1. Coronary Stents: Current Status

    Explore Article JACC (Aug 24 2010)

    Coronary Stents: Current Status Coronary artery stents revolutionized the practice of interventional cardiology after they were first introduced in the mid-1980s. Since then, there have been significant developments in their design, the most notable of which has been the introduction of drug-eluting stents. This paper reviews the benefits, risks, and current status of Food and Drug Administration-approved drug-eluting stents. (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Thoraxcenter at Erasmus University Medical Center

  2. Coronary Stents: Looking Forward

    Explore Article JACC (Aug 24 2010)

    Coronary Stents:  Looking Forward Despite all the benefits of drug-eluting stents (DES), concerns have been raised over their long-term safety, with particular reference to stent thrombosis. In an effort to address these concerns, newer stents have been developed that include: DES with biodegradable polymers, DES that are polymer free, stents with novel coatings, and completely biodegradable stents. Many of these stents are currently undergoing pre-clinical and clinical trials; however, early results seem promising. This paper reviews the current status of this new technology, together with other new coronary devices such as bifurcation stents and drug-eluting balloons, as efforts continue to design the ideal coronary ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Thoraxcenter at Erasmus University Medical Center

  3. 3-Dimensional Optical Coherence Tomography Assessment of Jailed Side Branches by Bioresorbable Vascular Scaffolds: A Proposal for Classification

    Explore Article interventions.onlinejacc.org (Aug 16 2010)

    3-Dimensional Optical Coherence Tomography Assessment of Jailed Side Branches by Bioresorbable Vascular Scaffolds: A Proposal for Classification Objectives The purpose of this study is to assess jailing of side branches (SB) by the everolimus-eluting, bioresorbable vascular scaffold (BVS) with 3-dimensional (3D) optical coherence tomography (OCT) reconstruction. Background Because BVS struts at the SB orifice are suspected of being bioresorbed and/or forming a neointimal bridge, OCT has been used to evaluate the struts in detail at that particular site. Our understanding of the 3D relationship of the strut and the SB orifice is limited by the use of 2-dimensional OCT images. Fourier-domain OCT enables reliable 3D reconstruction of coronary vessels. Methods The ABSORB Cohort B (A Clinical Evaluation ... (Read Full Article)

    Comment on Article Mentions:   LightLab Imaging   Patrick W. Serruys   Evelyn Regar

  4. The fate of bioresorbable struts located at a side branch ostium: serial three-dimensional optical coherence tomography assessment

    Explore Article Oxford Journals (Jun 1 2010)

    The fate of bioresorbable struts located at a side branch ostium: serial three-dimensional optical coherence tomography assessment A 64-year-old woman with stable angina pectoris underwent percutaneous coronary intervention of the left anterior descending coronary artery whereby a 3.0/12 mm bioresorbable everolimus-eluting stent (BVS, Abbot Vascular, Santa Clara, CA, USA) was deployed over the ostium of a diagonal branch. After stent post-dilatation, angiography showed no residual stenosis and TIMI III antegrade side branch flow (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Evelyn Regar   Thoraxcenter at Erasmus University Medical Center

  5. Relation between plaque type and dissections at the edges after stent implantation: An optical coherence tomography study

    Explore Article International Journal of Cardiology (May 13 2010)

    Relation between plaque type and dissections at the edges after stent implantation: An optical coherence tomography study Abstract: Background: Stent implantation can create vessel damage such as edge dissections. The objectives were i) to evaluate the frequency of edge dissections after stenting visible by intracoronary optical coherence tomography (OCT) in comparison with angiography. ii) to assess with OCT the plaque type left at the stent edges after implantation, and iii) to study whether there is an association between plaque type and dissections at stent edges.Methods: Seventy-three consecutive patients (80 vessels) with OCT post-stent implantation were included in the study. By OCT, plaque type at stent edges and presence of edge dissection were assessed. Angiograms were analyzed by ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Evelyn Regar   Hector M. Garcia-Garcia

  6. The fate of incomplete stent apposition with drug-eluting stents: an optical coherence tomography-based natural history study

    Explore Article Oxford Journals (Apr 2 2010)

