Insufficient treatment of vulnerable plaque in the coronary arteries leads to costly and health impairing re-interventions
In 2015, Coronary Artery Disease (CAD) affected 110 million people and resulted in 8.9 million deaths worldwide.
CAD occurs when the arteries that supply the heart muscle with blood become hardened and narrowed, due to the build-up of cholesterol and plaque on their inner walls.
Current treatment: To open the blocked coronary arteries patients can be treated using Percutaneous Coronary Intervention (PCI).
Worldwide, there are 4 million PCI’s performed each year.
12% of patients who have PCI, need another intervention within 12 months of their initial procedure.
50% of these re-interventions are caused by a type of stenosis called vulnerable plaques, that are formed by fat-filled cells with a thin cover. If the cover ruptures, a blood clot is formed blocking the coronary artery.
Total costs for these re-interventions are estimated at $2.4 billion. If these vulnerable plaques are treated in an early stage, repeat interventions could be prevented.
Kaminari medical combines Intravascular Ultrasound (IVUS) and Photoacoustic (PA) Imaging, providing better information on both plaque location and composition.
Intra vascular Ultrasound (IVUS)
With the ultrasound technology in IVUS the walls of the blood vessels can be visualised.
The catheter emits sound waves 40-60 MHz. With the returning echo information, an image of the blood vessel wall can be made with 100μm resolution.
Photoacoustic (PA) imaging
Photoacoustic (PA) imaging capitalises on the emission of an acoustic signal upon absorption of a short light pulse. Optical absorption enables chemical specificity, while the low acoustic scattering of tissue allows deep imaging. Therefore, lipids in the stenosis (plaque) can be characterised.
IVUS + PA = IVPA
Imaging coronary wall structure + plaque composition.
The Intravascular Photoacoustic (IVPA) catheter images the coronary wall while simultaneously identifying the plaque composition, leading to a better intervention strategy and clinical outcome.
INTRAVASCULAR PHOTOACOUSTIC (IVPA) IMAGING
(a) Principle of the technique; pulsed light (white arrow) gets absorbed by lipids (star) and emits an acoustic signal (blue wavefronts) that is registered by an ultrasound transducer on the catheter.
(b) Merged IVPA/US image of the plaque at locations with large plaque volume (the front surface of the volume in (c)).
(c) 3D reconstruction of pullback.
(d) Histology at the imaging plane corresponding to (b).
Intracoronary lipid imaging demonstrated in vivo in swine
2022: First in Human study