Intravascular Ultrasound Is an Effective Tool for Predicting Histopathology-Confirmed Evidence of Adventitial Injury Following Directional Atherectomy for the Treatment of Peripheral Artery Disease

Ramanathan, Krishnan; Tarricone, Arthur; Ali, Ziad A.; Purushothaman, K-Raman; Overbey, Jessica; Vasquez, Miguel; Wiley, Jose; Kapur, Vishal; Gujja, Karthik; Atallah, Richard T; Nasiadko, Katarzyna; Kini, Annapoorna; Sharma, Samin K.

doi:10.1177/1526602816647364

Cited by 7 publications

(4 citation statements)

References 16 publications

(18 reference statements)

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“…In a similar manner, IVUS imaging prior to and following vascular procedures have been reported to differentiate plaque morphology, assist in stent and balloon sizing, and identification of procedure-related injuries, such as dissection [4,54,55], which result in improved clinical outcomes. IVUS-directed percutaneous coronary interventions has been demonstrated to have lower incidence of stent thrombosis [56], while use of IVUS in peripheral vessels can monitor treatment efficacy in realtime, which is associated with lower target lesion revascularization rates up to one year post-procedure [5,49].…”

Section: Discussionmentioning

confidence: 99%

A post-market, multi-vessel evaluation of the imaging of peripheral arteries for diagnostic purposeS comparing optical Coherence tomogrApy and iNtravascular ultrasound imaging (SCAN)

Pavillard

Sewall

2020

BMC Med Imaging

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Background: Intravascular imaging plays an important part in diagnosis of vascular conditions and providing insight for treatment strategy. Two main imaging modalities are intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The objective of this study was to prove non-inferiority of OCT imaging to IVUS images in matched segments of peripheral vessels in patients with suspected peripheral vascular disease. Methods: The SCAN study was a prospective, non-inferiority clinical study of matched IVUS and OCT images collected along defined segments of peripheral vessels from twelve subjects (mean age 68 ± 10.3 years; 10 men) displaying symptoms of vascular disease. Luminal diameters were measured by both imaging systems at the distal, middle, and proximal points of the defined segments. Three blinded interventional radiologists evaluated the quality of both imaging modalities in identifying layered structures (3-point grading), plaque (5-point grading), calcification (5-point grading), stent structure (3-point grading), and artifacts (3-point grading) from 240 randomly ordered images. Mean grading scores and luminal diameters were calculated and analyzed with Student's t-Test and Mann-Whitney-Wilcoxon testing. Intrareader reproducibility was calculated by intraclass correlation (ICC) analysis. Results: The mean scoring of plaque, calcification, and vascular stent struts by the three readers was significant better in terms of image quality for OCT than IVUS (p < 0.001, p = 0.001, p = 0.004, respectively). The mean scores of vessel wall component visibility and artifacts generated by the two imaging systems were not significantly different (p = 0.19, p = 0.07, respectively). Mean vessel luminal diameter and area at three specific locations within the vessels were not significantly different between the two imaging modalities. No patient injury, adverse effect or device malfunction were noted during the study. Conclusions: Imaging by OCT provides the physician with better visualization of some vessel and plaque chacteristics, but both IVUS and OCT imaging are safe and effective methods of examining peripheral vessels in order to perform diagnostic assessment of peripheral vessels and provide information necessary for the treatment strategy of peripheral artery disease. Trial registration: NCT03480685 registered on 29 March 2018.

