BACKGROUND: Optical coherence tomography (OCT), a high resolution intravascular imaging technique, requires blood displacement for reliable image acquisition and the current technique uses a soft occlusion balloon plus saline injection in the coronary artery. A non-occlusive technique based on manual infusion of a viscous iso-osmolar solution has been developed and tested and validated through a 2-phase study. METHODS AND RESULTS: OCT assessment was performed with the M2 LightLab OCT (LightLab Imaging, Westford, MA, USA) image-wire in 3 swine by infusing 30 ml of each of 3 solutions differing in viscosity, osmolarity and electrolytic composition (A: iodixanol 320 and Lactated Ringer's; B: iodixanol 320 and 50% albumin; C: iodixanol 320). Image quality and adverse effects were evaluated. The solution with the best image quality/side-effect ratio was tested in 44 patients. The best image quality/side-effect ratio was obtained in the swine model with solution C, which enabled the study of arterial segments of 29.8+/-2.1 mm in length. The results were confirmed in the human study (average length of 28.3+/-2.5 mm and absence of major complications and/or major arrhythmias). Repeated OCT pull-back in the first 10 patients enabled comparison of 1,572 matched cross-sections with an excellent correlation for reproducibility (R=0.96; p<0.001). CONCLUSIONS: The non-occlusive technique using iodixanol 320 has an excellent ratio of safety, feasibility and efficacy.
BACKGROUND: Optical coherence tomography (OCT), a high resolution intravascular imaging technique, requires blood displacement for reliable image acquisition and the current technique uses a soft occlusion balloon plus saline injection in the coronary artery. A non-occlusive technique based on manual infusion of a viscous iso-osmolar solution has been developed and tested and validated through a 2-phase study. METHODS AND RESULTS: OCT assessment was performed with the M2 LightLab OCT (LightLab Imaging, Westford, MA, USA) image-wire in 3 swine by infusing 30 ml of each of 3 solutions differing in viscosity, osmolarity and electrolytic composition (A: iodixanol 320 and Lactated Ringer's; B: iodixanol 320 and 50% albumin; C: iodixanol 320). Image quality and adverse effects were evaluated. The solution with the best image quality/side-effect ratio was tested in 44 patients. The best image quality/side-effect ratio was obtained in the swine model with solution C, which enabled the study of arterial segments of 29.8+/-2.1 mm in length. The results were confirmed in the human study (average length of 28.3+/-2.5 mm and absence of major complications and/or major arrhythmias). Repeated OCT pull-back in the first 10 patients enabled comparison of 1,572 matched cross-sections with an excellent correlation for reproducibility (R=0.96; p<0.001). CONCLUSIONS: The non-occlusive technique using iodixanol 320 has an excellent ratio of safety, feasibility and efficacy.
Authors: Melissa J Suter; Manabu Kashiwagi; Kevin A Gallagher; Seemantini K Nadkarni; Nayan Asanani; Atsushi Tanaka; Gerard B Conditt; Armando Tellez; Krzysztof Milewski; Greg L Kaluza; Juan F Granada; Brett E Bouma; Guillermo J Tearney Journal: Int J Cardiovasc Imaging Date: 2015-04-29 Impact factor: 2.357