scholarly journals Frequency-Domain Optical Coherence Tomography for Intracranial Atherosclerotic Stenosis: Feasibility, Safety, and Preliminary Experience

2021 ◽  
Vol 12 ◽  
Author(s):  
Bin Yang ◽  
Yiding Feng ◽  
Yan Ma ◽  
Yabing Wang ◽  
Jian Chen ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Frequency Domain ◽  
Large Scale ◽  
Target Lesion ◽  
Posterior Circulation ◽  
Optical Coherence ◽  
Anterior Circulation ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
Optimal Medical Management

Background: Despite advances in non-invasive imaging, the characterization of atherosclerotic plaque remains superior with frequency-domain optical coherence tomography (FD-OCT) in the clinical coronary and experimental cerebrovascular literature. An assessment of the feasibility and safety of FD-OCT for intracranial atherosclerotic stenosis (ICAS) is desirable.Methods: We analyzed a cohort of all consecutive FD-OCT evaluations for ICAS performed at our institution from April 2017 to August 2018 (16 months) in patients who suffered from transient ischemic attack (TIA) or non-disabling stroke despite optimal medical management within 90 days of admission attributable to angiographically verified 70–99% stenosis of an intracranial artery.Results: Thirty-three patients harboring 36 lesions with an average age of (57.6 ± 7.1) years (male sex 27 cases) comprising nine cases of lesions located within the anterior circulation and 24 cases within the posterior circulation were identified. Of the 33 patients with 36 lesions, the FD-OCT imaging catheter detected 35/36 (97%) lesions except in one case in which the FD-OCT catheter failed to navigate excessively tortuous vessels, and FD-OCT images in 27 patients (81.8%) were finally obtained successful, where the target lesion was fully visible, and image quality under at least one pullback was graded 2 or 3. There were no symptomatic complications. Blood flow was the most common artifact encountered (51.9%).Conclusion: FD-OCT is safe and feasible for the assessment of ICAS in the anterior and posterior circulation. The use of diagnostic interferometry will have to be weighed against its cost, and these preliminary findings should be verified by prospective large-scale studies.

Abstract 122: Stroke Patterns And Causative Mechanisms Of Ischemia In Patients With Symptomatic Intracranial Atherosclerotic Stenosis

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Elena Lopez-Cancio ◽  
Maria G Matheus ◽  
Jose Romano ◽  
David S Liebeskind ◽  
Shyam Prabhakaran ◽  
...  
Keyword(s):  
Recurrent Stroke ◽  
Posterior Circulation ◽  
Embolic Stroke ◽  
Severe Stenosis ◽  
Anterior Circulation ◽  
Treatment Assignment ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
Artery Embolism ◽  
Circulation Patterns

Background/objectives: Putative mechanisms of stroke in intracranial atherosclerotic stenosis (ICAS) include hypoperfusion, artery-to-artery embolism or perforator occlusion, each of which may be characterized by different stroke patterns on neuroimaging. Our aims are to determine: 1) the different stroke patterns in patients with ICAS; 2) the correlation of angiographic factors (collaterals, degree and location of stenosis) with stroke patterns; and 3) if the patterns of recurrent stroke in the same territory are similar to qualifying strokes. Methods: From the WASID dataset, we selected patients with a stroke at baseline who had conventional angiographic information on collaterals (n=136), and patients with a recurrent stroke in the territory during follow-up (n= 47). We categorized stroke patterns as follows: for anterior circulation-subcortical (SC), cortical (C), territorial (T), borderzone (BZ) and multiple (M); for posterior circulation,-subcortical (SC), cortical (C), cerebellar (CB) and multiple (M). We defined an embolic mechanism if C, T, CB or multiple were present. The association between stroke patterns and collateral grade assessment (ASITN/SIR), location and degree of stenosis, and treatment assignment (warfarin vs aspirin) was analyzed using Chi-Square and McNemar’s tests. Results: Anterior circulation patterns (n=72) at baseline were: 14(19%) SC, 5(7%) T, 2(29%) C, 12(17%) BZ and 20(28%) M. All isolated BZ stroke patterns were located in internal borderzone region. BZ pattern was equally distributed among patients with no collaterals (5/40=12%) vs. patients with collaterals (7/32=22%) (p= 0.29) and among patients with moderate (8/43=19%) vs. severe stenosis (4/29=14%) (p=0.59). Posterior circulation patterns (n= 64) at baseline were: 25(39%) SC, 5(8%) C, 10(16%) CB and 24(38%)M. Embolic stroke pattern at baseline was the most frequent (85/136=62.5%). Among patients with a recurrent stroke in the territory (n=47), embolic pattern was also the most frequent (32/47, 68%). The probability of having a recurrent embolic stroke pattern was related to stenosis degree (81% in severe vs 50% in moderate stenosis, p= 0.03), collateral grade (83% with collaterals vs 53% no collaterals, p= 0.09), and previous embolic stroke pattern (74 % who had baseline embolic stroke vs 25% who had baseline non-embolic stroke,p= 0.01). Having a recurrent embolic stroke pattern was not influenced by treatment assignment (67% treated with warfarin vs 69% treated with aspirin, p=0.85). Conclusions: Artery-to-artery embolism seems to be the most frequent mechanism of stroke in ICAS patients and was not modified by antithrombotic treatment. Isolated BZ infarcts were less frequent, and were not related to poor collaterals or more severe stenosis.

