Slide 1Optical
Coherence
Tomography
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What is OCT?
Optical Coherence Tomography (OCT) is an optical imaging modality that uses near-infrared light to create high-resolution images of tissue microstructure. Blood needs to be displaced from the target segment for imaging.
Key Features: Micrometer-level resolution (15 microns)
Sub-surface imaging
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Occlusion-free Dragonfly
DragonflyTM
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Intravascular OCT
Flexible fiber-optic with distal lens used for light delivery
Fiber-optic rotates inside 2.7F catheter to create image frames
High-speed 54mm pullback (20mm/s) by imaging lens to map vessel segment
Pure contrast flushed along lumen to create imaging window
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CONFIDENTIAL: For internal use only
PCI Optimization and stent follow-up
Lesion assessment - extent of disease (i.e. length; proximal and distal reference points – stent sizing, luminal or media-to-media, geographic placement)
Plaque morphology
Identifying dissections & intimal tears
Data on file at LLI
CONFIDENTIAL: For internal use only
Intima
Media
Adventitia
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Drs Grube, Buellesfeld, Guerkens, Mueller, Helios Heart Center, Siegburg, Germany.
Guide flush, 12 mL contrast; 100 f/s; 15 mm/s pullback
Normal, Mild Intimal Thickening
Fibrous Tissue
Disrupted Neo Intima
OCT Imaging of Plaques …
Fibrofatty
Macrophages
Roughly in order from easiest to hardest to identify with OCT…
Data on file at LLI
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Calcium
Ring of calcium
Protrusive calcified plaque, or “calcific nodule”
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White Thrombus
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Calcium with white thrombus, and dissection
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White thrombus
Red Thrombus
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Thick cap fibroatheroma
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Drs Grube, Buellesfeld, Guerkens, Mueller, Helios Heart Center, Siegburg, Germany.
Guide flush, 12 mL contrast; 100 f/s; 15 mm/s pullback
Lipid Pool
Metallic stent struts
Stent overlap
Strut malapposition
Malapposition at stent-edge
Coronary dissection
Stent
Dissection
Dissection/false lumen
Dissection flap/ex-false lumen