1. Articles from Peter Barlis

    1-24 of 49 1 2 »
    1. Clozapine-Induced Myocarditis or Acute Coronary Syndrome? Optical Coherence Tomography to the Rescue

      Clozapine-Induced Myocarditis or Acute Coronary Syndrome? Optical Coherence Tomography to the Rescue

      Chest pain and troponin elevation may be due to an acute coronary syndrome, myocarditis, acute cardiomyopathy, or other less common conditions. Management differs depending on the aetiology, and the pathophysiologic diagnosis has direct implications on treatment and patient outcomes. History and clinical examination is supplemented by selected investigations including the electrocardiogram, chest X-ray, echocardiography, coronary angiography, and even myocardial perfusion scintigraphy or cardiac magnetic resonance imaging. Intravascular imaging can provide important insights into the underlying mechanism of acute coronary syndromes, especially when angiography is ambiguous.

      Read Full Article
    2. Coronary optical coherence tomography-derived virtual fractional flow reserve (FFR): anatomy and physiology all-in-one | European Heart Journal

      Coronary optical coherence tomography-derived virtual fractional flow reserve (FFR): anatomy and physiology all-in-one | European Heart Journal

      Most invasive coronary imaging modalities only provide anatomical information from which physiologic significance is inferred. Fractional flow reserve (FFR) and other physiologic indices of lesion severity are more reliable methods to identify physiologically significant lesions. Currently, accomplishing both anatomic and physiologic interrogation of an intermediate coronary stenosis requires the use of multiple devices within the coronary artery. Coronary angiography, optical coherence tomography (OCT), and FFR were performed in a left anterior descending artery harbouring an intermediate lesion. Quantitative coronary angiography (QAngio XA 7.3, Medis, the Netherlands) and OCT analysis were performed (QIvus 3.0, Medis, the Netherlands). Angiography and ...

      Read Full Article
    3. Clinical Significance of Lipid-Rich Plaque Detected by Optical Coherence Tomography : A 4-Year Follow-Up Study

      Clinical Significance of Lipid-Rich Plaque Detected by Optical Coherence Tomography : A 4-Year Follow-Up Study

      Background Lipid-rich plaque (LRP) is thought to be a precursor to cardiac events. However, its clinical significance in coronary arteries has never been systematically investigated. Objectives This study investigated the prevalence and clinical significance of LRP in the nonculprit region of the target vessel in patients undergoing percutaneous coronary intervention (PCI). Methods The study included 1,474 patients from 20 sites across 6 countries undergoing PCI, who had optical coherence tomography (OCT) imaging of the target vessel. Major adverse cardiac events (MACE) were defined as a composite of cardiac death, acute myocardial infarction, and ischemia-driven revascularization. Patients were followed for ...

      Read Full Article
    4. Biomechanical stress in coronary atherosclerosis: emerging insights from computational modelling

      Biomechanical stress in coronary atherosclerosis: emerging insights from computational modelling

      Coronary plaque rupture is the most common cause of vessel thrombosis and acute coronary syndrome. The accurate early detection of plaques prone to rupture may allow prospective, preventative treatment; however, current diagnostic methods remain inadequate to detect these lesions. Established imaging features indicating vulnerability do not confer adequate specificity for symptomatic rupture. Similarly, even though experimental and computational studies have underscored the importance of endothelial shear stress in progressive atherosclerosis, the ability of shear stress to predict plaque progression remains incremental. This review examines recent advances in image-based computational modelling that have elucidated possible mechanisms of plaque progression and rupture ...

      Read Full Article
    5. Quantitative analysis of the side-branch orifice after bifurcation stenting using en-face processing of OCT images: a comparison between Xience V and Resolute Integrity stents

      Quantitative analysis of the side-branch orifice after bifurcation stenting using en-face processing of OCT images: a comparison between Xience V and Resolute Integrity stents

      Objective: Methods for intravascular assessment of the side-branch (SB) orifice after stenting are not readily available. The aim of this study was to assess the utility of an en-face projection processing for optical coherence tomography (OCT) images for SB evaluation. Methods: Measurements of the SB orifice obtained using en-face OCT images were validated using a phantom model. Linear regression modeling was applied to estimated area measurements made on the en-face images. The SB orifice was then analyzed in 88 patients with bifurcation lesions treated with either Xience V (everolimus-eluting stent) or Resolute Integrity [zotarolimus-eluting stent (ZES)]. The SB orifice area ...

      Read Full Article
    6. Advances in three-dimensional coronary imaging and computational fluid dynamics: is virtual fractional flow reserve more than just a pretty picture?

