Abstract. We report the development and validation of an intravascular rotary catheter for bimodal interrogation of arterial pathologies. This is based on a point-spectroscopy scanning time-resolved fluorescence spectroscopy technique enabling reconstruction of fluorescence lifetime images (FLIm) and providing information on arterial intima composition and intravascular ultrasound (IVUS) providing information on arterial wall morphology. The catheter design allows for independent rotation of the ultrasonic and optical channels within an 8 Fr outer diameter catheter sheath and integrates a low volume flushing channel for blood removal in the optical pathways. In the current configuration, the two channels consist of (a) a standard 3 Fr IVUS catheter with single element transducer (40 MHz) and (b) a side-viewing fiber optic (400 μm core). Experiments conducted in tissue phantoms showed the ability of the catheter to operate in an intraluminal setting and to generate coregistered FLIm and IVUS in one pull-back scan. Current results demonstrate the feasibility of the catheter for simultaneous bimodal interrogation of arterial lumen and for generation of robust fluorescence lifetime data under IVUS guidance. These results facilitate further development of a FLIm-IVUS technique for intravascular diagnosis of atherosclerotic cardiovascular diseases including vulnerable plaques.
SUMMARY
Optical techniques including fluorescence lifetime spectroscopy have demonstrated potential as a tool for study and diagnosis of arterial vessel pathologies. However, their application in the intravascular diagnostic procedures has been hampered by the presence of blood hemoglobin that affects the light delivery to and the collection from the vessel wall. We report a computational fluid dynamics model that allows for the optimization of blood flushing parameters in a manner that minimizes the amount of saline needed to clear the optical field of view and reduces any adverse effects caused by the external saline jet. A 3D turbulence (k−ω) model was employed for Eulerian–Eulerian two-phase flow to simulate the flow inside and around a side-viewing fiber-optic catheter. Current analysis demonstrates the effects of various parameters including infusion and blood flow rates, vessel diameters, and pulsatile nature of blood flow on the flow structure around the catheter tip. The results from this study can be utilized in determining the optimal flushing rate for given vessel diameter, blood flow rate, and maximum wall shear stress that the vessel wall can sustain and subsequently in optimizing the design parameters of optical-based intravascular catheters.
We report the development and validation of an intravascular rotary catheter that enables bi-modal interrogation of arterial pathologies based on fast-frame time-resolved fluorescence spectroscopy (TRFS) and intravascular ultrasound (IVUS). The catheter is based on a parallel design that allows for independent rotation of the ultrasonic and optical channels within an 8 Fr outer diameter catheter sheath and integrates a low volume flushing channel for blood removal in the optical pathways. In current configuration, the two channels consist of a) a standard 8 Fr IVUS catheter with single element transducer (15 MHz) and b) a side-viewing UV-grade silica/silica fiber optic (400 μm core). The catheter is terminated by a small (0.82 mm internal diameter) polyimide tube to keep the fiber stable within the sheath. To clear the field of view from blood, a saline solution can be flushed in a sheath channel, concentric with the fiber optic, through the tube and in a radial opening aligned with the fiber's optical beam. The flushing function was optimized with a computational fluid dynamics (CFD) model pursued in a parallel study. The ability of the catheter to operate in intraluminal setting in blood flow, the effect of probe-to-tissue distance on optical signal and ability to generate coregistered TRFS and IVUS data were demonstrated in blood vessel phantoms. Current results demonstrate the feasibility of the described catheter for parallel interrogation of vessel walls based on TRFS and IVUS and to generate robust TRFS data. These results facilitate further development of a bi-modal TRFS-IVUS technique for intravascular diagnosis of atherosclerotic cardiovascular diseases including vulnerable plaques.
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