    The fate of incomplete stent apposition with drug-eluting stents: an optical coherence tomography-based natural history study Aims To assess the fate of incomplete stent apposition (ISA) after deployment of sirolimus-eluting stents (SESs). Methods and results Thirty-two patients having intravascular ultrasound (IVUS)-guided PCI with SESs underwent assessment of stent deployment with quantitative coronary angiography, IVUS, and optical coherence tomography (OCT) pre-procedure, post-procedure, and at 10 months follow-up. Incomplete stent apposition was defined as separation of a stent strut from the inner vessel wall by >160 µm. At follow-up, 4.67% of struts with ISA at deployment failed to heal and 7.59% which were well apposed did not develop neointimal hyperplasia even after 10 months. Lesion remodelling was responsible ... (Read Full Article)

    Comment on Article Mentions:   Imperial College London   Patrick W. Serruys   Thoraxcenter at Erasmus University Medical Center

  7. Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging

    Explore Article SPIE Digital Library (Jan 15 2010)

    Optical coherence tomography (OCT) is rapidly becoming the method of choice for assessing arterial wall pathology in vivo. Atherosclerotic plaques can be diagnosed with high accuracy, including measurement of the thickness of fibrous caps, enabling an assessment of the risk of rupture. While the OCT image presents morphological information in highly resolved detail, it relies on interpretation of the images by trained readers for the identification of vessel wall components and tissue type. We present a framework to enable systematic and automatic classification of atherosclerotic plaque constituents, based on the optical attenuation coefficient µt of the tissue. OCT images of ... (Read Full Article)

    Comment on Article Mentions:   Massachusetts Institute of Technology   Evelyn Regar   Thoraxcenter at Erasmus University Medical Center

  8. Three-dimensional visualization of intracoronary thrombus during stent implantation using the second generation, Fourier domain optical coherence tomography

    Explore Article Oxford Journals (Dec 4 2009)

    A 64-year-old man with dyslipidaemia, hypertension, and diabetes mellitus underwent percutaneous coronary intervention of the left anterior descending coronary artery because of post-infarct angina. After pre-dilatation, a 3.0/28 mm drug eluting stent was deployed ... (Read Full Article)

    Comment on Article Mentions:   LightLab Imaging   Patrick W. Serruys   Evelyn Regar

  9. How should I treat a complex Post-CABG patient?

    Explore Article eurointervention.org (Nov 18 2009)

    How should I treat a complex Post-CABG patient? A 69 year old man was admitted with unstable angina (Class IIB). He had a history of chronic renal impairment, diabetes melltus, hypertension and coronary bypass surgery in 1997 (LIMA graft to the LAD and diagonal branch, saphenous vein grafts to the RCA and first marginal branch of LCx). Diagnostic coronary angiogram revealed: occlusion of the proximal LCx and RCA. (Read Full Article)

    Comment on Article Mentions:   LightLab Imaging   Patrick W. Serruys   Hector M. Garcia-Garcia

  10. An optical coherence tomography study of a biodegradable vs. durable polymer-coated limus-eluting stent: a LEADERS trial sub-study

    Explore Article Oxford Journals (Nov 4 2009)

    Aims: Incomplete endothelialization has been found to be associated with late stent thrombosis, a rare but devastating phenomenon, more frequent after drug-eluting stent implantation. Optical coherence tomography (OCT) has 10 times greater resolution than intravascular ultrasound and thus appears to be a valuable modality for the assessment of stent strut coverage. The LEADERS trial was a multi-centre, randomized comparison of a biolimus-eluting stent (BES) with biodegradable polymer with a sirolimus-eluting stent (SES) using a durable polymer. This study sought to evaluate tissue coverage and apposition of stents using OCT in a group of patients from the randomized LEADERS trial. Methods ... (Read Full Article)

    Comment on Article Mentions:   Peter Barlis   Patrick W. Serruys   Evelyn Regar

  11. Optical Coherence Tomography Assessment Of The Acute Effects Of Stent Implantation On The Vessel Wall. A Systematic Quantitative Approach

    Explore Article Heart (Aug 9 2009)

