Intravascular Imaging: Current Applications and Research Developments
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Intravascular Imaging: Current Applications and Research Developments

Vasilios D. Tsakanikas (University of Ioannina, Greece), Lampros K. Michalis (University of Ioannina, Greece), Dimitrios I. Fotiadis (University of Ioannina, Greece), Katerina K. Naka (University of Ioannina, Greece and Michaelideion Cardiology Center, Greece) and Christos V. Bourantas (University of Ioannina, Greece)
Release Date: October, 2011|Copyright: © 2012 |Pages: 478
ISBN13: 9781613500958|ISBN10: 1613500955|EISBN13: 9781613500965|DOI: 10.4018/978-1-61350-095-8

Description

Limitations of angiography, the traditional invasive method for assessing vascular pathology, have led to an interest in alternative invasive techniques that visualize the arterial wall and allow characterization of plaque type. These alternative techniques, which include intravascular ultrasound, angioscopy, thermography, optical coherence tomography, near infrared spectroscopy, and intravascular magnetic resonance imaging are able to provide valuable information regarding plaque vulnerability, the composition of plaque, and luminal morphology.

Intravascular Imaging: Current Applications and Research Developments presents all available intravascular imaging techniques and analyzes their impact in clinical practice and research. This publication aims to inform medical specialists, biomedical engineers, bioinfomaticians, and researchers of current developments and future trends in intravascular imaging techniques, promoting continued evolution of this discipline.

Topics Covered

The many academic areas covered in this publication include, but are not limited to:

  • Angioscopy
  • Fusion Methodologies and Intravascular Imaging
  • Future Trends in Intravascular Imaging
  • Implications of Intravascular Imaging
  • Intravascular Magnetic Resonance Imaging
  • Intravascular Ultrasound (IVUS)
  • Near Infrared Spectroscopy
  • Optical Coherence Tomography (OCT)
  • Role of Rheology in the Atherosclerotic Process
  • Thermography

Reviews and Testimonials

"This objective of this book is to inform the readers and give a thorough and complete description of all the available intravascular imaging modalities. More specifically, it presents the technical aspects of each methodology aiming to demonstrate their advantages and indigenous limitations. A major scope of this manuscript is to familiarize the clinicians with these new intravascular modalities and to provide guidance about the interpretation of the obtained data. [...]"

– Vasilios D. Tsakanikas, University of Ioannina, Greece; Lampros K. Michalis, University of Ioannina, Greece; Dimitrios I. Fotiadis, University of Ioannina, Greece; Katerina K. Naka, University of Ioannina, Greece and Michaelideion Cardiology Center, Gree

Table of Contents and List of Contributors

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Preface

Section three is devoted to thermography and is divided in two chapters. In the fist we analyze the basic principles of thermography, discuss its limitations, and present the available devices used to measure in vivo the temperature of the coronary atherosclerotic plaques. This chapter is completed with the description of microwave radiometry, an alternative technique that provides non-invasive measurements of the heating of the plaque, and is currently under clinical evaluation. In the second chapter we review the literature and present data from in vitro and in vivo studies that implemented thermography to measure the coronary wall temperature. These studies have improved our knowledge about the association between arterial wall inflammation and plaque vulnerability helped us to identify morphological characteristics associated with high risk plaques, and allowed us to assess their prevalence in different populations and the anti-inflammatory efficacy of various pharmacological treatments.

Section four deals with OCT and is divided in four chapters. The first chapter describes the engineering behind OCT image acquisition, while the second chapter focuses on the interpretation of OCT images and presents the available techniques developed for automated OCT processing. The third and the fourth chapter discuss the utility of this imaging technique in the current clinical practice and research arena.

NIRS is described in section five. Initially, we present the physical principles of NIRS and highlight its advantages in analyzing coronary wall tissue. In the main focus of the chapter we describe the NIRS system and present the results of the most important in vitro and in vivo validation studies. Finally, we discuss the clinical value of NIRS in assessing outcome after pharmaceutical or percutaneous coronary interventions and in detecting high risk patients who would be benefit by aggressive medical treatment.

Section six focuses on ICE. It describes the available devices and presents an overview of the typical images obtained during ICE examination. In addition, it discusses the current clinical applications of ICE in electrophysiology and structural interventional cardiology, and concludes with its limitations.

Section seven summarizes the current status of cardiovascular imaging. The first chapter of this section is devoted to the intravascular imaging techniques and particularly, IVUS and OCT, which are mainly used in clinical settings. The book focuses on their value in the assessment of the extent and the severity of coronary atherosclerosis and their utility in treatment planning during complex percutaneous coronary interventions. The second chapter deals with the non invasive imaging. It presents the current applications of non invasive imaging in portraying and assessing coronary atherosclerosis discusses its potentialities in the detection of vulnerable plaques and concludes with its current limitations.

Hybrid imaging is based on the integration of data provided by different imaging techniques and provides models which allow a more comprehensive and complete representation of coronary artery morphology. Today there are numerous data fusion methodologies with an evidenced based role in the diagnosis of coronary artery disease and have enriched our understanding about the atherosclerotic evolution. In section eight the available data fusion techniques are reviewed, and their clinical and research potentialities are discussed.