      Advances in three-dimensional coronary imaging and computational fluid dynamics: is virtual fractional flow reserve more than just a pretty picture?

      Percutaneous coronary intervention (PCI) has shown a high success rate in the treatment of coronary artery disease. The decision to perform PCI often relies on the cardiologist’s visual interpretation of coronary lesions during angiography. This has inherent limitations, particularly due to the low resolution and two-dimensional nature of angiography. State-of-the-art modalities such as three-dimensional quantitative coronary angiography, optical coherence tomography and invasive fractional flow reserve (FFR) may improve clinicians’ understanding of both the anatomical and physiological importance of coronary lesions. While invasive FFR is the gold standard technique for assessment of the haemodynamic significance of coronary lesions, recent studies ...

      Read Full Article
    7. Optical coherence tomography to evaluate coronary stent implantation and complications

      Optical coherence tomography to evaluate coronary stent implantation and complications

      Coronary optical coherence tomography (OCT) is now an established imaging technique in many catheterization laboratories worldwide. With its near-histological view of the vessel wall and lumen interface, it offers unprecedented imaging quality to improve our understanding of the pathophysiology of atherosclerosis, plaque vulnerability, and vascular biology. Not only is OCT used to accurately detect atherosclerotic plaque and optimize stent position, but it can further characterize plaque composition, quantify stent apposition, and assess stent tissue coverage. Given that its resolution of 15 μm is well above that of angiography and intravascular ultrasound, OCT has become the invasive imaging method of choice ...

      Read Full Article
    8. Hazy filling defect on coronary angiography: insights from optical coherence tomography

      Hazy filling defect on coronary angiography: insights from optical coherence tomography

      A middle-aged patient with previous stent to the left circumflex artery (LCx) 12 months before suffering from angina, now presented with acute-onset severe retrosternal chest pain with an ECG showing ST-elevation in the precordial leads (see online supplementary figure S1). He underwent emergency coronary angiography, which showed normal flow in all arteries and a patent LCx stent. The left anterior descending artery (LAD) contained a hazy filling defect in the mid vessel (figure 1A). Following administration of heparin, the filling defect in the mid-LAD resolved (figure 1B). The left ventriculogram showed severe systolic dysfunction involving the mid and apical segments ...

      Read Full Article
    9. Hazy filling defect on coronary angiography: insights from optical coherence tomography

      Hazy filling defect on coronary angiography: insights from optical coherence tomography

      A middle-aged patient with previous stent to the left circumflex artery (LCx) 12 months before suffering from angina, now presented with acute-onset severe retrosternal chest pain with an ECG showing ST-elevation in the precordial leads (see online supplementary figure S1). He underwent emergency coronary angiography, which showed normal flow in all arteries and a patent LCx stent. The left anterior descending artery (LAD) contained a hazy filling defect in the mid vessel (figure 1A). Following administration of heparin, the filling defect in the mid-LAD resolved (figure 1B). The left ventriculogram showed severe systolic dysfunction involving the mid and apical segments ...

      Read Full Article
    10. Bivalirudin versus unfractionated heparin for residual thrombus burden: A frequency-domain optical coherence tomography study

      Bivalirudin versus unfractionated heparin for residual thrombus burden: A frequency-domain optical coherence tomography study

      Objectives: This study aimed to compare the effect of bivalirudin and unfractionated heparin (UFH) on residual thrombus burden assessed by frequency-domain optical coherence tomography (FD-OCT), and on angiographic indices of microvascular obstruction (MVO). Background: The efficacy of bivalirudin to inhibit thrombus formation inside the stent during percutaneous coronary interventions (PCI) as compared to UFH is unknown. Methods: Sixty patients with coronary artery disease who underwent post-PCI FD-OCT were studied, including 20 patients treated with bivalirudin and 40 control patients treated with UFH, matched by clinical presentation, stent characteristics, and periprocedural medications. In-stent thrombus volume, thrombus score (number of quadrants with ...

