OCT of Chronic Total Occulsions

Chronic total occlusions of coronary and peripheral arteries are defined as arteries that appear occluded under angiography and are thought to have been present for greater than one month. Current intravascular interventions are limited by the lack of a suitable guidance means for differentiating between the occluded lumen and the vessel wall. Optical Coherence Tomography (OCT) is an attractive means for providing depth-resolved guidance during intervention of these lesions due to its sensitivity to the different arterial components. Previous work sought to evaluate OCT's ability to image different pathologies seen in CTOs using a time domain system to image arterial segments. Here we explore the use of a miniaturized electrothermal polymer incorporated into a catheter with a GRIN lens as a means of providing an intravascular image. Imaging parameters of the probe will be discussed. The appearance of tapered entrances of CTOs is presented. The use of a swept-source frequency domain imaging system is shown to provide greater imaging range through clarified endoluminal microchannels; doppler flow through these channels is also seen which may aid in guidance during recanalization.

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