Optical Coherence Tomography

For years coronary angiography and intravascular ultrasound (IVUS) system have been relied on to visualize and determine malapposed struts (Figure 2), lumen size, thrombus (Figure 3), and edge dissection (Figure 4). Now there is new technology that has graced the horizon, optical coherence tomography (OCT). OCT is intravascular imaging that uses near-infrared light to image vessels. It can be used preand poststent and gives clarity of coronary artery disease, structure, precise measurements of lesions, and vessel size. St. Jude Medical performed a 1 month introductory trial at Carolinas Medical Center (CMC) in Charlotte, North Carolina. This was the first introduction of this technology within North and South Carolina. OCT has been widely accepted within our lab. It proves to be user friendly among the specialists and doctors here at CMC. Since this technology is fairly new, it is not integrated; but it is mounted on a portable computer that can be easily maneuvered into the procedure room. The computer is set up with two monitors that face opposite each other, one side for the physician and the other for the specialist/nurse operating the equipment. There is a motor drive that is connected to the computer mounting, and it is handed to the scrub specialist in a similar fashion to the motor drive of IVUS. When the computer is powered on, the patient information can be entered and a new case can be started. The OCT catheter, known as the C-7 Dragonfly Imaging Catheter, is 2.7 Fr Rx System, with a 135-cm working length that comes in a hoop within a sterile plastic package. Also, there is a small blue syringe and a plastic sleeve to cover the motor drive, both packaged separately from the C-7 Dragonfly Imaging Catheter. Care must be taken when removing the catheter so as to not bend the catheter at the hub of the hoop. The prep is fairly simple; the blue syringe is filled with pure