      Read Full Article
    11. Simultaneous single-vessel plaque rupture causing acute coronary syndrome detected by optical coherence tomography

      Simultaneous single-vessel plaque rupture causing acute coronary syndrome detected by optical coherence tomography

      A 67-year-old male presented with non-ST segment elevation myocardial infarction accompanied by inferior electrocardiogram (ECG) changes. Coronary angiography demonstrated a dominant right coronary artery (RCA) with two discrete regions of angiographic haziness, suggesting possible plaque ulceration and the presence of thrombus ( Panel A ). Prior studies have demonstrated non-culprit plaque rupture in acute myocardial infarction patients; however,

      Read Full Article
    12. The invasive assessment of coronary atherosclerosis and stents using optical coherence tomography: a clinical update

      The invasive assessment of coronary atherosclerosis and stents using optical coherence tomography: a clinical update

      Ischaemic heart disease (IHD) remains one of the leading causes of death. Atherosclerosis has been intensely researched given the IHD prevalence and the financial impacts on healthcare systems. More recently, in vivo characterisation of coronary atherosclerotic plaque and tissue responses following stent implantation in a coronary artery has been made possible by a novel technology called optical coherence tomography (OCT). OCT is a light-based, invasive, intracoronary imaging modality long applied to the field of ophthalmology and now in clinical use worldwide. It gives a unique view of within the coronary artery using near-infrared light with a resolution of 15 microns ...

      Read Full Article
    13. Expert review document part 2: methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures

      Expert review document part 2: methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures

      Introduction This document is complementary to an Expert Review Document on Optical Coherence Tomography (OCT) for the study of coronary arteries and atherosclerosis.1 The goal of this companion manuscript is to provide a practical guide framework for the appropriate use and reporting of the novel frequency domain (FD) OCT imaging to guide interventional procedures, with a particular interest on the comparison with intravascular ultrasound (IVUS).1–4 Technique for optical coherence tomography imaging In the OCT Expert Review Document on Atherosclerosis, a comprehensive description of the physical principles for OCT imaging and time domain (TD) catheters (St Jude Medical ...

      Read Full Article
    14. Current applications of optical coherence tomography for coronary intervention

      Current applications of optical coherence tomography for coronary intervention

      Opticalcoherencetomography (OCT) is the ‘new kid on the block’ in coronary imaging. This technology offers clinicians a high resolution (approximately 15 μm), that is ten times higher than the currently accepted gold standard of intravascular ultrasound and has emerged as the ideal imaging tool for the assessment of superficial components of coronary plaques and stent struts. Novel OCT systems can perform quick and safe scanning of coronary arteries with a non-occlusive technique. A brief summary containing the key physical principles of OCT technology with particular attention to the novel Fourier domain system is presented. This review will focus on clinical ...

      Read Full Article
    15. Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies: A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

      Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies: A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

      Objectives: The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease.Background: Intravascular optical coherence tomography (IVOCT) is a catheter-based modality that acquires images at a resolution of 10 μm, enabling visualization of blood vessel wall microstructure in vivo at an unprecedented level of detail. IVOCT devices are now commercially available worldwide, there is an active user base, and ...

      Read Full Article
    16. Thrombus Contribution to Very Late Restenosis of Bare-Metal Stent Treated by Excimer Laser Angioplasty: In Vivo Assessment with Optical Coherence Tomography

      Thrombus Contribution to Very Late Restenosis of Bare-Metal Stent Treated by Excimer Laser Angioplasty: In Vivo Assessment with Optical Coherence Tomography
      A 75-year-old, male ex-smoker with hypertension and family history of ischemic heart disease, previous anterior myocardial infarction, and angioplasty with bare-metal stent implantation to the left anterior descending artery 4 years earlier, developed effort angina. A nuclear myocardial scan documented a stress-inducible perfusion defect in the left ventricular anterior wall. The patient was taking 100 mg aspirin daily and a 300 mg loading dose of clopidogrel was administered the day before coronary angiography. Coronary angiography showed focal proximal in-stent restenosis (Figure 1, Panel A). Optical coherence tomography (OCT) (ImageWire and Imaging System M2, LightLab Imaging, Westford, Massachusetts) was performed using ...
      Read Full Article
    17. Intracoronary Optical Coherence Tomography for the Assessment of In-Stent Restenosis

      Intracoronary Optical Coherence Tomography for the Assessment of In-Stent Restenosis
      Optical coherence tomography (OCT) is a novel imaging modality in interventional cardiology. With its clear image quality, it has attracted considerable attention as a tool to accurately evaluate atherosclerosis and coronary stents in vivo. It has a 10-fold higher resolution compared to intravascular ultrasound and utilises near-infrared light that requires temporary blood clearance during image acquisition. We present a case of in-stent restenosis in a patient five years after percutaneous intervention. Optical coherence tomography clearly showed the mechanism behind the stent failure and helped appropriately plan the subsequent repeat intervention. The technology heralds an exciting advance in the invasive assessment ...
      Read Full Article
    18. Simple versus complex approaches to treating coronary bifurcation lesions: direct assessment of stent strut apposition by optical coherence tomography.

