Catheters play a key role in diagnostic and therapeutic medicine. Nowhere is this more apparent than in the specialty of interventional cardiology which is dedicated to catheter-based treatment of cardiovascular diseases. The tools of an interventional cardiologist include a variety of developed and emerging imaging technologies to guide therapy. This talk will focus not only on the science and engineering but also the on art of intracoronary imaging catheters. Intravascular ultrasound and optical coherence tomography catheter systems will serve as examples.

1. The A!
of
Catheter-Based Imaging
Kendall R. Waters, PhD
Manager, IP and Technology Development
kendallw@svmii.com
Animation from iStockPhoto.com

2. Coronary Artery Disease
Animation from CardioTube
Bare-Metal
IVUS Stent
Balloon Drug-Eluting
Angioplasty Stent
Coronary
Angiogram TD-OCT
Cardiac
Catheterization FD-OCT
1920 1940 1960 1980 2000 2020

3. Cardiac Catheterization
Image from Angioplasty.org
Accessing the Coronary Arteries
Image from ShutterStock.com

4. Coronary Angiogram
Video from YouTube.com
Balloon Angioplasty
Post-Intervention Pre-Intervention
Video from YouTube.com

5. An Early IVUS Image
5.5F
20 MHz
10 FPS
Nissen et al., Circulation 1991; 84: 1087-1099.
Advances in Intracoronary Imaging
Light Catheter
Source Profile
Pullback Transducer
Technology Orientation
Blood Imaging
Clearing Frequency
Plaque System
Classification Integration

6. Transducer Orientation
InterTherapy
CVIS
Endosonics
Patents downloaded from FreePatentsOnline.com
Intracoronary Ultrasound Catheters
Mechanically Rotating Catheter
Synthetic Aperture Array Catheter

7. 2 Progress ?
%(
c. 1999 c. 2009
Fitzgerald et al., Circulation. 2000;102:523-530. Waksman, China Interventional Therapeutics 2009.
A Telescoping Catheter
Catheter Proximal Distal!
Hub !!!!!!!!!!!!!!!!!!!!!!!!!!
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Sheath
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Tip
One Way Luer
Proximal Shaft Monorail
109 cm 23mm
3.5F 3.2F RO
Telescoping Section Marker
Pullback Length Usable Length
Fig. 1
150 mm 135 cm
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Image from VolcanoCorp.com
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8. Interface Module and Sled
Modular
Integrated
Intravascular Ultrasound
Video from YouTube.com

9. Plaque Classification
Volcano VH-IVUS BSC iMAP Terumo IB-IVUS
Necrotic Core Necrotic Lipid Pool
Fibro-Fatty Lipidic Fibrosis
Fibrosis Fibrotic Dense Fibrosis
Calcification Calcified Calcification
First Generation OCT
TD-OCT Vessel Occlusion
Animations from LightlabImaging.com

10. Second Generation OCT
FD-OCT Contrast Flush
Animations from LightlabImaging.com
FD-OCT Pullback
Video from LightlabImaging.com

11. c. 1995 c. 2000 c. 2005

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Courtesy of Dr. Brian Courtney MD and Brian Liang, Sunnybrook Health Sciences Centre,Toronto, CA

13. Thank You
Kendall R. Waters, PhD
Manager, IP and Technology Development
kendallw@svmii.com