Université d'Auvergne Clermont1 | CNRS

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Axis 1: Endovascular analysis of atheroma plaque and coronary stents

Context

The cardiology department of the University Hospital in Clermont-Ferrand has been the first center in France to use Optical Coherence Tomography (OCT) for endovascular analysis since 2006 [Motreff10a]. This high-resolution imaging (10 microns) gives a very accurate description of the atheroma plaque morphology over about one mm. This technique is therefore very well suited to assess the fibrous cap thickness which is one of the major criteria for vulnerability.

Another dedicated indication is the analysis of stents just after implantation [Motreff09a] or after reendothelialization [Motreff09b]. The thickness of the neointimal coverage has been assessed either manually or automatically [Dubuisson09a,Kauffmann10a] by using specific algorithms for strut and vessel wall detection and dense approximation methods from sparse data. A plugin is under development on the ORS Visual platform.

 
 Strut configurations: covered, malaposed or in front of a bifurcation.  Dense coverage scores extrapolated from distances at struts: from covered (red) to malaposed (green).

The longitunal follow-up of plaques and stents requires new methods for the registration of endovascular recordings. Combination with angiography opens the ways to 3D reconstruction of complex lesions and stents with localized coverage indices. In future prospects, we also plan to fuse OCT with IVUS [Finet08a,Souteyrand08a,Motreff10b], mono or dual-energy CT [Chopard10a], to image deep wall layers, thrombotic lesions and plaque.

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