Article Figures & Data
Figures
- FIG 1.
Clot identification and differentiation. A, Clot interface seen ex vivo with a red clot. A white clot is seen through the catheter (B) and in vivo in a porcine model (C). Red clots are seen clearly ex vivo (D), within the distal access catheter (E), and in vivo lodged in the porcine vessel (F).
- FIG 2.
Visualization of a flow-diverting device by the microangioscope. A, The fine-woven mesh of the PED is seen. B, The interface between the PED and the distal vessel is seen (thin arrow), and the distal vessel is dark (thick arrow) and beyond the illumination of the microangioscope, giving depth perception. Thrombus formation is excluded, and good wall apposition is confirmed. C, After 1 month post-procedure, the device is partially endothelialized, with struts less visible (medium white arrow) and endothelium more prominent (medium black arrow).
- FIG 3.
Visualization of mechanical thrombectomy. A, A clot is visualized by the microangioscope, and an aspiration catheter is positioned at the face of the clot. The interface between the artery and the clot is seen (thin arrow). B, Corresponding view on roadmap fluoroscopy shows the positioning of the aspiration catheter at the sharp cutoff point. C, A red thrombus is seen during removal by stent-retriever thrombectomy. D, The struts of the device can be clearly seen, as can the endothelium, with clear color differentiation (thick arrows).
Tables
Ratings of microangioscope image quality and interventional utility
Ratings MD 1 MD 2 MD 3 Mean Image-quality ratinga Video clip Diagnostic, cadaver carotid 3 4 5 4.0 Diagnostic, clot identification 2 3 4 3.0 Diagnostic, vessel wall injury 2 4 4 3.3 Diagnostic, PED follow-up 4 5 5 4.7 Diagnostic, PED initial 3 5 5 4.3 Interventional, aspiration 2 4 3 3.0 Interventional, stent retriever 3 4 3 3.3 Interventional, coil embolization 3 5 5 4.3 Interventional, WEB deployment 2 5 3 3.3 Utility ratinga Interventional application Aspiration 2 4 3 3.0 Stent retriever 3 4 3 3.3 Coil embolization 4 5 5 4.7 WEB deployment 4 5 5 4.7 Note:—MD indicates independent neurointerventionalist evaluator.
↵a One worst; 5 best. Image quality rating scale described first, followed by device interventional utility rating scale:
1) Poor, no diagnostic value; not useful at all for intervention.
2) Limited diagnostic value; minimally useful, just of research value/interest.
3) Average quality, of possible clinical utility; moderately useful, adds to procedure quality/safety.
4) Good quality, minimal restrictions on visibility, probably adds benefit beyond angiography; significantly useful, should strongly consider for this indication.
5) Excellent quality, adds benefit beyond angiography, could definitely use as an adjunct; extremely useful, would definitely use in most/all such procedures.
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