    Objective: To observe and characterise vessel injury post-stenting using optical coherence tomography (OCT), to propose a systematic OCT classification for periprocedural vessel trauma, to evaluate its frequency in stable vs unstable patients and to assess its clinical impact during the hospitalization period. Setting: stenting causes vessel injury. Design and interventions: All consecutive patients in whom OCT was performed after stent implantation were included in the study. Qualitative and quantitative assessment of, tissue prolapse, intrastent dissection and edge dissection were performed. Results: Seventy-three patients (80 vessels) were analyzed. Tissue prolapse within the stented segment was visible in 78/80 vessels (97.5%). Median ... (Read Full Article)

    Comment on Article Mentions:   Thoraxcenter at Erasmus University Medical Center   Patrick W. Serruys   Evelyn Regar

  12. Virtual histology and optical coherence tomography: from research to a broad clinical application

    Explore Article Heart (Jul 27 2009)

    Invasive coronary imaging techniques have improved our understanding of atherosclerosis and helped us to evaluate the effectiveness of new drugs and new intravascular devices. We have adopted and integrated them rapidly into our clinical decision making process in the catheterisation laboratory. So far, only significant lesions in the coronary angiogram have been treated either by percutaneous coronary intervention (PCI) or coronary bypass artery grafting (CABG), while normal looking coronary segments in angiography have been regarded as "disease-free", and mild/moderate stenoses as "non-treatable" by PCI or CABG; from these non-significantly diseased areas, acute coronary events may potentially arise. In response to ... (Read Full Article)

    Comment on Article Mentions:   Thoraxcenter at Erasmus University Medical Center   Patrick W. Serruys   Evelyn Regar

  13. Optical coherence tomography patterns of stent restenosis

    Explore Article American Heart Journal (Jul 23 2009)

    Background Stent restenosis is an infrequent but poorly understood clinical problem in the drug-eluting stent era. The aim of the study was to evaluate the morphologic characteristics of stent restenosis by optical coherence tomography (OCT). Methods Patients (n = 24, 25 vessels) presenting with angiographically documented stent restenosis were included. Quantitative OCT analysis consisted of lumen and stent area measurement and calculation of restenotic tissue area and burden. Qualitative restenotic tissue analysis included assessment of tissue structure, backscattering and symmetry, visible microvessels, lumen shape, and presence of intraluminal material. Results By angiography, restenosis was classified as diffuse, focal, and at ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Evelyn Regar   Hector M. Garcia-Garcia

  14. Reproducibility of quantitative optical coherence tomography for stent analysis

    Explore Article eurointervention.org (Jul 5 2009)

    Aims: To assess the inter- and intra- observer reproducibility for strut count, strut apposition and strut tissue coverage measurements with optical coherence tomography (OCT).Methods and results: Ten drug-eluting stents (244 frames, 1712 struts) imaged with OCT nine months after implantation were analysed by two independent analysts. One of the analysts repeated the analysis of five stents (120 frames, 795 struts) one week later. Offline analysis was performed with the proprietary LightLab Imaging software. The number of struts was counted and lumen and stent area contours were traced. Tissue coverage thickness was measured at 360 degrees of vessel circumference and in ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Evelyn Regar   Hector M. Garcia-Garcia

  15. The Risk of Stent Thrombosis in Patients With Acute Coronary Syndromes Treated With Bare-Metal and Drug-Eluting Stents

    Explore Article interventions.onlinejacc.org (Jun 16 2009)

    Objectives: We aimed to evaluate the risk of definite stent thrombosis with bare-metal stents (BMS) and drug-eluting stents (DES) in patients treated for acute coronary syndromes. Background: Acute coronary syndromes (ACS) have been reported as increasing the risk for stent thrombosis. Methods: Between January 2000 and December 2005, 5,816 consecutive patients underwent percutaneous coronary intervention for de novo lesions with a single stent type. These patients consisted of 3 sequential groups of BMS (n = 2,248), sirolimus-eluting stents (n = 822) and paclitaxel-eluting stents (n = 2,746). In total, 3,485 patients presented with an ACS. Results: After a median follow-up ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Hector M. Garcia-Garcia   Thoraxcenter at Erasmus University Medical Center

  16. A Multicentre Evaluation of the Safety of Intra-Coronary Optical Coherence Tomography

    Explore Article eurointervention.org (May 20 2009)

