© 2002 Slide 1

Trans-Blood Vision™ Possibilitiesfor Vulnerable Plaque

A Presentation for the3rd Annual

Vulnerable Plaque SymposiumMarch 16, 2002

© 2002 Slide 2

Seeing Through Blood

The technique is adapted from military methods to see through smoke, mist, fog, etc.

SWIR WavelengthVisible Wavelengths

For example, the following satellite photos of a section of the Oahu coastline illustrate how mist and haze seen at visible wavelengths disappear when viewed in the Short Wave IR band.

Trans-Blood Vision™ is a patented infrared technique to see directly through blood.

© 2002 Slide 3

System Illustration

Monitor – already in place

CardioOptics IR Instrument: - IR illumination source - IR video camera

IR interconnect cable

Sterile, disposableIR fiberoptic catheter:

© 2002 Slide 4

• Looking directly through flowing blood in a live animal

• Clip begins with exploration of bifurcation in the portal vein system & ends with canulation of selected branch

• Raw, unprocessed video. Black & white presentation.

Video Clip: Endocardial Imagingof IVC-Portal Vein System

1

2

To Heart(Inferior Vena Cava)

Portal Vein

System

CaudalVein

© 2002 Slide 5

Video Clip of Vein Bifurcation

Unprocessed proof of concept video taken through flowing blood.

© 2002 Slide 6

Comments

• Structures appear as if viewed through water

• High degree of reflectivity from tissue surfaces

• No video enhancement techniques have yet been applied, which will dramatically improve images.

© 2002 Slide 7

Augmentative Technologies

o Dimensional measurement: The ability to quantitatively measure the size of structures visualized. This includes granularity and surface feature detail assessment.

o Tissue/material characterization: The ability to provide the clinician with information about the nature of the structure in the TBV™ view (e.g., detection of calcification, presence of lipids).

o Real-time motion analysis: The ability to perform real-time dynamic elastic properties assessment.

o Membrane penetration: The ability to determine tissue/material characterization below the surface of membranes associated with Vulnerable Plaque lesions.

Note: The following are extensions of Trans-Blood Vision ™. They have been theorized, tested to some degree in vitro, but not yet tested in vivo or on Vulnerable Plaque lesions.

© 2002 Slide 8

Vulnerable Plaque Potential

Find lesions without first entering them (forward view) Determine size & surface characteristics in high resolution Look at material constituents, both on and below the

surface (within limited IR wavelengths) Perform dynamic elastic velocity profiles in real time

But not: Provide direct visual guidance for therapy

Penetrate deeply like ultrasound

Combining Trans-Blood Vision™ with these promising augmentative technologies provides the potential to simultaneously in real-time:

Measure lesion temperature (though a temperature probe could be visually guided)

© 2002 Slide 9

Conclusion:

Trans-Blood Vision™ has sufficient potential to provide a platform for real-time, simultaneous, multi-mode Vulnerable Plaque lesion detection, analysis, and therapy guidance that it warrants significant investigation, possibly in combination with other technologies currently under development.