      Simple versus complex approaches to treating coronary bifurcation lesions: direct assessment of stent strut apposition by optical coherence tomography.
      Introduction and objectives. Stenting of coronary bifurcation lesions carries an increased risk of stent deformation and malapposition. Anatomical and pathological observations indicate that the high stent thrombosis rate in bifurcations is due to malapposition of stent struts. Methods. Strut apposition was assessed with optical coherence tomography (OCT) in bifurcation lesions treated either using the simple technique of stent implantation in the main vessel only or a complex technique (i.e. Culotte’s). A strut was regarded as malapposed if the gap between its endoluminal surface and the vessel wall was greater than its thickness plus an OCT resolution error margin ...
      Read Full Article
    19. In-stent restenosis associated with stent malapposition: Seven year optical coherence tomography findings

      In-stent restenosis associated with stent malapposition: Seven year optical coherence tomography findings
      Abstract: Stent thrombosis and in-stent restenosis remain significant issues in post-coronary angioplasty care despite advances in anti-platelet therapy and stent technology. Angiographic predictors of stent failure have been proposed, but its precise mechanism has been difficult to elucidate on conventional coronary angiography and intravascular ultrasound due to the low resolution of either approach. Optical coherence tomography (OCT) as a high-resolution intracoronary imaging modality has enabled more detailed insight into the interaction between implanted stent and underlying endothelium, the evolution of unstable plaque, and the pathogenesis of late lumen loss, affirming its place as an essential tool in the modern-day cardiac ...
      Read Full Article
    20. Interventional Cardiology: Principles and Practice (Book)

      Interventional Cardiology: Principles and Practice (Book)
      This new volume offers a balanced and current presentation of the key topics that form the cornerstone of an Interventional Cardiology training program including sections on Optical Coherence Tomography. Globally recognized editors and contributors draw on their years of experience to provide practical information emphasizing the basics of material selection and optimal angiographic setup for purposes of the interventional procedure. Comprehensive chapters address the different techniques of approaching complex coronary lesions such as chronic occlusions, bifurcations, and unprotected left main lesions.
      Read Full Article
    21. Optical coherence tomography assessment of a new dedicated bifurcation stent

      Optical coherence tomography assessment of a new dedicated bifurcation stent
      Dedicated bifurcation stents should facilitate deployment and improved coverage of bifurcational lesions. We used optical coherence tomography (OCT) to assess bifurcation lesions treated with a dedicated stent implanted in the side branch (SB) in conjunction with drug eluting stents in the main vessel (MV) in a culotte-like fashion.
      Read Full Article
    1-24 of 49 1 2 »
  1. Categories

    1. Applications:

      Art, Cardiology, Dentistry, Dermatology, Developmental Biology, Gastroenterology, Gynecology, Microscopy, NDE/NDT, Neurology, Oncology, Ophthalmology, Other Non-Medical, Otolaryngology, Pulmonology, Urology
    2. Business News:

      Acquisition, Clinical Trials, Funding, Other Business News, Partnership, Patents
    3. Technology:

      Broadband Sources, Probes, Tunable Sources
    4. Miscellaneous:

      Jobs & Studentships, Student Theses, Textbooks
  2. Topics in the News

    1. (48 articles) Peter Barlis
    2. (30 articles) University of Melbourne
    3. (20 articles) Royal Brompton Hospital
    4. (20 articles) Carlo Di Mario
    5. (19 articles) Erasmus University
    6. (14 articles) Patrick W. Serruys
    7. (13 articles) Evelyn Regar
    8. (13 articles) St. Jude Medical
    9. (12 articles) Imperial College London
    10. (9 articles) Giuseppe Ferrante
  3. Popular Articles

  4. Picture Gallery

    In-vivo characterisation of coronary atherosclerosis with optical coherence tomography Novelties in cardiac imaging – Optical Coherence Tomography (OCT) Current and future developments in intracoronary optical coherence tomography imaging Optical coherence tomography assessment of a new dedicated bifurcation stent Interventional Cardiology: Principles and Practice (Book) In-stent restenosis associated with stent malapposition: Seven year optical coherence tomography findings Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies: A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation Postdoctoral Associate Position at Duke Vision and Image Processing Laborator Anterior segment optical coherence tomography angiography Refining percutaneous coronary intervention: intracoronary imaging, haemodynamics, P2Y12 antagonists, and public outcomes reporting Optical Coherence Tomography/Fluorescence Imaging: Fiber assembly enables efficient multimodal endoscopy Optical Fabrication: Glassblowing technique creates arrays of axicon lenses