The ability to visualize internal vessel architecture provides clinicians with useful information for the evaluation of stenosis, dissection and plaque morphology. Intravascular imaging can therefore assist in the development or modification of treatment strategies.¹

The SCAN Study²

The SCAN study compared Optical Coherence Tomography (OCT) with Intravascular Ultrasound (IVUS). The objective was to prove equivalence of OCT imaging to IVUS.

The Results:

OCT imaging was significantly better than IVUS in visualizing:

OCT imaging was found to be statistically equivalent as IVUS in visualizing:

Conclusion:

Imaging by OCT has been shown to be superior in providing better visualization of some vessel and plaque characteristics. Both IVUS and OCT imaging are safe and effective methods of examining peripheral vessels in order to perform diagnostic assessment of peripheral vessels and provide information necessary for the treatment strategy of Peripheral Artery Disease (PAD).

Read the Abstract and Download the Article:

This is an open-access article and is available at the following link:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023791/

“The results of this study further validate how intravascular image-guidance allows the physician to assess the burden and location of plaque within a vessel, understand plaque composition, and gain further insights on the patient’s condition.”

                                                                                             - Edward Pavillard, MD  & Luke Sewall, MD 

About OCT and IVUS

IVUS interprets high frequency sound waves that rebound off vessel walls and are collected by a processing system. The intensity of the sound waves varies depending on the tissue encountered and the operating system processes the signals in order to create a cross-sectional image.³ IVUS can be used to measure plaque extent, morphology and distribution, but it has low spatial resolution (150 μm) and calcium deposits in the vessel walls can reduce penetration of the sound waves.^{4, 5}

In contrast, OCT imaging measures the intensity reflected near-infrared light that is captured by a system to develop images of tissue and structures.⁶ OCT images have higher resolution (10 μm) and faster imaging acquisition than IVUS.⁷

About the SCAN Study²

SCAN is a prospective, non-inferiority, post-market study comparing Optical Coherence Tomography (OCT) with Intravascular Ultrasound (IVUS) as a diagnostic imaging tool in the peripheral arteries. As part of the protocol, 120 OCT and IVUS matched images (240 images in total) were captured at identical positions within vessel segments of multiple patients at two clinical centers. Three independent radiologists then reviewed the matched images and ranked them in terms of image quality and ability to display vessel morphology, disease, and important intravascular structures. Vessel measurement capabilities were also compared between the two imaging modalities.

Read the SCAN Press Release, click here 

Lumivascular: Combining OCT Imaging and Real-time therapy

Being able to see inside the artery with OCT while performing the procedure is a real game changer.

“This information attained from within the vessel, especially in real-time with an interventional technology such as Pantheris, can produce safer and more effective results for our patients than if we rely solely on traditional X-ray fluoroscopic imaging, which only provides an overhead view of the artery.

                                                                                             - Edward Pavillard, MD  & Luke Sewall, MD 

Lumivascular technology combines OCT imaging with a therapeutic device. This means, for the first time ever, physicians can see from inside the artery during an atherectomy or a CTO crossing procedure.  Physicians performing atherectomy or crossing CTOs with other devices must rely solely on X-ray as well as tactile feedback to guide their interventions while treating complicated arterial disease.

With the Lumivascular approach, physicians can more accurately navigate their devices and treat PAD lesions. Research has shown that 53% of patients undergoing x-ray guided (non-Lumivascular) atherectomy procedures result in injury inside the artery. 97% of these patients experiencing blockage (restenosis) at 1-year.⁷ Data using the Lumivascular approach showed only a 7% restenosis rate.⁸

“The added benefit of increased accuracy in vessel diameter sizing also helps appropriately size adjunctive therapy such as stents and balloons, which has shown to improve patient outcomes.”  

                                                                                             - Edward Pavillard, MD  & Luke Sewall, MD 

Learn more about OCT-Guided Atherectomy & CTO Crossing

To find a representative in your area, please click here.

References:

1. Hachinohe, et al. A practical approach to assessing stent results with IVUS and OCT. Methodist Debakey Cardiovasc J. 2018;14:32–41.
2. Pavillard, et. al. A post-market, multi-vessel evaluation of the imaging of peripheral arteries for diagnostic purposeS comparing optical Coherence tomogrApy and iNtravascular ultrasound imaging (SCAN). BMC Med Imaging. 2020 Feb 14;20(1):18.
3. Makris GC, Chrysafi P, Little M, et al. The role of intravascular ultrasound in lower limb revascularization in patients with peripheral arterial disease. Int Angiol. 2017;36:505–16.
4. Singh, et al. Tissue removal by ultrasound evaluation. (the TRUE study): the Jetstream G2 system post-market peripheral vascular IVUS study. J Invasive Cardiol. 2011;23(7):269–73.
5. Kashyap, et al. In vivo assessment of endothelial function in human lower extremity arteries. J Vasc Surg. 2013;58(5):1259–66.
6. Farooq, et al.. The role of optical coherence tomography in vascular medicine. Vasc Med. 2009;14:63–71.
7. Tarricone, et al. Histopathological Evidence of Adventitial or Medial Injury Is a Strong Predictor of Restenosis During Directional Atherectomy for Peripheral Artery Disease. J Endovasc Ther. 2015 Oct;22(5):712-5.
8. Stavroulakis, et al. Optical coherence tomography guided directional atherectomy with antirestenotic therapy for femoropopliteal arterial disease. J Cardiovasc Surg (Torino). 2019 Apr;60(2):191-197