Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention
First generation drug-eluting stents (DES) are associated with reduced in-stent restenosis but significant increased risk of very late stent thrombosis (VLST). The absence of polymer in DES systems may reduce the occurrence of VLST. Optic coherence tomography (OCT) has been used for stent analysis as a surrogate safety endpoint. This study aimed to assess the long-term follow up of strut apposition and tissue coverage of BioMatrix™ DES by OCT. 20 patients undergoing BioMatrix™ DES (n = 15) or S-Stent™ BMS (n = 5) implantation were followed for at least 5 years and evaluated by quantitative coronary angiography, intravascular ultrasound, and OCT. The ...
FD-OCT is a new imaging technique that allows unprecedented in vivo microlevel assessment of human carotid plaque morphologic patterns and stent-vessel interactions. Prior reports describing the use of this technique have used balloon occlusion of the target vessel or iodinated contrast media to facilitate imaging. We report, for the first time, in vivo FD-OCT imaging of human carotid arteries without the use of iodinated contrast material or balloon occlusion techniques.
Objectives: To investigate safety and feasibility of imaging unprotected left main (ULM) using frequency-domain optical coherence tomography (FD-OCT) compared with intravascular ultrasound (IVUS). Background: IVUS has been used to assess and guide percutaneous coronary intervention (PCI) of ULM disease. FD-OCT offers 10-fold higher axial resolution than IVUS and its high-speed image acquisition obviates the need for proximal balloon occlusion. Methods: We prospectively enrolled 35 consecutive patients with ULM disease. FD-OCT and IVUS assessments were attempted pre- and post-PCI and compared in regards to safety, ability to image the region of interest (ROI), number of pullbacks, volume of contrast and ability ...
Cardiovascular disease is the leading cause of death worldwide. Stent implantation by means of percutaneous coronary intervention is the most common coronary revascularization procedure. Intravascular Optical Coherence Tomography (iOCT) is the only imaging modality with the resolution and contrast necessary to enable accurate measurements of luminal architecture and neointima stent coverage. Manual analysis of intravascular OCT pullbacks is time consuming, limiting the size and number of studies that can be performed. We developed a highly automated method for detecting stent struts and measuring tissue coverage. Candidate struts were first identified using image processing techniques. We trained a bagged decision trees ...
Abstract: Background. Novel vascular scaffolds aim at equipoise between safety and efficacy. Intravascular optical coherence tomography (OCT) allows in-vivo serial assessment of stent-vessel interactions with high resolution and frequent sampling and may complement histology assessment. We investigated the vascular response to a novel absorbable coating sirolimus-eluting stent (AC-SES) by means of serial OCT and histology evaluation in a porcine model. Methods. One AC-SES and one bare-metal stent (BMS) were implanted in separate coronary arteries of three Yucatan mini-swine. Serial OCT was performed post procedure and at 3-, 28-, 90-, and 180-day follow-up. Normalized optical density (NOD) was used for the ...
Intravascular optical coherence tomography (iOCT) is being used to assess viability of new coronary artery stent designs. We developed a highly automated method for detecting stent struts and measuring tissue coverage. We trained a bagged decision trees classifier to classify candidate struts using features extracted from the images. With 12 best features identified by forward selection, recall (precision) were 90%–94% (85%–90%). Including struts deemed insufficiently bright for manual analysis, precision improved to 94%. Strut detection statistics approached variability of manual analysis. Differences between manual and automatic area measurements were 0.12 ± 0.20 mm 2 and 0.11 ...
Introduction This document is complementary to an Expert Review Document on Optical Coherence Tomography (OCT) for the study of coronary arteries and atherosclerosis.1 The goal of this companion manuscript is to provide a practical guide framework for the appropriate use and reporting of the novel frequency domain (FD) OCT imaging to guide interventional procedures, with a particular interest on the comparison with intravascular ultrasound (IVUS).1–4 Technique for optical coherence tomography imaging In the OCT Expert Review Document on Atherosclerosis, a comprehensive description of the physical principles for OCT imaging and time domain (TD) catheters (St Jude Medical ...
The rupture of thin-cap fibroatheroma accounts for most acute coronary events. Optical Coherence Tomography (OCT) allows quantification of fibrous cap (FC) thickness in vivo. Conventional manual analysis, by visually determining the thinnest part of the FC is subject to inter-observer variability and does not capture the 3-D morphology of the FC. We propose and validate a computer-aided method that allows volumetric analysis of FC. The radial FC boundary is semi-automatically segmented using a dynamic programming algorithm. The thickness at every point of the FC boundary, along with 3-D morphology of the FC, can be quantified. The method was validated against ...
Marco Costa, MD, is Director of the Heart Vascular Institute University Hospitals Case Medical Center.
I walk into hearts of people without much visualization...When I first saw this, I was like, ‘Oh my God, this is unbelievable. It's like walking into a different world.In New stent treatment shows doctors have a heart
LightLab's C7-XR FD-OCT image resolution is extraordinary, but what is most fascinating about this technology is its ease of use and extremely fast image acquisition...These features will enable optimization of drug-eluting stent procedures with unprecedented accuracy, potentially reducing the number of stents placed per patient by ensuring appropriate disease assessment and targeting. The physician armed with OCT will have the ability to see the lumen vividly from the inside giving us incredible information and the ability to treat sub-optimal results while the patient is still in the cath lab.In LightLab Imaging Announces FDA Clearance of C7-XR™ Coronary OCT Products in the United States
Cardiologists have long been searching for imaging tools to enhance our understanding of vascular disease and guide optimal PCI and other coronary therapeutic strategies...The LightLab's C7-XR™ imaging system is the first non-occlusive optical intravascular imaging system already available in Europe and Asia. Many have focused on the eye catching micron-level vascular images, but "ease-of-use" and speed at > 100 frames/sec are the key features of this imaging tool that will revolutionize the way real-world interventionalists approach coronary artery disease.In LightLab Highlights OCT Market Leadership at the Society for Cardiovascular Angiography and Interventions