Guidewire shadow artifacts in optical coherence tomography

BACKGROUND Because of the high resolution made possible by optical coherence tomography (OCT), previously indistinguishable guidewire artifacts are recognized during coronary imaging, and these affect image interpretation. This study aimed to assess the effect of guidewire size and structure on the artifacts produced and to introduce a novel guidewire specifically for OCT imaging that produces fewer artifacts. Elimination or minimization of guidewire artifacts supports optimal OCT imaging. METHODS Silicon tubes simulating the coronary arteries were used to assess guidewire shadow artifacts in OCT imaging. The angles of artifacts produced by 4 types of guidewires were evaluated, including our newly designed guidewire. Clinical data of guidewire artifacts were also obtained from 20 patients with coronary artery disease who underwent OCT examination with these guidewires before stenting. RESULTS The angles of the guidewire artifacts decreased with a reduction in the wire diameter. Wires with the dipping polymer structure produced unique artifacts brought about by a combination of the sparse spring coil structure, wire core, and polymer, and these affected image interpretation. The guidewire designed in this study could be used in clinical settings and produced fewer artifacts than the other examined guidewires. Our novel guidewire, which had a small diameter, lacked the dipping polymer structure, and was easy to handle, was successfully used for OCT imaging. CONCLUSIONS Guidewire artifacts are affected by guidewire size and structure. We developed a specialized guidewire for optimal OCT imaging that effectively produced fewer shadow artifacts than its generally used counterparts.