Blood flow haemodynamics appear to play a significant role in plaque development and destabilization. The current developments in intravascular imaging have allowed reliable representation of vessel’s morphology and geometry and permitted in vivo study of the role of local haemodynamics in the atherosclerotic evolution. Section nine provides the definition regarding the haemodynamic forces and flow patterns, reviews the literature, and cites the evidence concerning the effect of blood flow on atherosclerotic process.

Finally, the last section is devoted to the future trends in cardiovascular imaging. In the first chapter we analyze the necessity in developing new invasive imaging techniques, which will allow more accurate assessment of the anatomical and histopathological characteristics associated with increased plaque vulnerability. The second chapter discusses the potentialities of non invasive imaging modalities, and particularly, of multi slice computed tomography. It summarizes the current clinical utility of this promising imaging technique and attempts to foresee its future clinical and research applications. The last chapter is devoted to imaging techniques applied not to assess coronary morphology and anatomy but mainly to detect other features associated with increased vulnerability, such as the biomechanical profile of the plaque, or the presence of inflammation and increased neo-vascularization, and aims to highlight the variety of the imaging options and the need to invest in the early detection of vulnerable plaques.

We would like to thank all authors for their valuable contributions, the reviewers for the careful review, as well as the advisory editorial board for its valuable comments and suggestions.

Lampros K. Michalis
Ioannina, Greece
Dimtrios I. Fotiadis
Ioannina, Greece
Katerina K. Naka
Ioannina, Greece
Christos V. Bourantas
Hull, UK
Vasilios D. Tsakanikas
Ioannina, Greece
July 2011

Author(s)/Editor(s) Biography

Vasilios D. Tsakanikas was born on 1st of January of 1983 in Agrinio, Greece. He graduated from the 1st High School of Agrinio in 2000. He received the Diploma Degree in Electrical and Computer Engineering in 2005 from the National Technical University of Athens, Greece. In his thesis, he performed an analysis of the established link between terminal mobile communication devices and users’ heads, utilizing the F.D.T.D. (Finite Difference Time Domain) numerical method. He received a M.Sc. in Computer Science from the Athens University of Economics and Business, Department of Informatics, Greece in 2007. Today, he is working as Software Engineer on several biomedical projects.
Lampros K. Michalis was born in Arta, Greece, in 1960. He received the M.D. degree with Distinction from the University of Athens Medical School, Greece in 1984 and in 1989, he was awarded his M.D. Thesis with Distinction also from the University of Athens Medical School. He has been fully trained in clinical and interventional cardiology in the United Kingdom. Since 1995 he has been with the University of Ioannina Medical School, Ioannina, Greece, where he is a Professor of Cardiology. His research interests focus on interventional cardiology, intravascular imaging, percutaneous treatment of peripheral arterial disease, bioengineering, and diagnosis and prevention of preclinical arteriosclerosis.
Dimitrios I. Fotiadis received the Diploma degree in chemical engineering from the National Technical University of Athens, Athens, Greece, in 1985, and the Ph.D. degree in chemical engineering and materials Science from the University of Minnesota, Minneapolis, MN, in 1990. He is currently a Professor of biomedical engineering in the Department of Materials Science and Engineering, the Director of the Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece, and an Affiliated Member of FORTH, Biomedical Research Institute. He was a Visiting Researcher at the RWTH, Aachen, Germany and the Massachusetts Institute of Technology, Boston, MA. He has published more than 150 papers in scientific journals, 280 papers in peer-reviewed conference proceedings, and more than 30 chapters in books. He is the editor of 16 books. His research interests include modeling of human tissues and organs, intelligent wearable devices for automated diagnosis and bioinformatics. His work has received more than 1,700 citations (Scopus).
Katerina K. Naka received the M.D. degree with distinction from the University of Ioannina Medical School, Ioannina, Greece and the Ph.D. degree in Cardiology from the University of Wales College of Medicine, Cardiff, Wales, U.K in 2003. She is fully trained in cardiology and since 2006, she has been with the University of Ioannina Medical School, Ioannina, Greece, where she is currently an Assistant Professor of Cardiology. Her research interests include vascular endothelial function, large arterial mechanics, heart failure, echocardiography, intravascular ultrasound, and bioengineering.
Christos V. Bourantas graduated from the Medical School, University of Ioannina, Greece in 1999, and 6 years later, he was awarded with distinction for his PhD degree in Cardiology from the same Medical School. He completed his training in Cardiology in UK and he is currently working as a Fellow in interventional cardiology in East Yorkshire NHS Trust, UK. His research interests include image processing, 3D modeling, invasive imaging, and cardiac MRI. He is an Honorary Lecturer in the Department of Academic Cardiology Hull University, Kingston upon Hull, UK.

Indices

Editorial Board

  • Metin Akay, Arizona State University, USA
  • Angela Hoye, Castle Hill Hospital, UK
  • Jurgen Ligthart, Erasmus Medical Center, The Netherlands
  • Miodrag C. Ostojic, Clinical Center of Serbia, Serbia
  • Obeardan Parodi, Niguarda Ca’ Granda Hospital, Italy
  • Michael R. Rees, Bangor University, UK
  • Christodoulos Stefanadis, University of Athens, Greece
  • Attila Thury, University of Szeged, Hungary
  • Ann C. Tweddel, Castle Hill Hospital, UK