Endovascular treatment of unruptured intracranial aneurysms with flow diverters: A retrospective long-term single center analysis.

PURPOSE: The introduction of flow diverters (FDs) in 2007 greatly enhanced the treatment of intracranial aneurysms. Here, we present our long-term clinical experience in treating unruptured intracranial aneurysms with FDs. METHODS: 107 patients with unruptured aneurysms and treated with an FD between 2010 and 2019 were retrospectively reviewed. Aneurysm occlusion, procedural complications, and clinical outcome were evaluated. RESULTS: Angiographic follow-up was available for 93 patients with a mean long-term follow-up time of 28.4 ± 21.6 months. Additional coiling was performed in 15.1% of patients (n = 14). Adequate aneurysm occlusion (Kamran grades 3 and 4) at long-term follow-up was achieved in 94.6% of patients (n = 88). 3.2% (n = 3) required endovascular retreatment since the last follow-up showed a lack of aneurysm occlusion (Kamran grade 0) due to a foreshortening of the FD. Incomplete opening of the FD and parent vessel occlusion was seen in 1.1% (n = 1) and 3.2% (n = 3) of patients, respectively. In-stent stenosis was observed in 57% (n = 53) of cases at short-term follow-up and 22.6% (n = 21) at long-term, which were moderate and asymptomatic overall. In-stent stenosis decreased significantly between short- and long-term follow-ups (31.4 ± 17.0% vs 9.7 ± 13.6%, respectively; p ≤ 0.001). Thromboembolic and hemorrhagic events occurred in 7.5% (n = 7) and 1.1% (n = 1) of patients, respectively. Good clinical outcome (modified Rankin scale: 0-2) was obtained in 97.8% (n = 91) leading to an overall treatment-related morbidity of 2.2% (n = 2). There was no procedural mortality. CONCLUSION: Our study shows that FD treatment of unruptured intracranial aneurysms is effective and safe with high occlusion rates and low rates of permanent morbidity at long-term follow-up.

Treatment of Wide-Necked Cerebral Aneurysms Using the WEB Device Including Flow Alteration Assessment With Color-Coded Imaging: A Single Center Experience.

Objective: The Woven EndoBridge (WEB) device (MicroVention, Tustin, CA) has extended the treatment of cerebral aneurysms. Despite the fact that the WEB device has shown promising clinical results, little is known about the caused intra-aneurysmal flow alterations. Here we present our clinical experience with the WEB, including examining various syngo iFlow (Siemens AG, Erlangen, Germany) parameters to predict aneurysm occlusion. Methods: We reviewed the data from patients with unruptured cerebral aneurysms treated with a WEB device between 2016 and 2020. Aneurysm occlusion and complications were assessed. Furthermore, different quantitative criteria were evaluated using syngo iFlow after digital subtraction angiography. Results: A total of 26 patients hosting 26 cerebral aneurysms met the inclusion criteria. Follow-up was available for 21 patients, with a mean of 7.3 ± 6.3 months. A total of 71.4% (n = 15) of the aneurysms included were located in the anterior and 28.6% (n = 6) in the posterior circulation. Adequate aneurysm occlusion was achieved in 85.7% (n = 18). The iFlow parameters for reduced aneurysm outflow (ID-R) differed significantly from the parameters for reduced inflow (PI-R and PI-D) (P < 0.001). The parameters did not differ significantly between adequately and insufficiently occluded aneurysms. Only a trend towards a lower ID-R of insufficiently occluded aneurysms was observed (P = 0.063), indicating a potential predictive value for insufficient aneurysmal outflow. There was no treatment-related morbidity or mortality. Conclusions: The applied syngo iFlow parameters confirmed that flow changes induced by the WEB device significantly affect outflow compared to inflow and have potential predictive value for adequate aneurysm occlusion.

3D-printed facet-attached optical elements for beam shaping in optical phased arrays.

