University Hospitals Case Medical Center’s Cardiovascular Imaging Core Laboratory produces some of the foremost technology in cardiovascular imaging. Optical Coherence Tomography (OCT) is the latest tool to be developed through the core lab and to get approval from the U.S. Food and Drug Administration. This breakthrough intravascular imaging technology allows the clinician to readily see and measure important vessel characteristics otherwise invisible or difficult to observe with older intracoronary imaging modalities.
The Cardiovascular Core Imaging Laboratory at UH Case Medical Center has been the world leader in procuring and analyzing the results of OCT testing. We are excited to share this technology and how it will shape the future of cardiovascular imaging.
In addition to OCT, the core lab offers other invasive imaging techniques such as quantitative coronary analysis and intravascular ultrasound, and also non-invasive imaging through computed tomography and magnetic resonance.
What is OCT?
While a Percutaneous Coronary Intervention (PCI) guide wire is being advanced to the area of interest through the arteries, the OCT imaging catheter is advanced through the guide wire. The vessel is flushed with contrast (x-ray dye) to clear the blood from the artery. The OCT console automatically detects blood clearance and the pullback is initiated, scanning the entire length of the vessel. Once the pullback is complete, blood flow is restored and the light source automatically returns to its initial position; the catheter is ready to acquire another image. Image acquisition is complete is under three seconds.
OCT is a relatively new technology for vascular and other imaging applications. Intravascular OCT has been used for the past eight years in Europe and Japan and received U.S. clearance from the FDA in May 2010.
Cardiovascular Optical Coherence Tomography is a catheter-based invasive imaging system. Using light rather than ultrasound, OCT produces high-resolution images of coronary arteries and deployed stents.
This technology provides super high resolution images, almost to the level of a microscope, to look inside heart vessels of cardiac patients.
Who is a candidate for OCT?
Any individual with heart disease, who has had a heart attack or is experiencing chest pain, has coronary blockages or may have coronary blockages, or who may require treatment or clarification of need for treatment for bypass or angioplasty.
Patients who are scheduled for a cardiac catheterization would be referred by their physician for OCT. The procedure is conducted in conjunction with a cardiac catheterization. OCT will be incorporated into clinical practice over the coming months.
What is the benefit of this technology for patients?
This imaging tool provides unprecedented detailed images of blood vessels, allowing physicians to make more informed decisions during assessments and treatments of heart blockages.
“What is most fascinating about this technology is its ease of use and extremely fast image acquisition," said Marco Costa, MD, PhD, Director, Center for Research and Innovation and Interventional Cardiovascular Center, UH Harrington Heart & Vascular Institute; and Professor of Medicine, Case Western Reserve University School of Medicine. "These features enable optimization of drug-eluting stent procedures with unprecedented accuracy, potentially reducing the number of stents placed per patient by ensuring appropriate disease assessment and targeting. The physician armed with OCT will have the ability to see the lumen vividly from the inside giving us incredible information and the ability to treat sub-optimal results while the patient is still in the cath lab."
What is new about this technology?
It provides super fast and high resolution images of the blood vessels. Compared with previous intravascular technologies (intravascular ultrasound), the image resolution improved from 250 microns to 20 microns, offering more than 10 times better visualization of the inside of blood vessels. This technology provides the clinician the ability to see details of the blood vessels that were never seen before.
Why UH?
UH Case Medical Center’s Cardiovascular Imaging Core Laboratory physicians and scientists have been directly involved with the development of OCT technology for nearly 10 years before receiving FDA approval. The Cardiovascular Imaging Core Laboratory database houses 750 OCT images from hospitals around the world, making us the world leader in core lab OCT analysis. In addition to the experience with post-processing of images, UH Case Medical Center is the first U.S. site providing training in our experimental lab on how to perform OCT to physicians across the country prior to FDA approval.
UH physicians were the first to perform OCT in the U.S. after FDA approval and will continue to lead and train other physicians nationally and internationally on how best to practice OCT to improve patient care.
For more information, call 1-866-UH4-CARE (1-866-844-2273).