Abstract 1: Optical Coherence Tomography Imaging in Acute Ischemic Stroke: Preliminary Animal and Human Results

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Christopher Pasarikovski ◽  
Julia Keith ◽  
Leodante daCosta ◽  
Joel Ramjist ◽  
Yuta Dobashi ◽  
...  
Keyword(s):  
Animal Model ◽  
Optical Coherence Tomography ◽  
Mr Imaging ◽  
Real Time ◽  
Endothelial Injury ◽  
Basilar Artery Occlusion ◽  
Complete Revascularization ◽  
Optical Coherence ◽  
Oct Imaging ◽  
Residual Thrombus

Background: Studies evaluating endothelial injury after EVT have been done by means of retrieved human thrombus, MR vessel-wall imaging, and animal histopathologic studies. These techniques have limitations, as MR imaging has insufficient spatial resolution to directly visualize endothelium, and histopathologic examinations are ex-vivo and unable to provide real-time patterns of injury. Objective: Endovascular imaging after EVT using optical coherence tomography (OCT) to examine for vessel injury in real-time. Methodology: Three swine weighing 35-40kg were selected for the animal model. Autologous venous whole-blood was used to create thrombus. A second-generation stent retriever was used for EVT. Next, three consecutive patients with basilar artery occlusion underwent EVT and endovascular OCT imaging. Results: In the animal model, revascularization and OCT imaging was successful for all 9 vessels. Endothelial injury was observed in 4/9 (44%) of vessels, and residual thrombus was observed in 4/9 (44%) of vessels despite complete angiographic revascularization. All vessels undergoing EVT after 6 hours had evidence of endothelial injury, and 2/3 (66%) had residual thrombus. Two basilar stroke patients (2/3) 66% had significant residual thrombus despite complete angiographic revascularization. The residual thrombus was also not visible on CT angiography or MR imaging done within 24 hours of EVT. Conclusions: Endothelial injury and residual thrombus despite complete revascularization is present after EVT and can be observed in real-time using OCT. It is possible that the longer occlusive thrombus is present, the more endothelial injury will occur during EVT.

scholarly journals Optical Coherence Tomography Imaging in Acute Ischemic Stroke: Preliminary Animal and Human Results

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Christopher R Pasarikovski ◽  
Leo da Costa ◽  
Joel Ramjist ◽  
Yuta Dobashi ◽  
Victor Xiao Dong Yang
Keyword(s):  
Animal Model ◽  
Optical Coherence Tomography ◽  
Real Time ◽  
Endothelial Injury ◽  
Basilar Artery Occlusion ◽  
Complete Revascularization ◽  
Optical Coherence ◽  
Stroke Patients ◽  
Oct Imaging ◽  
Residual Thrombus

Abstract INTRODUCTION Studies evaluating endothelial injury after endovascular thrombectomy (EVT) have been done by means of retrieved human thrombus, magnetic resonance (MR) vessel-wall imaging, and animal histopathologic studies. These techniques have limitations, as MR imaging has insufficient spatial resolution to directly visualize endothelium, and histopathologic examinations are ex vivo and unable to provide real-time patterns of injury. The aim of the current study is intraluminal imaging after EVT using optical coherence tomography (OCT). We describe our animal model for thrombus preparation, vessel occlusion, mechanical thrombectomy, and subsequent endovascular OCT imaging. Furthermore, we describe the first human endovascular OCT imaging after EVT in 2 stroke patients. METHODS A total of 3 swine weighing 35 to 40 kg were selected for the animal model. Autologous venous whole blood drawn 48 h before the procedure was used to create thrombus. The bilateral superficial cervical arteries and right internal thoracic artery were used for occlusion given their diameters of 2 to 3 mm and 3 to 4 mm, respectively. A second-generation stent retriever was used for EVT. Thrombi were retrieved after 1, 3, and 6 h with subsequent intraluminal OCT imaging. Next, 2 consecutive patients with basilar artery occlusion underwent EVT and endovascular OCT imaging. RESULTS In the animal model, revascularization and OCT imaging was successful for all 9 vessels. Endothelial injury was observed in 4/9 (44%) of vessels, and residual thrombus was observed in 4/9 (44%) of vessels despite complete revascularization. All vessels undergoing EVT after 6 h had evidence of endothelial injury, and 2/3 (66%) had residual thrombus. Both basilar stroke patients had significant residual thrombus despite complete angiographic revascularization. CONCLUSION Endothelial injury and residual thrombus despite complete revascularization is present after EVT and can be observed in real time using intravascular OCT. It is possible that the longer occlusive thrombus is present, the more endothelial injury will occur during EVT.