We demonstrate an optical phased-array equipped with a 3D-printed facet-attached element for shaping and deflection of the emitted beam. The beam shaper combines freeform refractive surfaces with total-internal-reflection mirrors and is in-situ printed to edge-emitting waveguide facets using high-resolution multi-photon lithography, thereby ensuring precise alignment with respect to on-chip waveguide structures. In a proof-of-concept experiment, we achieve a grating-lobe free steering range of ±30∘ and a full-width-half-maximum beam divergence of approximately 2∘. The concept opens an attractive alternative to currently used grating structures and is applicable to a wide range of integration platforms.

3D-printed facet-attached optical elements for connecting VCSEL and photodiodes to fiber arrays and multi-core fibers.

Multicore optical fibers and ribbons based on fiber arrays allow for massively parallel transmission of signals via spatially separated channels, thereby offering attractive bandwidth scaling with linearly increasing technical effort. However, low-loss coupling of light between fiber arrays or multicore fibers and standard linear arrays of vertical-cavity surface-emitting lasers (VCSEL) or photodiodes (PD) still represents a challenge. In this paper, we demonstrate that 3D-printed facet-attached microlenses (FaML) offer an attractive path for connecting multimode fiber arrays as well as individual cores of multimode multicore fibers to standard arrays of VCSEL or PD. The freeform coupling elements are printed in situ with high precision on the device and fiber facets by high-resolution multi-photon lithography. We demonstrate coupling losses down to 0.35 dB along with lateral 1 dB alignment tolerances in excess of 10 µm, allowing to leverage fast passive assembly techniques that rely on industry-standard machine vision. To the best of our knowledge, our experiments represent the first demonstration of a coupling interface that connects individual cores of a multicore fiber to VCSEL or PD arranged in a standard linear array without the need for additional fiber-based or waveguide-based fan-out structures. Using this approach, we build a 3 × 25 Gbit/s transceiver assembly which fits into a small form-factor pluggable module and which fulfills many performance metrics specified in the IEEE 802.3 standard.

Superconducting nanowire single-photon detector with 3D-printed free-form microlenses.

We present an approach to increase the effective light-receiving area of superconducting nanowire single-photon detectors (SNSPD) by free-form microlenses. These lenses are printed in situ on top of the sensitive detector areas using high-resolution multi-photon lithography. We demonstrate a detector based on niobium-nitride (NbN) nanowires with a 4.5 µm × 4.5 µm sensitive area, supplemented with a lens of 60-µm-diameter. For a plane-wave-like free-space illumination at a wavelength of 1550 nm, the lensed sensor has a 100-fold increased effective collection area, which leads to a strongly enhanced system detection efficiency without the need for long nanowires. Our approach can be readily applied to a wide range of sensor types. It effectively overcomes the inherent design conflict between high count rate, high timing accuracy, and high fabrication yield on the one hand and high collection efficiency through a large effective detection area on the other hand.

Hybrid external-cavity lasers (ECL) using photonic wire bonds as coupling elements.

Combining semiconductor optical amplifiers (SOA) on direct-bandgap III-V substrates with low-loss silicon or silicon-nitride photonic integrated circuits (PIC) has been key to chip-scale external-cavity lasers (ECL) that offer wideband tunability along with small optical linewidths. However, fabrication of such devices still relies on technologically demanding monolithic integration of heterogeneous material systems or requires costly high-precision package-level assembly, often based on active alignment, to achieve low-loss coupling between the SOA and the external feedback circuits. In this paper, we demonstrate a novel class of hybrid ECL that overcome these limitations by exploiting 3D-printed photonic wire bonds as intra-cavity coupling elements. Photonic wire bonds can be written in-situ in a fully automated process with shapes adapted to the mode-field sizes and the positions of the chips at both ends, thereby providing low-loss coupling even in presence of limited placement accuracy. In a proof-of-concept experiment, we use an InP-based reflective SOA (RSOA) along with a silicon photonic external feedback circuit and demonstrate a single-mode tuning range from 1515 to 1565 nm along with side mode suppression ratios above 40 dB and intrinsic linewidths down to 105 kHz. Our approach combines the scalability advantages of monolithic integration with the performance and flexibility of hybrid multi-chip assemblies and may thus open a path towards integrated ECL on a wide variety of integration platforms.

