scholarly journals White Thrombosis on Optical Coherence Tomography after Rotational Atherectomy of Severely Coronary Calcified Lesions

2021 ◽  
Author(s):  
Cheng-fu CAO ◽  
Yu-liang MA ◽  
Qi LI ◽  
Jian LIU ◽  
Hong ZHAO ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Platelet Activation ◽  
Stent Implantation ◽  
Average Length ◽  
Pearson Correlation ◽  
Rotational Atherectomy ◽  
Control Group ◽  
Optical Coherence ◽  
No Reflow ◽  
Oct Imaging

Abstract Purpose Rotational atherectomy (RA) has improved percutaneous treatment of severe coronary calcified lesions, but the "no-reflow" phenomenon remains a serious complication. Platelet activation by RA may contribute to the no-reflow, we use optical coherence tomography (OCT) to test the effect of RA on white thrombosis that could confirm platelet activation indirectly. Methods We analyzed 53 consecutive patients with coronary angiographic severe calcified lesions. All the patients were examined by OCT. Twenty patients received RA and OCT imaging performed before and after RA and stent implantation. The remaining patients were as a control group and OCT imaging performed before balloon dilatation and after stent implantation. Results The patients were older and higher incidence of Diabetes mellitus in the RA group. In the control group, there was no thrombogenesis during the procedure, but in the RA group, all the target vessels had white thrombosis on OCT after RA. The average number of white thrombus per lesion after RA was 7.23 ± 4.4, and the average length of every white thrombus was 0.51 ± 0.33mm. In Pearson Correlation Analysis, Thrombotic load was related with burr size (r = 0.575, P = 0.040) and rotation number (r = 0.599, P = 0.031). Conclusions White thrombosis during RA is proved by OCT in vivo. Treating calcified lesions with RA may enhance thrombogenesis. These data suggest using a proper therapy to avoid no-reflow during RA.

scholarly journals White Thrombosis on Optical Coherence Tomography after Rotational Atherectomy of Severely Coronary Calcified Lesions

2020 ◽  
Author(s):  
Cheng-fu CAO ◽  
Yu-liang MA ◽  
Qi LI ◽  
Jian LIU ◽  
Hong ZHAO ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Platelet Activation ◽  
Stent Implantation ◽  
Rotational Atherectomy ◽  
Control Group ◽  
Optical Coherence ◽  
Burr Size ◽  
No Reflow ◽  
The Mean ◽  
Oct Imaging

Abstract Background: Rotational atherectomy (RA) has improved percutaneous treatment of severe coronary calcified lesions, but the "no-reflow" phenomenon remains a serious complication. Platelet activation by RA may contribute to the no-reflow, we use optical coherence tomography (OCT) to test the effect of RA on white thrombosis that could confirm platelet activation indirectly. Methods: We analyzed 53 consecutive patients with coronary angiographic severe calcified lesions. All the patients were examined by OCT. Twenty patients received RA and OCT imaging performed before and after RA and after stent implantation. The remaining patients were as a control group and OCT imaging performed before balloon dilatation and after stent implantation. Results: The patients were older and higher incidence of Diabetes mellitus in the RA group. In the RA group, the mean burr size was 1.48±0.14mm. The mean rotation speed was 152,300±4,200rpm. The mean number of rotations per patient was 5.3±2.1 times and the mean ablation time per RA was 11.3±3.2 seconds. In the control group, there was no thrombogenesis during the procedure, but in the RA group, all the target vessels had only white thrombosis on OCT after RA. The average number of white thrombus per lesion after RA was 7.23±4.4, and the average length of every white thrombus was 0.51±0.33mm. In Pearson Correlation Analysis, Thrombotic load was related with burr size (r=0.575, P=0.040) and rotation number (r=0.599, P=0.031).Conclusions: White thrombosis during RA is proved by OCT in vivo. Treating calcified lesions with RA may enhance thrombogenesis. These data suggest using a proper therapy to avoid no-reflow during RA.

scholarly journals Platelet Aggregation on Optical Coherence Tomography after Rotational Atherectomy of Severely Coronary Calcified Lesions

2020 ◽  
Author(s):  
Cheng-fu CAO ◽  
Yu-liang MA ◽  
Qi LI ◽  
Jian LIU ◽  
Hong ZHAO ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Rotation Speed ◽  
Average Length ◽  
Pearson Correlation ◽  
Percutaneous Treatment ◽  
Rotational Atherectomy ◽  
Burr Size ◽  
No Reflow ◽  
Before And After