Optical coherence tomography imaging after endovascular thrombectomy for basilar artery occlusion: report of 3 cases

2020 ◽  
Vol 133 (4) ◽  
pp. 1141-1146 ◽  
Author(s):  
Christopher R. Pasarikovski ◽  
Joel Ramjist ◽  
Leodante da Costa ◽  
Sandra E. Black ◽  
Victor Yang
Keyword(s):  
Optical Coherence Tomography ◽  
Real Time ◽  
Basilar Artery ◽  
Vessel Wall ◽  
Artery Occlusion ◽  
Endothelial Injury ◽  
Basilar Artery Occlusion ◽  
Optical Coherence ◽  
Endovascular Thrombectomy ◽  
Residual Thrombus

Studies evaluating individuals for endothelial injury after endovascular thrombectomy (EVT) have been done by means of retrieved human thrombus, MR vessel-wall imaging, and animal histopathological studies. These techniques have limitations, because MR imaging has insufficient spatial resolution to directly visualize endothelium, and histopathological examinations are performed ex vivo and are unable to provide real-time patterns of injury. The purpose of the current study was to obtain in vivo intraluminal imaging after EVT by using optical coherence tomography (OCT), examining for evidence of endothelial injury in real time.Three consecutive patients with acute basilar artery occlusion underwent OCT imaging immediately after EVT. There were no complications and adequate images were obtained for all patients. Anatomical features of the vessel wall were discernible, including intima, media, adventitia, and internal/external elastic lamina. Basilar artery thick concentric plaque fibrosis was present, causing outward remodeling and loss of the internal/external lamina in certain regions. Evidence of significant residual thrombus was also visible, with mostly red thrombus present despite complete angiographic revascularization. The residual thrombus was not visible on CT, MR, or cerebral angiography and could certainly cause ongoing function-limiting strokes with occlusion of adjacent vital basilar perforators after EVT.

scholarly journals Real-time volumetric optical coherence tomography OCT imaging with a surgical microscope

2010 ◽  
Vol 2 (S1) ◽  
Author(s):  
Gereon Hüttmann ◽  
Joachim Probst ◽  
Tino Just ◽  
Hans Pau ◽  
Stefan Oelckers ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Real Time ◽  
Optical Coherence ◽  
Surgical Microscope ◽  
Oct Imaging

Blood Vessel Density Measured Using Dynamic Optical Coherence Tomography is a Tool for Wound Healers

2021 ◽  
pp. 153473462110173
Author(s):  
Rajgopal Mani ◽  
Jon Holmes ◽  
Kittipan Rerkasem ◽  
Nikolaos Papanas
Keyword(s):  
Blood Flow ◽  
Optical Coherence Tomography ◽  
Blood Vessel ◽  
Chronic Wounds ◽  
Vessel Density ◽  
Optical Coherence ◽  
Skin Microcirculation ◽  
Wound Edge ◽  
Venous Ulcers ◽  
Oct Imaging

Dynamic optical coherence tomography (D-OCT) is a relatively new technique that may be used to study the substructures in the retina, in the skin and its microcirculation. Furthermore, D-OCT is a validated method of imaging blood flow in skin microcirculation. The skin around venous and mixed arterio-venous ulcers was imaged and found to have tortuous vessels assumed to be angiogenic sprouts, and classified as dots, blobs, coils, clumps, lines, and curves. When these images were analyzed and measurements of vessel density were made, it was observed that the prevalence of coils and clumps in wound borders was significantly greater compared with those at wound centers. This reinforced the belief of inward growth of vessels from wound edge toward wound center which, in turn, reposed confidence in following the wound edge to study healing. D-OCT imaging permits the structure and the function of the microcirculation to be imaged, and vessel density measured. This offers a new vista of skin microcirculation and using it, to better understand angiogenesis in chronic wounds.

