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Scanning fiber angioscopic images with red reflectance for structural images (left) and blue fluorescence for label-free biochemical contrast (right). The images reveal multiple atherosclerotic lesions with very low fluorescence in the blue spectrum in comparison to the surrounding healthy artery. (University of Michigan Medicine Photos)

Researchers have found a way to use a laser-scanning mini-camera to map the inner working of blood vessels and spot the early signs of stroke risk.

The proof-of-concept demonstrations, conducted using carotid arteries that were harvested during autopsies, are described today in the journal Nature Biomedical Engineering.

The technique takes advantage of an instrument known as a scanning fiber endoscope, or SFE, which was invented by Eric Seibel, a mechanical engineering research professor at the University of Washington.

Seibel designed the endoscope to be used in early cancer detection, but medical researchers at the University of Michigan repurposed the device to look for signs of atherosclerosis inside the harvested arteries. The researchers also conducted experiments using live rabbits.

Scanning fiber endoscope
This graphic shows how a scanning fiber endoscope is used to illuminate and image the interior of a blood vessel. (University of Michigan Medicine Graphic)

“The camera actually goes inside the vessels,” principal author Luis Savastano, a Michigan Medicine resident neurosurgeon, said in a news release. “We can see with very high resolution the surface of the vessels and any lesions, such as a ruptured plaque, that could cause a stroke.

“This technology could possibly find the ‘smoking gun’ lesion in patients with strokes of unknown cause, and may even be able to show which silent, but at-risk, plaques may cause a cardiovascular event in the future,” he said.

The endoscope sends laser light in red, blue and green wavelengths through optical fibers to illuminate the tissue. The resulting scans can be digitally processed to show the severity of atherosclerosis.

“In addition to discovering the cause of the stroke, the endoscope can also assist neurosurgeons with therapeutic interventions by guiding stent placement, releasing drugs and biomaterials and helping with surgeries,” Seibel says.

Fluorescence indicators can reveal interior features that are associated with increased risk of stroke and heart attacks – including features that might not show up using conventional radiological techniques.

The research is currently in the pre-clinical phase.

In addition to Savastano and Seibel, the authors of “Multimodal Laser-based Angioscopy for Structural, Chemical and Biological Imaging of Atherosclerosis” include Quan Zhou, Arlene Smith, Karla Vega, Carlos Murga-Zamalloa, David Gordon, Jon McHugh, Lili Zhao, Michael Wang, Aditya Pandey, B. Gregory Thompson, Jie Xu, Jifeng Zhang, Y. Eugene Chen and Thomas Wang.

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