Selection of Flow-Diverter Stent Models Using Optical Coherence Tomography and Mathematical Modeling of Hemodynamics

2018 ◽  
Vol 51 (6) ◽  
pp. 381-384 ◽  
Author(s):  
S. V. Frolov ◽  
A. Yu. Potlov ◽  
S. V. Sindeev
Keyword(s):  
Mathematical Modeling ◽  
Optical Coherence Tomography ◽  
Flow Diverter ◽  
Optical Coherence ◽  
Flow Diverter Stent ◽  
Selection Of

scholarly journals Intravascular optical coherence tomography (OCT) as an additional tool for the assessment of stent structures

2015 ◽  
Vol 1 (1) ◽  
pp. 257-260 ◽  
Author(s):  
Thomas Hoffmann ◽  
Axel Boese ◽  
Sylvia Glaßer ◽  
Martin Skalej ◽  
Oliver Beuing
Keyword(s):  
Optical Coherence Tomography ◽  
Flow Diverter ◽  
Structural Defects ◽  
Optical Coherence ◽  
Vascular Stent ◽  
X Ray ◽  
Additional Tool ◽  
Imaging Tool ◽  
Intravascular Optical Coherence Tomography ◽  
Therapy And Diagnosis

AbstractEvaluation of the vascular stent position, shape and correct expansion has a high relevance in therapy and diagnosis. Hence, the wall apposition in vessel areas with differing diameters and the appearance of torsions or structural defects of the implant body caused by catheter based device dropping are of special interest. Neurovascular implants like braided flow diverter and laser cut stents consist of metal struts and wires with diameters of about 40 µm. Depending on the implants material composition, visibility is poor with conventional 2D X-ray fluoroscopic and radiographic imaging. The metal structures of the implants also lead to artifacts in 3D X-ray images and can hamper the assessment of the device position. We investigated intravascular optical coherence tomography (OCT) as a new imaging tool for the evaluation of the vascular stent position, its shape and its correct expansion for 3 different vascular implants.

External elastic lamina vs. luminal diameter measurement for determining stent diameter by optical coherence tomography: an ILUMIEN III substudy

2020 ◽  
Author(s):  
Evan Shlofmitz ◽  
Allen Jeremias ◽  
Yasir Parviz ◽  
Keyvan Karimi Galougahi ◽  
Björn Redfors ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Correction Factor ◽  
Vessel Diameter ◽  
Optical Coherence ◽  
Diameter Measurement ◽  
Luminal Diameter ◽  
Stent Diameter ◽  
Vessel Diameter Measurement ◽  
Elastic Lamina ◽  
Selection Of

Abstract Aims Optical coherence tomography (OCT)-guided external elastic lamina (EEL)-based stent sizing is safe and as effective as intravascular ultrasound in achieving post-procedural lumen dimensions. However, when compared with automated lumen diameter (LD) measurements, this approach is time-consuming. We aimed to compare vessel diameter measurements and stent diameter selection using either of these approaches and examined whether applying a correction factor to automated LD measurements could result in selecting similar stent diameters to the EEL-based approach. Methods and results We retrospectively compared EEL-based measurements vs. automated LD in reference segments in 154 OCT acquisitions and derived a correction factor for stent sizing using the ratio of EEL to LD measurements. We then prospectively applied the correction factor in 119 OCT acquisitions. EEL could be adequately identified in 100 acquisitions (84%) at the distal reference to allow vessel diameter measurement. Vessel diameters were larger with EEL-based vs. LD measurements at both proximal (4.12 ± 0.74 vs. 3.14 ± 0.67 mm, P < 0.0001) and distal reference segments (3.34 ± 0.75 vs. 2.64 ± 0.65 mm, P < 0.0001). EEL-based downsizing led to selection of larger stents vs. an LD-based upsizing approach (3.33 ± 0.47 vs. 2.70 ± 0.44, P < 0.0001). Application of correction factors to LD [proximal 1.32 (IQR 1.23–1.37) and distal 1.25 (IQR 1.19–1.36)] resulted in discordance in stent sizing by >0.25 mm in 63% and potentially hazardous stent oversizing in 41% of cases. Conclusion EEL-based stent downsizing led to selection of larger stent diameters vs. LD upsizing. While applying a correction factor to automated LD measurements resulted in similar mean diameters to EEL-based measurements, this approach cannot be used clinically due to frequent and potentially hazardous stent over-sizing.

scholarly journals Instant Stent-Accentuated Three-Dimensional Optical Coherence Tomography Guided Selection of Proper Distal Cell for Side Branch Dilatation in Bifurcation Stenting

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Fumiaki Nakao
Keyword(s):  
Optical Coherence Tomography ◽  
Three Dimensional ◽  
Side Branch ◽  
Optical Coherence ◽  
Two Dimensional ◽  
Bifurcation Stenting ◽  
Distal Cell ◽  
Selection Of

In the bifurcation stenting, the distal rewiring for the side branch postdilatation confirmed by two-dimensional modalities may not lead to favorable results in some cases. If there are two distal cells divided by the link bridging from the carina, the rewiring through the larger distal cell may be recommended for the side branch postdilatation. Detailed confirmation of the rewired cell by the intraprocedural instant stent-accentuated three-dimensional optical coherence tomography is important.

