Clever catheter lets surgeons see inside arteries to trim plaque

The Pantheris catheter developed by Avinger takes the physician out of the radiation field.

A clever catheter design lets cardiologists see inside arteries and precisely remove plaque from diseased tissue. The Pantheris catheter is safer than conventional radiation-guided procedures because it takes the surgeon out of the radiation field, and along with on-board optics, it allows greater precision than previous methods.

“The device is the culmination of recent size reduction – it’s 2 mm in diameter − and resolution in fiberoptics, combined with signal processing capability and catheter technology, which is getting better at transmitting torque,” said Bart Beasley, the vice president of marketing with developer Avinger (Redwood City, Calif.). “The progression of all three technologies and the entrepreneurial spirit of the inventor Dr. John Simpson made the Pantheris possible.”

Beasley said that Pantheris for the first time lets surgeons see inside arteries they are working on. An OCT fiber in the catheter transmits laser light to the vessel wall, then back into the catheter, and back into the computer and processor, which creates the high-resolution image. Pantheris, which won FDA approval last year, has been used successfully in 1,500 patients with no vessel wall perforations, Beasley said.

Other catheter procedures used a contrast-inducing die in the vessels and high-radiation-emitting X-rays to give surgeons an idea of where they were operating.

“Shortcomings of previous devices also include a difficulty in assessing the 3D nature of the obstructive plaque in the vessels with only contrast angiography and 2D fluoroscopy,” Beasley said.

See more and radiate less, said the developer.

The image-guided Pantheris device lets surgeons see the plaque during an atherectomy, a minimally invasive procedure that involves cutting plaque away from the artery and capturing and removing it to restore blood flow.

The catheter is intended for patients suffering from peripheral artery disease (PAD), a common circulatory problem in which plaque builds inside arteries and obstructs blood flow to the lower limbs and feet. The catheter, with a fiberoptic lens less than 0.5 mm in diameter, is fed through a small incision in the groin that does not require full anesthesia. Now without radiation, the cardiologist can see what must be removed without damaging the artery wall.

Patients with PAD frequently develop life-threatening complications including heart attack and stroke. In severe cases, amputation can be necessary. The condition affects nearly 20 million adults in the U.S. and more than 200 million globally.

“Peripheral artery disease greatly impacts quality of life, with patients experiencing cramping, numbness, and discoloration of their extremities,” according to Dr. Mitul Patel, a cardiologist at UC San Diego Health. “This new device is a significant step forward for the treatment of PAD with a more efficient approach for plaque removal and less radiation exposure to the doctor and patient.”

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