Author + information
- Vasim Farooq, MBChB,
- Takayuki Okamura, MD, PhD,
- Bill D. Gogas, MD,
- Jung Ho Heo, MD,
- Michael Magro, MD,
- Josep Gomez-Lara, MD,
- Salvatore Brugaletta, MD,
- Yoshinobu Onuma, MD,
- Maria Radu, MD,
- Hector M. Garcìa-Garcìa, MD, MSc, PhD and
- Patrick W. Serruys, MD, PhD⁎ ()
- ↵⁎Interventional Cardiology Department, Erasmus MC, ′s-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands
Two-dimensional (2D) Fourier domain optical coherence tomography (FD-OCT) has enhanced our understanding of coronary atherosclerotic disease and is increasingly being used in conventional percutaneous coronary intervention (PCI) to elucidate mechanisms of disease and to improve our understanding of complex coronary anatomy. Prototypes of current generation “real-time” (i.e., peri-procedural) 3-dimensional (3D) FD-OCT are experimental, are still works in progress and have not yet entered conventional clinical practice.
Offline 3D FD-OCT reconstructions have previously been described (1). We have demonstrated the clear progression of this technology since then (Figs. 1 and 2).⇓ The 3D FD-OCT reconstructions of patients who underwent conventional PCI from the original first-in-man study of the intracoronary Terumo optical frequency domain imaging (OFDI) system (Terumo Corporation, Tokyo, Japan) are presented (2). The high-speed Terumo OFDI system is capable of acquiring 160 frames/s during the catheter pullback, to a maximum speed of 40 mm/s; all images were acquired with a motorized pullback of 20 mm/s. Manual detection of every strut in each cross section, using bitmap sequences (704 × 704 pixels) generated from prior 2D FD-OCT imaging, were performed and 3D reconstructions generated using volume-rendering software (INTAGE Realia, KGT, Tokyo, Japan).
Nomenclature for 3D FD-OCT Reconstructions
“Fly-through” views indicate a selected still image of an internal view of a vessel looking either downstream (proximal to distal vessel) or upstream (distal to proximal vessel). The fly-through (internal) view of the vessel is akin to the view obtained during endoscopy or angioscopy showing the internal lumen of the vessel.
Longitudinal views are a cutaway view of the vessel down the longitudinal axis with the internal lumen viewed externally.
External views are taken from outside the vessel with views to show the internal vessel at the region of interest.
We demonstrate the potential complementary clinical role that 3D reconstruction of FD-OCT has over 2D FD-OCT imaging. Instantaneous, real-time 3D FD-OCT rendering of a resolution similar to that seen with offline production would be advantageous before this can potentially enter conventional PCI practice. Validation of 3D FD-OCT is required to help further understand the complexities of these findings, in particular at the bifurcation.
Dr. Farooq wishes to thank the Dickinson Trust Travelling Scholarship, Manchester Royal Infirmary, Manchester, England, United Kingdom. The authors wish to express their sincere thanks to Robert-Jan M. van Geuns, MD, PhD; Carl Schultz, MD, PhD; Willem J. van der Giessen, MD, PhD; Jurgen Ligthart, BSc; and Evelyn Regar, MD, PhD, of the ThoraxCenter, Erasmus University Medical Centre, Rotterdam, the Netherlands, part of the team who undertook the original first-in-man study of the intracoronary Terumo OFDI system. The authors also thank Drs. Dragica Paunovic and Vladimir Borovicanin of Terumo Corporation and Terumo Europe N.V. for their invaluable technical support.
- American College of Cardiology Foundation