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Original research
Intravascular optical coherence tomography for the evaluation of arterial bifurcations covered by flow diverters
  1. Christina Iosif1,2,
  2. Suzana Saleme1,2,
  3. Sebastien Ponsonnard3,
  4. Pierre Carles4,
  5. Eduardo Pedrolo Silveira1,
  6. Eduardo Waihrich1,
  7. Gilles Trolliard4,
  8. Catherine Yardin2,5,
  9. Charbel Mounayer1,2
  1. 1Interventional Neuroradiology Department, Dupuytren University Hospital (CHU Limoges), Limoges, France
  2. 2Applied Medical Research Team (ERMA), University of Limoges, Limoges, France
  3. 3Anesthesiology Department, Dupuytren University Hospital (CHU Limoges), Limoges, France
  4. 4Departments of Science of Ceramic Processes and Surface Treatments, CNRS, UMR 7315, European Ceramic Center, University of Limoges, France
  5. 5Department of Histology, Cytology, Cellular Biology and Cytogenetics, Mother and Child (HME) University Hospital, Limoges, France
  1. Correspondence to Dr Christina Iosif, Interventional Neuroradiology Department, Dupuytren University Hospital (CHU Limoges), 2 Avenue Martin Luther King, Limoges 87042, France; christina.iosif{at}gmail.com, christinaiosif{at}yahoo.gr

Abstract

Background and objective Due to its high spatial resolution, intravascular optical coherence tomography (OCT) has been used as a valid method for in vivo evaluation of several types of coronary stents at straight lumen and bifurcation sites. We sought to evaluate its effectiveness for flow diverting stents deployed in arterial bifurcation sites involving jailing of a side branch.

Methods Four large white swine were stented with flow diverting stents covering the right common carotid artery–ascending pharyngeal artery bifurcation. After 12 weeks of follow-up the animals were evaluated by digital subtraction angiography and intravascular OCT and subsequently sacrificed. Neointimal thickness on the parent arteries and the free segments of the stent were measured. The stented arteries were harvested and underwent scanning electron microscopy (SEM) imaging. Ostia surface values were measured with OCT three-dimensional (3D) reconstructions and SEM images.

Results All endovascular procedures and OCT pullback runs were feasible. Stent apposition was satisfactory on the immediate post-stent OCT reconstructions. At 12-week controls, all stents and jailed branches were patent. Mean neointimal thickness was 0.11±0.04 mm on the free segments of the stent. The mean ostia surface at 12 weeks was 319 750±345 533 μm2 with 3D-OCT reconstructions and 351 198±396 355 μm2 with SEM image-derived calculations. Good correlation was found for ostia surface values between the two techniques; the values did not differ significantly in this preliminary study.

Conclusions Intravascular OCT appears to be a promising technique for immediate and follow-up assessment of the orifice of arterial branches covered by flow diverting stents.

  • Catheter
  • Flow Diverter
  • Material
  • Stent
  • Vessel Wall

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