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Proceedings Paper

Navigating a guide wire through total occlusions: clinical experience
Author(s): John M. Neet; Thomas R. Winston M.D.; Allan D. Hedrick; Jaques J. Koolen M.D.; Hans Bonnier M.D.
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Paper Abstract

One of the last remaining frontiers in angioplasty interventions is successfully recanalizing arteries containing total occlusions. The primary limiting condition is the inability to pass a guide wire safely across the total occlusion to facilitate therapeutic interventions. The operator has to perform the intervention without the assistance of x-ray imaging to define the vessel's path since the contrast media flow is blocked by the occlusion. To overcome this limitation, a guide wire system has been developed that transmits low coherence near-infrared light through an optical fiber internal to the guide wire and illuminates the tissue adjacent the distal end. Differences in the scattering of near-infrared light by the normal arterial wall and occluding tissues are detected by optical coherence reflectometry (OCR) techniques. Through a real-time monitoring system and display, the physician is warned if the guide wire approaches the normal arterial wall, allowing the guide wire to be redirected to prevent perforating the vessel. The system has been used in clinical coronary angioplasty cases demonstrating the ability to cross 10 out of 11 total occlusions without any perforations or dissections. The OCR guide wire system has demonstrated clinical potential and will require additional testing for clinical efficacy claims.

Paper Details

Date Published: 17 May 2000
PDF: 8 pages
Proc. SPIE 3907, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems X, (17 May 2000);
Show Author Affiliations
John M. Neet, IntraLuminal Therapeutics, Inc. (United States)
Thomas R. Winston M.D., IntraLuminal Therapeutics, Inc. (United States)
Allan D. Hedrick, IntraLuminal Therapeutics, Inc. (United States)
Jaques J. Koolen M.D., Catharina Hospital/Eindhoven (Netherlands)
Hans Bonnier M.D., Catharina Hospital/Eindhoven (Netherlands)

Published in SPIE Proceedings Vol. 3907:
Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems X
R. Rox Anderson M.D.; Kenton W. Gregory M.D.; Eugene A. Trowers M.D.; David S. Robinson M.D.; Kenneth Eugene Bartels D.V.M.; Lou Reinisch; Reza S. Malek M.D.; C. Gaelyn Garrett M.D.; Lloyd P. Tate V.D.M.; Hans-Dieter Reidenbach; Timothy A. Woodward M.D.; Kenneth Eugene Bartels D.V.M.; Lawrence S. Bass M.D.; George M. Peavy D.V.M.; C. Gaelyn Garrett M.D.; Kenton W. Gregory M.D.; Nikiforos Kollias; Harvey Lui M.D.; Reza S. Malek M.D.; George M. Peavy D.V.M.; Hans-Dieter Reidenbach; Lou Reinisch; David S. Robinson M.D.; Lloyd P. Tate V.D.M.; Eugene A. Trowers M.D.; Timothy A. Woodward M.D., Editor(s)

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