Imaging a spiral dissection of the superficial femoral artery in high resolution with optical coherence tomography—Seeing is believing

Authors

  • Gregory T. Stefano MD,

    1. Harrington Heart and Vascular Institute, Department of Medicine, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio
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  • Emile Mehanna MD,

    1. Harrington Heart and Vascular Institute, Department of Medicine, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio
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  • Sahil A. Parikh MD, FSCAI

    Corresponding author
    • Harrington Heart and Vascular Institute, Department of Medicine, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio
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  • Conflict of interest: Dr. Stefano is a consultant for St. Jude Medical. The remaining authors report no conflict of interest.

Correspondence to: Sahil A. Parikh, MD, FSCAI, Case Western Reserve University School of Medicine, Director, Experimental Interventional Cardiology Laboratory, Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, 11100 Euclid Avenue, Lakeside 3019, Cleveland, OH 44106-5038. E-mail: sahil.parikh@uhhospitals.org

Abstract

Optical coherence tomography (OCT) offers an alternative to intravascular ultrasound (IVUS) for endovascular imaging. Clinical and research applications for OCT have emerged in percutaneous coronary intervention (PCI), however, OCT has not found similar utility in peripheral arterial interventions. Early generation time-domain OCT systems required arterial occlusion to create the blood free environment needed for image acquisition and could not reliably scan vessel diameters encountered in the peripheral circulation. However, the frequency-domain OCT (FD-OCT) system currently FDA approved for use in the United States does not require arterial occlusion to generate images and permits a greater scan diameter allowing for exploratory use in peripheral arteries. To our knowledge, this is the first report using non-occlusive OCT imaging to serve as an adjunct to endovascular intervention for femoropopliteal disease. We illustrate the feasibility of acquiring high resolution images of a spiral dissection of the superficial femoral artery following balloon angioplasty that was not adequately visualized by angiography. © 2012 Wiley Periodicals, Inc.

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