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Proceedings Paper

First clinical pilot study with intravascular polarization sensitive optical coherence tomography (Conference Presentation)
Author(s): Martin Villiger; Antonios Karanasos; Jian Ren; Norman Lippok; Milen Shishkov; Joost Daemen; Nicolas Van Mieghem; Roberto Diletti; Marco Valgimigli; Robert-Jan van Geuns; Peter de Jaegere; Felix Zijlstra; Gijs van Soest; Seemantini Nadkarni; Evelyn Regar; Brett E. Bouma
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Paper Abstract

Polarization sensitive (PS) OCT measures the polarization states of the light backscattered by tissue and provides measures of tissue birefringence and depolarization in addition to the structural OCT signal. Ex vivo studies have demonstrated that birefringence is increased in tissue rich in collagen and with elevated smooth muscle cell content. Preliminary data further suggests that depolarization can identify regions of macrophage infiltration, lipid, and irregularly arranged collagen fibers. These are important aspects of the mechanical integrity and vulnerability of atherosclerotic plaques. To evaluate the potential of PS-OCT in the clinical setting, we combined our custom PS-OCT system with commercially available OCT catheters (Fastview, Terumo Corporation) and performed a pilot study in 30 patients, scheduled to undergo percutaneous coronary intervention (PCI) on the grounds of stable or unstable angina. A total of 82 pullbacks in 39 vessels were performed, either in the native coronary arteries or post procedure. Comparing consecutive pullbacks of the same coronary artery, we found excellent agreement between the polarization features in the repeat pullbacks, validating the repeatability and robustness of PS-OCT in the clinical in vivo setting. In addition we observed that the birefringence and depolarization features vary significantly across lesions with identical structural OCT appearance, suggesting morphological subtypes. This first human pilot study proved the feasibility and robustness of intravascular PS-OCT. PS-OCT achieves improved tissue characterization and may help in identifying high-risk plaques, with the potential to ultimately improve risk stratification and help guiding PCI.

Paper Details

Date Published: 9 May 2016
PDF: 0 pages
Proc. SPIE 9689, Photonic Therapeutics and Diagnostics XII, 96892O (9 May 2016); doi: 10.1117/12.2211463
Show Author Affiliations
Martin Villiger, Harvard Medical School (United States)
Antonios Karanasos, Erasmus MC (Netherlands)
Jian Ren, Wellman Ctr. for Photomedicine (United States)
Norman Lippok, Harvard Medical School (United States)
Milen Shishkov, Harvard Medical School (United States)
Joost Daemen, Erasmus MC (Netherlands)
Nicolas Van Mieghem, Erasmus MC (Netherlands)
Roberto Diletti, Erasmus MC (Netherlands)
Marco Valgimigli, Erasmus MC (Netherlands)
Robert-Jan van Geuns, Erasmus MC (Netherlands)
Peter de Jaegere, Erasmus MC (Netherlands)
Felix Zijlstra, Erasmus MC (Netherlands)
Gijs van Soest, Erasmus MC (Netherlands)
Seemantini Nadkarni, Harvard Medical School (United States)
Evelyn Regar, Erasmus MC (Netherlands)
Brett E. Bouma, Harvard Medical School (United States)

Published in SPIE Proceedings Vol. 9689:
Photonic Therapeutics and Diagnostics XII
Hyun Wook Kang; Guillermo J. Tearney; Melissa C. Skala; Bernard Choi; Andreas Mandelis; Brian J. F. Wong; Justus F. Ilgner; Nikiforos Kollias; Paul J. Campagnola; Kenton W. Gregory; Laura Marcu; Haishan Zeng, Editor(s)

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