No abstract

We aimed to validate for the first time optical coherence tomography (OCT) measurements of epidermal thickness (ET) using cryopreparation for histology. OCT assessments of ET were performed on healthy skin using the algorithms as follows: first, peak-to-valley analysis of the A-scan (ET-OCT-V), second, line-traced image analysis of the B-scan (ET-OCT-IA). Histology was performed using cryostat sections which were also evaluated using the image analysis (ET-Histo). We selected 114 samples, including B-scans and corresponding histology, for method comparison between ET-OCT-IA and ET-Histo. Forty-two A-scans were available for method comparison between ET-OCT-V and ET-Histo. Bland and Altman plots revealed a marked bias with wide 95% limits of agreement for ET-OCT-V versus ET-Histo. Comparison of ET-OCT-IA versus ET-Histo revealed only a slight bias and narrow 95% limits of agreement. A-scan analysis for ET determination is linked to significant limitations and lacks agreement with histology. By contrast, we observed satisfactory agreement between ET-OCT-IA and ET-Histo indicating that both methods can be utilized interchangeably. OCT using the line-traced image analysis of the B-scan appears to be a valid and relatively practicable method for the determination of ET in vivo. Furthermore, the comparisons with the in vivo OCT profiles demonstrate that cryostat sectioning provides a better preservation of relative and absolute dimensions of skin layers than paraffin embedding.

ZusammenfassungDer Goldstandard in der Behandlung der Phlebothrombose ist die konservative Therapie mittels Antikoagulation und Kompression. Bei akuten proximalen iliofemoralen Thrombosen mit Beteiligung der Beckenvene muss jedoch hierbei mit einer Inzidenz für das Entstehen eines postthrombotischen Syndroms im Langzeitverlauf von bis zu 70 % gerechnet werden. Zur Prävention eines solchen Folgeschadens rückt neben der selten durchgeführten operativen venösen Thrombektomie in den letzten Jahren zunehmend die interventionelle rekanalisierende Therapie in den Fokus der Behandlungsstrategie. In dieser Übersicht werden die verschiedenen Techniken und aktuellen Entwicklungen dieser Therapie dargestellt und einer kritischen Wertung vor dem Hintergrund der bestehenden Evidenz unterzogen.