Ex vivo imaging of chronic total occlusions using forward-looking optical coherence tomography.
OBJECTIVE
Percutaneous coronary interventions (PCI) of chronic total occlusions (CTOs) of arteries are more challenging lesions to treat with angioplasty and stenting than stenotic vessels due primarily to the difficulty in guiding the wire across the lesion. Angiography alone is unable to differentiate between the occluded lumen and the vessel wall and to characterize the content of the occlusion. New technologies to aid in interventional guidance are therefore highly desirable. We sought to evaluate tissue characterization in arterial (CTOs) by imaging ex vivo peripheral arterial samples with optical coherence tomography (OCT).


METHODS
Ex vivo arterial samples were obtained from patients undergoing peripheral limb amputation. Samples were imaged in an enface orientation using an OCT system, enabling sequential acquisition of longitudinal images and volumetric reconstruction of cross-sectional views of the occluded arteries. Histology was performed for comparison.


RESULTS
OCT imaging reliably differentiated between the occluded lumen and the underlying arterial wall in peripheral CTOs. OCT correctly identified tissue composition within the CTO, such as the presence of collagen and calcium and was also able to identify intraluminal microchannels.


CONCLUSIONS
OCT imaging of CTO anatomy and tissue characteristics may potentially lead to substantial improvements in PCI interventions by providing novel guiding capabilities.
Munce
Nigel R
NR
Department of Medical Biophysics, University of Toronto, Toronto, Canada.
Yang
Victor X D
VX
Standish
Beau A
BA
Qiang
Beiping
B
Butany
Jagdish
J
Courtney
Brian K
BK
Graham
John J
JJ
Dick
Alexander J
AJ
Strauss
Bradley H
BH
Wright
Graham A
GA
Vitkin
I Alex
IA
D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D001158:Arteries / Q000033:anatomy & histology; D002908:Chronic Disease; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007866:Leg / Q000098:blood supply*; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D041623:Tomography, Optical Coherence