Guidance of aortic ablation using optical coherence tomography

  • Nirlep A. Patel
  • Xingde Li
  • Debra L. Stamper
  • James G. Fujimoto
  • Mark E. Brezinski
Article

Abstract

Purpose: There is a significant need for an imaging modality that is capable of providing guidance for intravascular procedures, as current technologies suffer from significant limitations. In particular, laser ablation of in-stent restenosis, revascularization of chronic total occlusions, and pulmonary vein ablation could benefit from guidance. Optical coherence tomography (OCT), a recently introduced technology, is similar to ultrasound except that it measures the back-reflection of infrared light instead of sound. This study examines the ability of OCT to guide vascular laser ablation. Methods: Aorta samples underwent laser ablation using an argon laser at varying power outputs and were monitored with OCT collecting images at 4frames. Samples were compared to the corresponding histopathology. Results: Arterial layers could be differentiated in the images sequences. This allowed correlation of changes in the OCT image with power and duration in addition to histopathology. Conclusions: OCT provides real-time guidance of arterial ablation. At 4 frames, OCT was successfully able to show the microstructural changes in the vessel wall during laser ablation. Since current ablation procedures often injure surrounding tissue, the ability to minimize collateral damage to the adjoining tissue represents a useful advantage of this system. This study suggests a possible role for OCT in the guidance of intravascular procedures.

ablation IVUS optical coherence tomography plaque rabbit restenosis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Koster R, Kahler J, Terres W, et al. Six month clinical and angiographic outcome after successful excimer laser angioplasty for in stent restenosis. J Am Coll Cardiol 2000; 36: 69–74.Google Scholar
  2. 2.
    Mehran R, Dangas G, Mintz GS, et al. Treatment of instent restenosis with excimer laser coronary angioplasty versus rotational atherectomy. Circulation 2000; 101: 2484–2489.Google Scholar
  3. 3.
    TenHoff H, Hamm MA, Lowe GE, Koger JD. Technical aspects of ultrasound imaging guide wires. Semin Interv Cardiol 1997; 2(1): 63–68.Google Scholar
  4. 4.
    Brezinski ME, Tearney GJ, Bouma BE, et al. Optical coherence tomography for optical biopsy; properties and demonstration of vascular pathology. Circulation 1996; 93: 1206–1213.Google Scholar
  5. 5.
    Brezinski ME, Tearney GJ, Bouma BE, et al. Imaging of coronary artery microstructure with optical coherence tomography. Am J Cardiol 1996; 77: 92–93.Google Scholar
  6. 6.
    Fujimoto JG, Boppart SA, Tearney GJ, Bouma BE, Pitris C, Brezinski ME. High resolution in vivo intra-arterial imaging with optical coherence tomography. Heart 1999; 82: 128–133.Google Scholar
  7. 7.
    Huang D, Swanson EA, Lin CP, et al. Optical coherence tomography. Science 1991; 254: 1178–1181.Google Scholar
  8. 8.
    Tearney GJ, Brezinski ME, Bouma BE, et al. In vivo endoscopic optical biopsy with optical coherence tomography. Science 1997b; 1276: 2037–2039.Google Scholar
  9. 9.
    Brezinski ME, Saunders K, Jesser C, Li X, Fujimoto JG. Index matching to improve optical coherence imaging through blood. Circulation 2001; 103: 1999–2003.Google Scholar
  10. 10.
    Brezinski ME, Tearney GJ, Weissman NJ, et al. Assessing atherosclerotic plaque morphology: comparison of optical coherence tomography and high frequency intravascular ultrasound. Heart 1997; 77(5): 397–403.Google Scholar
  11. 11.
    Patwari P, Weissman NJ, Boppart SA, et al. Assessment of coronary plaque with optical coherence tomography and high-frequency ultrasound. Am J Cardiol 2000; 85: 641–644.Google Scholar

Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • Nirlep A. Patel
    • 1
  • Xingde Li
    • 2
  • Debra L. Stamper
    • 4
  • James G. Fujimoto
    • 2
  • Mark E. Brezinski
    • 1
  1. 1.Department of Orthopedic SurgeryBrigham and Women's HospitalBostonUSA
  2. 2.Department of Electrical Engineering and Computer Science, Research Laboratory of ElectronicsMassachusetts Institute of TechnologyCambridgeUSA
  3. 3.Department of BioengineeringUniversity of WashingtonSeattle
  4. 4.Department of BiologyKings CollegeWilkes-BarreUSA

Personalised recommendations