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The Art of Catheter-Based Imaging

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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 …

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.

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  • 1. The A! of Catheter-Based Imaging Kendall R. Waters, PhD Manager, IP and Technology Development kendallw@svmii.com Animation from iStockPhoto.com
  • 2. Coronary Artery Disease Animation from CardioTube Bare-Metal IVUS Stent Balloon Drug-Eluting Angioplasty Stent Coronary Angiogram TD-OCT Cardiac Catheterization FD-OCT 1920 1940 1960 1980 2000 2020
  • 3. Cardiac Catheterization Image from Angioplasty.org Accessing the Coronary Arteries Image from ShutterStock.com
  • 4. Coronary Angiogram Video from YouTube.com Balloon Angioplasty Post-Intervention Pre-Intervention Video from YouTube.com
  • 5. An Early IVUS Image 5.5F 20 MHz 10 FPS Nissen et al., Circulation 1991; 84: 1087-1099. Advances in Intracoronary Imaging Light Catheter Source Profile Pullback Transducer Technology Orientation Blood Imaging Clearing Frequency Plaque System Classification Integration
  • 6. Transducer Orientation InterTherapy CVIS Endosonics Patents downloaded from FreePatentsOnline.com Intracoronary Ultrasound Catheters Mechanically Rotating Catheter Synthetic Aperture Array Catheter
  • 7. 2 Progress ? %( c. 1999 c. 2009 Fitzgerald et al., Circulation. 2000;102:523-530. Waksman, China Interventional Therapeutics 2009. A Telescoping Catheter Catheter Proximal Distal! Hub !!!!!!!!!!!!!!!!!!!!!!!!!! !!!!!!!!!!!!!!!!!!!!!!!!!!!! ! ! ! Sheath !!!!!!!!!!!!!! Tip One Way Luer Proximal Shaft Monorail 109 cm 23mm 3.5F 3.2F RO Telescoping Section Marker Pullback Length Usable Length Fig. 1 150 mm 135 cm Telescoping ! ! ! ! ! ! ! Distal ! ! ! ! ! ! ! Section ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Sheath ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 2 2 2 Image from VolcanoCorp.com ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! 2 ! ! 2 ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !
  • 8. Interface Module and Sled Modular Integrated Intravascular Ultrasound Video from YouTube.com
  • 9. Plaque Classification Volcano VH-IVUS BSC iMAP Terumo IB-IVUS Necrotic Core Necrotic Lipid Pool Fibro-Fatty Lipidic Fibrosis Fibrosis Fibrotic Dense Fibrosis Calcification Calcified Calcification First Generation OCT TD-OCT Vessel Occlusion Animations from LightlabImaging.com
  • 10. Second Generation OCT FD-OCT Contrast Flush Animations from LightlabImaging.com FD-OCT Pullback Video from LightlabImaging.com
  • 11. c. 1995 c. 2000 c. 2005
  • 12. ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' Advances in Intracoronary Imaging ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' Light ' Catheter ' ' ' ' ' ' ' ' ' ' ' ' ' Source ' ' ' Profile ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' Pullback ' ' ' ' ' Transducer ' ' 'Technology ' ' ' ' ' Orientation '' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' Blood ' ' ' ' Imaging ' ' ' ' ' Clearing ' '' ' Frequency ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' Plaque ' ' ' System ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' Classification' Integration ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ! Perspectives '' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' '' ' ' '' ' ' ' ' ' ' ' ' Yuan et al., 2008' IEEE International Ultrasonics' Symposium.' ' '! ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' ' Courtesy of Dr. Brian Courtney MD and Brian Liang, Sunnybrook Health Sciences Centre,Toronto, CA
  • 13. Thank You Kendall R. Waters, PhD Manager, IP and Technology Development kendallw@svmii.com

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