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Section: Discussionmentioning

confidence: 99%

A post-market, multi-vessel evaluation of the imaging of peripheral arteries for diagnostic purposeS comparing optical Coherence tomogrApy and iNtravascular ultrasound imaging (SCAN)

Pavillard

Sewall

2020

BMC Med Imaging

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“…In a similar manner, IVUS imaging prior to and following vascular procedures have been reported to differentiate plaque morphology, assist in stent and balloon sizing, and identification of procedurerelated injuries, such as dissection [4,54,55], which result in improved clinical outcomes. IVUSdirected percutaneous coronary interventions has been demonstrated to have lower incidence of stent thrombosis [56], while use of IVUS in peripheral vessels can monitor treatment efficacy in realtime, which is associated with lower target lesion revascularization rates up to one year postprocedure [5,49].…”

Section: Discussionmentioning

confidence: 99%

A Post-market, Multi-vessel Evaluation of the Imaging of Peripheral Arteries for Diagnostic PurposeS Comparing Optical Coherence TomogrAphy and INtravascular Ultrasound Imaging (SCAN)

Pavillard

Sewell

2020

Preprint

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Background: Intravascular imaging plays an important part in diagnosis of vascular conditions and providing insight for treatment strategy. Two main imaging modalities are intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The objective of this study was to prove non-inferiority of OCT imaging to IVUS images in matched segments of peripheral vessels in patients with suspected peripheral vascular disease. Methods: The SCAN study was a prospective, non-inferiority clinical study of matched IVUS and OCT images collected along defined segments of peripheral vessels from twelve subjects (mean age 68 10.3 years; 10 men) displaying symptoms of vascular disease. Luminal diameters were measured by both imaging systems at the distal, middle, and proximal points of the defined segments. Three blinded interventional radiologists evaluated the quality of both imaging modalities in identifying lMann-Whitney-Wilcoxon testing. Intrareader reproducibility was calculated by intraclass correlation (ICC) analysis. Results: The mean scoringof plaque, calcification, and vascular stent struts by the three readers was significant better in terms of image quality for OCT than IVUS (p<0.001, p=0.001, p=0.004, respectively). The mean scores of vessel wall component visibility and artifacts generated by the two imaging systems were not significantly different (p=0.19, p=0.07, respectively). Mean vessel luminal diameter and area at three specific locations within the vessels were not significantly different between the two imaging modalities. No patient injury, adverse effect or device malfunction were noted during thestudy. Conclusions: Imaging byOCT provides the physician with better visualization of some vessel and plaque chacteristics, but both IVUS and OCT imaging are safe and effective methods of examining peripheral vessels in order to perform diagnostic assessment of peripheral vessels and provide information necessary for the treatment strategy of peripheral artery disease.

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“…Adjunctive IVUS imaging allows for greater understanding of lesion morphology, residual stenosis, adventitial injury and results in improved primary patency. [15][16][17][18] The use of IVUS in the coronary vasculature has been shown to increase luminal diameter by allowing for more accurate sizing of the vessel and thereby allowing for larger balloons to significantly improve luminal diameter without increasing dissection. 19 Aggressive debulking has been previously postulated to delay re-intervention for these femoropopliteal in-stent restenosis patients.…”

Section: Discussionmentioning

confidence: 99%

Intravascular ultrasound guided directional atherectomy versus directional atherectomy guided by angiography for the treatment of femoropopliteal in-stent restenosis

Ramanathan

Tarricone

Purushothaman

et al. 2017

Therapeutic Advances in Cardiovascular Disease

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Intravascular Ultrasound Is an Effective Tool for Predicting Histopathology-Confirmed Evidence of Adventitial Injury Following Directional Atherectomy for the Treatment of Peripheral Artery Disease

Cited by 7 publications

References 16 publications

A post-market, multi-vessel evaluation of the imaging of peripheral arteries for diagnostic purposeS comparing optical Coherence tomogrApy and iNtravascular ultrasound imaging (SCAN)

A post-market, multi-vessel evaluation of the imaging of peripheral arteries for diagnostic purposeS comparing optical Coherence tomogrApy and iNtravascular ultrasound imaging (SCAN)

A Post-market, Multi-vessel Evaluation of the Imaging of Peripheral Arteries for Diagnostic PurposeS Comparing Optical Coherence TomogrAphy and INtravascular Ultrasound Imaging (SCAN)

Intravascular ultrasound guided directional atherectomy versus directional atherectomy guided by angiography for the treatment of femoropopliteal in-stent restenosis

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