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<meta name="DC.Title" content="Intravascular Frequency-Domain Optical Coherence Tomography Assessment of Atherosclerosis and Stent-Vessel Interactions in Human Carotid Arteries" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3016" />
<meta name="DC.Date" content="2012-09-01" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Carotid artery–related stroke is largely an embolic disease that has been correlated with inflammation, plaque rupture, and thrombus formation in “vulnerable” atherosclerotic plaque. Nevertheless, current guidelines for carotid revascularization in asymptomatic patients rely on the calculation of stenosis for risk assessment, a parameter that has been viewed with increasing skepticism. Intravascular OCT is an imaging technique that offers high axial resolution (10 μm), allowing an unprecedented micron-level assessment of human carotid plaque morphology. This observational article reports the first successful use of the newest iteration of this technology, FDOCT without balloon occlusion to assess human carotid artery disease and carotid stent-vessel interaction in vivo.

MATERIALS AND METHODS: Four patients with asymptomatic carotid artery disease and ambiguous noninvasive and/or angiographic data underwent carotid FDOCT to assess risk and to formulate a treatment strategy.

RESULTS: Findings include the unexpected demonstration of TCFAs, plaque rupture, thrombus, inflammation, and marked tissue prolapse through stent struts in patients without high-risk factors by conventional criteria, as well as low-risk features in a patient with a high-risk noninvasive study. The procedures were performed without safety issues or special accommodations for vessel occlusion.

CONCLUSIONS: The present study demonstrates the technical feasibility of FDOCT in cervical carotid arteries. As such, this technology holds the promise of not only clarifying ambiguous data in individual patients but of providing data that might call for a future paradigm shift in the assessment of asymptomatic carotid artery disease.

CCA
:   common carotid artery
FDOCT
:   frequency-domain optical coherence tomography
NIH
:   neointimal hyperplasia
OCT
:   optical coherence tomography
TCFA
:   thin-cap fibroatheroma
TDOCT
:   time-domain optical coherence tomography" />
<meta name="DC.Contributor" content="M.R. Jones" />
<meta name="DC.Contributor" content="G.F. Attizzani" />
<meta name="DC.Contributor" content="C.A. Given" />
<meta name="DC.Contributor" content="W.H. Brooks" />
<meta name="DC.Contributor" content="M.A. Costa" />
<meta name="DC.Contributor" content="H.G. Bezerra" />
<meta name="article:published_time" content="2012-09-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Intravascular Frequency-Domain Optical Coherence Tomography Assessment of Atherosclerosis and Stent-Vessel Interactions in Human Carotid Arteries" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Carotid artery–related stroke is largely an embolic disease that has been correlated with inflammation, plaque rupture, and thrombus formation in “vulnerable” atherosclerotic plaque. Nevertheless, current guidelines for carotid revascularization in asymptomatic patients rely on the calculation of stenosis for risk assessment, a parameter that has been viewed with increasing skepticism. Intravascular OCT is an imaging technique that offers high axial resolution (10 μm), allowing an unprecedented micron-level assessment of human carotid plaque morphology. This observational article reports the first successful use of the newest iteration of this technology, FDOCT without balloon occlusion to assess human carotid artery disease and carotid stent-vessel interaction in vivo.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Four patients with asymptomatic carotid artery disease and ambiguous noninvasive and/or angiographic data underwent carotid FDOCT to assess risk and to formulate a treatment strategy.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Findings include the unexpected demonstration of TCFAs, plaque rupture, thrombus, inflammation, and marked tissue prolapse through stent struts in patients without high-risk factors by conventional criteria, as well as low-risk features in a patient with a high-risk noninvasive study. The procedures were performed without safety issues or special accommodations for vessel occlusion.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The present study demonstrates the technical feasibility of FDOCT in cervical carotid arteries. As such, this technology holds the promise of not only clarifying ambiguous data in individual patients but of providing data that might call for a future paradigm shift in the assessment of asymptomatic carotid artery disease.&lt;/p&gt;" />
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<meta name="twitter:title" content="Intravascular Frequency-Domain Optical Coherence Tomography Assessment of Atherosclerosis and Stent-Vessel Interactions in Human Carotid Arteries" />
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<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/33/8.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Carotid artery–related stroke is largely an embolic disease that has been correlated with inflammation, plaque rupture, and thrombus formation in “vulnerable” atherosclerotic plaque. Nevertheless, current guidelines for carotid revascularization in asymptomatic patients rely on the calculation of stenosis for risk assessment, a parameter that has been viewed with increasing skepticism. Intravascular OCT is an imaging technique that offers high axial resolution (10 μm), allowing an unprecedented micron-level assessment of human carotid plaque morphology. This observational article reports the first successful use of the newest iteration of this technology, FDOCT without balloon occlusion to assess human carotid artery disease and carotid stent-vessel interaction in vivo.