    Optical coherence tomography (OCT) is increasingly being applied to the coronary arteries. However, the risks associated with the imaging procedure are not yet well defined. The purpose of the present multicentre registry was to access the acute complicaitons associated with the clinical use of intera-coronary OCT in a large number of patients. (Read Full Article)

    Comment on Article Mentions:   Carlo Di Mario   Peter Barlis   Royal Brompton Hospital

  17. Incomplete Stent Apposition and Delayed Tissue Coverage Are More Frequent in Drug-Eluting Stents Implanted During Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction Than in Drug-Eluting Stents Implanted for Stable/Un

    Explore Article interventions.onlinejacc.org (May 17 2009)

    Objectives The aim of this study was to compare the frequency of incomplete stent apposition (ISA) and struts not covered by tissue at long-term follow-up (as assessed by optical coherence tomography [OCT]) in drug-eluting stents (DES) implanted during primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) versus DES implanted for unstable and stable angina. Background Incomplete stent apposition and the absence of strut endothelialization might be linked to stent thrombosis. DES implanted for STEMI might have a higher risk of thrombosis. Methods Consecutive patients in whom OCT was performed at least 6 months after DES implantation were ... (Read Full Article)

    Comment on Article Mentions:   Peter Barlis   University of Melbourne   Patrick W. Serruys

  18. First case of stenting of a vulnerable plaque in the Secritt I trial—the dawn of a new era?

    Explore Article Nature Publishing Group (Apr 22 2009)

    Background. A 63-year-old man presented with class II anginal symptoms. Investigations. Cardiac catheterization, intravascular ultrasound (IVUS) virtual histology, optical coherence tomography and off-line palpography. Diagnosis. The patient was diagnosed as having a culprit lesion in the left circumflex artery and a vulnerable plaque in the left anterior descending artery. Management. The culprit lesion was treated with two overlapping drug-eluting stents. The vulnerable plaque was then treated with a self-expanding stent tailored to shield vulnerable plaques (vProtect® Luminal Shield). After dilatation of the stent with a low-pressure balloon, IVUS and optical coherence tomography showed excellent apposition of the stent to the ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Evelyn Regar   Hector M. Garcia-Garcia

  19. In Vivo Assessment of High-Risk Coronary Plaques at Bifurcations With Combined Intravascular Ultrasound and Optical Coherence Tomography

    Explore Article imaging.onlinejacc.org (Apr 12 2009)

    Objectives: This study sought to evaluate the in vivo frequency and distribution of high-risk plaques (i.e., necrotic core rich) at bifurcations using a combined plaque assessment with intravascular ultrasound–virtual histology (IVUS-VH) and optical coherence tomography (OCT). Background Pathological examinations have shown that atherosclerotic plaque rich in necrotic core is prone to develop at bifurcations. High-risk plaque detection could be improved by the combined use of a technique able to detect necrotic core (IVUS-VH) and a high-resolution technique that allows the measurement of the fibrous cap thickness (OCT). Methods: From 30 patients imaged with IVUS-VH and OCT, 103 bifurcations were selected. ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Evelyn Regar   Thoraxcenter at Erasmus University Medical Center

  20. Intracoronary optical coherence tomography and the evaluation of stents

    Explore Article Expert Reviews (Mar 19 2009)

    The application of optical coherence tomography to the cardiovascular system has led to intense interest, both clinically and also on the research front. Based on sound optical physics, intracoronary, in vivo imaging with high resolution (15 µm) has given unique insights into not only atherosclerotic plaques but also the tissue responses underlying stent implantation. This article will introduce the application of optical coherence tomography technology to coronary arteries, with particular reference to the evaluation of stents, and will also give a glimpse into current and future developments that will see optical coherence tomography remain a key tool in the armamentarium ... (Read Full Article)

    Comment on Article Mentions:   Evelyn Regar   Gijs van Soest   Peter Barlis

  21. A bioabsorbable everolimus-eluting coronary stent system (ABSORB): 2-year outcomes and results from multiple imaging methods

    Explore Article TheLancet.com (Mar 15 2009)

