Frequency-Domain Optical Coherence Tomography Assessment of Human Carotid Atherosclerosis Using Saline Flush for Blood Clearance without Balloon Occlusion

Abstract

SUMMARY 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. ABBREVIATIONS:FD ϭ frequency-domain; OCT ϭ optical coherence tomography; TD ϭ time-domain

Intravascular Frequency-Domain Optical Coherence Tomography Assessment of Carotid Artery Disease in Symptomatic and Asymptomatic Patients

“…First, it is the only observational study to date that explores the morphological differences between recently symptomatic and asymptomatic carotid plaque using OCT. Second, the study suggests that the described technique, by offering the highest image resolution of any intravascular imaging technique available, even without any special technique accommodation for balloon occlusion or, in some cases, contrast use (26), can reliably and safely identify complicated or vulnerable plaque in the carotid arteries.…”

“…In each case, the delivered guidewires were used to advance a 2.7-F Dragonfly imaging catheter (St. Jude Medical, St. Paul, Minnesota) into the carotid artery under study. Images were calibrated by adjustment of the Z-offset and automated pullbacks covering 54 mm of the vessel at 20 mm/s were then obtained (26). During image acquisition, blood was displaced by hand injection of undiluted contrast (25 ml of iodixanol 320 over a 5-s period using a 30-ml syringe) in 46 patients or hand injection of a heparinized saline solution (50 ml over a 5-s period using a 60-ml syringe) in the remaining 7 patients.…”

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.…”

New Frontiers in the Feasibility of Optical Coherence Tomography in Carotid Arteries

“…In this issue of the American Journal of Neuroradiology, Given et al 4 document the benefits of a new OCT system using a nonocclusive technique in the carotid artery. The authors should be congratulated on discovering this new protocol, which does not need iodinated contrast or balloon occlusion to obtain a bloodfree environment.…”

“…Plaque prolapse through the cell stent has been suggested as one of the major causes of postprocedural complications after CAS, 5,6 and OCT images can accurately recognize microdetails of the interaction between carotid plaque and stent. After Given et al 4 have proved that OCT imaging can be safely, easily, and efficiently applied to carotid arteries, future studies are now expected to investigate the relationship between carotid plaques and stents with regard to stent design and plaque composition.…”