MATERIALS AND METHODS: Four patients with asymptomatic carotid artery disease and ambiguous noninvasive and/or angiographic data underwent carotid FDOCT to assess risk and to formulate a treatment strategy.

RESULTS: Findings include the unexpected demonstration of TCFAs, plaque rupture, thrombus, inflammation, and marked tissue prolapse through stent struts in patients without high-risk factors by conventional criteria, as well as low-risk features in a patient with a high-risk noninvasive study. The procedures were performed without safety issues or special accommodations for vessel occlusion.

CONCLUSIONS: The present study demonstrates the technical feasibility of FDOCT in cervical carotid arteries. As such, this technology holds the promise of not only clarifying ambiguous data in individual patients but of providing data that might call for a future paradigm shift in the assessment of asymptomatic carotid artery disease.

CCA
:   common carotid artery
FDOCT
:   frequency-domain optical coherence tomography
NIH
:   neointimal hyperplasia
OCT
:   optical coherence tomography
TCFA
:   thin-cap fibroatheroma
TDOCT
:   time-domain optical coherence tomography" />
<meta name="og-title" property="og:title" content="Intravascular Frequency-Domain Optical Coherence Tomography Assessment of Atherosclerosis and Stent-Vessel Interactions in Human Carotid Arteries" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/33/8/1494" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Carotid artery–related stroke is largely an embolic disease that has been correlated with inflammation, plaque rupture, and thrombus formation in “vulnerable” atherosclerotic plaque. Nevertheless, current guidelines for carotid revascularization in asymptomatic patients rely on the calculation of stenosis for risk assessment, a parameter that has been viewed with increasing skepticism. Intravascular OCT is an imaging technique that offers high axial resolution (10 μm), allowing an unprecedented micron-level assessment of human carotid plaque morphology. This observational article reports the first successful use of the newest iteration of this technology, FDOCT without balloon occlusion to assess human carotid artery disease and carotid stent-vessel interaction in vivo.

MATERIALS AND METHODS: Four patients with asymptomatic carotid artery disease and ambiguous noninvasive and/or angiographic data underwent carotid FDOCT to assess risk and to formulate a treatment strategy.

RESULTS: Findings include the unexpected demonstration of TCFAs, plaque rupture, thrombus, inflammation, and marked tissue prolapse through stent struts in patients without high-risk factors by conventional criteria, as well as low-risk features in a patient with a high-risk noninvasive study. The procedures were performed without safety issues or special accommodations for vessel occlusion.

CONCLUSIONS: The present study demonstrates the technical feasibility of FDOCT in cervical carotid arteries. As such, this technology holds the promise of not only clarifying ambiguous data in individual patients but of providing data that might call for a future paradigm shift in the assessment of asymptomatic carotid artery disease.

