Endovascular interventions are being increasingly favored for treating strokes and cerebral artery diseases, but rely heavily on angiographical imaging that often struggles with limited contrast and spatial resolution. For more effective procedural decision-making, improved visualization of arterial pathology and neurovascular implants is essential. Now, a miniaturized endovascular neuro optical coherence tomography (nOCT) imaging probe has been developed to navigate the complex pathways of the cerebrovascular system, providing high-resolution imaging directly at the site of intervention. It is also designed to be compatible with standard neurovascular microcatheters, seamlessly integrating into the existing clinical procedural workflow.

Spryte Medical’s (Boston, MA, USA) nOCT technology comprises an imaging probe that is as slender as a guidewire and effortlessly navigates through the brain's vascular system using conventional neuro-interventional techniques. It features a miniaturized optical fiber and a lens at the distal end, which illuminate the tissue and capture the backscattered near-infrared light. By rotating the fiber and lens rapidly while retracting the probe, a spiral-shaped light pattern is created, allowing comprehensive visualization of the arterial walls and any neurovascular devices in place. This breakthrough from Spryte marks the first time that intravascular imaging has been successfully applied to brain vessels, significantly enhancing clinicians’ ability to discern the pathology related to neurovascular diseases. This advancement has potential future applications in the treatment of strokes and related conditions.

During clinical trials, the nOCT probe demonstrated successful navigation and imaging capabilities in 32 patients undergoing routine diagnostic or therapeutic procedures for cerebrovascular disease. The system and imaging probes integrated well with existing medical workflows, providing exceptional images and vital data unavailable through other technologies. This research marks a significant scientific advancement by Spryte in miniaturizing OCT technology to safely traverse the brain's blood vessels while delivering high-resolution, micron-level imaging. The aim is to provide physicians with a better understanding of anatomy, pathology, and device implants, thereby enhancing therapeutic decision-making. The potential of this technology to improve treatment outcomes for patients with neurovascular diseases is just beginning to be realized.

“This is an incredibly exciting milestone for the field of neuro-intervention. Direct imaging of the pathology and its relationship to devices will transform treatment decisions, and the fundamental understanding of cerebrovascular pathology,” said Matthew Gounis, Professor and Vice Chair of Research in the Department of Radiology at UMass Chan Medical School. “Revolutions in imaging technology, from the discovery of x-rays over 120 years ago to 3-dimensional imaging in the angiography suite more than 20 years ago, occur roughly once in a generation.” 

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