Abstract Background Rotational atherectomy (RA) has improved percutaneous treatment of severe coronary calcified lesions, but the "no-reflow" phenomenon remains a serious complication. Platelet activation by RA may contribute to the no-reflow, we use OCT to test the effect of RA on platelet aggregation. Methods We analyzed 20 consecutive patients with severe coronary calcified lesions by OCT imaging performed before and after RA and after stent implantation. Results Mean burr size was 1.48 ± 0.14. Mean rotation speed was 152,300 ± 4,200 rpm. Mean number of rotations per patient was 5.3 ± 2.1 times and mean ablation time per RA was 11.3 ± 3.2 seconds. All the target vessels had platelet aggregation on OCT after RA. The average number of white thrombus per lesion after RA was 7.23 ± 4.4, and the average length of every white thrombus was 0.51 ± 0.33 mm. In Pearson Correlation Analysis, platelet aggregation load was related with burr size (r = 0.575, P = 0.040) and rotation number (r = 0.599, P = 0.031). Conclusions Platelet aggregation during RA is proved by OCT in vivo. The bigger burr size, higher number of ablation times, maybe together with higher rotation speed can influence the platelet aggregation load. These data suggest a proper RA strategy to avoid no-reflow during RA.

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.

scholarly journals The role of quantitative deep capillary plexus in the pathogenesis of type 3 macular neovascularization: an optical coherence tomography angiography study

2021 ◽  
Author(s):  
Marina Concilio ◽  
Federica Fossataro ◽  
Daniela Montorio ◽  
Mariapaola Giordano ◽  
Gilda Cennamo
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Early Stage ◽  
Study Groups ◽  
Control Group ◽  
Main Role ◽  
Optical Coherence ◽  
Capillary Plexus ◽  
Type 3

Abstract Purpose To quantitatively investigate the role of deep capillary plexus (DCP) in patients affected by type 3 macular neovascularization (MNV), compared to patients with reticular pseudodrusen (RPD) eyes and healthy controls, using optical coherence tomography angiography (OCTA). Methods In this prospective observational study, a total of seventy-eight eyes of 78 patients were included. Group 1 consisted of 40 eyes of 40 patients with stage 1 of type 3 MNV (22 males, 18 females, mean age 73.7, SD ± 6.60) and group 2 included 38 eyes of 38 patients with RPD (17 males, 21 females, mean age 73.2, SD ± 4.55). The control group included 40 eyes of 40 healthy subjects (20 males, 20 females, mean age 71.4, SD ± 6.36 years). We evaluated the retinal vessel density (VD) of superficial capillary plexus (SCP) and deep capillary plexus (DCP) using OCTA. Results Patients with diagnosis of type 3 MNV showed statistically lower values of VD in DCP with respect to controls and to RPD group (p < 0.001), while there were no statistical differences between RPD and control group in macular region. No significant differences in VD of SCP were detected among the three study groups. Conclusion OCTA provides a reproducible, non-invasive detailed quantitative analysis of retinal vascular features and changing in early-stage type 3 MNV patients, which allowed to shed the light on the main role of DCP ischemia in the development of type 3 MNV.

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.

Ex Vivo assessment of competent strut coverage after coronary stenting by optical coherence tomography

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Bhoite ◽  
H Jinnouchi ◽  
F Otsuka ◽  
Y Sato ◽  
A Sakamoto ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Predictive Value ◽  
Ex Vivo ◽  
High Sensitivity ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Neointimal Thickness ◽  
Stent Strut ◽  
Oct Imaging ◽  
Definition Of

Abstract Background In many studies, struts coverage is defined as &gt;0 mm of tissue overlying the stent struts by optical coherence tomography (OCT). However, this definition has never been validated using histology as the “gold standard”. The present study sought to assess the appropriate cut-off value of neointimal thickness of stent strut coverage by OCT using histology. Methods OCT imaging was performed on 39 human coronary arteries with stents from 25 patients at autopsy. A total of 165 cross-sectional images from 46 stents were co-registered with histology. The optimal cut-off value of strut coverage by OCT was determined. Strut coverage by histology was defined as endothelial cells with at least underlying two layers of smooth muscle cells. Considering the resolution of OCT is 10–20 μm, 3 different cut-off values (i.e. at ≥20, ≥40, and ≥60 μm) were assessed. Results A total of 2235 struts were evaluated by histology. Eventually, 1216 struts which were well-matched struts were analyzed in this study. By histology, uncovered struts were observed in 160 struts and covered struts were observed in 1056 struts. The broadly used definition of OCT-coverage which does not consider neointimal thickness yielded a poor specificity of 37.5% and high sensitivity 100%. Of 3 cut-off values, the cut-off value of &gt;40 μm was more accurate as compared to &gt;20 and &gt;60 mm [sensitivity (99.3%), specificity (91.0%), positive predictive value (98.6%), and negative predictive value (95.6%)] Conclusion The most accurate cut-off value was ≥40 μm neointimal thickness by OCT in order to identify stent strut coverage validated by histology. Funding Acknowledgement Type of funding source: None

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