Frequency-domain optical coherence tomography assessment of very late vascular response after carotid stent implantation

Abstract

Intravascular optical coherence tomography is a high-resolution invasive imaging modality that allows the evaluation of vascular responses after stent implantation in a micron-scale level. We describe for the first time two patients with very late vascular response after carotid artery stenting that exhibit two different patterns of low-signal intensity (LSI), "ill-appearing" neointima: the first patient shows layered LSI neointima leading to stent restenosis, coupled with the presence of intraluminal thrombus, whereas the second patient demonstrates another pattern of non-restenotic LSI stent strut coverage, suggestive of lipid laden neointima (ie, "neoatherosclerosis"), recently associated with stent failure in coronary arteries.

Collar Sign in Incompletely Occluded Aneurysms after Pipeline Embolization: Evaluation with Angiography and Optical Coherence Tomography

“…An OCT acquisition over 2.7 seconds was done during power injection of contrast to trigger the internalized automated "pull-back" method that renders catheter manipulation unnecessary during image acquisition and to transiently clear red blood cells from the imaging area. 5,6 Image processing and data analysis were done using a commercially available OCT system (Ilumien System; St. Jude Medical).…”

Optical coherence tomography of traumatic aneurysms of the internal carotid artery: report of 2 cases

“…6 Others have applied the technology for in vivo assessment of arteriosclerosis and stent-artery interactions in the carotid artery. 1,5,9,17 As compared with intravascular ultrasonography, OCT appears to be superior in the detection of intraluminal thrombi and neovascularization in carotid artery plaques, 17 and has proven useful in the evaluation of an intraluminal thrombus in a patient with symptomatic ICA stenosis who underwent carotid endarterectomy instead of carotid stenting in light of this finding. 16 This report details the use of OCT in 2 patients with saccular traumatic aneurysms of the ICA in an attempt to further elucidate the pathophysiology of these lesions.…”

“…1 and 2). 1 Image processing and data analysis were performed using a commercially available OCT system (Ilumien System, LightLab Imaging Inc., St. Jude Medical). The use of OCT as an adjunct to DSA was performed with Institutional Review Board approval.…”

Comparison between Preoperative Optical Coherence Tomography Findings of Carotid Artery Stenosis and Pathological Specimen of Removed Carotid Plaque: Case Report

“…OCT has been used to characterize plaque in coronary intervention, and it has recently been applied for the characterization of carotid plaque. [1][2][3][4][5][6][7][8][9][10][11] However, few studies have compared OCT findings with findings from histopathologic examination of carotid plaques.…”