Optical Coherence Tomography-Guided Stenting for Common Carotid Free-Floating Thrombus

Area of Science:

• Vascular imaging
• Interventional neurology
• Medical device technology

Background:

• Digital subtraction angiography (DSA) is a standard but limited tool for visualizing carotid free-floating thrombus (CFFT).
• DSA lacks detailed luminal and thrombus composition information, hindering etiological diagnosis.
• Accurate CFFT characterization is crucial for effective stroke prevention strategies.

Purpose of the Study:

• To evaluate the utility of intravascular optical coherence tomography (OCT) as an adjunct to DSA for CFFT assessment.
• To compare the diagnostic capabilities of OCT and DSA in characterizing thrombus structure and composition.
• To determine OCT's role in guiding endovascular treatment decisions for CFFTs.

Main Methods:

• Intravascular optical coherence tomography (OCT) was employed alongside digital subtraction angiography (DSA).
• OCT provided high-resolution imaging of the carotid artery lumen and vessel wall.
• Thrombus characteristics, including composition (red vs. white thrombus), were analyzed using OCT.

Main Results:

• OCT precisely delineated the extent of free-floating thrombi within the carotid artery.
• OCT accurately distinguished between red and white thrombus components, offering etiological insights.
• OCT provided detailed visualization of the intrinsic vessel wall, complementing DSA findings.

Conclusions:

• Intravascular OCT is a valuable adjunct to DSA for comprehensive CFFT evaluation.
• OCT enhances diagnostic accuracy by revealing thrombus composition and detailed luminal structures.
• OCT imaging aids in guiding endovascular treatment decisions for carotid free-floating thrombus.