Feature | September 07, 2010| Dave Fornell

Forward-Looking IVUS May Aid CTO Visualization

FL-IVUS has promise to help speed chronic total occlusion procedures

A major issue in treating chronic total occlusions (CTOs) is the lack of angiographic visualization. The flow of blood and contrast is completely blocked, eliminating the ability to navigate the vessel or see where wires are being poked. Not being able to see what you are treating is a big reason why operators do not attempt these lesions.

“All you see is the start and the end of the lesion. It can be very terrifying,” said William Lombardi, M.D., FSCAI, medical director of cardiac cath labs at St. Joseph Hospital, Bellingham, Wash.

In a comparison of items needed to treat CTOs, Scott Huennekens, president and CEO of Volcano Corp., said to build a car you need wheels, steering and headlights. There are already interventional tools available to steer and treat CTOs, but operators still need a way to see where they are driving. “You are always driving in the dark. You have wheels and steering, but you have no headlights, so you can’t see where you are going,” Huennekens said.

Volcano is developing two forward-looking intravascular ultrasound systems (FL-IVUS). One is for visualization ahead of the catheter and the second will incorporate a radio frequency (RF) ablation tip.

Aaron Grantham, M.D., FACC, Mid-America Heart Institute, Kansas City, Mo., is not convinced that incorporating the RF tip will completely solve CTO treatment issues. He said prior RF catheters were unsuccessful. However, he thinks FL-IVUS has the potential to make visualizing and traversing CTOs with wires easier and safer. He is very interested to hear reports about the first-in-man experience scheduled to start this fall in the Netherlands and Chile. “Translation from bench models to bedside will be a major milestone for FL-IVUS,” he said.

Volcano hopes for European CE-mark clearance of its FL-IVUS device by mid-2011, and in the U.S. by the end of 2011. The company said its first-in-man trial for the FL-IVUS ablation system is set to begin by mid-2011.

“In theory, forward-looking IVUS has promise. However, some operators already have a 95 percent success rate, so it will have to show it can do the procedure faster,” Lombardi said. “All technology is going to do is shorten the procedure.”

Related Content

Vascular Solutions, Teleflex
Feature | December 07, 2016
December 7, 2016 — Teleflex Inc. and Vascular Solutions Inc.
Siemens Healthineers, PURE Platform, angiography, EVAR, CTO, RSNA 2016
News | Angiography| December 07, 2016
December 7, 2016 — At the 102nd Scientific Assembly and Annual Meeting of the Radiological Society of North America (
Sponsored Content | Videos | TCT| November 18, 2016
DAIC Editor Dave Fornell takes a video tour of some of the most innovative new interventional cardiology technologies
Sponsored Content | Videos | Guidewires| November 18, 2016
A discussion with guidewire expert Dimitri Karmpaliotis, M.D., Ph.D., FACC, about the basics of interventional guidew
OCT stent strut coverage

OCT imaging showing neointimal tissue coverage of metallic stent struts.

News | Stents| November 07, 2016
November 7, 2016 – Results from TRANSFORM-OCT, a prospective, randomized trial using optical coherence tomography (OC
COLOR trial, TCT, NIRS, stenting vulnerable plaques, near infrared spectroscopy

An intravascular ultrasound image (IVUS) with co-registered NIRS showing yellow for the detection of lipid rich plaque in a coronary artery. 

News | Cath Lab| November 07, 2016
November 7, 2016 – Two-year results from the COLOR Trial, the first large-scale multicenter prospective study of its
OCT, optical coherence tomography, coronary stent implantation, superior resolution, TCT 2016, ILLUMIEN III OPTIMIZE PCI Trial
News | Optical Coherence Tomography (OCT)| October 31, 2016
Optical coherence tomography (OCT) provides safe and improved guidance for patients undergoing percutaneous coronary...
Avinger, Pantheris atherectomy catheter, OCT, Lumivascular technology, expanded FDA indication, diagnostic imaging device
News | Atherectomy Devices| October 20, 2016
Avinger Inc. recently announced that the company has received expanded indications from the U.S. Food and Drug...
Avinger, U.S. Department of Veterans Affairs, VA, Lumivascular technology, FSS Contract Award
News | Optical Coherence Tomography (OCT)| September 27, 2016
Avinger Inc. recently announced the company has received an FSS Contract Award from the U.S. Department of Veterans...
News | Peripheral Arterial Disease (PAD)| August 22, 2016
Avinger Inc. recently announced the closing of its previously announced public offering of 9,857,800 shares of Avinger’...
Overlay Init