Metasurface Optical Guidewire for percutaneous coronary intervention (PCI) - PROJECT SUMMARY / ABSTRACT
Coronary artery disease, aggravated by arterial calcification, poses a significant challenge to successful
percutaneous coronary intervention (PCI). Coronary artery calcification (CAC) reduces vessel compliance and
increases the complexities of stent deployment, stent expansion, balloon expansion, and results in uneven drug
distribution. Specifically, reduced vessel compliance prohibits stent delivery and reduces the ability of deployed
stents to expand, or causing “stent regret”, resulting in stent failure through either restenosis or stent thrombosis.
Importantly, these complications are exasperated in highly stenotic CAC lesions – hence, endovascular devices
and therapeutic techniques are needed with improved safety and efficacy to advance the clinical management
of CAC.
The objective of this proposal is to develop novel metasurface optical guidewires for therapeutic applications
to treat previously untreatable highly stenotic CAC lesions. Our project addresses these challenges by
hypothesizing that: 1) metasurfaces are specialized planar lens elements that can provide optimal energy
delivery over a sub-millimeter profile; 2) with advances in fiber-coupled diode laser technologies, fiber-optic
metasurfaces are an attractive platform for endovascular devices; 2) a flexible, small-diameter fiber-optic
embedded guidewire with metasurfaces – termed 'metasurface optical guidewires' – can offer dual benefits of a
rapid exchange monorail for PCI devices and provide light-based endovascular therapeutic capabilities including
laser intravascular lithotripsy (L-IVL). The metasurface optical guidewires and associated innovative light-based
endovascular therapies will be successfully developed and demonstrated by completing the following specific
aims: Aim 1: Design, develop and manufacture metasurface optical guidewires for precise control of
intravascular laser dosimetry; Aim 2: Develop a PCI workflow for use of an metasurface optical guidewire for
laser intravascular lithotripsy (L-IVL); Aim 3: Develop a PCI workflow and study L-IVL’s efficacy in a preclinical
model; Aim 4: Evaluate L-IVL treatment efficacy in a pre-clinical CAC animal model.
Successful completion of these aims will lead to the development of the metasurface optical guidewire and
other innovative devices and procedures that can significantly improve PCI outcomes in patients with calcified
coronary arteries, reducing complications and enhancing patient care.
