Comprehensive data visualization for high resolution endovascular carotid arterial wall imaging

Kyle H Y Cheng,Cuiru Sun,Walter J Montanera,Brian Courtney,Victor X D Yand,Beau Standish,Juan P Cruz,Aman Thind,Thomas R Marotta,Julian Spears

doi:10.32920/14640006.v1

Abstract

Carotid angioplasty and stenting is a minimally invasive endovascular procedure that may benefit from in vivo high resolution imaging for monitoring the physical placement of the stent and potential complications. The purpose of this pilot study was to evaluate the ability of optical coherence tomography to construct high resolution 2D and 3D images of stenting in porcine carotid artery. Four Yorkshire pigs were anaesthetized and catheterized. A state-of-the-art optical coherence tomography (OCT) system and an automated injector were used to obtain both healthy and stented porcine carotid artery images. Data obtained were then processed for visualization. The state-of-the-art OCT system was able to capture high resolution images of both healthy and stented carotid arteries. High quality 3D images of healthy and stented carotid arteries were constructed, clearly depicting vessel wall morphological features, stent apposition and thrombus formation over the inserted stent. The results demonstrate that OCT can be used to generate high quality 3D images of carotid arterial stents for accurate diagnosis of stent apposition and complications under appropriate imaging conditions

Highlights

Atherosclerosis is a disease where atheroma is deposited within the vessel wall
Our study reported in this paper was in part to define blood clearing technique to improve optical coherence tomography (OCT) imaging
Normal carotid artery imaging was optimized at ∼6 cc∕s contrast/saline injection rate at a pullback speed of ∼5 mm∕s

Summary

Introduction

Atherosclerosis is a disease where atheroma is deposited within the vessel wall. The atheroma is composed of variable amounts of macrophages, lipids, fibrous tissue and calcium. Depending on the composition of the lesion, the American heart Association has classified atherosclerosis from I to VI, with V and VI being considered to be high-risk lesions.[1–3]. Carotid artery atherosclerosis is an important cause of ischemic stroke.[4,5]. Patients with symptomatic high grade carotid stenosis benefit from revascularization.[6,7]. Treatment modalities include surgical intervention, such as the resection of diseased tissue called carotid endarterectomy (CEA) or endovascular treatment such as carotid angioplasty and stenting (CAS).[8] Depending on the composition of the lesion, the American heart Association has classified atherosclerosis from I to VI, with V and VI being considered to be high-risk lesions.[1–3] Carotid artery atherosclerosis is an important cause of ischemic stroke.[4,5] Patients with symptomatic high grade carotid stenosis benefit from revascularization.[6,7] Treatment modalities include surgical intervention, such as the resection of diseased tissue called carotid endarterectomy (CEA) or endovascular treatment such as carotid angioplasty and stenting (CAS).[8]

Methods

Results

Discussion

Conclusion