scholarly journals Development and validation of a deep learning system to screen vision-threatening conditions in high myopia using optical coherence tomography images

2020 ◽  
pp. bjophthalmol-2020-317825
Author(s):  
Yonghao Li ◽  
Weibo Feng ◽  
Xiujuan Zhao ◽  
Bingqian Liu ◽  
Yan Zhang ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Deep Learning ◽  
High Myopia ◽  
Large Scale ◽  
Learning System ◽  
Youden Index ◽  
Optical Coherence ◽  
Test Dataset ◽  
Independent Test ◽  
Independent Test Dataset

Background/aimsTo apply deep learning technology to develop an artificial intelligence (AI) system that can identify vision-threatening conditions in high myopia patients based on optical coherence tomography (OCT) macular images.MethodsIn this cross-sectional, prospective study, a total of 5505 qualified OCT macular images obtained from 1048 high myopia patients admitted to Zhongshan Ophthalmic Centre (ZOC) from 2012 to 2017 were selected for the development of the AI system. The independent test dataset included 412 images obtained from 91 high myopia patients recruited at ZOC from January 2019 to May 2019. We adopted the InceptionResnetV2 architecture to train four independent convolutional neural network (CNN) models to identify the following four vision-threatening conditions in high myopia: retinoschisis, macular hole, retinal detachment and pathological myopic choroidal neovascularisation. Focal Loss was used to address class imbalance, and optimal operating thresholds were determined according to the Youden Index.ResultsIn the independent test dataset, the areas under the receiver operating characteristic curves were high for all conditions (0.961 to 0.999). Our AI system achieved sensitivities equal to or even better than those of retina specialists as well as high specificities (greater than 90%). Moreover, our AI system provided a transparent and interpretable diagnosis with heatmaps.ConclusionsWe used OCT macular images for the development of CNN models to identify vision-threatening conditions in high myopia patients. Our models achieved reliable sensitivities and high specificities, comparable to those of retina specialists and may be applied for large-scale high myopia screening and patient follow-up.

scholarly journals Full-field time-encoded frequency-domain optical coherence tomography

2006 ◽  
Vol 14 (17) ◽  
pp. 7661 ◽  
Author(s):  
Boris Považay ◽  
Angelika Unterhuber ◽  
Boris Hermann ◽  
Harald Sattmann ◽  
Holger Arthaber ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Frequency Domain ◽  
Optical Coherence ◽  
Full Field

scholarly journals An advanced algorithm for dispersion encoded full range frequency domain optical coherence tomography

2012 ◽  
Vol 20 (22) ◽  
pp. 24925 ◽  
Author(s):  
Felix Köttig ◽  
Peter Cimalla ◽  
Maria Gärtner ◽  
Edmund Koch
Keyword(s):  
Optical Coherence Tomography ◽  
Frequency Domain ◽  
Full Range ◽  
Optical Coherence ◽  
Advanced Algorithm

Optimal sparsifying bases for frequency-domain optical-coherence tomography

2012 ◽  
Vol 37 (23) ◽  
pp. 4907 ◽  
Author(s):  
Rohit Nayak ◽  
Chandra Sekhar Seelamantula
Keyword(s):  
Optical Coherence Tomography ◽  
Frequency Domain ◽  
Optical Coherence

Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque

2014 ◽  
Vol 171 (2) ◽  
pp. 281-283 ◽  
Author(s):  
Yusuke Fujino ◽  
Guilherme F. Attizzani ◽  
Satoko Tahara ◽  
Kensuke Takagi ◽  
Hiram G. Bezerra ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Kawasaki Disease ◽  
Frequency Domain ◽  
Optical Coherence ◽  
Calcified Plaque

scholarly journals Treatment Of Ruptured Tiny Intracranial Aneurysms By Electrocoagulation With Guidewire Manipulation:12 Cases Report

2020 ◽  
Author(s):  
Lixia Xia ◽  
Zhongfei Hao ◽  
Hongjun Wang ◽  
Yan Feng ◽  
Yongxuan Zhan ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Intracranial Aneurysms ◽  
Large Scale ◽  
Posterior Circulation ◽  
Suitable Method ◽  
Anterior Circulation ◽  
Long Term Follow Up

Abstract Background: Ruptured tiny intracranial aneurysm (RTIA) is particularly rare seen. Treatment of RTIA is more difficult and not under control.Methods: We hereby present twelve rare cases of RTIA that were diagnosed based on DSA. These patients were found due to spontaneous or traumatic SAH, 11 of whom were treated only by electrocoagulation, and one of whom was treated by stent-assisted coiling and electrocoagulation.Results: There were eight patients with aneurysms located in posterior circulation and four patients with aneurysms located in anterior circulation. 11 patients were cured only by electrocoagulation merely: ten patient’ RTIA disappeared completely and immediately and another patient’s RTIA was thrombosed two months later. The twelfth patient was carried out stent-assisted coiling and electrocoagulation. The twelve patients’ average follow-up time was 12.5 months and the outcomes were all surprisingly excellent. No revascularization of aneurysm was found. Conclusions: Electrocoagulation with guidewire manipulation is a suitable method to treat RTIA. While large-scale studies with long-term follow-up are required to validate these promising results.

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