Optimizing flushing parameters in intracoronary optical coherence tomography: an in vivo swine study.
Optimizing flushing parameters in intracoronary optical coherence tomography: an in vivo swine study.
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DOI：
10.1007/s10554-015-0668-0
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发表时间：
2015-08
影响因子：
2.1
通讯作者：
Tearney, Guillermo J.
中科院分区：
文献类型：
--
作者：
Suter, Melissa J.;Kashiwagi, Manabu;Gallagher, Kevin A.;Nadkarni, Seemantini K.;Asanani, Nayan;Tanaka, Atsushi;Conditt, Gerard B.;Tellez, Armando;Milewski, Krzysztof;Kaluza, Greg L.;Granada, Juan F.;Bouma, Brett E.;Tearney, Guillermo J.
关键词：
冠状动脉内光学频域成像（OFDI）需要血液位移来清晰显示动脉壁。造影剂在置换血液方面非常有效，然而，可能会增加造影剂肾病的风险。冲洗介质粘度、流速和冲洗时间影响血液置换效率，这是获得诊断质量OFDI图像所必需的。本研究的目的是确定可靠进行冠状动脉内OFDI所需的最佳冲洗参数，同时减少放射造影剂的体积，并评估冲洗介质选择对血管壁测量的影响。对3头猪进行了144次OFDI回拉，同时进行了同步心电图和冠状动脉内压线记录。根据诊断质量对OFDI图像进行分级，并对有和没有精确折射率校准的冲洗效率和冠状动脉内横截面积进行定量比较。具有较高粘度的冲洗介质导致快速有效的血液置换。黏度较低的介质导致血-介质过渡区增加，减少了获得诊断质量图像的回拉长度。冲洗效率随着流量和持续时间的增加而增加。使用不同冲洗介质计算的管腔面积差异显著，差异达23%（<0.0001）。通过仔细的折射率校准消除了这一误差。冲洗介质粘度、流速和冲洗时间影响血液置换效率，这是获得诊断质量OFDI图像所必需的。对于对造影剂敏感的患者，为了降低造影剂引起肾毒性的风险，我们建议冠状动脉内OFDI使用含有少量或不含造影剂的冲洗溶液。此外，我们的研究结果表明，为了获得准确的血管内OFDI测量结果，应考虑到使用的特定造影剂，进行仔细的折射率补偿。
Intracoronary optical frequency domain imaging (OFDI), requires the displacement of blood for clear visualization of the artery wall. Radiographic contrast agents are highly effective at displacing blood however, may increase the risk of contrast-induced nephropathy. Flushing media viscosity, flow rate, and flush duration influence the efficiency of blood displacement necessary for obtaining diagnostic quality OFDI images. The aim of this work was to determine the optimal flushing parameters necessary to reliably perform intracoronary OFDI while reducing the volume of administered radiographic contrast, and assess the influence of flushing media choice on vessel wall measurements. 144 OFDI pullbacks were acquired together with synchronized EKG and intracoronary pressure wire recordings in 3 swine. OFDI images were graded on diagnostic quality and quantitative comparisons of flushing efficiency and intracoronary cross-sectional area with and without precise refractive index calibration were performed. Flushing media with higher viscosities resulted in rapid and efficient blood displacement. Media with lower viscosities resulted in increased blood-media transition zones, reducing the pullback length of diagnostic quality images obtained. Flushing efficiency was found to increase with increases in flow rate and duration. Calculations of lumen area using different flushing media were significantly different, varying up to 23% (<0.0001). This error was eliminated with careful refractive index calibration. Flushing media viscosity, flow rate, and flush duration influence the efficiency of blood displacement necessary for obtaining diagnostic quality OFDI images. For patients with sensitivity to contrast, to reduce the risk of contrast induced nephrotoxicity we recommend that intracoronary OFDI be conducted with flushing solutions containing little or no radiographic contrast. In addition, our findings show that careful refractive index compensation should be performed, taking into account the specific contrast agent used, in order to obtain accurate intravascular OFDI measurements.
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影响因子：
3.5
作者：
Tearney, Guillermo J.;Jang, Ik-Kyung;Bouma, Brett E.
通讯作者：
Bouma, Brett E.
影响因子：
5.9
作者：
Gonzalo, Nieves;Tearney, Guillermo J.;Regar, Evelyn
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Regar, Evelyn
影响因子：
3.7
作者：
Petitjeans, P;Maxworthy, T
通讯作者：
Maxworthy, T
DOI：
10.1136/hrt.2006.091876
发表时间：
2007-03-01
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Tanigawa, J;Barlis, P;Di Mario, C
通讯作者：
Di Mario, C
影响因子：
24
作者：
MacNeill, BD;Jang, IK;Tearney, GJ
通讯作者：
Tearney, GJ