Intravascular Ultrasound for Plaque Characterization by vOX8VB8

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									Intravascular Ultrasound for
Plaque Characterization

              Scott R. Smith
       Boston Scientific Corporation

   The 3rd Vulnerable Plaque Symposium
              March 16, 2002
Who needs interventional diagnosis
and treatment?
     Population                Size          Annual Risk

   Healthy People             Huge             <<1%


    “Risk Factors”         Really Big           ~1%


   Walking Time        Still quite a few       >10%
     Bombs

Summary of
National Heart, Lung, and Blood Institute
Workshop on Cardiovascular Risk Assessment
Diagnosis of Vulnerable Plaque
selecting a population


                  positive            negative
                            9%                  5%               67%
       positive                                            14%
                      true positive      false positive          positive predictive value
test




                            1%                 86%               99%
       negative                                            87%
                    false negative       true negative           negative predictive value
                           10%                 90%
                     total affected     total unaffected
                           90%                 95%
                                                           18
                        sensitivity        specificity           likelyhood ratio



                       Total             100
                       at risk           10
                       treated           14
                       saved             9
                       unnecessary       5
                       missed            1
Plaque Structure




                   Courtesy of
                   Dr. Renu Virmani
                   Armed Forces Institute
                   of Pathology
IVUS Plaque Imaging




               Ruptured plaque
Boston Scientific Imaging Systems

Atlantis SR Plus Catheter        Galaxy IVUS System




Features & Intended Benefits
• Tapered tip; 2.5 Fr. Crossing
  Profile
• High definition 40MHz IVUS
  catheter.
• 6F Guide Catheter
  Compatibility.
Galaxy System Features and
Intended Benefits

 Time-Saving Features
   – Image Bookmarking
   – LongView™ longitudinal
     measurements
   – Pullback sled
 Enhanced Ease of Use
   – TraceAssist™ automatic
     lumen trace function
   – Angiographic compatibility
   – Push button control
Galaxy System Research
Capabilities

Expanded Functionality
  – Digital image storage
  – Patient database
  – Pre/post intervention analysis.
RF Output
  – Direct Access to RF signal for
    acquisition and analysis
  – Future plans may include
    direct RF signal acquisition
Imaging vs. Analysis

                   RF




            Rectified and Log compressed




            Low passed filtered - 10MHz




             One image vector
Other Imaging Modalities

             IVUS          acoustic
                           impedance
             MRI           proton
                           relaxation
             Thermal       temperature

             OCT          refractive
                          index
             Spectroscopy chemical
                          bonds

Independence
Spatial resolution
Contrast
Conclusion

 • Intravascular Ultrasound currently widely used
   for intravascular imaging
 • Broad potential for plaque volume
   measurement and tissue characterization
 • Variety of research efforts aimed at improving
   tissue contrast and resolution



 Thanks to:
   – Tat Jin Teo, PhD - BSC Imaging
   – Renu Virmani, MD - AFIP
   – Jay Kokate, PhD - BSC Applied Research

								
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