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.

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 Coherence tomography with broad bandwidth extreme ultraviolet and soft X-ray radiation

2021 ◽  
Vol 127 (4) ◽  
Author(s):  
S. Skruszewicz ◽  
S. Fuchs ◽  
J. J. Abel ◽  
J. Nathanael ◽  
J. Reinhard ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Near Infrared ◽  
Extreme Ultraviolet ◽  
Infrared Light ◽  
Imaging Method ◽  
Optical Coherence ◽  
Axial Resolution ◽  
Cross Sectional ◽  
X Ray ◽  
Broad Bandwidth

AbstractWe present an overview of recent results on optical coherence tomography with the use of extreme ultraviolet and soft X-ray radiation (XCT). XCT is a cross-sectional imaging method that has emerged as a derivative of optical coherence tomography (OCT). In contrast to OCT, which typically uses near-infrared light, XCT utilizes broad bandwidth extreme ultraviolet (XUV) and soft X-ray (SXR) radiation (Fuchs et al in Sci Rep 6:20658, 2016). As in OCT, XCT’s axial resolution only scales with the coherence length of the light source. Thus, an axial resolution down to the nanometer range can be achieved. This is an improvement of up to three orders of magnitude in comparison to OCT. XCT measures the reflected spectrum in a common-path interferometric setup to retrieve the axial structure of nanometer-sized samples. The technique has been demonstrated with broad bandwidth XUV/SXR radiation from synchrotron facilities and recently with compact laboratory-based laser-driven sources. Axial resolutions down to 2.2 nm have been achieved experimentally. XCT has potential applications in three-dimensional imaging of silicon-based semiconductors, lithography masks, and layered structures like XUV mirrors and solar cells.

Optical coherence tomography for elucidation of flow-diversion phenomena: The concept of endothelized mural thrombus behind reversible in-stent stenosis in flow-diverters

2021 ◽  
pp. 159101992110034
Author(s):  
Andre Monteiro ◽  
Demetrius K Lopes ◽  
Amin Aghaebrahim ◽  
Ricardo Hanel
Keyword(s):  
Optical Coherence Tomography ◽  
Intracranial Aneurysms ◽  
Flow Diversion ◽  
Optical Coherence ◽  
Recurrence Rates ◽  
Oct Imaging ◽  
Intravascular Optical Coherence Tomography ◽  
Stenotic Area ◽  
Flow Diverters ◽  
Stent Stenosis

Purpose Flow-diverters have revolutionized the endovascular treatment of intracranial aneurysms, offering a durable solution to aneurysms with high recurrence rates after conventional stent-assisted coiling. Events that occur after treatment with flow-diversion, such as in-stent stenosis (ISS) are not well understood and require further assessment. After assessing an animal model with Optical Coherence Tomography (OCT), we propose a concept that could explain the mechanism causing reversible ISS after treatment of intracranial aneurysms with flow-diverters. Methods Six Pipeline Flex embolization devices (PED-Flex), six PED with Shield technology (PED-Shield), and four Solitaire AB devices were implanted in the carotid arteries (two stents per vessel) of four pigs. Intravascular optical coherence tomography (OCT) and digital subtraction angiography (DSA) images obtained on day 21 were compared to histological specimens. Results A case of ISS in a PED-Flex device was assessed with OCT imaging. Neointima with asymmetrical topography completely covering the PED struts was observed. Histological preparations of the stenotic area demonstrated thrombus on the surface of device struts, covered by neointima. Conclusion This study provides a plausible concept for reversible ISS in flow-diverters. Based on an observation of a previous experiment, we propose that similar cases of ISS are related to thrombus presence underneath endothelization, but further experiments focused on this phenomenon are needed. Optical Coherence Tomography will be useful tool when available for clinical use.

scholarly journals Synthetic polarization-sensitive optical coherence tomography by deep learning

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Yi Sun ◽  
Jianfeng Wang ◽  
Jindou Shi ◽  
Stephen A. Boppart
Keyword(s):  
Optical Coherence Tomography ◽  
Deep Learning ◽  
Imaging System ◽  
Imaging Modality ◽  
Similarity Index ◽  
Polarization Sensitivity ◽  
Imaging Method ◽  
Optical Coherence ◽  
The Real ◽  
Oct Imaging

