Is optical coherence tomography a coherent strategy for carotid artery stenting?

Key Points

• Optical coherence tomography (OCT) is rarely necessary to guide clinical decisions about the appropriateness of carotid revascularization.
• For carotid artery stenting (CAS), computed tomography angiography is the best imaging tool to assess arch, carotid, and lesion-specific anatomy, including vessel dimensions and calcification.
• OCT is a coherent strategy after CAS to assess ambiguous angiographic findings and to guide appropriate therapy for dissection, thrombosis, and plaque prolapse.

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