Near real-time magnetic particle imaging for visual assessment of vascular stenosis in a phantom model.

PURPOSE: This study aimed to investigate the potential of magnetic particle imaging (MPI) to quantify artificial stenoses in vessel phantoms in near real-time. METHODS: Custom-made stenosis phantoms with different degrees of stenosis (0%, 25%, 50%, 75%, and 100%; length 40 mm, inner diameter 8 mm, Polyoxymethylene) were filled with diluted Ferucarbotran (superparamagnetic iron-oxide nanoparticle (SPION) tracer agent, 500 mmol (Fe)/l). A traveling wave MPI scanner (spatial resolution ~ 2 mm, gradient strength ~ 1.5 T/m, field of view: 65 mm length and 29 mm diameter, frequencies f1 = 1050 Hz and f2 = 12150 Hz) was used to acquire images of the phantoms (200 ms total acquisition time per image, 10 averages). Standardized grey scaling was used for comparability. All measured stenoses (n = 80) were graded manually using a dedicated software tool. RESULTS: MPI allowed for accurate visualization of stenoses at a frame rate of 5frames per second. Less severe stenoses were detected more precisely than higher-grade stenoses and came with smaller standard deviations. In particular, the 0%, 25%, 50%, 75%, and 100% stenosis phantom were measured as 3.7 ± 2.7% (mean ± standarddeviation), 18.6 ± 1.8%, 52.8 ± 3.7%, 77.8 ± 14.8% and 100 ± 0%. Geometrical distortions occurred around the center of the high-grade stenosis and led to higher standard deviations compared to lower grade stenoses. In the frame of this study the MPI signal depended linearly on the SPION concentration down to 0.05 mmol (Fe)/l. CONCLUSION: Near real-time MPI accurately visualized and quantified different stenosis grades in vascular phantoms.

Solitaire Stentectomy Using a Stent-Retriever Technique in a Porcine Model.

PURPOSE: Mechanical thrombectomy using the Solitaire device has become a standard treatment of ischemic stroke due to large vessel occlusions. Inadvertent detachment is a feared complication, which is associated with poor clinical outcome. The aim of this experimental study was to assess in a porcine model the feasibility and effectiveness of rescuing detached Solitaire devices using different stent retrievers. METHODS: Solitaire FR devices (4â€¯× 15/20 mm and 6â€¯× 20/30 mm) were placed in the axillary artery of pigs. By means of 3 different stent retrievers (Trevo ProVue; EmboTrap II revascularization device; 3D revascularization device) a total of 24 rescue maneuvers (8 per retriever) were performed by deploying the retrievers within the deployed Solitaire devices and trapping parts of the Solitaire within the microcatheter. Rescue rates, rescue time and complications were assessed. RESULTS: Overall stentectomy of the Solitaire devices was successful in all cases (100%). Time of rescue was comparable using the applied stent retrievers (Trevo ProVue; EmboTrap II revascularization device; 3D revascularization device). Complications, such as entrapment of the Solitaire-retriever complex at the intermediate catheter, Solitaire migration, vasospasm, perforation, or dissection were not observed. CONCLUSION: Stentectomy of inadvertently detached Solitaire devices using different stent retrievers is a feasible and effective method. Rescue rates and times with the Trevo ProVue, EmboTrap II and 3D revascularization device were comparable.

Single Center Experience in Stent-Assisted Coiling of Complex Intracranial Aneurysms Using Low-Profile Stents : The ACCLINO® Stent Versus the ACCLINO® Flex Stent.