    Background: Drug-eluting metallic coronary stents predispose to late stent thrombosis, prevent late lumen vessel enlargement, hinder surgical revascularisation, and impair imaging with multislice CT. We assessed the safety of the bioabsorbable everolimus-eluting stent (BVS). Methods: 30 patients with a single de-novo coronary artery lesion were followed up for 2 years clinically and with multiple imaging methods: multislice CT, angiography, intravascular ultrasound, derived morphology parameters (virtual histology, palpography, and echogenicity), and optical coherence tomography (OCT). Findings: Clinical data were obtained from 29 of 30 patients. At 2 years, the device was safe with no cardiac deaths, ischaemia-driven target lesion revascularisations, or ... (Read Full Article)

    Comment on Article Mentions:   Evelyn Regar   Nico Bruining   Yoshinobu Onuma

  22. Quantitative Ex Vivo and In Vivo Comparison of Lumen Dimensions Measured by Optical Coherence Tomography and Intravascular Ultrasound in Human Coronary Arteries

    Explore Article Elsevier (Feb 13 2009)

    Quantitative Ex Vivo and In Vivo Comparison of Lumen Dimensions Measured by Optical Coherence Tomography and Intravascular Ultrasound in Human Coronary Arteries Introduction and objectives. The relationship between the lumen dimensions obtained in human coronary arteries using intravascular ultrasound (IVUS) and those obtained using optical coherence tomography (OCT) is not well understood. The objectives were to compare the lumen measurement obtained ex vivo in human coronary arteries using IVUS, OCT, and histomorphometry, and in vivo in patients using IVUS and OCT with and without balloon occlusion. Methods. Ex vivo study: the lumen areas of matched anatomical sections of human coronary arteries were measured using IVUS, OCT, and histology. In vivo study: the lumen areas in matched sections were measured using IVUS and ... (Read Full Article)

    Comment on Article Mentions:   LightLab Imaging   Patrick W. Serruys   Lightlab ImageWire

  23. Optical Coherence Tomography Findings At Two Years Follow Up In Fully Biodegradable Everolimus Eluting Stents

    Explore Article Circulation (Nov 10 2008)

    Optical Coherence Tomography Findings At Two Years Follow Up In Fully Biodegradable Everolimus Eluting Stents Fully biodegradable stents may avoid the potential long-term complications of metallic drug-eluting stents such as late and very late stent thrombosis. We sought to evaluate the structural changes in a bioabsorbable DES and its interaction with the coronary vessel wall over time using optical coherence tomography (OCT). We investigated 14 consecutive patients undergoing implantation of a bioabsorbable everolimus-eluting coronary stent (BVS: Abbott Laboratories, IL, USA), composed of a poly-L-lactic acid backbone, coated with a degradable polymer/everolimus matrix. OCT (LightLab Imaging, Inc., Westford, MA) was performed immediately after stent implantation, at 6 months and at 24 months follow-up. All patients tolerated ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Evelyn Regar   Thoraxcenter at Erasmus University Medical Center

  24. Multi-modality intra-coronary plaque characterization: A pilot study☆

    Explore Article International Journal of Cardiology (Sep 9 2008)

    Background The risk of rupture and subsequent thrombosis of the atherosclerotic coronary plaques is related to the presence of necrotic core with high lipid content. We conducted an exploratory pilot trial to compare the capability for lipid tissue detection using four intra-coronary diagnostic techniques: greyscale intravascular ultrasound (GS IVUS), IVUS radiofrequency data (IVUS RFD) analysis, optical coherence tomography (OCT) and intravascular magnetic resonance spectroscopy (IVMR). Methods Twenty-four matched target plaques were analyzed with the 4 techniques in non-culprit lesions in five patients with stable angina. Following IVUS pullback, OCT and IVMR was performed. Plaque composition was assessed using established criteria ... (Read Full Article)

    Comment on Article Mentions:   Peter Barlis   Royal Brompton Hospital   Patrick W. Serruys

  25. Optical Coherence Tomography Findings in Very Late (4 Years) Paclitaxel-Eluting Stent Thrombosis

    Explore Article interventions.onlinejacc.org (Aug 18 2008)

    No Abstract Provided (Read Full Article)

    Comment on Article Mentions:   Peter Barlis   Patrick W. Serruys   Evelyn Regar

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