IVUS, OCT, FFR Guidance in Kalyan
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Brief Overview of FFR, IVUS, OCT technology
These are new technology Interventional Cardiology gadgets which helps in better angioplasty results and reducing human errors.
Fractional Flow Reserve (FFR)
In coronary catheterization, the Fractional Flow Reserve (FFR) technique is used to measure the pressure difference across the coronary artery stenosis (narrowing, often due to atherosclerosis) to determine if the narrowing is impeding movement.
Whether the coronary arteries supply oxygen to the heart muscle (myocardial ischemia). It uses a pressure cord to sense pressure near and far from the stenosis and determine the physiological significance of the stenosis.
Intravascular Ultrasound (IVUS)
Intravascular ultrasound (IVUS) is a medical imaging technique that involves inserting a catheter with a miniature ultrasound probe at the distal end into a blood vessel. The proximal end of the catheter is connected to a computer-controlled ultrasound device.
The IVUS technique is used to determine the amount of plaque present in the artery wall as well as the degree of narrowing in the artery lumen. This is particularly useful when angiographic imaging is found to be unreliable, such as the lumen of an osmotic lesion, the degree of calcification, or when the angiogram does not accurately visualize the lumen. Vessels, such as in areas where multiple arterial segments overlap.
Optical Coherence Tomography (OCT)
Optical Coherence Tomography (OCT), on the other hand, uses light waves to visualize plaque morphology. It’s also useful for confirming optimal expansion and deployment after stenting.
IVUS and OCT: Characteristics, Benefits, and Drawbacks
| IVUS (40–45 MHz)∗ | IVUS (50–60 MHz)† | OCT Frequency Domain‡ | |
|---|---|---|---|
| Wave source | Ultrasound | Ultrasound | Near-infrared light |
| The axial resolution, μm§ | 38–46 | 20–40 | 15–20 |
| Penetration depth in soft tissue, mm | >5 | 3–8 | 1–2 |
| Distance between adjacent frames in mm | 0.02–0.03 | 0.02–0.17 | 0.1–0.25 |
| Maximum pullback length, mm | 100–150 | 100–150 | 75–150 |
| Problem with blood | Blood backscatter is moderate. | Blood has a lot of backscatters. | Blood clearance is required. |
| Aorto-ostial lesion visualization | + | + | – |
| Calcium evaluation in cross-section | Only angle | Only angle | Angle and thickness |
| Evaluation of lipidic plaques | Plaque that has deteriorated | Plaque that has deteriorated | The thickness of the lipidic plaque and the cap |
| Plaque burden at the lesion site | + | + | – |
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