PURPOSE: The introduction of low-profile stent systems has broadened and facilitated the treatment of complex intracranial aneurysms. This retrospective case series study was conducted to assess and compare the clinical and angiographic outcomes of patients with complex intracranial aneurysms who were treated with ACCLINO® (AS) and ACCLINO® flex stents (AFS). METHODS: In 85 patients (female 61; male 24) a total of 95 complex intracranial aneurysms, 71 (74.7%) in the anterior circulation and 24 (25.3%) in the posterior circulation were treated. Angiographic and clinical data, aneurysm characteristics and follow-up results were analyzed. RESULTS: The AS was used in 47 cases (49.5%) and the AFS in 48 cases (50.5%). Initial angiography after the intervention showed a complete occlusion in 52.6% (Raymond-Roy occlusion classification [RROC] 1), a neck remnant in 38.9% (RROC 2) and an incomplete occlusion in 8.4% (RROC 3). Follow-up (AS: 25.2 ± 15.4 months; AFS: 9.6 ± 8.0 months) revealed an occlusion rate of 70.5% (RROC 1), 27.4% (RROC 2) and 2.1% (RROC 3). There was no statistically significant difference between the initial (p = 0.484) and the follow-up occlusion rate (p = 0.284) when comparing the two devices. Recoiling was performed in 8 cases (8.4%). The overall complication rate was 9.5% with 5 strokes (5.3%), 2 hemorrhages (2.1%), 1 in-stent stenosis (1.1%), 1 stent occlusion (1.1%) and 2 stent thromboses (2.1%). There was no procedure-related mortality. CONCLUSION: Using the ACCLINO® and ACCLINO® flex stent system is a feasible and effective procedure with an acceptable safety profile. Initial and follow-up angiographic results were satisfactory.

Different Rescue Approaches of Migrated Woven Endobridge (WEB) Devices: an Animal Study.

PURPOSE: Treatment of wide-necked intracranial aneurysms using the Woven Endobridge (WEB) device has become broadly accepted. Feared complications with the potential of increased poor clinical outcome include dislocations and migration of the device. This study was carried out to determine the effectiveness of a variety of different strategies to rescue migrated WEB devices. METHODS: In a porcine model, WEB devices of different sizes (SL [single layer] 3.5â€¯× 2mm and SL 4.0â€¯× 3 mm, SL 8â€¯× 5 mm and SLS 8 mm [single layer spherical]) were placed into both the subclavian and axillary arteries. A total of 32 rescue maneuvers (8 per rescue device) were performed. Small WEBs were rescued using reperfusion catheters (RC) (SOFIA Plus and JET 7), larger WEBs were rescued using dedicated rescue devices (Microsnare and Alligator). Rescue rates, times, attempts and complications were assessed. RESULTS: Rescue attempts of migrated WEBs were successful in all cases (100%). Rescue time (p = 0.421) and attempts (p = 0.619) of small WEBs using RCs were comparable without significant differences. Aspiration alone was not successful for larger WEBs. Rescue of larger WEBs was slightly faster (122.75 ± 41.15 s vs. 137.50 ± 54.46 s) with fewer attempts (1 vs. 1.37) when using the Microsnare compared to the Alligator device. Complications such as entrapment of the WEB in the RCs, vasospasm, perforation, or dissection were not observed. CONCLUSION: Rescue of migrated WEB devices is a feasible and effective method and 100% successful rescue rates and appropriate rescue times can be achieved for small WEBs using RCs and for larger WEBs using dedicated rescue devices (Microsnare and Alligator).

3D-printed optical probes for wafer-level testing of photonic integrated circuits.

Wafer-level probing of photonic integrated circuits is key to reliable process control and efficient performance assessment in advanced production workflows. In recent years, optical probing of surface-coupled devices such as vertical-cavity lasers, top-illuminated photodiodes, or silicon photonic circuits with surface-emitting grating couplers has seen great progress. In contrast to that, wafer-level probing of edge-emitting devices with hard-to-access vertical facets at the sidewalls of deep-etched dicing trenches still represents a major challenge. In this paper, we address this challenge by introducing a novel concept of optical probes based on 3D-printed freeform coupling elements that fit into deep-etched dicing trenches on the wafer surface. Exploiting the design freedom and the precision of two-photon laser lithography, the coupling elements can be adapted to a wide variety of mode-field sizes. We experimentally demonstrate the viability of the approach by coupling light to edge-emitting waveguides on different integration platforms such as silicon photonics (SiP), silicon nitride (TriPleX), and indium phosphide (InP). Achieving losses down to 1.9 dB per coupling interface, we believe that 3D-printed coupling elements represent a key step towards highly reproducible wafer-level testing of edge-coupled photonic integrated circuits.

