Resonant Grating without a Planar Waveguide Layer as a Refractive Index Sensor.

Dielectric grating-based sensors are usually based on the guided mode resonance (GMR) obtained using a thin planar waveguide layer (PWL) adjacent to a thin subwavelength grating layer. In this work, we present a detailed investigation of thick subwavelength dielectric grating structures that exhibit reflection resonances above a certain thickness without the need for the waveguide layer, showing great potential for applications in biosensing and tunable filtering. Analytic and numerical results are thoroughly discussed, as well as an experimental demonstration of the structure as a chemical sensor in the SWIR (short wave infrared) spectral range (1200-1800 nm). In comparison to the GMR structure with PWL, the thick grating structure has several unique properties: (i) It gives higher sensitivity when the spaces are filled, with the analyte peaking at certain space values due to an increase in the interaction volume between the analyte and the evanescent optical field between the grating lines; (ii) the TM (transverse magnetic) resonance, in certain cases, provides a better figure of merit; (iii) the sensitivity increases as the grating height increases; (iii) the prediction of the resonance locations based on the effective medium approximation does not give satisfactory results when the grating height is larger than a certain value, and the invalidity becomes more severe as the period increases; (iv) a sudden increase in the Q-factor of the resonance occurs at a specific height value accompanied by the high local field enhancement (~103) characteristic of a nano-antenna type pattern. Rigorous numerical simulations of the field distribution are presented to explain the different observed phenomena.

The Leaflex™ Catheter System - a viable treatment option alongside valve replacement? Preclinical feasibility of a novel device designed for fracturing aortic valve.

AIMS: To demonstrate the feasibility of the Leaflex™ Catheter System, a novel percutaneous device for fracturing valve calcification using mechanical impact in order to regain leaflet mobility. METHODS AND RESULTS: Radiographic analysis of calcium patterns in 90 ex vivo human aortic valve leaflets demonstrated that 82% of leaflets had a typical "bridge" or "half-bridge" pattern, which formed the basis for the catheter design. The therapeutic effect was quantified in 13 leaflets showing a reduction of 49±16% in leaflet resistance to folding after treatment. A pulsatile flow simulator was then used with 11 ex vivo valves demonstrating an increase in aortic valve area of 35±12%. Using gross pathology and histology on fresh calcified leaflets, we then verified that mechanical impacts do not entail excessive risk of embolisation. In vivo safety and usability were then confirmed in the ovine model. CONCLUSIONS: We demonstrated preclinically that it is feasible to improve valve function using the Leaflex™ technology. Once demonstrated clinically, such an approach may have an important role as preparation for or bridging to TAVI, as destination treatment for patients where TAVI is clinically or economically questionable and, in the future, maybe even as a means to slow disease progression in asymptomatic patients.

Diagnosis of thin-cap fibroatheromas by a self-contained intravascular magnetic resonance imaging probe in ex vivo human aortas and in situ coronary arteries.

OBJECTIVES: We sought to correlate findings obtained from a self-contained magnetic resonance imaging (MRI) probe with plaque morphology of ex vivo human aortas and coronary arteries. BACKGROUND: Early detection of thin-cap fibroatheromas (TCFAs) may allow for early preventive treatment of acute coronary syndromes. We developed an intravascular MRI catheter capable of imaging the arterial wall without external magnets or coils by differentiating lipid-rich and fibrotic-rich areas of the atherosclerotic plaque on the basis of differential water diffusion. METHODS: Aortic samples (n = 16) and coronary arteries were obtained within 12 h of death. Coronary specimens were intermediate in angiographic severity (30% to 60% luminal narrowing, n = 18). Blinded histologic and immunohistochemical analyses of the tissues were performed and correlated to MRI findings. RESULTS: The 16 aortic lesions included four ulcerated plaques, two TCFAs, two thick-cap fibrous atheromas, two intimal xanthomas, and six adaptive intimal thickenings. The MRI scan correctly correlated with the histologic diagnosis in 15 (94%) of 16 lesions. The 18 coronary lesions included one plaque rupture, three TFCAs, seven thick-cap fibrous atheromas, four fibrocalcific plaques, two intimal xanthomas, and one adaptive intimal thickening. The MRI scan correlated with the histologic diagnosis in 16 of 18 lesions (sensitivity 100%, specificity 89%). CONCLUSIONS: The self-contained intravascular MRI catheter successfully identified TCFA and may prove to be an important diagnostic approach to determining the presence of lesions with increased risk of causing death or myocardial infarction.

Miniature self-contained intravascular magnetic resonance (IVMI) probe for clinical applications.

A miniature (1.73 mm in diameter) NMR probe, which contains a magnet and a radiofrequency (RF) coil, is presented. This probe is integrated at the tip of a standard catheter and can be inserted into the human coronary arteries, creating local magnetic fields needed to obtain the NMR signal from the blood vessel walls, without the need for external magnet or RF coils. The basic theory governing the probe performance in terms of signal-to-noise-ratio and contrast parameters is presented, along with measured results from test samples. The NMR signal can be analyzed to obtain tissue contrast parameters such as T1, T2 and the diffusion coefficient, which may be used to detect lipid-rich vulnerable plaques in the coronary arteries.