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Atherosclerosis is the leading cause of death in the United
States, however current diagnostic techniques provide a very
limited range of information to guide treatment. In particular,
no methods are available to identify the rupture prone plaques
responsible for the majority of sudden cardiac death. Raman
spectroscopy yields an enhanced analysis because of the detailed
chemical information it accesses. We have developed a spectroscopic
model of atherosclerosis that can diagnose disease with >94%
accuracy. This model translates the chemical information into
a morphological description similar to that which a pathologist
can only provide through tissue biopsy. It is not possible
to biopsy coronary arteries, however Raman spectroscopy allows
for non-destructive analysis without tissue removal, and it
is likely that the model will be useful in locating rupture
prone plaques. Unfortunately, clinical application of this
technique has previously been prohibited by the absence of
satisfactory optical fiber Raman probes. Using a combination
of theory, experiment, and optical design software, we have
designed and constructed efficient, small-diameter Raman probes
that eliminate the majority of spectral background generated
in the optical fibers. Trials conducted during vascular surgery
resulted in high quality, interpretable Raman spectra with
only 1 second collection times. This is the first in vivo
use of Raman spectroscopy to diagnose human atherosclerosis
and demonstrates the potential clinical application of this
technology.
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