Volumetric microscopy of cerebral arteries with a miniaturized optical coherence tomography imaging probe

Vitor M. Pereira, Department of Surgery, Division of Neurosurgery, St Michael's Hospital, Toronto, ON M5B 1W8, Canada.
Pedro Lylyk, Department of Interventional Neuroradiology, Clínica Sagrada Familia, Buenos Aires, CABA C1426, Argentina.
Nicole Cancelliere, Department of Surgery, Division of Neurosurgery, St Michael's Hospital, Toronto, ON M5B 1W8, Canada.
Pedro N. Lylyk, Department of Interventional Neuroradiology, Clínica Sagrada Familia, Buenos Aires, CABA C1426, Argentina.
Ivan Lylyk, Department of Interventional Neuroradiology, Clínica Sagrada Familia, Buenos Aires, CABA C1426, Argentina.
Vania Anagnostakou, Department of Radiology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA.
Carlos Bleise, Department of Interventional Neuroradiology, Clínica Sagrada Familia, Buenos Aires, CABA C1426, Argentina.
Hidehisa Nishi, Department of Surgery, Division of Neurosurgery, St Michael's Hospital, Toronto, ON M5B 1W8, Canada.
Mark Epshtein, Department of Radiology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA.
Robert M. King, Department of Radiology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA.
Mohammed Salman Shazeeb, Department of Radiology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA.
Ajit S. Puri, Department of Radiology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA.
Conrad W. Liang, Department of Neurosurgery, Kaiser Permanente Fontana Medical Center, Fontana, CA 92335, USA.
Ricardo A. Hanel, Lyerly Neurosurgery, Baptist Medical Center Jacksonville, Jacksonville, FL 32207, USA.
Julian Spears, Department of Surgery, Division of Neurosurgery, St Michael's Hospital, Toronto, ON M5B 1W8, Canada.
Thomas R. Marotta, Department of Surgery, Division of Neurosurgery, St Michael's Hospital, Toronto, ON M5B 1W8, Canada.
Demetrius K. Lopes, Advocate Health - MidwestFollow
Matthew J. Gounis, Department of Radiology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA.
Giovanni J. Ughi, Department of Radiology, University of Massachusetts Chan Medical School, Worcester, MA 01655, USA.

Abstract

Endovascular interventions are increasingly becoming the preferred approach for treating strokes and cerebral artery diseases. These procedures rely on sophisticated angiographical imaging guidance, which encounters challenges because of limited contrast and spatial resolution. Achieving a more precise visualization of the underlying arterial pathology and neurovascular implants is crucial for accurate procedural decision-making. In a human study involving 32 patients, we introduced the clinical application of a miniaturized endovascular neuro optical coherence tomography (nOCT) imaging probe. This technology was designed to navigate the tortuous paths of the cerebrovascular circulation and to offer high-resolution imaging in situ. The nOCT probe is compatible with standard neurovascular microcatheters, integrating with the procedural workflow used in clinical routine. Equipped with a miniaturized optical fiber and a distal lens, the probe illuminates the tissue and collects the backscattered, near-infrared light. While rotating the fiber and the lens at high speed, the probe is rapidly retracted, creating a spiral-shaped light pattern to comprehensively capture the arterial wall and implanted devices. Using nOCT, we demonstrated volumetric microscopy of cerebral arteries in patients undergoing endovascular procedures. We imaged the anterior and posterior circulation of the brain, including distal segments of the internal carotid and middle-cerebral arteries, as well as the vertebral, basilar, and posterior cerebral arteries. We captured a broad spectrum of neurovascular pathologies, such as brain aneurysms, ischemic stroke, arterial stenoses, dissections, and intracranial atherosclerotic disease. nOCT offered artifact-free, high-resolution visualizations of intracranial artery pathology and neurovascular devices.

Document Type

Article

PubMed ID

38748771

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