Trans-Blood Vision is a patented infrared technique that uses short-wave infrared wavelengths to see directly through blood. It has the potential to find vulnerable plaque lesions without first entering them, determine their size and surface characteristics in high resolution, and look at their material constituents both on and below the surface. While it cannot provide direct visual guidance for therapy or penetrate as deeply as ultrasound, combining it with augmentative technologies could allow for real-time multi-mode detection, analysis, and therapy guidance of vulnerable plaque lesions. The document concludes that Trans-Blood Vision warrants significant investigation, possibly in combination with other emerging technologies.

1. © 2002 Slide 1
Trans-Blood Vision™ Possibilities
for Vulnerable Plaque
A Presentation for the
3rd
Annual
Vulnerable Plaque Symposium
March 16, 2002

2. © 2002 Slide 2
Seeing Through Blood
The technique is adapted from military methods to see through
smoke, mist, fog, etc.
SWIR WavelengthVisible Wavelengths
For example, the following satellite photos of a section of the
Oahu coastline illustrate how mist and haze seen at visible
wavelengths disappear when viewed in the Short Wave IR band.
Trans-Blood Vision™ is a patented infrared
technique to see directly through blood.

3. © 2002 Slide 3
System Illustration
Monitor – already in place
CardioOptics IR Instrument:
- IR illumination source
- IR video camera
IR interconnect cable
Sterile, disposable
IR fiberoptic catheter:

4. © 2002 Slide 4
• Looking directly through flowing
blood in a live animal
• Clip begins with exploration of
bifurcation in the portal vein
system & ends with canulation
of selected branch
• Raw, unprocessed video.
Black & white presentation.
Video Clip: Endocardial Imaging
of IVC-Portal Vein System
1
2
To Heart
(Inferior Vena Cava)
Portal
Vein
System
Caudal
Vein

5. © 2002 Slide 5
Video Clip of Vein Bifurcation
Unprocessed proof of concept video taken through flowing blood.

6. © 2002 Slide 6
Comments
• Structures appear as if viewed through water
• High degree of reflectivity from tissue surfaces
• No video enhancement techniques have yet been
applied, which will dramatically improve images.

7. © 2002 Slide 7
Augmentative Technologies
o Dimensional measurement: The ability to quantitatively
measure the size of structures visualized. This includes
granularity and surface feature detail assessment.
o Tissue/material characterization: The ability to provide the
clinician with information about the nature of the structure in the
TBV™ view (e.g., detection of calcification, presence of lipids).
o Real-time motion analysis: The ability to perform real-time
dynamic elastic properties assessment.
o Membrane penetration: The ability to determine tissue/material
characterization below the surface of membranes associated with
Vulnerable Plaque lesions.
Note: The following are extensions of Trans-Blood Vision ™.
They have been theorized, tested to some degree in vitro, but not
yet tested in vivo or on Vulnerable Plaque lesions.

8. © 2002 Slide 8
Vulnerable Plaque Potential
 Find lesions without first entering them (forward view)
 Determine size & surface characteristics in high resolution
 Look at material constituents, both on and below the
surface (within limited IR wavelengths)
 Perform dynamic elastic velocity profiles in real time
But not:
 Provide direct visual guidance for therapy
 Penetrate deeply like ultrasound
Combining Trans-Blood Vision™ with these promising
augmentative technologies provides the potential to
simultaneously in real-time:
 Measure lesion temperature (though a temperature
probe could be visually guided)

9. © 2002 Slide 9
Conclusion:
Trans-Blood Vision™ has sufficient potential to
provide a platform for real-time, simultaneous,
multi-mode Vulnerable Plaque lesion detection,
analysis, and therapy guidance that it warrants
significant investigation, possibly in
combination with other technologies currently
under development.

10. © 2002 Slide 9
Conclusion:
Trans-Blood Vision™ has sufficient potential to
provide a platform for real-time, simultaneous,
multi-mode Vulnerable Plaque lesion detection,
analysis, and therapy guidance that it warrants
significant investigation, possibly in
combination with other technologies currently
under development.