Optical coherence tomography in neurovascular intervention: Technical aspects and emerging directions
Abstract
Since its initial introduction to interventional cardiology over two decades ago, optical coherence tomography (OCT) has emerged as a powerful tool in neurovascular intervention. This intravascular imaging modality uses near-infrared light to provide cross-sectional visualization of the vessel wall with a resolution approaching 10 μm. The resolution of OCT far surpasses that of other imaging techniques. This higher resolution enables radiologists to directly assess arterial wall disease, including atherosclerotic plaque, aneurysm, and thrombus, as well as the interaction between therapeutic devices and the arterial wall in real time, providing actionable information during neurovascular interventions. The growing reliance on endovascular approaches to treat intracranial aneurysms and ischemia underscores the importance of precise vessel evaluation during treatment to provide accurate imaging guidance. However, digital subtraction angiography and cone beam computed tomography angiography often fail to reveal underlying arterial disease and other key features, such as the presence of thrombi, dissections, and malapposed stents, that could lead to incomplete treatment and acute and chronic complications. By enabling direct visualization of these microstructural details, OCT may overcome some of the most persistent challenges in neurovascular practice, ultimately improving diagnostic accuracy, procedural safety, and long-term patient outcomes. Nevertheless, integrating OCT into neurovascular settings remains challenging. There is still a lack of large-scale clinical validation, and existing coronary devices are not suitable for reliable use in tortuous intracranial vascular circulations. To overcome the technical limitations of current technologies, neuroOCT technology was designed specifically for neurovascular use and was evaluated in a first-in-human study. This technology will enable future clinical studies to investigate using neuroOCT to guide and optimize neurovascular treatments. This review article aims to provide a comprehensive perspective on the potential of neuroOCT in neurovascular practice. It highlights the technology's technical principles, current applications, limitations, and prospects for reshaping vascular imaging and therapy in the brain.
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BibTeX
@article{forestier2026optical,
title = {{Optical coherence tomography in neurovascular intervention: Technical aspects and emerging directions}},
author = {Géraud Forestier and Giovanni Ughi and Maxime Baudouin and Romain Chauvet and Kévin Janot and Jonathan Cortese and Charles Roux and Francesco Diana and Nicolas Dubois and Nicole Cancelliere and Charbel Mounayer and Vitor Pereira and Aymeric Rouchaud},
journal = {Diagnostic and Interventional Imaging},
year = {2026},
month = sep,
doi = {10.1016/j.diii.2026.04.003},
url = {https://hal.science/hal-05751589v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Optical coherence tomography in neurovascular intervention: Technical aspects and emerging directions
AU - Géraud Forestier
AU - Giovanni Ughi
AU - Maxime Baudouin
AU - Romain Chauvet
AU - Kévin Janot
AU - Jonathan Cortese
AU - Charles Roux
AU - Francesco Diana
AU - Nicolas Dubois
AU - Nicole Cancelliere
AU - Charbel Mounayer
AU - Vitor Pereira
AU - Aymeric Rouchaud
PY - 2026
DA - 2026/09/16
JO - Diagnostic and Interventional Imaging
DO - 10.1016/j.diii.2026.04.003
UR - https://hal.science/hal-05751589v1
AB - Since its initial introduction to interventional cardiology over two decades ago, optical coherence tomography (OCT) has emerged as a powerful tool in neurovascular intervention. This intravascular imaging modality uses near-infrared light to provide cross-sectional visualization of the vessel wall with a resolution approaching 10 μm. The resolution of OCT far surpasses that of other imaging techniques. This higher resolution enables radiologists to directly assess arterial wall disease, including atherosclerotic plaque, aneurysm, and thrombus, as well as the interaction between therapeutic devices and the arterial wall in real time, providing actionable information during neurovascular interventions. The growing reliance on endovascular approaches to treat intracranial aneurysms and ischemia underscores the importance of precise vessel evaluation during treatment to provide accurate imaging guidance. However, digital subtraction angiography and cone beam computed tomography angiography often fail to reveal underlying arterial disease and other key features, such as the presence of thrombi, dissections, and malapposed stents, that could lead to incomplete treatment and acute and chronic complications. By enabling direct visualization of these microstructural details, OCT may overcome some of the most persistent challenges in neurovascular practice, ultimately improving diagnostic accuracy, procedural safety, and long-term patient outcomes. Nevertheless, integrating OCT into neurovascular settings remains challenging. There is still a lack of large-scale clinical validation, and existing coronary devices are not suitable for reliable use in tortuous intracranial vascular circulations. To overcome the technical limitations of current technologies, neuroOCT technology was designed specifically for neurovascular use and was evaluated in a first-in-human study. This technology will enable future clinical studies to investigate using neuroOCT to guide and optimize neurovascular treatments. This review article aims to provide a comprehensive perspective on the potential of neuroOCT in neurovascular practice. It highlights the technology's technical principles, current applications, limitations, and prospects for reshaping vascular imaging and therapy in the brain.
SN - 2211-5684
SN - 2211-5684
ER -