Abstract

We report clinical study results of three-dimensional (3D) <i>in vivo</i> imaging of human coronary arteries using frequency domain optical coherence tomography (FD-OCT). At the time of this report, over 2000 patients in over 10 countries have been imaged using FD-OCT systems and disposable fiberoptic catheters developed by LightLab Imaging Inc. The first commercial versions of the systems were introduced in Europe in May 2009. The system operates at 50,000 axial lines/s, performing a 50 mm spiral pullback in 2.5 seconds with a rotational frame rate of 100 Hz. The commercial system employs a proprietary micro-cavity swept laser, allowing imaging of vessel diameters up to 10 mm. Data compiled from early studies indicate that FD-OCT is being used for post-intervention imaging of deployed coronary stents in over 40% of cases. High-resolution 3D imaging of stent geometry immediately following deployment enables detection of stent malapposition, which can increase the risk of thrombosis. Longer term follow-up imaging of stented vessels can detect thrombus formation, which can be treated pharmacologically, and excessive neointimal growth, which may require angioplasty or re-stenting. FD-OCT is also being used for pre-intervention imaging of stenotic lesions in about 60% of cases. Here FD-OCT is used to measure the minimum lumen area and to identify calcified deposits, side branches, or other vascular structures that could interfere with the stenting procedure. Overall, FD-OCT continues to be adopted at an increasing rate and has provided interventional cardiologists with a powerful tool for pre- and postintervention assessment of the coronary arteries.

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