CCA
:   common carotid artery
FDOCT
:   frequency-domain optical coherence tomography
NIH
:   neointimal hyperplasia
OCT
:   optical coherence tomography
TCFA
:   thin-cap fibroatheroma
TDOCT
:   time-domain optical coherence tomography" />
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      <h1 class="highwire-cite-title" id="page-title">Intravascular Frequency-Domain Optical Coherence Tomography Assessment of Atherosclerosis and Stent-Vessel Interactions in Human Carotid Arteries</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">M.R. Jones</span>, <span class="highwire-citation-author" data-delta="1">G.F. Attizzani</span>, <span class="highwire-citation-author" data-delta="2">C.A. Given</span>, <span class="highwire-citation-author" data-delta="3">W.H. Brooks</span>, <span class="highwire-citation-author" data-delta="4">M.A. Costa</span> and <span class="highwire-citation-author" data-delta="5">H.G. Bezerra</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2012,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">33 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1494-1501; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3016 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-12056--6178104194" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">M.R. Jones </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Baptist Heart and Vascular Institute (M.R.J., C.A.G., W.H.B.), Central Baptist Hospital, Lexington, Kentucky</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.R.%2BJones%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Jones%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.R.%2BJones%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">G.F. Attizzani </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>bHarrington McLaughlin Heart and Vascular Institute (G.F.A., M.A.C., H.G.B.), University Hospitals, Case Medical Center, Case Western Reserve University, Cleveland, Ohio</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.F.%2BAttizzani%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Attizzani%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AG.F.%2BAttizzani%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">C.A. Given <span class="nlm-suffix">II</span></div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Baptist Heart and Vascular Institute (M.R.J., C.A.G., W.H.B.), Central Baptist Hospital, Lexington, Kentucky</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.A.%2BGiven%2B%3Cspan%2Bclass%3D%22nlm-suffix%22%3EII%3C/span%3E" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Given%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AC.A.%2BGiven%2BII" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">W.H. Brooks </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>aFrom the Baptist Heart and Vascular Institute (M.R.J., C.A.G., W.H.B.), Central Baptist Hospital, Lexington, Kentucky</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=W.H.%2BBrooks%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Brooks%20W&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AW.H.%2BBrooks%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">M.A. Costa </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>bHarrington McLaughlin Heart and Vascular Institute (G.F.A., M.A.C., H.G.B.), University Hospitals, Case Medical Center, Case Western Reserve University, Cleveland, Ohio</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.A.%2BCosta%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Costa%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.A.%2BCosta%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">H.G. Bezerra </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>bHarrington McLaughlin Heart and Vascular Institute (G.F.A., M.A.C., H.G.B.), University Hospitals, Case Medical Center, Case Western Reserve University, Cleveland, Ohio</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.G.%2BBezerra%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bezerra%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AH.G.%2BBezerra%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> Carotid artery–related stroke is largely an embolic disease that has been correlated with inflammation, plaque rupture, and thrombus formation in “vulnerable” atherosclerotic plaque. Nevertheless, current guidelines for carotid revascularization in asymptomatic patients rely on the calculation of stenosis for risk assessment, a parameter that has been viewed with increasing skepticism. Intravascular OCT is an imaging technique that offers high axial resolution (10 μm), allowing an unprecedented micron-level assessment of human carotid plaque morphology. This observational article reports the first successful use of the newest iteration of this technology, FDOCT without balloon occlusion to assess human carotid artery disease and carotid stent-vessel interaction in vivo.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> Four patients with asymptomatic carotid artery disease and ambiguous noninvasive and/or angiographic data underwent carotid FDOCT to assess risk and to formulate a treatment strategy.</p>
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<p id="p-4"><strong>RESULTS:</strong> Findings include the unexpected demonstration of TCFAs, plaque rupture, thrombus, inflammation, and marked tissue prolapse through stent struts in patients without high-risk factors by conventional criteria, as well as low-risk features in a patient with a high-risk noninvasive study. The procedures were performed without safety issues or special accommodations for vessel occlusion.</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> The present study demonstrates the technical feasibility of FDOCT in cervical carotid arteries. As such, this technology holds the promise of not only clarifying ambiguous data in individual patients but of providing data that might call for a future paradigm shift in the assessment of asymptomatic carotid artery disease.</p>
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</div><div class="section glossary" id="glossary-1"><h2>ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">CCA<span class="def-item-dt-sep"></span></dt><dd>common carotid artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">FDOCT<span class="def-item-dt-sep"></span></dt><dd>frequency-domain optical coherence tomography<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">NIH<span class="def-item-dt-sep"></span></dt><dd>neointimal hyperplasia<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">OCT<span class="def-item-dt-sep"></span></dt><dd>optical coherence tomography<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">TCFA<span class="def-item-dt-sep"></span></dt><dd>thin-cap fibroatheroma<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">TDOCT<span class="def-item-dt-sep"></span></dt><dd>time-domain optical coherence tomography</dd></dl>
</div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2012 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/33/8/1494.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 33</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 8 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Sep 2012 </div></div>
      
      
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