Navigating a guide wire through total occlusions: clinical experience

John M. Neet; Thomas R. Winston M.D.; Allan D. Hedrick; Jaques J. Koolen M.D.; Hans Bonnier M.D.

doi:10.1117/12.386297

17 May 2000 Navigating a guide wire through total occlusions: clinical experience

John M. Neet, Thomas R. Winston M.D., Allan D. Hedrick, Jaques J. Koolen M.D., Hans Bonnier M.D.

Proceedings Volume 3907, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems X; (2000) https://doi.org/10.1117/12.386297
Event: BiOS 2000 The International Symposium on Biomedical Optics, 2000, San Jose, CA, United States

Abstract

One of the last remaining frontiers in angioplasty interventions is successfully recanalizing arteries containing total occlusions. The primary limiting condition is the inability to pass a guide wire safely across the total occlusion to facilitate therapeutic interventions. The operator has to perform the intervention without the assistance of x-ray imaging to define the vessel's path since the contrast media flow is blocked by the occlusion. To overcome this limitation, a guide wire system has been developed that transmits low coherence near-infrared light through an optical fiber internal to the guide wire and illuminates the tissue adjacent the distal end. Differences in the scattering of near-infrared light by the normal arterial wall and occluding tissues are detected by optical coherence reflectometry (OCR) techniques. Through a real-time monitoring system and display, the physician is warned if the guide wire approaches the normal arterial wall, allowing the guide wire to be redirected to prevent perforating the vessel. The system has been used in clinical coronary angioplasty cases demonstrating the ability to cross 10 out of 11 total occlusions without any perforations or dissections. The OCR guide wire system has demonstrated clinical potential and will require additional testing for clinical efficacy claims.

Citation Download Citation

John M. Neet, Thomas R. Winston M.D., Allan D. Hedrick, Jaques J. Koolen M.D., and Hans Bonnier M.D. "Navigating a guide wire through total occlusions: clinical experience", Proc. SPIE 3907, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems X, (17 May 2000); https://doi.org/10.1117/12.386297

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