Author + information
- Received August 16, 2018
- Revision received September 5, 2018
- Accepted September 11, 2018
- Published online December 3, 2018.
- Tej N. Sheth, MDa,∗ (, )
- Natalia Pinilla-Echeverri, MD, MSca,
- Shamir R. Mehta, MD, MSca and
- Brian K. Courtney, MD, MSEEb,c
- aPopulation Health Research Institute, Hamilton Health Sciences and Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- bSunnybrook Research Institute, Schulich Heart Program, University of Toronto, Toronto, Ontario, Canada
- cConavi Medical, North York, Ontario, Canada
- ↵∗Address for correspondence:
Dr. Tej Sheth, DBCVSRI Building, Hamilton General Hospital, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada.
We report the first-in-human images with any hybrid imaging catheter combining intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The catheter has a 2.8-F imaging window with a 40-MHz center frequency for IVUS imaging. The IVUS and OCT beams are aligned with each other, allowing inherent coregistration and immediate simultaneous image review.
Imaging was performed in a 74-year-old male patient with a recent inferior ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention in the distal right coronary artery (Online Video 1). Imaging was performed over 90 mm of the right coronary artery at a pull-back speed of 25 mm/s, with contrast flushing at 3 ml/s for 5 s. Figure 1 highlights the complementary roles of IVUS and OCT to characterize atherosclerotic plaque types.
A nonculprit lesion was present in the mid left anterior descending coronary artery (Online Video 2). Staged intervention was performed with implantation of a Promus 2.75 × 20 mm (Boston Scientific, Natick, Massachusetts) stent (Online Video 3). Imaging was performed after stent implantation over a 70-mm length at a pull-back speed of 25 mm/s and contrast flush at 4 ml/s for 4 s. Imaging findings in the left anterior descending coronary artery and D1 are shown in Figure 2. The imaging pull-back (Online Video 4) shows a dissection distal to the left anterior descending coronary artery stent. Near-field findings of dissection and stent apposition are better appreciated on OCT, while deeper features such as side branches and plaque burden are better assessed on IVUS.
This first in vivo experience of hybrid IVUS and OCT demonstrates the synergistic ability of these modalities to characterize coronary atherosclerosis and coronary interventions.
This study was supported by a research grant from Conavi Medical. Dr. Pinilla-Echeverri is a consultant for Conavi Medical. Dr. Courtney has significant equity ownership, a director position, and employment with Conavi Medical as well as royalty rights; his lab at the Sunnybrook Research Institute also receives research funding from Conavi Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 16, 2018.
- Revision received September 5, 2018.
- Accepted September 11, 2018.
- 2018 American College of Cardiology Foundation