AbstractPolarization-sensitive optical coherence tomography (PS-OCT) is a high-resolution label-free optical biomedical imaging modality that is sensitive to the microstructural architecture in tissue that gives rise to form birefringence, such as collagen or muscle fibers. To enable polarization sensitivity in an OCT system, however, requires additional hardware and complexity. We developed a deep-learning method to synthesize PS-OCT images by training a generative adversarial network (GAN) on OCT intensity and PS-OCT images. The synthesis accuracy was first evaluated by the structural similarity index (SSIM) between the synthetic and real PS-OCT images. Furthermore, the effectiveness of the computational PS-OCT images was validated by separately training two image classifiers using the real and synthetic PS-OCT images for cancer/normal classification. The similar classification results of the two trained classifiers demonstrate that the predicted PS-OCT images can be potentially used interchangeably in cancer diagnosis applications. In addition, we applied the trained GAN models on OCT images collected from a separate OCT imaging system, and the synthetic PS-OCT images correlate well with the real PS-OCT image collected from the same sample sites using the PS-OCT imaging system. This computational PS-OCT imaging method has the potential to reduce the cost, complexity, and need for hardware-based PS-OCT imaging systems.

scholarly journals Functional Monitoring after Trabeculectomy or XEN Microstent Implantation Using Spectral Domain Optical Coherence Tomography and Visual Field Indices—A Retrospective Comparative Cohort Study

Biology ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 273
Author(s):  
Marc Schargus ◽  
Catharina Busch ◽  
Matus Rehak ◽  
Jie Meng ◽  
Manuela Schmidt ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Cohort Study ◽  
Visual Field ◽  
Spectral Domain ◽  
Optical Coherence ◽  
Treatment Groups ◽  
Rnfl Thickness ◽  
Comparative Cohort Study ◽  
The Mean ◽  
All Treatment

The aim of this study was to compare the efficacy of trabeculectomy (TE), single XEN microstent implantation (solo XEN) or combined XEN implantation and cataract surgery (combined XEN) in primary open-angle glaucoma cases, naïve to prior surgical treatment, using a monocentric retrospective comparative cohort study. Intraocular pressure (IOP) and the number of IOP-lowering drugs (Meds) were monitored during the first 24 months after surgery. Further disease progression was monitored using peripapillary retinal nerve fiber layer (RNFL) thickness examinations using spectral domain optical coherence tomography (OCT) as well as visual acuity (VA) and visual field (VF) tests. In the TE group (52 eyes), the mean IOP decreased from 24.9 ± 5.9 to 13.9 ± 4.2 mmHg (p < 0.001) and Meds decreased from 3.2 ± 1.2 to 0.5 ± 1.1 (p < 0.001). In the solo XEN (38 eyes) and the combined XEN groups, the mean IOP decreased from 24.1 ± 4.7 to 15.7 ± 3.0 mmHg (p < 0.001) and 25.4 ± 5.6 to 14.7 ± 3.2 mmHg (p < 0.001), while Meds decreased from 3.3 ± 0.8 to 0.8 ± 1.2 (p < 0.001) and 2.7 ± 1.2 to 0.4 ± 1.0 (p < 0.001), respectively. The VF and VA indices showed no sign of further deterioration, the RNFL thickness further decreased in all treatment groups after surgery. TE and XEN led to comparable reductions in IOP and Meds. Although the VA and VF indices remained unaltered, the RNFL thickness continuously decreased in all treatment groups during the 24-month follow-up.

Abstract 3322: Chronic Vascular Responses To Sirolimus-eluting Stent Compared With Bare-metal Stent In Diabetic Patients: Evaluated By Optical Coherence Tomography.

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Takashi Kubo ◽  
Toshio Imanishi ◽  
Hiroki Matsumoto ◽  
Manabu Kashiwagi ◽  
Hiroto Tsujioka ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Neointimal Hyperplasia ◽  
Bare Metal Stent ◽  
Diabetic Patients ◽  
Imaging Method ◽  
Bare Metal ◽  
Optical Coherence ◽  
Metal Stent ◽  
Cross Sectional ◽  
Sirolimus Eluting Stent

