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Commentary
'Exploring outer space': neurovascular optical coherence tomography beyond the vessel wall
  1. Michael O Breckwoldt,
  2. Martin Bendszus,
  3. Markus A Möhlenbruch
  1. Department of Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany
  1. Correspondence to Dr Michael O Breckwoldt, Department of Neuroradiology, University Hospital Heidelberg Im Neuenheimer Feld 400 69120, Heidelberg, Germany; Michael.Breckwoldt{at}med.uni-heidelberg.de

https://doi.org/10.1136/neurintsurg-2022-018822

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    Intravascular imaging has always depended on contrast agents. This gives excellent contrast to delineate the vascular anatomy by DSA with sub-millimeter resolution. However, DSA does not visualize details of the vessel wall or adjacent structures, such as the subarachnoid space (SAS). Therefore, the SAS with its small vessel branches and perforators, cranial nerves, and connecting tissues that run in the SAS have largely been a 'hidden space' that was not assessable by neurological imaging (although MRI captures the SAS to some degree with resolution of ~1 mm at clinical field strengths).

    The developments in intravascular optical coherence tomography (OCT) have opened new avenues to visualize the vessel wall to probe for example, atherosclerotic plaques, vessel stenosis, dissection, and aneurysmal wall anatomy. In their JNIS paper, Anagnostakou et al take neurovascular OCT imaging to …

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    Footnotes

    • Contributors MOB wrote the manuscript with input from all of the coauthors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

    • Competing interests There was no specific funding source for this comment. MOB received research support outside of this work from the German Research Foundation (DFG,Emmy Noether program, BR 6153/1-1 and CRC 1389), the Else Kröner Foundation, and Novartis GmbH. MB received grants from DFG, HoppFoundation, Novartis, Siemens, Guerbet, Stryker, and the European Union; MB reports receiving honoraria from Roche, Guerbet, and Codman, and lecture honoraria for lectures (including service on speakers bureaus) from Novartis, Roche, Guerbet, Teva, Bayer, Codman, Boehringer, and Grifols; MB holds board memberships at DSMB Vascular Dynamics, Guerbet, and NeuroScios. MAM has received consulting honoraria, speaker honoraria, and travel support outside this work from Codman, Covidien/Medtronic, MicroVention, Phenox and Stryker.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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      Transvascular in vivo microscopy of the subarachnoid space
      Vania Anagnostakou Mark Epshtein Giovanni J Ughi Robert M King Antonios Valavanis Ajit S Puri Matthew J Gounis
      Journal of NeuroInterventional Surgery 2022; 14 420-428 Published Online First: 03 Feb 2022. doi: 10.1136/neurintsurg-2021-018544