CardioVascular and Interventional Radiology

, Volume 29, Issue 6, pp 1039–1045 | Cite as

The Potential Role of Optical Coherence Tomography in the Evaluation of Vulnerable Carotid Atheromatous Plaques: A Pilot Study

  • Vikramaditya Prabhudesai
  • Cordelia Phelan
  • Ying Yang
  • Ruikang K. Wang
  • Mark G. Cowling
LABORATORY INVESTIGATION

Abstract

Purpose

The decision to intervene surgically in patients with carotid artery disease is based on the presence of symptoms, along with the severity of carotid artery stenosis as assessed by ultrasound or X-ray computed tomography (CT). Optical coherence tomography (OCT) is a relatively new imaging technique that offers potential in the identification of, as well as the distinction between, stable and unstable atherosclerotic plaques. The purpose of our study was to evaluate whether OCT can be used as a noninvasive diagnostic tool to reveal the morphology of carotid stenosis from the adventitial surface of the carotid artery. To achieve this aim, excised atheromatous plaques were scanned by OCT from the external surface.

Methods

Plaques removed at carotid endarterectomy were scanned by OCT from the external surface within 72 hr of surgery and then examined histologically. The images of the histologic slides and the scans were then compared.

Results

We examined 10 carotid endarterectomy specimens and were able to identify calcification, cholesterol crystal clefts, and lipid deposits in the OCT images with histologic correlation. The strong light scattering from the calcified tissue and cholesterol crystal clefts limited the depth of light penetration, making observation of the intimal surface and the detail of the fibrous cap difficult. However, we were able to confidently identify the absence of an atherosclerotic plaque by OCT scans even from the external surface.

Conclusion

The results of this pilot study demonstrate that OCT can reveal the main features of carotid stenosis but that plaque vulnerability cannot be reliably and precisely assessed if scanned from the external surface with OCT in its present form.

Keywords

Carotid artery stenosis Endarterectomy Noninvasive diagnosis Optical coherence tomography 

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Vikramaditya Prabhudesai
    • 1
  • Cordelia Phelan
    • 2
  • Ying Yang
    • 3
  • Ruikang K. Wang
    • 4
  • Mark G. Cowling
    • 5
  1. 1.Diagnostic ImagingSt. Joseph’s HospitalHamiltonCanada
  2. 2.Department of PathologyUniversity Hospital of North Staffordshire, NHS TrustStoke-on-TrentUK
  3. 3.Institute of Science and Technology in Medicine, Keele UniversityStoke-on-TrentUK
  4. 4.Department of Biomedical EngineeringOregon Health & Science UniversityBeavertonUSA
  5. 5.Department of RadiologyUniversity Hospital of North Staffordshire, NHS TrustStoke-on-TrentUK

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