OBJECTIVE: An optical coherence tomography (OCT) study was performed to compre the vascular response to sirolimus-eluting stent (SES) with bare-metal stent (BMS) in patients with diabetic mellitus (DM). BACKGROUND: Despite advances in the medical treatment and revascularization procedures, coronary artery disease remains a leading cause of morbidity and mortality in patients with DM. Few retrospective subgroup analyses of pivotal clinical trials have suggested that SES may be effective for reduction of restenosis in diabetic patients. OCT is a new intravascular imaging method with a high resolution of approximately 10 micrometer and allows us to evaluate instent neointimal hyperplasia (NIH) in vivo. METHODS and RESULTS: Serial OCT analyses were performed in 60 lesions (SES in DM patients=19; SES in non-DM patients=14; BMS in DM patients=10; BMS in non-DM patients=17) at 9-month follow-up. A total of 6920 stent struts were visualized by OCT and NIH thickness inside each strut and incidence of exposed stnet struts were evaluated in cross-sectional image. The NIH thickness was significantly different among 4 groups (97 +/− 100 vs. 43 +/− 61 vs. 425 +/− 206 vs. 209 +/− 138 micrometer, respectively). The NIH thickness of SES in DM was significantly thicker than that of SES in non-DM (p<0.001), although it was significantly thinner than that of BMS in DM (p<0.001) or BMS in non-DM (p<0.001). All struts of BMS were covered by neointima, but 14% of struts of SES were exposed. The incidence of exposed struts and exposed struts with inadequate apposition in DES were significantly lower in DM compared with those in non-DM (5% vs. 34%, p<0.0001; 2% vs. 5%, p <0.001, respectively). Moreover, the frequency of DES with partially exposed strut was significantly lower in DM than non-DM (32% vs. 71%, p<0.027). CONCLUSION: The present OCT study revealed that DES inhibited the NIH effectively with low incidence of exposed stent strut in DM patients at 9-month after implantation.

Optical Coherence Tomography Angiography in Retinal Diseases

2017 ◽  
pp. 69-74
Keyword(s):  
Optical Coherence Tomography ◽  
Contrast Agent ◽  
Optical Coherence Tomography Angiography ◽  
Imaging Method ◽  
Retinal Diseases ◽  
Optical Coherence ◽  
Vascular Networks ◽  
Motion Contrast ◽  
Choroidal Vasculature

Optical coherence tomography angiography (OCTA) is a new imaging method providing the assessment of retinal and choroidal vasculature without a contrast agent. In this angiography type, the vascular networks have been visualized in detail though detecting motion contrast of erythrocytes in the vessel, using serial optical coherence tomography B-scans. Currently, OCTA findings of many retinal diseases have been reported.

scholarly journals Micro-Heterogeneity of Flow in a Mouse Model of Chronic Cerebral Hypoperfusion Revealed by Longitudinal Doppler Optical Coherence Tomography and Angiography

2015 ◽  
Vol 35 (10) ◽  
pp. 1552-1560 ◽  
Author(s):  
Vivek J Srinivasan ◽  
Esther Yu ◽  
Harsha Radhakrishnan ◽  
Anil Can ◽  
Mihail Climov ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Capillary Density ◽  
Chronic Cerebral Hypoperfusion ◽  
Cerebral Hypoperfusion ◽  
Oct Angiography ◽  
Imaging Method ◽  
Optical Coherence ◽  
Doppler Optical Coherence Tomography ◽  
Longitudinal Imaging

Although microvascular dysfunction accompanies cognitive decline in aging, vascular dementia, and Alzheimer's disease, tools to study microvasculature longitudinally in vivo are lacking. Here, we use Doppler optical coherence tomography (OCT) and angiography for noninvasive, longitudinal imaging of mice with chronic cerebral hypoperfusion for up to 1 month. In particular, we optimized the OCT angiography method to selectively image red blood cell (RBC)-perfused capillaries, leading to a novel way of assessing capillary supply heterogeneity in vivo. After bilateral common carotid artery stenosis (BCAS), cortical blood flow measured by Doppler OCT dropped to half of baseline throughout the imaged tissue acutely. Microscopic imaging of the capillary bed with OCT angiography further revealed local heterogeneities in cortical flow supply during hypoperfusion. The number of RBC-perfused capillaries decreased, leading to increased oxygen diffusion distances in the days immediately after BCAS. Linear regression showed that RBC-perfused capillary density declined by 0.3% for a drop in flow of 1 mL/100 g per minute, and decreases in RBC-perfused capillary density as high as 25% were observed. Taken together, these results demonstrate the existence of local supply heterogeneity at the capillary level even at nonischemic global flow levels, and demonstrate a novel imaging method to assess this heterogeneity.

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.

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