In vivo comparison of braided (Accero) and laser-cut intracranial stents (Acclino, Credo): evaluation of vessel responses at subacute and mid-term follow-up in a rabbit model.

This study aimed to investigate in vivo two stent technologies, with particular emphasis on thrombogenicity and inflammatory vessel remodeling processes. The micro-stents tested in this study were developed for intracranial aneurysm treatment. In our study twelve, New Zealand white rabbits were divided into two groups: 18 laser-cut stents (LCS) and 18 braided stents (BS) were impanated without admiration of antiplatelet medication. Three stents were implanted into each animal in the common carotid artery, subclavian artery, and abdominal aorta. Digital subtraction angiography was performed before and after stent implantation and at follow-up for the visualization of occurring In-stent thromboembolism or stenosis. The Stents were explanted for histopathological examination at two different timepoints, after 3 and 28 days. Angiographically neither in-stent thrombosis nor stenosis for both groups was seen. There was a progressive increase in the vessel diameter, which was more pronounced for BS than for LCS. We detected a higher number of thrombi adherent to the foreign material on day 3 for BS. On day 3, the neointima was absent, whereas the complete formation observed was on day 28. There was no significant difference between both groups regarding the thickness of the neointima. The in vivo model of our study enabled the evaluation of blood and vessel reactions for two different stent technologies. Differences in vessel dimension and tissue around the stents were observed on day 28. Histological analysis on day 3 enabled the assessment of thrombotic reactions, representing an important complementary result in long-term studies.

Hybrid multi-chip assembly of optical communication engines by in situ 3D nano-lithography.

Three-dimensional (3D) nano-printing of freeform optical waveguides, also referred to as photonic wire bonding, allows for efficient coupling between photonic chips and can greatly simplify optical system assembly. As a key advantage, the shape and the trajectory of photonic wire bonds can be adapted to the mode-field profiles and the positions of the chips, thereby offering an attractive alternative to conventional optical assembly techniques that rely on technically complex and costly high-precision alignment. However, while the fundamental advantages of the photonic wire bonding concept have been shown in proof-of-concept experiments, it has so far been unclear whether the technique can also be leveraged for practically relevant use cases with stringent reproducibility and reliability requirements. In this paper, we demonstrate optical communication engines that rely on photonic wire bonding for connecting arrays of silicon photonic modulators to InP lasers and single-mode fibres. In a first experiment, we show an eight-channel transmitter offering an aggregate line rate of 448 Gbit/s by low-complexity intensity modulation. A second experiment is dedicated to a four-channel coherent transmitter, operating at a net data rate of 732.7 Gbit/s - a record for coherent silicon photonic transmitters with co-packaged lasers. Using dedicated test chips, we further demonstrate automated mass production of photonic wire bonds with insertion losses of (0.7 ± 0.15) dB, and we show their resilience in environmental-stability tests and at high optical power. These results might form the basis for simplified assembly of advanced photonic multi-chip systems that combine the distinct advantages of different integration platforms.

Rescue of migrated Woven Endobridge devices using a stent-retriever-technique in a porcine model.

