Neuro Optical Coherence Tomography Imaging for Intracranial Aneurysm Treatment: A Technical Video Case

Endovascular therapies are increasingly becoming the primary approach for treating cerebrovascular disorders.^1,2 However, these procedures rely on DSA, which provides limited visualization due to inherently limited spatial resolution.³ Intravascular optical coherence tomography (OCT) enables 3D, high-resolution visualization of the coronary arteries, allowing detailed assessment of the vascular wall, atherosclerotic plaque characteristics, and stent deployment.⁴ OCT has led cardiology societies to recommend intravascular imaging for the management of complex coronary interventions (level 1A evidence).^5,6 OCT is now being adapted for neurointerventional applications.⁷ A dedicated neuro-OCT (nOC; Spryte Medical) technology, designed to enable OCT imaging in tortuous intracranial arteries, has been recently introduced.⁸ Initial studies showed nOCT safety and feasibility for neurovascular use and explored its potential value for improved intracranial vascular imaging in stroke settings.⁹ The successful integration of nOCT technology into clinical workflows requires standardized principles for image acquisition and interpretation.^10,11 This video describes how to use nOCT in clinical practice.