OPTIS SYSTEM(PART I)
OPTICAL COHERENCE TOMOGRAPHY
PRESENTED BY :
MUHAMMAD NAVEED SAEEDCATH LAB TECH.
KING FAISAL SPECIALIST HOSPITAL & RESEACH CENTER. RIYADH, KSA
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OUTLINES :
• Introduction
• What is OCT
• OCT from SJM
• What is Optis system
• Optis system components
• What is DragonFly Duo Catheter
• OCT procedures (How can we do)
• Interpretation Image with OCT
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OCT TECHNOLOGY
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DEFINATION :
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OCT FROM SJM
2004 2007 2009 2011 2012
M2 System M3 System C7XR™ System ILUMIEN™ System ILUMIEN™ OPTIS™
First Commercial OCT System15 fps / 200 linesOcclusion + flush
2nd Generation 20 fps / 240 linesOcclusion + flush
Europe and US only100 fps / 500 linesOcclusion-free
Commercially available 2011100 fps / 54 mm pullbackCombined FFR and OCTWireless FFR
Japan launch 2012180 fps/75 and 54 mm pullbackAdvanced software tools for PCI OptimizationTableside control from DOC
Occlusion balloon + ImageWireTM Occlusion-free Flush FFR and OCT System 2nd Gen FFR and OCT System
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OCT TECHNOLOGY FROM ST. JUDE MEDICAL
• Console• Rapid exchange (Rx) imaging catheter• Contrast flush; balloon occlusion not required• Fast image acquisition: 7.5cm pullback in 2.5 sec
C7 DragonflyTM OCT Catheter
OCT
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OPTIS – SYSTEM COMPONENTS
PressureWireTM AerisTM
ILUMIEN™ Console
Wireless FFR
FFRand OCT
Physician’s Monitor
DOC
Removable Tray
Connector Panel
Service Access Panel
Wheel Locks Main Power Cord Connector
Main Power Switch
Physician’s Side
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ILUMIEN™ – CONSOLE OVERVIEW
Operator’s
Monitor
Keyboard
CD/DVD Drive
Fan Filter
Hibernate/wake-up button
Mouse
Chart Holder
Operator’s Side
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DRAGON-FLY DUO CATHETER ( WHAT IS NEW)
• Fiber optic• Three radioparque
marker • Compatible with
G.C 6 or 7 Fr without holes
• G.W 0.14”
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PULLBACK SETTINGS
System Specifications C7/ILUMIEN C8 Clinical
Impact
Frame rate (frames per second)
100 fps 180 fps Higher frame rate = faster pullback
Pullback speeds
10, 20, 25 mm/sec
18, 36 mm/sec
Faster speed minimizes contrast required for longer
pullback
Pullback length 54 mm 75 mm
~90% of total lesions will occur in the proximal 50 mm of the left arterial
system. In the RCA, 80% of lesions are within 75 mm of the
ostium. Ref: Lesion locations within Arteries; J Am Coll Cardiol, 2005; 45:1186-1192
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APPLICATION OF OCT
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PRIOR TO STARTING A CASERequired Materials
– Dragonfly™ Duo imaging catheter – Sterile DOC cover
– 3 ml purge syringe
– Contrast media indicated for coronary use
– 0.014" guidewire
– Guide catheter (6-7 F, with no sideholes)
HOW CAN WE DO..............................
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TURNING ON THE SYSTEM – POWER SWITCHES
Powerup / Wake-up buttonon upper right of keyboard
.
Main Switch next to power cable
Tech.
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ENTERING PATIENT DATA……………………
Tech.
Press Add new patient data.
Put all the information's concerning the patient.
Press New OCT Recording.
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CATHETER PREPARATION
• Purge with contrast until 3-5 drops exit distal tip.
Scrub Tech.
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CATHETER PREPARATION• Remove the hoop carefully from the catheter
Scrub Tech.
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CONNECT CATHETER
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CONNECTING CATHETER TO DOC
Counter clockwise
clockwise
Scrub Tech.
CATHETER PREPARATION
Insert the DOC into the sterile bag.
Scrub Tech Fix the DOC by her hand and the Technician pull the sterile cover.
Place it on the table.
Scrub Tech.
Tech.
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PREPARATIONS
• Watch the five yellow LEDs light up on the DOC
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PREPARATIONS
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PREPARATIONS OF CALIBARATION Press Live View
Ask the physician to put his 2 fingers to calibrate the catheter
Press Auto-Calibrate , The system is calibrated automatically
Tech.
Stop Button
Unload Button
Laser Emission Symbol
Advance
Button
Pullback Button
Pullback Position
LEDs
Load LED
DRIVE MOTOR OPTICAL CONTROLLER (DOC) – OVERVIEW
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INSIDE THE PATIENT
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PULLBACK PREPARATION – PURGE THE CATHETER
• If blood enters the catheter lumen, purge with the attached 3 cc contrast syringe.
Blood in catheter lumen Purged catheter lumen
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PREPARATION OF INJECTION
Recommended Settings:• Injection by hand
• Left coronary, Right coronary arteries: (16----20) ml ;
• We can use 12-20 ml syring In your Cath. (Depend on operator)
• When the operator is ready to inject contrast, click the “Enable Pullback ” button.
• Ask the Physician to inject, 3 sec from the injection and when the image is clear press ”Start Pullback”
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PERFORMING A PROCEDURE
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PULLBACK PREPARATION – PUFF INTO THE VESSEL
• During live scan, puff with the contrast injector to determine guiding catheter position for optimal image clarity.
Suboptimal clearance, blood swirls
Optimal clearance
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REVIEWING AN ACQUIRED IMAGE
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ADJUSTING CALIBRATION
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ADJUSTING CALIBRATION
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BOOKMARKS
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PERFORMING MEASUREMENTS
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ENTERING NOTES
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NEW RECORDING FOR THE SAME PATIENT
Press New Recording
Ask again the physician to put his 2 fingers to do calibration Repeat the same step of the Injection
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ENDING PROCEDURE
• Press “Unload” to disconnect catheter
WHAT WE CAN FOUND WITH OCT ................................
• Detect the Thrombus , not detected with Angio – Image
• Rapture Plaque
• Differentiate between the Red and white Thrombus
• Stent Thrombosis and Malappositon
RAPTURE PLAQUE
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THROMBUS
41White Thrombus Red Thrombus
STENT MALAPOSITION
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THANK YOU FOR YOUR PARTICIPATION AND PATIENCE
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