Accuracy of optical coherence tomography imaging in assessing aneurysmal remnants after flow diversion

2020 ◽  
pp. neurintsurg-2020-016129 ◽  
Author(s):  
Frederik Fries ◽  
Alexander Maßmann ◽  
Toshiki Tomori ◽  
Umut Yilmaz ◽  
Michael Kettner ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Flow Diverter ◽  
Diagnostic Tools ◽  
Imaging Method ◽  
Optical Coherence ◽  
Conventional Angiography ◽  
Device Implantation ◽  
Optical Coherence Tomography Imaging ◽  
Stent Lumen

BackgroundOptical coherence tomography (OCT) is an ultra-high resolution real-time intravascular imaging method that is gaining interest in cerebrovascular applications.ObjectiveTo compare, in a rabbit elastase aneurysm model, digital subtraction angiography (DSA) and OCT as diagnostic tools for the assessment of aneurysmal remnants and baseline characteristics of aneurysms after flow diverter (FD) implantation.MethodsWith Institutional Animal Care and Use Committee approval, saccular aneurysms were created in 28 rabbits and treated with Derivo FDs. DSA was performed before, and immediately after, stent implantation. As a follow-up, DSA and OCT were performed 28 days after device implantation.ResultsDSA and OCT were successfully performed in 23 cases. OCT could not be achieved in 5 cases owing to navigational difficulties in the stent lumen with the OCT catheter. Residual aneurysms were significantly more often visible with OCT (18/23 (78%) than with DSA 12/23 (52%), p = 0.031).ConclusionOCT was more sensitive than conventional angiography for the assessment of residual aneurysms at 28 days after FD implantation in an animal model.

scholarly journals Case Report: Combination of Pressure Guidewire and Optical Coherence Tomography-Guided Drug-Coated Balloon Revascularization for Renal Artery Fibromuscular Dysplasia

2022 ◽  
Vol 8 ◽  
Author(s):  
Yuxi Li ◽  
Xinyan Wen ◽  
Bo Zheng ◽  
Ming Chen ◽  
Wei Ma ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Renovascular Hypertension ◽  
Fibromuscular Dysplasia ◽  
Optical Coherence ◽  
Fractional Flow ◽  
Flow Reserve ◽  
Drug Coated Balloon ◽  
Selection Of

Fibromuscular dysplasia (FMD) is the second common cause of renovascular hypertension. With the advent of endovascular therapy, angiography has become a diagnostic gold standard for FMD. Optical coherence tomography (OCT) by reflecting in vivo histology may improve diagnostic and classification accuracy. Renal fractional flow reserve (rFFR), measured by pressure guidewire, may distinguish the patients who may benefit from revascularization by identifying physiologically significant stenoses. However, the role of usage of both OCT and rFFR is not well-studied. We herein report a 17-year-old male with renovascular hypertension due to FMD. Angioplasty of drug-coated balloon (DCB) guided by OCT and FFR favorably achieved blood pressure (BP) control. In conclusion, the utility of both OCT and FFR may be useful for the appropriate selection of patients with renal FMD.

Improved selection of cortical ovarian strips for autotransplantation of ovarian tissue using full-field optical coherence tomography (FFOCT)

2016 ◽  
Author(s):  
Paulien L. Stegehuis ◽  
Inge T. A. Peters ◽  
Jeroen Eggermont ◽  
Peter J. K. Kuppen ◽  
J. Baptist Trimbos ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Ovarian Tissue ◽  
Optical Coherence ◽  
Full Field ◽  
Selection Of

Communicating malapposition of flow diverters assessed with optical coherence tomography correlates with delayed aneurysm occlusion

2017 ◽  
Vol 10 (7) ◽  
pp. 693-697 ◽  
Author(s):  
Robert M King ◽  
Olivia W Brooks ◽  
Erin T Langan ◽  
Jildaz Caroff ◽  
Frédéric Clarençon ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Positive Outcome ◽  
Flow Diverter ◽  
Fisher Exact Test ◽  
Imaging Method ◽  
Optical Coherence ◽  
Exact Test ◽  
Treatment Groups ◽  
Potential Factor ◽  
Flow Diverters

BackgroundOptical coherence tomography (OCT) is a high resolution intravascular imaging method that allows visualization of flow diverter struts and the vessel wall. In this study, malapposition of the flow diverter that continues into the neck of the aneurysm, named communicating malapposition (CM), was investigated as a potential factor for delayed aneurysm healing.Methods40 New Zealand White rabbits underwent elastase induced aneurysm creation, and were subsequently assigned to one of four treatment groups based on flow diverter type and administration of antiplatelet therapy. All animals underwent post device deployment balloon angioplasty and subsequent OCT to assess device/vessel apposition. The incidence of CM seen on OCT was assessed with a binary scoring system: 0–CM present; 1–CM absent. At 30 days, DSA was acquired to assess aneurysm healing. Aneurysm healing on terminal DSA was measured using a previously developed 5 point scale, with a score of 3 or 4 considered a positive outcome.ResultsAll animals were grouped into a single cohort for analysis as no difference in the rate of CM or healing was seen in the four treatment groups. Significant interaction between the absence of CM and a positive outcome was confirmed by Fisher exact test (P=0.0034). Angioplasty was shown to treat 33% of the cases of CM seen at implant, and these treated cases overwhelmingly had a positive outcome (P<0.001).ConclusionThe use of OCT to assess CM of flow diverters has been shown to be predictive of the 30 day healing rate of an animal model of aneurysms.

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