Intravascular optical coherence tomography (OCT) enables imaging of the three-dimensional (3D) microstructure of a blood vessel wall. While 3D vascular visualization provides detailed information of the vessel wall and intraluminal structures, a longitudinal imaging pitch that is several times bigger than the imaging resolution of the system has limited true high-resolution 3D imaging. In this paper we demonstrate high-speed intravascular OCT in vivo, acquiring images at a rate of 350 frames per second. A 47-mm-long rabbit aorta was imaged in 3.7 seconds, after a short flush with contrast agent. The longitudinal imaging pitch was 34 micrometers, comparable to the transverse imaging resolution of the system. Three-dimensional volume rendering showed greatly enhanced visualization of tissue microstructure and stent struts, relative to what is provided by conventional intravascular imaging speeds.