Visualization of the Human Intracranial Vasa Vasorum In Vivo Using Optical Coherence Tomography

Long, Li; Dmytriw, Adam A; Krings, Timo; Feng, Yiding

doi:10.1001/jamaneurol.2020.0546

Cited by 8 publications

(9 citation statements)

References 4 publications

(4 reference statements)

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“…Finally, the authors comment that only contrast agentenhanced MRI and DSA are feasible modalities for observing intracranial VV. Our article work on a similar topic was published in 2020 and readily reveals firstorder VV (9). Using a higher resolution (10 μm) imaging modality, optical coherence tomography, we reported in vivo visualization of the human native intracranial arterial VV and intraplaque neovasculature, as well subsequently this year of neointimal VV with the same technology (10).…”

mentioning

confidence: 73%

Response to: effect of vasa vasorum in cerebrovascular compensation: 2 case reports

Li¹,

Dmytriw²

2021

Ann Transl Med

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mentioning

confidence: 73%

Response to: effect of vasa vasorum in cerebrovascular compensation: 2 case reports

Li¹,

Dmytriw²

2021

Ann Transl Med

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“…A thrombus was defined as a mass (≥250 μm) attached to the luminal surface or floating within the lumen ( Jang et al, 2005 ; Tearney et al, 2012 ). Microvessels or neovascularization was defined as signal-voiding tubular structures (50–300 μm) present on at least three consecutive cross-sectional frames ( Takano et al, 2009 ; Prati et al, 2010 ; Li et al, 2020 ). Dissection was defined as the presence of an intimomedial flap producing a double-lumen or an intramural hematoma formation ( Alfonso et al, 2012 ).…”

Section: Methodsmentioning

confidence: 99%

Optical Coherence Tomography Evaluation of Carotid Artery Stenosis and Stenting in Patients With Previous Cervical Radiotherapy

Huang

Shi

et al. 2022

Front. Neurosci.

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ObjectivesCervical radiotherapy can lead to accelerated carotid artery stenosis, increased incidence of stroke, and a higher rate of in-stent restenosis in irradiated patients. Our objective was to reveal the morphological characteristics of radiation-induced carotid stenosis (RICS) and the stent–vessel interactions in patients with previous cervical radiotherapy by optical coherence tomography (OCT).Materials and MethodsBetween November 2017 and March 2019, five patients with a history of cervical radiotherapy were diagnosed with severe carotid artery stenosis and underwent carotid artery stenting (CAS). OCT was conducted before and immediately after the carotid stent implantation. Two patients received OCT evaluation of carotid stenting at 6- or 13-month follow-up.ResultsThe tumor types indicating cervical radiotherapy were nasopharyngeal carcinoma (n = 3), cervical esophageal carcinoma (n = 1), and cervical lymphoma (n = 1). The median interval from the radiotherapy to the diagnosis of RICS was 8 years (range 4–36 years). Lesion characteristics of RICS were detected with heterogeneous signal-rich tissue, dissection, and advanced atherosclerosis upon OCT evaluation. Post-interventional OCT revealed 18.2–57.1% tissue protrusion and 3.3–13.8% stent strut malapposition. Follow-up OCT detected homogeneous signal-rich neointima and signal-poor regions around stent struts. In the patient with high rates of tissue protrusion and stent strut malapposition, the 6-month neointima burden reached 48.9% and microvessels were detected.ConclusionThe morphological features of RICS were heterogeneous, including heterogeneous signal-rich tissue, dissection, and advanced atherosclerosis. Stenting was successful in all 5 patients with severe RICS. One patient, with high rates of tissue protrusion and stent strut malapposition immediately after stenting, received in-stent neointimal hyperplasia at a 6-month follow-up.

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“…Neovascularization was defined as signal-absent holes within a plaque between 50 and 300 μm in diameter, and visible for at least three consecutive frames on pullback imaging. 10 Cholesterol crystals were defined as thin linear structures with high signal and low signal attenuation. 12 OCT and histology co-registration A total of 12,982 histopathology slides were obtained, and image matching was achieved by one OCT investigator and one pathology investigator.…”

Section: Oct Image Analysismentioning

confidence: 99%

“…Optical coherence tomography (OCT), a real-time intravascular imaging technique with ultra-high resolution, can assist in assessing the microarchitecture of vessels, including vasa vasorum, cholesterol crystals, erosion, and more. [10][11][12] In the last decade, studies performed by OCT have allowed us to shed new light on the pathologic substrate of cerebrovascular disease. [13][14][15] What's more, MC could be visible on OCT images as signal-rich, distinct, or confluent punctate regions that exceed the intensity of background speckle noise.…”

Section: Introductionmentioning

confidence: 99%

Heavy macrophage infiltration identified by optical coherence tomography relates to plaque rupture

Shi,

Tao,

Wang

et al. 2023

Ann Clin Transl Neurol

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ObjectiveRisk stratification plays a critical role in patients with asymptomatic carotid atherosclerotic stenosis. Heavy macrophage infiltration (HMC) is an important factor of plaque destabilization. However, in vivo imaging technologies and screening criteria for HMC remain limited. We aimed to (i) introduce algorithms for in vivo detection of macrophage infiltrations using optical coherence tomography (OCT) and (ii) to investigate the threshold of HMC and its association with plaque vulnerability.MethodsEx vivo OCT images were co‐registered with histopathology in 282 cross‐sectional pairs from 19 carotid endarterectomy specimens. Of these, 197 randomly selected pairs were employed to define the parameters, and the remaining 85 pairs were used to evaluate the accuracy of the OCT‐based algorithm in detecting macrophage infiltrations. Clinical analysis included 93 patients receiving carotid OCT evaluation. The prevalence and burden of macrophage infiltration were analyzed. Multivariable and subgroup analysis were performed to investigate the association between HMC and plaque rupture.ResultsThe sensitivity and specificity of algorithm for detecting macrophage infiltration were 88.0% and 74.9%, respectively. Of 93 clinical patients, ruptured plaques exhibited higher prevalence of macrophage infiltration than nonruptured plaques (83.7% [36/43] vs 32.0% [16/50], p < 0.001). HMC was identified when the macrophage index was greater than 60.2 (sensitivity = 74.4%, specificity = 84.0%). Multivariable analysis showed that HMC and multiple calcification were independent risk factors for non‐lipid‐rich plaque rupture.InterpretationThis study provides a novel approach and screening criteria for HMC, which might be valuable for atherosclerotic risk stratification.

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Visualization of the Human Intracranial Vasa Vasorum In Vivo Using Optical Coherence Tomography

Cited by 8 publications

References 4 publications

Response to: effect of vasa vasorum in cerebrovascular compensation: 2 case reports

Response to: effect of vasa vasorum in cerebrovascular compensation: 2 case reports

Optical Coherence Tomography Evaluation of Carotid Artery Stenosis and Stenting in Patients With Previous Cervical Radiotherapy

Heavy macrophage infiltration identified by optical coherence tomography relates to plaque rupture

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