New device offers better insight into arteries

St. Charles-Bend is the first hospital in Oregon to offer a new kind of technology that helps physicians better diagnose and treat patients with coronary artery disease, or blockages in the arteries that feed the heart muscle.

Patients with coronary artery disease experience decreased oxygen delivery to the heart due to plaque or cholesterol build-up inside arteries. Eventually, decreased blood flow may cause chest pain (angina), shortness of breath or other coronary artery disease symptoms. A complete blockage can cause a heart attack.

Approved by the FDA last year, St. Charles’ new technology — the St. Jude Medical’s ILUMIEN™ PCI Optimization System — has two key features: one is a wireless tool that helps evaluate the severity of blood flow blockages in coronary arteries. The other is near-infrared light that creates highly detailed images, allowing physicians to visualize and measure important vessel characteristics otherwise not visible or difficult to assess with older intracoronary imaging technologies.

Combined, these two technologies are helping physicians at St. Charles Bend to identify the precise measurement and dimensions of narrowings in the coronary arteries responsible for obstructing blood flow to a patient’s heart muscle, as well as determine vessel size and structure.

Karen Doolan, St. Charles’ manager of cardiovascular services, said the key to optimizing treatment of coronary artery disease is zeroing in on which blockage needs treatment and how to treat it.

“The ILUMIEN™ PCI Optimization System is quicker and easier to use, and physicians get more detailed information,” she said. “It’s really a step forward.”

The imaging component of the tool — optical coherence tomography (OCT) — offers 10 times the resolution of its predecessors, such as fluoroscopy and intravascular ultrasound. This allows physicians to visualize and measure important vessel characteristics that are used in guiding stent selection and deployment.

“The holy grail of stent placement is adequate visualization of the stent from inside the artery,” said Dr. Bruce McClellan, a Bend cardiologist. “OCT imaging has 10 to 20 times the resolution of our older intravascular ultrasound device. It’s like looking at the inside of the artery in high definition.”

Doolan said it is important for stents to be inserted as close as possible to the vessel wall in order to avoid a disruption of blood flow and prevent the formation of blood clots. “It helps physicians make better decisions on where to stent and how to treat the vessel,” she said.

OCT also provides important post-stenting information to help ensure the procedure was successful. “If we can do a better job with this technology and keep a patient from having to come back and have this procedure redone,” Doolan said,” we’re providing better care at a lower cost.”