Intravascular Polarimetry for Tissue Characterization of Coronary Atherosclerosis

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Abstract

The microscopic tissue structure and organization influence the polarization of light. Intravascular polarimetry leverages this compelling intrinsic contrast mechanism by using polarization-sensitive optical frequency domain imaging to measure the polarization properties of the coronary arterial wall. Tissues rich in collagen and smooth muscle cells appear birefringent, while the presence of lipid causes depolarization, offering quantitative metrics related to the presence of important components of coronary atherosclerosis. Here, we review the basic principles, the interpretation of polarization signatures, and first clinical investigations of intravascular polarimetry and discuss how this extension of contemporary intravascular imaging may advance our knowledge and improve clinical practice in the future.

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Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation.

Guillermo Tearney, Evelyn Regar, Takashi Akasaka … (2012)

The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease. Intravascular optical coherence tomography (IVOCT) is a catheter-based modality that acquires images at a resolution of ~10 μm, enabling visualization of blood vessel wall microstructure in vivo at an unprecedented level of detail. IVOCT devices are now commercially available worldwide, there is an active user base, and the interest in using this technology is growing. Incorporation of IVOCT in research and daily clinical practice can be facilitated by the development of uniform terminology and consensus-based standards on use of the technology, interpretation of the images, and reporting of IVOCT results. The IWG-IVOCT, comprising more than 260 academic and industry members from Asia, Europe, and the United States, formed in 2008 and convened on the topic of IVOCT standardization through a series of 9 national and international meetings. Knowledge and recommendations from this group on key areas within the IVOCT field were assembled to generate this consensus document, authored by the Writing Committee, composed of academicians who have participated in meetings and/or writing of the text. This document may be broadly used as a standard reference regarding the current state of the IVOCT imaging modality, intended for researchers and clinicians who use IVOCT and analyze IVOCT data. Copyright Â© 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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Mechanisms of acute coronary syndromes and their implications for therapy.

Peter Libby (2013)

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Pathophysiology of native coronary, vein graft, and in-stent atherosclerosis.

Kazuyuki Yahagi, Frank Kolodgie, Fumiyuki Otsuka … (2016)

Plaque rupture, usually of a precursor lesion known as a 'vulnerable plaque' or 'thin-cap fibroatheroma', is the leading cause of thrombosis. Less-frequent aetiologies of coronary thrombosis are erosion, observed with greatest incidence in women aged <50 years, and eruptive calcified nodules, which are occasionally identified in older individuals. Various treatments for patients with coronary artery disease, such as CABG surgery and interventional therapies, have led to accelerated atherosclerosis. These processes occur within months to years, compared with the decades that it generally takes for native disease to develop. Morphological identifiers of accelerated atherosclerosis include macrophage-derived foam cells, intraplaque haemorrhage, and thin fibrous cap. Foam-cell infiltration can be observed within 1 year of a saphenous vein graft implantation, with subsequent necrotic core formation and rupture ensuing after 7 years in over one-third of patients. Neoatherosclerosis occurs early and with greater prevalence in drug-eluting stents than in bare-metal stents and, although rare, complications of late stent thrombosis from rupture are associated with high mortality. Comparison of lesion progression in native atherosclerotic disease, atherosclerosis in saphenous vein grafts, and in-stent neoatherosclerosis provides insight into the pathogenesis of atheroma formation in natural and iatrogenic settings.

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Author and article information

Journal

Journal ID (nlm-ta): Circ Rep

Journal ID (iso-abbrev): Circ Rep

Title: Circulation Reports

Publisher: The Japanese Circulation Society

ISSN (Electronic): 2434-0790

Publication date (Electronic, pub): 13 November 2019

Publication date (Electronic, collection): 10 December 2019

Volume: 1

Issue: 12

Pages: 550-557

Affiliations

[1) ] Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School Boston, MA USA

[2) ] Institute for Medical Engineering and Science, Massachusetts Institute of Technology Cambridge, MA USA

Author notes

Mailing address

Kenichiro Otsuka, MD, PhD

[*]Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School 40 Blossom Street, Boston, MA 02114USA kotsuka@ 123456mgh.harvard.edu

Article

DOI: 10.1253/circrep.CR-19-0102

PMC ID: 7236778

PubMed ID: 32432174

SO-VID: afde8453-8ac9-425b-8799-4c7bcb552f2c

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This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.

Intravascular Polarimetry for Tissue Characterization of Coronary Atherosclerosis

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Abstract

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Sex and gender-sensitive medicine

Most cited references 60

Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation.

Mechanisms of acute coronary syndromes and their implications for therapy.

Pathophysiology of native coronary, vein graft, and in-stent atherosclerosis.

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