Safety and Feasibility of an Intravascular Optical Coherence Tomography Image Wire System in the Clinical Setting

Yamaguchi, Tetsu; Terashima, Mitsuyasu; Akasaka, Takashi; Hayashi, Tetsuo; Mizuno, Kyoichi; Muramatsu, Toshiya; Nakamura, Masato; Nakamura, Shigeru; Saito, Satoshi; Takano, Masamichi; Takayama, Tadateru; Yoshikawa, Junichi; Suzuki, Takahiko

doi:10.1016/j.amjcard.2007.09.116

Cited by 149 publications

(82 citation statements)

References 16 publications

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“…32 OCT also provides accurate measurement of reference lumen diameters with studies showing that for proximal culprit lesions, TD-OCT measurements were almost identical to those measured with IVUS. 33 …”

Section: Vessel Sizingmentioning

confidence: 99%

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Rathod¹,

Hamshere²,

Jones³

et al. 2015

Interventional Cardiology Review

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Coronary angiography has been the gold standard technique for evaluating coronary arterial disease for the past 50 years. Increasingly, however, realisation of the limitations of coronary angiography, mainly the inability to supply information regarding the coronary wall, has prompted the design and development of adjunctive technologies to better evaluate not just luminal disease but also the burden and character of atherosclerotic plaque within the vessel. The development of intracoronary imaging modalities, namely intravascular ultrasound (IVUS) and optical coherence tomography (OCT), has progressed quickly and these technologies now have established roles in the diagnosis and treatment of coronary artery disease. In general, intracoronary devices that can assess the coronary endothelium use either acoustic or optical signals that are received by a coronary catheter (IVUS uses ultrasound, OCT uses near-infrared light).This review addresses these two widely used intracoronary imaging techniques, looking at their clinical applications, recent evidence for their use and describes new developments in the field. Intravascular UltrasoundIn the last 25 years IVUS has been established as the most commonly used intracoronary imaging device. An IVUS system consists of a flexible monorail catheter with an ultrasound transducer at its tip that emits ultrasound waves in the 10-40 MHz range and an electronics console to reconstruct the image (see Figure 1).1 After reflection from tissue, part of the ultrasound energy returns to the transducer and is converted into the image.There are two types of IVUS transducers for clinical use: the mechanical rotating transducer and the electronically switched phased array system.The mechanical transducer uses a single crystal on a rotational device, which visualises the entire vessel in cross-section providing better image quality (compared with phased array technology) of 100-150 μm.2 The main disadvantage of mechanical transducers is the central drive shaft that decreases flexibility and prevents the concurrent use of a central guidewire.3 However, newer rotational IVUS catheters have developed a monorail system that allows for the presence of a central guidewire.Phased array catheters use multiple transducer elements, which are mounted along the circumference of the catheter tip. Each element sends and receives ultrasounds from a sector and multiple sectors are gathered to produce a cross-sectional image of the artery. However, they are disadvantaged by a technically complex set-up, requiring detailed programming; 3 but some of the newer catheters are easier to set up.Intracoronary imaging of coronary vessels by IVUS is performed using standard coronary interventional techniques and equipment (guiding catheter and 0.014 inch angioplasty guidewire) for catheter delivery along the guidewire beyond the target lesion/area of interest. Intravenous heparin and glyceryl trinitrate (nitroglycerin) are routinely administered before imaging. The IVUS catheter is then drawn back across the tar...

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Section: Vessel Sizingmentioning

confidence: 99%

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Rathod¹,

Hamshere²,

Jones³

et al. 2015

Interventional Cardiology Review

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“…Our results about the relationship between inflation pressure and outer diameter of the occlusion balloon indicate that balloon inflation pressures of 0.3-0.5 atm can completely arrest proximal blood flow in these arteries. Yamaguchi et al (10) found that the mean occlusion balloon pressure for intracoronary OCT imaging was 0.4±0.1 atm, whereas Chen (12) found that this pressure was 0.51±0.07 atm.…”

Section: Discussionmentioning

confidence: 99%

Optical coherence tomography in imaging of peripheral pulmonary arteries

Hong¹,

Zhong²,

Liu³

et al. 2017

J. Thorac. Dis.

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Background: To establish an optical coherence tomography (OCT)-based method for imaging peripheral pulmonary arteries. Methods:We recruited eight patients (five men; average age, 48±12 years; peripheral pulmonary artery thrombosis, three patients; idiopathic pulmonary hypertension, three patients; interstitial lung disease, and September 2010. OCT was performed using both the conventional OCT imaging method (COI) and the improved pulmonary artery imaging method (IPI). In the IPI, contrast agent was used as an indicator of balloon inflation meanwhile increases in flushing speed of the replacement fluid. The percentage of optimal images, inflation pressure, flushing speeds and complications were compared between the two methods.Results: We performed OCT of 33 vessel segments by both methods. IPI produced more optimal images than COI (88% vs. 24%). Mean inflation pressure and flushing speed were higher during IPI than COI (0.62±0.15 vs. 0.43±0.08 atm; 1 atm =101.3 kPa; 0.82±0.10 vs. 0.42±0.06 mL/s; both P<0.01). Decreased blood oxygen saturation (SaO2) was associated with 9% and 30% segments (P<0.01) in the COI (mean decrease, 8.4%±3.6%) and IPI groups (mean decrease, 12.1%±5.3%; P<0.05) respectively. SaO2 recovered to pre-imaging levels after oxygen inhalation.Conclusions: IPI is safe and effective for OCT of peripheral pulmonary arteries.

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“…Yamaguchi et al also demonstrated that 87.8% of OCT images of the vessel border at a minimum lumen site were poor as a result of low penetration. 20 If OCT-guided-PCI is performed, the restenosis rate might be high, especially with bare metal stents because OCT is not suitable for measuring vessel size or selecting a large stent size. Now that drug-eluting stents are available, however, the restenosis rate after stent implantation has been dramatically reduced, even in small vessels and for long lesions, [21][22][23] and the major concern of post-DES implantation is now late-stent thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Factors That Influence Measurements and Accurate Evaluation of Stent Apposition by Optical Coherence Tomography Assessment Using a Phantom Model

Sawada

Shite

Negi

et al. 2009

Circ J

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Background: Factors influencing measurements and accurate evaluation of stent apposition by optical coherence tomography (OCT) are not established. Methods and Results: Phantom models of known luminal sizes and lengths were evaluated by OCT under various conditions and measurements were compared with actual values. Stents implanted into phantom models were examined by OCT to validate the measurement point on the stent strut surface for accurate evaluation of stent apposition. Strut thickness was measured at 3 points (midpoint, inner and outer surfaces of the stent shadow). The precision of OCT measurements of lumen diameter and area was satisfactory when the image wire was positioned in the center, but the error and deviation were unsatisfactory when the image wire was positioned eccentrically using a low frame acquisition rate. Longitudinal OCT measurements were close to actual values under all conditions examined. Measurements from the midpoint of the stent shadow to the adjacent vessel wall surface coincided with actual stent thickness. Conclusions: Significant measurement error can occur if the image wire is positioned eccentrically with a lower frame acquisition rate than specified by the manufacturer. To accurately evaluate stent apposition, the stent surface should be measured from the center of the stent reflection. (Circ J 2009; 73: 1841 -1847

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Safety and Feasibility of an Intravascular Optical Coherence Tomography Image Wire System in the Clinical Setting

Cited by 149 publications

References 16 publications

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

Optical coherence tomography in imaging of peripheral pulmonary arteries

Factors That Influence Measurements and Accurate Evaluation of Stent Apposition by Optical Coherence Tomography Assessment Using a Phantom Model

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