography

Progress in understanding, diagnosis, and treatment of coronary artery disease (CAD) has been hindered by our inability to observe cells and extracellular components associated with human coronary atherosclerosis in situ. The current standards for microstructural investigation, histology and electron microscopy are destructive and prone to artifacts. The highest-resolution intracoronary imaging modality, optical coherence tomography (OCT), has a resolution of similar to 10 mu m, which is too coarse for visualizing most cells. Here we report a new form of OCT, termed micro-optical coherence tomography (mu OCT), whose resolution is improved by an order of magnitude. We show that mu OCT images of cadaver coronary arteries provide clear pictures of cellular and subcellular features associated with atherogenesis, thrombosis and responses to interventional therapy. These results suggest that mu OCT can complement existing diagnostic techniques for investigating atherosclerotic specimens, and that mu OCT may eventually become a useful tool for cellular and subcellular characterization of the human coronary wall in vivo.