University Hospitals Harrington Heart & Vascular Institute Leads Study of Optical Coherence Tomography in Below-the-Knee Endovascular Interventions

Innovations in Cardiovascular Medicine & Surgery | September 2026

The research on using intravascular ultrasound (IVUS) and optical coherence tomography (OCT) in endovascular interventions of the lower extremities has been limited by a lack of quantitative data and evidence-based protocols. This new prospective, multicenter, core-lab adjudicated study, aimed to change that. Led by University Hospitals Harrington Heart & Vascular Institute, the study set out to correlate IVUS, OCT and fluoroscopic quantitative findings in the below-the-knee tibial arteries. The study enrolled 44 patients with chronic limb-threatening ischemia (CLTI), who underwent angiography, IVUS and OCT. All images were analyzed by the Cardiovascular Imaging Core Laboratory at University Hospitals Harrington Heart & Vascular Institute in Cleveland, Ohio. Results show that optical coherence tomography of tibial arteries is feasible and correlates well with IVUS. However, study authors say its unique ability to better define tibial artery calcification burden -- compared to IVUS and fluoroscopy -- may alter treatment strategies for below-the-knee vessels in CLTI, as therapies continue to evolve.