Cardio Imaging Device Combines Two Modalities into Single System

Tom Looby, Conavi Medical, and Darcy Hart, Minnetronix Medical

Co-registered imaging beams at the head of the imaging catheter, the core Conavi IP that allows for hybrid co-registered images.

Interventional cardiologists have long used the traditional angiogram technique to diagnose and plan interventional procedures. An estimated 80–85 percent still lean on the process, which includes injecting contrasting material and utilizing x-ray images to guide the next steps for patient care. The other 15–20 percent supplement angiography with catheter-driven intravascular imaging devices to view arteries internally. Intravascular imaging is rapidly growing, with technological advancements, increased physician utilization, and a growing body of evidence showing positive patient outcomes when imaging is used to guide procedures.

According to a study of over 12,000 patients completed by the European Society of Cardiology in August 2023, the use of intravascular imaging dramatically reduced instances of cardiac death (46 percent reduction), target vessel MI (20 percent), stent thrombosis (52 percent), and reintervention (29 percent). Yet which imaging fits best and what are the choices? Traditionally, physicians have had to choose between one of two modalities — intravascular ultrasound (IVUS) or optical coherence tomography (OCT). While there are advantages and disadvantages to both, cardiologists had to decide between one or the other when performing coronary interventions. That’s where Conavi came in, with a new and different idea. This article presents how Conavi combined the two standard intravascular imaging modalities into one — the Novasight Hybrid™ System, the first and only intravascular imaging system to combine co-registered IVUS and OCT in a single system.

Example of side-by-side hybrid IVUS OCT image.

What’s the Difference?

When it comes to the two cardiac imaging options, IVUS has been the more commonly used option, with over 70 percent of cardiologists choosing this method when selecting an imaging device. IVUS’ depth penetration is far superior to OCT, making it the optimal choice for larger vessels such as the left main and ostial lesions. IVUS gives a better overall view of the artery and plaque burden and eliminates the need to use contrast to evaluate imaging results.

The Conavi Novasight HybridT System in a lab.

OCT, on the other hand, provides a much clearer view of the affected vessel than IVUS. OCT images can reach up to 10 times the resolution of IVUS. This advantage makes OCT an ideal solution for post-stent implantation evaluation and assessment.

The obvious predicament is the tradeoffs both require. With IVUS, the inferior resolution of the imagery makes determining calcium thickness difficult. OCT’s lack of depth limits usage in larger vessels and requires a contrast flush.

Conavi Medical recognized the shortcomings of both options and brought to life the idea of integrating the two distinct capabilities together into one hybrid option. With that goal in mind, Conavi developed its Novasight Hybrid IVUS/OCT System™. The system, which can capture and provide both IVUS and OCT images with the use of a single catheter, is a first dual IVUS OCT device in the interventional cardiology field. Conavi Medical is currently working on a next-generation version of the system, with enhanced features and performance, alongside the optics team at Minnetronix Medical, also Conavi’s manufacturing partner.

The Novasight enters the intravascular imaging market, sized at $650 million–$700 million dollars, and is expected to grow to $1 billion dollars by 2028, largely because of clinical evidence that demonstrates the benefits of imaging utilization. The launch of the first generation of Novasight took place at seven pilot sites across Canada and the United States, including New York Presbyterian, Cleveland Clinic, and Mount Sinai Hospital.

Along with eliminating the need to choose between two imaging technologies, Conavi’s development of its system meets multiple needs in the imaging space. Image interpretation becomes easier, making the transition from angiograms an attractive option. The dual-imaging system also provides a much more comprehensive assessment of the vessels, allowing for more accurate diagnosis and optimal treatment — saving time and cost.

Recently, Convai completed a reverse merger with Titan Medical Inc. to focus on further development, commercialization, manufacturability, and expansion of the Novasight Hybrid System™. The next generation of the system is scheduled for release in 2026, with further refined image quality and improved imaging depth, developed in partnership with Minnetronix’s optical engineers. Additional enhancements include the addition of a bedside controller, angio co-registration, AI-driven software features, and enhanced catheter deliverability.

The next-generation Conavi Novasight Hybrid System.

Conavi expects these upgrades will enhance and expand interventional imaging capabilities among physicians and save hospitals money by eliminating the need to purchase multiple single-modality systems. The goal of expanding Novasight’s U.S. installation base for Conavi is timely, given that current guidelines around interventional imaging for complex percutaneous coronary intervention (PCI) are being updated in the EU to Class 1A, with North America expected to follow with Class 1 status. Conavi expects this development will highlight intervascular imaging and drive adoption. In the meantime, the company is making its new choice as clear as can be for cardiologists.

This article was written by Tom Looby, CEO at Conavi Medical, Toronto, ON, Canada, and Darcy Hart, Director of Optics at Minnetronix Medical. For more information on Conavi Medical, visit here . For more information on Minnetronix Medical, visit here .