Advances in IVUS/OCT and Future Clinical Perspective of Novel Hybrid Catheter System in Coronary Imaging

Abstract

Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have been developed and improved as both diagnostic and guidance tools for interventional procedures over the past three decades. IVUS has a resolution of 100 µm with a high tissue penetration and capability of assessing the entire structure of a coronary artery including the external elastic membrane, whereas OCT has a higher resolution of 10-20 µm to assess endoluminal structures with a limited tissue penetration compared to IVUS. Recently, two companies, CONAVI and TERUMO, integrated IVUS and OCT into a single catheter system. With their inherent strength and limitations, the combined IVUS and OCT probes are complementary and work synergistically to enable a comprehensive depiction of coronary artery. In this review, we summarize the performance of the two intracoronary imaging modalities-IVUS and OCT-and discuss the expected potential of the novel hybrid IVUS-OCT catheter system in the clinical field.

Intracoronary optical coherence tomography: state of the art and future directions

“…Numerous other established companies and start-ups have released products or are in the process of entering the market, including Argus, Avinger, Canon, Conavi Medical, Dyad Medical, Forssman Medical, Gentuity, Horimed, InnerMedical, OCT Medical Incorporated, SpectraWave, and Vivolight, amongst several others. Novasight Hybrid™ (Conavi Medical Inc., Toronto, Canada) and Dual Sensor (Terumo) are the available OCT/IVUS hybrid catheter systems that are in use for research purposes, with the potential to provide the combined strengths of OCT and IVUS in a single catheter in clinical practice 8 .…”

“…Some features of vulnerable plaques, such as intraplaque haemorrhage, are not readily identifiable on OCT alone. Future studies are warranted to establish whether OCT alone or in combination with other imaging modalities 82 , such as hybrid IVUS/ OCT 8 , near-infrared autofluorescence to detect necrotic core 83 or intraplaque haemorrhage 84 , or near-infrared spectroscopy to detect lipid (Supplementary Figure 12), will have clinical impact.…”

Mechanically Rotating Intravascular Ultrasound (IVUS) Transducer: A Review

“…Thus, more than one imaging modality has been integrated into the IVUS images. For example, IVUS/intravascular optical coherence tomography (IV-OCT) [184][185][186][187][188][189] and IVUS/near-infrared spectroscopy (NIRS) [190][191][192][193][194] are currently available for practical use, and IVUS images with near-infrared fluorescence (NIRF) [195][196][197][198][199], fluorescence lifetime imaging (FLIm) [200][201][202][203][204], and intravascular photoacoustic (IVPA) [123,[205][206][207][208] have been investigated at the laboratory level. These combinations can complement the drawbacks of each imaging modality while providing more clinical information.…”

Molecular Imaging and Non-molecular Imaging of Atherosclerotic Plaque Thrombosis

“…Li et al ( 38 ) designed a miniature integrated OCT-IVUS probe wherein an OCT lens and an IVUS transducer were placed back-to-back within a catheter, thus enabling confocal OCT-IVUS imaging in concert with an enhanced ultrasound transducer and a powerful graphical processing unit. Their resultant OCT-IVUS imaging system was able to capture images at 72 fps, enabling the visualization of 7 cm of the artery in 4 s. Recently developed multimodal intravascular imaging approaches including OCT-IVUS, multi-frequency IVUS, IVUS-NIRF, IVUS-IVPA, IVUS-FLIM/TRFS, and OCT-IVUS Fluorescence thus represent powerful approaches to improving image resolution and penetration depth, thereby aiding in the diagnosis of thrombosis in atherosclerosis patients ( 39 ). Future research has the potential to further improve IVUS imaging speeds and to unify OCT and IVUS technologies.…”