PURPOSE: The Woven Endobridge device (WEB) has become widely applied for the treatment of intracranial aneurysms. Complications are rare, however, especially dislocations and migrations can potentially increase poor clinical outcome. The aim of this study was to assess the feasibility and effectiveness of rescuing migrated Woven Endobridges using different stent retrievers. METHODS: In a porcine model, Woven Endobridges of different sizes (SLS 4, SLS 7, SL 5 × 3, SL 4 × 3) were placed into the axillary arteries. By means of two different stent retrievers (Solitaire Platinum and 3D Revascularization Device), a total of 20 rescue maneuvers were performed. For this purpose, the retrievers were deployed distally of the migrated Woven Endobridges. After retracting the stent retrievers partially, the Woven Endobridges were trapped within the microcatheter. Rescue rates, time, attempts and complications were assessed. RESULTS: Successful rescue of the migrated Woven Endobridges was observed in all cases (100%). Rescue was slightly faster (177.8 ± 72.8 s vs. 223.4 ± 104.1 s) with fewer attempts (1.5 ± 0.8 vs. 1.8 ± 0.9) when using the 3D Revascularization Device compared to the Solitaire Platinum. However, there were no significant differences (p = 0.327; p = 0.554). Migration of the Woven Endobridges during rescue was seen with both stent retrievers in a comparable frequency (p = 0.642). Further complications, such as entrapment of the stent-retriever-WovenEndobridge-complex at the intermediate catheter, vasospasm, perforation or dissection, were not observed. CONCLUSIONS: Rescue of migrated Woven Endobridges using stent retrievers is a feasible and effective method. Rescue rates, times and attempts with the Solitaire Platinum and 3D Revascularization Device are comparable with each other.

Why we fail: mechanisms and co-factors of unsuccessful thrombectomy in acute ischemic stroke.

PURPOSE: Mechanical thrombectomy (MT) is an effective treatment for patients suffering from acute ischemic stroke. However, recanalization fails in about 16.5% of interventions. We report our experience with unsuccessful MT and analyze technical reasons plus patient-related parameters for failure. METHODS: Five hundred ninety-six patients with acute ischemic stroke in the anterior circulation and intention to perform MT with an aspiration catheter and/or stent retriever were analyzed. Failure was defined as 0, 1, or 2a on the mTICI scale. Patients with failing MT were analyzed for interventional progress and compared to patients with successful intervention, whereby parameters included demographics, medical history, stroke presentation, and treatment. RESULTS: One hundred of the 596 (16.8%) interventions failed. In 20 cases, thrombus could not be accessed or passed with the device. Peripheral arterial occlusive disease is common in those patients. In 80 patients, true stent retriever failure occurred. In this group, coagulation disorders are associated with poor results, whereas atrial fibrillation is associated with success. The administration of intravenous thrombolysis and intake of nitric oxide donors are associated with recanalization success. Intervention duration was significantly longer in the failing group. CONCLUSION: In 20% of failing MT, thrombus cannot be reached/passed. Direct carotid puncture or surgical arterial access could be considered in these cases. In 80% of failing interventions, thrombus can be passed with the device, but the occluded vessel cannot be recanalized. Rescue techniques can be an option. Development of new devices and techniques is necessary to improve recanalization rates. Assessment of pre-existing illness could sensitize for occurring complications.

3D-Printed Scanning-Probe Microscopes with Integrated Optical Actuation and Read-Out.

Scanning-probe microscopy (SPM) is the method of choice for high-resolution imaging of surfaces in science and industry. However, SPM systems are still considered as rather complex and costly scientific instruments, realized by delicate combinations of microscopic cantilevers, nanoscopic tips, and macroscopic read-out units that require high-precision alignment prior to use. This study introduces a concept of ultra-compact SPM engines that combine cantilevers, tips, and a wide variety of actuator and read-out elements into one single monolithic structure. The devices are fabricated by multiphoton laser lithography as it is a particularly flexible and accurate additive nanofabrication technique. The resulting SPM engines are operated by optical actuation and read-out without manual alignment of individual components. The viability of the concept is demonstrated in a series of experiments that range from atomic-force microscopy engines offering atomic step height resolution, their operation in fluids, and to 3D printed scanning near-field optical microscopy. The presented approach is amenable to wafer-scale mass fabrication of SPM arrays and capable to unlock a wide range of novel applications that are inaccessible by current approaches to build SPMs.