Feasibility and Clinical Utility of Ultra-Widefield–Navigated Swept-Source Optical Coherence Tomography Imaging

2021 ◽  
pp. 247412642199733
Author(s):  
Kyle D. Kovacs ◽  
M. Abdallah Mahrous ◽  
Luis Gonzalez ◽  
Benjamin E. Botsford ◽  
Tamara L. Lenis ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Clinical Utility ◽  
Clinical Decision Making ◽  
Imaging System ◽  
Imaging Modality ◽  
Case Series ◽  
Subretinal Fluid ◽  
Optical Coherence ◽  
Swept Source ◽  
Oct Imaging

Purpose: This work aims to evaluate the clinical utility and feasibility of a novel scanning laser ophthalmoscope-based navigated ultra-widefield swept-source optical coherence tomography (UWF SS-OCT) imaging system. Methods: A retrospective, single-center, consecutive case series evaluated patients between September 2019 and October 2020 with UWF SS-OCT (modified Optos P200TxE, Optos PLC) as part of routine retinal care. The logistics of image acquisition, interpretability of images captured, nature of the peripheral abnormality, and clinical utility in management decisions were recorded. Results: Eighty-two eyes from 72 patients were included. Patients were aged 59.4 ± 17.1 years (range, 8-87 years). During imaging, 4.4 series of images were obtained in 4.1 minutes, with 86.4% of the image series deemed to be diagnostic of the peripheral pathology on blinded image review. The most common pathologic findings were chorioretinal scars (18 eyes). In 31 (38%) eyes, these images were meaningful in supporting clinical decision-making with definitive findings. Diagnoses imaged included retinal detachment combined with retinoschisis, retinal hole with overlying vitreous traction and subretinal fluid, vitreous inflammation overlying a peripheral scar, Coats disease, and peripheral retinal traction in sickle cell retinopathy. Conclusions: Navigated UWF SS-OCT imaging was clinically practical and provided high-quality characterization of peripheral retinal lesions for all eyes. Images directly contributed to management plans, including laser, injection or surgical treatment, for a clinically meaningful set of patients (38%). Future studies are needed to further assess the value of this imaging modality and its role in diagnosing, monitoring, and treating peripheral lesions.

scholarly journals Optical Coherence Tomography of Peri-Ocular Skin Cancers: An Optical Biopsy

2020 ◽  
pp. 1-9
Author(s):  
Sabrina Bergeron ◽  
Bryan Arthurs ◽  
Debra-Meghan Sanft ◽  
Christina Mastromonaco ◽  
Miguel N. Burnier Jr.
Keyword(s):  
Squamous Cell Carcinoma ◽  
Optical Coherence Tomography ◽  
Basal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Basal Cell ◽  
Skin Lesions ◽  
Sebaceous Carcinoma ◽  
Optical Coherence ◽  
Oct Imaging

<b><i>Introduction:</i></b> Optical coherence tomography (OCT) imaging has been used as a diagnostic tool for retinal disease for several years, and OCT apparatuses are becoming increasingly powerful. However, OCT has yet to reach its full potential in ophthalmology clinics. Alike retinal layers, it has been shown that OCT is able to generate cross-sectional images of the skin and allows visualization of skin lesions in a histopathology-like manner. <b><i>Objective:</i></b> We aim to validate OCT as an imaging modality for peri-ocular skin cancer. Through a series of cases, we highlight findings for 3 common eyelid malignancies: basal cell carcinoma, squamous cell carcinoma and sebaceous carcinoma. We propose an OCT image-based signature for basal cell carcinoma. <b><i>Methods:</i></b> This is a prospective study. Fifty-eight lesions suspicious of malignancy from 57 patients were subjected to OCT imaging prior to the surgical excision of the lesion. OCT images were analysed and scored according to previously identified OCT features. Eight representative examples are presented, highlighting the OCT patterns for each malignancy side by side to its corresponding histopathological sections. <b><i>Results:</i></b> Out of the 58 lesions analysed, 53 were malignant. A loss of the dermal-epidermal junction is observed in all malignant lesions. A strong link is observed between the presence of subepithelial hyporeflective nests on OCT and the diagnosis of basal cell carcinoma (present in 83% of cases). Conversely, lesions of epithelial origin such as squamous cell carcinoma are most often represented on OCT by acanthosis. Two supplementary cases, one basal cell carcinoma and one sebaceous carcinoma, are provided to illustrate how OCT imaging is a valuable tool in cases where clinical observations may be unusual. <b><i>Conclusions:</i></b> We provide evidence supporting the use of OCT for the evaluation of peri-ocular cancers. OCT enables visualization of the skin layers in vivo, before biopsy. Our results show that certain OCT features can contribute to include or exclude a diagnosis of basal cell carcinoma. By integrating this non-invasive imaging methodology into the routine assessment of peri-ocular skin lesions, especially in health care centres where access to specialists is limited, OCT imaging can increase clinical precision, reduce delays in patient referral and enhance patient care.

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.

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