Abstract
This manuscript describes initial applications of a unique new intravascular ultrasound imaging catheter. This 5.5F catheter uses an over-the-wire design and incorporates a phased array transducer at its tip. There are no moving parts. A 360° image is produced perpendicular to the catheter axis using a 20 MHz center frequency. A dedicated minicomputer is used for initial image processing, as well as enhancement and analysis. Initial studies using phantoms demonstrated excellent accuracy for linear dimensions (r=0.99, range 3.0 to 7.6mm, image = 1.0 phantom + 0.1). Serial imaging of the same arterial segment in vitro showed good reproducibility (coefficients of variance 2.5–5.2%). Likewise, intra- and inter-observer variability in image analysis was minimal (r=0.92–0.99). Initial in vivo studies were performed in dogs. The catheter was easily passed over a wire into mesenteric, cerebral and coronary vessels without evidence of significant vessel trauma. Subsequently, 20 patients had percutaneous coronary imaging performed during cardiac catheterization. Cardiac motion was rarely a problem and acceptable images were obtained in all but two patients. Areas of calcification, mild stenoses, branching vessels and graft atherosclerosis could be identified. We conclude that intracoronary ultrasound imaging will be useful for assessing vascular pathology, for studying both rapid change in vessel size as well as chronic progression or regression of atherosclerosis, and for assisting with new therapeutic interventions.
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Mancini G, Simon G, McGillem MJ, LeFree M, Friedman H, Vogel R. Automated quantitative coronary arteriography: morphologic and physiologic validation in vivo of a rapid digital angiographic method. Circulation 1987; 75: 452–60.
Spears J, Sandor T, Als A, et al. Computerized image analysis for quantitative measurement of vessel diameter from cineangiograms. Circulation 1983; 68: 453–61.
Grondin C, Dyrda I, Pasternac A, Campean L, Bourassa M, Lesperance J. Discrepancies between cineangiographic and postmortem findings in patients with coronary artery disease and recent myocardial revascularization. Circulation 1974; 49: 703–8.
Arnett E, Isner J, Redwood P, et al. Coronary artery narrowing in coronary heart disease: Comparison of cineangiographic and necropsy findings. Ann Intern Med 1979; 91: 350–6.
Sherman C, Litvack F, Grundfest W, et al. Coronary angioscopy in patients with unstable angina pectoris. N Engl J Med 1986; 315: 913–9.
Grundfest W, Litvack F, Sherman T, et al. Delineation of peripheral and coronary detail by intraoperative angioscopy. Ann Surg 1985; 202: 394–400.
Johnson M, McPherson D, Fleagle S, et al. Videodensitometric analysis of human coronary stenosis: validation in vivo by intraoperative high-frequency epicardial echocardiography. Circulation 1988; 77: 328–36.
Sahn D, Copeland J, Temkin L, Wirt D, Mammana R, Glenn W. Anatomic-ultrasound correlations for intraoperative open chest imaging of coronary artery atherosclerotic lesions in human beings. J Am Coll Cardiol, 1984; 3: 1169–77.
Roelandt J, Serruys P, Bom N, Gussenhoven J, van Egmond F, Lancee C, ten Hoff H, van Alphen W. Intravascular real-time, high resolution two-dimensional echocardiography. (Abst) J Am Coll Cardiol 1989; 13: 4A.
Yock P, Linker D, Saether O, Thapliyal H, Arenson J, White N, Ports T, Angelsen B. Intravascular two-dimensional catheter ultrasound: initial clinical studies. (Abst) Circulation 1988; 78(11): II-21.
Pandian N, Kreis A, Desnoyers M, Isner J, Salem D, Sacharoff A, Boleza E, Wilson R, Caro R. In vivo ultrasound angioscopy in humans and animals: intraluminal imaging of blood vessels using a new catheter-based high resolution ultrasound probe. (Abst) Circulation 1988; 78(II): II-22.
Hodgson J, Graham S, Savakus A. Percutaneous intravascular ultrasound imaging in humans: initial peripheral and coronary studies. (Abst) J Am Soc Echo 1989 (in press).
Hodgson J, Eberle M, Savakus A. Validation of a new real-time percutaneous intrasound intravascular ultrasound imaging catheter. (Abst) Circulation 1988; 78(II): II-21.
Pandian NG, Kreis A, Brockway B, Isner JM, Sacharoff A, Boleza E, Caro R, Muller D. Ultrasound angioscopy: realtime, two-dimensional, intraluminal ultrasound imaging of blood vessels. Am J Cardiol 1988; 62: 493–4.
Bartorelli A, Potkin B, Almagor Y, Gessert J, Roberts W, Leon M. Intravascular ultrasound imaging of atherosclerotic coronary arteries: an in vitro validation study. (Abst) J Am Cardiol 1989; 13: 4A.
Tobis J, Mallery J, Gessert J, Griffith J, Bessen M, Macleay L, Morcos N, Henry W. Intravascular ultrasound visualization before and after balloon angioplasty. (Abst) Circulation 1988; 78(II): II-84.
Tobis J, Mallery J, Mahon D, Griffith J, Gessert J, Macleay L, Mcrae M, Bessen M, Henry W. Intravascular ultrasound visualization of atheroma plaque removal by atherectomy. (Abst) J Am Coll Cardiol 1989; 13: 222A.
Graham S, Brands D, Savakus A, Hodgson J. Utility of an intravascular ultrasound imaging device for arterial wall definition and atherectomy guidance. (Abst) J Am Coll Cardiol 1989; 13: 222A.
Pandian N, Kreis A, Brockway B, Sacharoff A, Boleza E, Caro R. Detection of intravascular thrombus by high frequency intraluminal ultrasound angioscopy: in vitro and in vivo studies. (Abst) J Am Coll Cardiol 1989; 13: 5A.
Pandian N, Kreis A, Brockway B, Sacharoff A, Boleza E, Caro R. Intraluminal ultrasound angioscopic detection of arterial dissection and intimal flaps: in vitro and in vivo studies. (Abst) Circulation 1988; 78(II): II-21.
Hodgson J, Graham S, Savakus A. Usefulness of Doppler and ultrasound imaging catheters for assessing rapid changes incoronary flow and artery area. (Abst) J Am Soc Echo 1989 (in press).
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Hodgson, J.B., Graham, S.P., Savakus, A.D. et al. Clinical percutaneous imaging of coronary anatomy using an over-the-wire ultrasound catheter system. Int J Cardiac Imag 4, 187–193 (1989). https://doi.org/10.1007/BF01745149
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DOI: https://doi.org/10.1007/BF01745149