Magnetic Particle Imaging-Guided Stenting.

Purpose:To assess the feasibility of magnetic particle imaging (MPI) to guide stenting in a phantom model. Materials and Methods: MPI is a new tomographic imaging method based on the background-free magnetic field detection of a tracer agent composed of superparamagnetic iron oxide nanoparticles (SPIOs). All experiments were conducted on a custom-built MPI scanner (field of view: 29-mm diameter, 65-mm length; isotropic spatial resolution 1-1.5-mm). Stenosis phantoms (n=3) consisted of polyvinyl chloride (PVC) tubes (8-mm inner diameter) prepared with centrally aligned cable binders to form a ~50% stenosis. A dedicated image reconstruction algorithm allowed precise tracking of endovascular instruments at 8 frames/s with a latency time of ~115 ms. A custom-made MPI-visible lacquer was used to manually label conventional guidewires, balloon catheters, and stainless steel balloon-expandable stents. Vascular stenoses were visualized by injecting a diluted SPIO tracer (ferucarbotran, 10 mmol iron/L) into the vessel phantoms. Balloon angioplasty and stent placement were performed by inflating balloon catheters and stent delivery balloons with diluted ferucarbotran. Results: After deployment of the stent, the markers on its ends were clearly visible. The applied lacquer markers were thin enough to not relevantly alter gliding properties of the devices while withstanding friction during the experiments. Placing an optimized flexible lacquer formulation on the preexisting radiopaque stent markers provided enough stability to withstand stent expansion. Final MPA confirmed successful stenosis treatment, facilitated by the disappearance of the lacquer markers on the stent due to differences in SPIO concentration. Thus, the in-stent lumen could be visualized without interference by the signal from the markers. Conclusion: Near real-time visualization of MPI-guided stenting of stenoses in a phantom model is feasible. Optimized MPI-visible markers can withstand the expansion process of stents.

Magnetic Particle Imaging Guided Real-Time Percutaneous Transluminal Angioplasty in a Phantom Model.

PURPOSE: To investigate the potential of real-time magnetic particle imaging (MPI) to guide percutaneous transluminal angioplasty (PTA) of vascular stenoses in a phantom model. MATERIALS AND METHODS: Experiments were conducted on a custom-built MPI scanner. Vascular stenosis phantoms consisted of polyvinyl chloride tubes (inner diameter 8 mm) prepared with a centrally aligned cable tie to form ~ 50% stenoses. MPI angiography for visualization of stenoses was performed using the superparamagnetic iron oxide nanoparticle-based contrast agent Ferucarbotran (10 mmol (Fe)/l). Balloon catheters and guidewires for PTA were visualized using custom-made lacquer markers based on Ferucarbotran. Stenosis dilation (n = 3) was performed by manually inflating the PTA balloon with diluted Ferucarbotran. An online reconstruction framework was implemented for real-time imaging with very short latency time. RESULTS: Visualization of stenosis phantoms and guidance of interventional instruments in real-time (4 frames/s, ~ 100 ms latency time) was possible using an online reconstruction algorithm. Labeling of guidewires and balloon catheters allowed for precise visualization of instrument positions. CONCLUSION: Real-time MPI-guided PTA in a phantom model is feasible.

Printed freeform lens arrays on multi-core fibers for highly efficient coupling in astrophotonic systems.

Coupling of light into multi-core fibers (MCF) for spatially resolved spectroscopy is of great importance to astronomical instrumentation. To achieve high coupling efficiencies along with fill-fractions close to unity, micro-optical elements are required to concentrate the incoming light to the individual cores of the MCF. In this paper we demonstrate facet-attached lens arrays (LA) fabricated by two-photon polymerization. The LA provide close to 100% fill-fraction along with efficiencies of up to 73% (down to 1.4 dB loss) for coupling of light from free space into an MCF core. We show the viability of the concept for astrophotonic applications by integrating an MCF-LA assembly in an adaptive-optics test bed and by assessing its performance as a tip/tilt sensor.