the art of catheter-based imaging
DESCRIPTION
Catheters play a key role in diagnostic and therapeutic medicine. Nowhere is this more apparent than in the specialty of interventional cardiology which is dedicated to catheter-based treatment of cardiovascular diseases. The tools of an interventional cardiologist include a variety of developed and emerging imaging technologies to guide therapy. This talk will focus not only on the science and engineering but also the on art of intracoronary imaging catheters. Intravascular ultrasound and optical coherence tomography catheter systems will serve as examples.TRANSCRIPT
The A!of
Catheter-Based Imaging
Kendall R. Waters, PhDManager, IP and Technology Development
Animation from iStockPhoto.com
Coronary Artery Disease
Animation from CardioTube
CardiacCatheterization
BalloonAngioplasty
IVUSBare-Metal
StentDrug-Eluting
Stent
TD-OCT
FD-OCT
202020001980196019401920
Coronary Angiogram
Cardiac Catheterization
Image from Angioplasty.org
Accessing the Coronary Arteries
Image from ShutterStock.com
Video from YouTube.com
Coronary Angiogram
Balloon Angioplasty
Post-Intervention Pre-Intervention
Video from YouTube.com
An Early IVUS Image
Nissen et al., Circulation 1991; 84: 1087-1099.
5.5F20 MHz10 FPS
Advances in Intracoronary Imaging
CatheterProfile
TransducerOrientation
PlaqueClassification
BloodClearing
ImagingFrequency
SystemIntegration
LightSource
PullbackTechnology
Transducer Orientation
InterTherapy
CVIS
Endosonics
Patents downloaded from FreePatentsOnline.com
Synthetic Aperture Array Catheter
Mechanically Rotating Catheter
Intracoronary Ultrasound Catheters
Fitzgerald et al., Circulation. 2000;102:523-530. Waksman, China Interventional Therapeutics 2009.
%(
2
2 2 2 ! 2 2
Progress ?
c. 1999 c. 2009
A Telescoping Catheter
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Fig. 1
One Way Luer
Telescoping Section Pullback Length
150 mm
Proximal Shaft109 cm
Usable Length135 cm
Monorail23mm
ROMarker
3.5F 3.2F
Image from VolcanoCorp.com
TelescopingSection
DistalSheath
ProximalSheath
DistalTip
CatheterHub
Interface Module and Sled
Modular
Integrated
Video from YouTube.com
Intravascular Ultrasound
Plaque Classification
Necrotic
FibroticLipidic
Calcified
BSC iMAPVolcano VH-IVUS
Fibro-Fatty
Calcification
Necrotic Core
Fibrosis
Terumo IB-IVUS
Fibrosis
Calcification
Lipid Pool
Dense Fibrosis
First Generation OCT
Vessel Occlusion
Animations from LightlabImaging.com
TD-OCT
Second Generation OCT
Contrast Flush
Animations from LightlabImaging.com
FD-OCT
Video from LightlabImaging.com
FD-OCT Pullback
c. 1995 c. 2000 c. 2005
Advances in Intracoronary Imaging
CatheterProfile
TransducerOrientation
PlaqueClassification
BloodClearing
ImagingFrequency
SystemIntegration
LightSource
PullbackTechnology
Perspectives
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Yuan et al., 2008 IEEE International Ultrasonics Symposium.
Courtesy of Dr. Brian Courtney MD and Brian Liang, Sunnybrook Health Sciences Centre, Toronto, CA
