Safety and efficiency of percutaneous coronary intervention using a standardised optical coherence tomography workflow

Osborn, Eric A.; Johnson, Michael; Maksoud, Aziz; Spoon, Daniel; Zidar, Frank; Korngold, Ethan C; Buccola, Jana; Cabrera, Hector Garcia; Rapoza, Richard; West, Nick E.J.; Rauch, Judah

doi:10.4244/eij-d-22-00512

Cited by 4 publications

(1 citation statement)

References 24 publications

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“…Acquisitions were successfully conducted with a limited contrast volume, ~16 to 18 ml per scan, and the overall increase in contrast usage was only marginal. Moreover, recent coronary studies showed that, with the use of OCT imaging, fewer angiography views were needed, leading to decreased radiation exposure and no difference in contrast amount utilization ( 43 ). However, a limited subset of patients undergoing neurovascular procedures may be deemed to be at higher risk when exposed to high contrast medium amounts, including contrast-associated kidney injury and other rare adverse reactions, such as contrast-induced encephalopathy and contrast-induced neurotoxicity ( 44 – 46 ).…”

Section: Discussionmentioning

confidence: 99%

Volumetric microscopy of cerebral arteries with a miniaturized optical coherence tomography imaging probe

Pereira,

Lylyk,

Cancelliere

et al. 2024

Sci. Transl. Med.

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Endovascular interventions are increasingly becoming the preferred approach for treating strokes and cerebral artery diseases. These procedures rely on sophisticated angiographical imaging guidance, which encounters challenges because of limited contrast and spatial resolution. Achieving a more precise visualization of the underlying arterial pathology and neurovascular implants is crucial for accurate procedural decision-making. In a human study involving 32 patients, we introduced the clinical application of a miniaturized endovascular neuro optical coherence tomography ( n OCT) imaging probe. This technology was designed to navigate the tortuous paths of the cerebrovascular circulation and to offer high-resolution imaging in situ. The n OCT probe is compatible with standard neurovascular microcatheters, integrating with the procedural workflow used in clinical routine. Equipped with a miniaturized optical fiber and a distal lens, the probe illuminates the tissue and collects the backscattered, near-infrared light. While rotating the fiber and the lens at high speed, the probe is rapidly retracted, creating a spiral-shaped light pattern to comprehensively capture the arterial wall and implanted devices. Using n OCT, we demonstrated volumetric microscopy of cerebral arteries in patients undergoing endovascular procedures. We imaged the anterior and posterior circulation of the brain, including distal segments of the internal carotid and middle-cerebral arteries, as well as the vertebral, basilar, and posterior cerebral arteries. We captured a broad spectrum of neurovascular pathologies, such as brain aneurysms, ischemic stroke, arterial stenoses, dissections, and intracranial atherosclerotic disease. n OCT offered artifact-free, high-resolution visualizations of intracranial artery pathology and neurovascular devices.

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Section: Discussionmentioning

confidence: 99%