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Boston sci

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Boston sci

  1. 1. Intravascular Ultrasound for Plaque Characterization Scott R. Smith Boston Scientific Corporation The 3rd Vulnerable Plaque Symposium March 16, 2002
  2. 2. Who needs interventional diagnosis and treatment? Population Size Annual Risk Healthy People Huge <<1% “Risk Factors” Really Big ~1% Walking Time Bombs Still quite a few >10% Summary of National Heart, Lung, and Blood Institute Workshop on Cardiovascular Risk Assessment
  3. 3. Diagnosis of Vulnerable Plaque selecting a population positive negative 67% positive predictive value 99% negative predictive value likelyhood ratio test 9% 5% total unaffected 14% true positive false positive 1% 86% 87% false negative true negative positive negative 18 90% 95% sensitivity specificity 10% 90% total affected Total 100 at risk 10 treated 14 saved 9 unnecessary 5 missed 1
  4. 4. Plaque Structure Courtesy of Dr. Renu Virmani Armed Forces Institute of Pathology
  5. 5. IVUS Plaque Imaging Ruptured plaque
  6. 6. Boston Scientific Imaging Systems Atlantis™ SR Plus Catheter Galaxy™ IVUS System Features & Intended Benefits • Tapered tip; 2.5 Fr. Crossing Profile • High definition 40MHz IVUS catheter. • 6F Guide Catheter Compatibility.
  7. 7. Galaxy™ System Features and Intended Benefits Time-Saving Features – Image Bookmarking – LongView™ longitudinal measurements – Pullback sled Enhanced Ease of Use – TraceAssist™ automatic lumen trace function – Angiographic compatibility – Push button control
  8. 8. Galaxy™ System Research Capabilities Expanded Functionality – Digital image storage – Patient database – Pre/post intervention analysis. RF Output – Direct Access to RF signal for acquisition and analysis – Future plans may include direct RF signal acquisition
  9. 9. Imaging vs. Analysis RF Rectified and Log compressed Low passed filtered - 10MHz One image vector
  10. 10. Other Imaging Modalities IVUS acoustic impedance MRI proton relaxation Thermal temperature OCT refractive index Spectroscopy chemical bonds Independence Spatial resolution Contrast
  11. 11. Conclusion • Intravascular Ultrasound currently widely used for intravascular imaging • Broad potential for plaque volume measurement and tissue characterization • Variety of research efforts aimed at improving tissue contrast and resolution Thanks to: – Tat Jin Teo, PhD - BSC Imaging – Renu Virmani, MD - AFIP – Jay Kokate, PhD - BSC Applied Research

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