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Popular Articles
Diagnosis and treatment of coronary vulnerable plaques.
Virtual histology and optical coherence tomography: from research to a broad clinical application
Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging
Multi-modality intra-coronary plaque characterization: A pilot study☆
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Atherosclerotic tissue characterization in vivo by optical coherence tomography attenuation imaging
Explore Article SPIE Digital Library (Jan 15 2010) Cardiology
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
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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) Cardiology
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
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How should I treat a complex Post-CABG patient?
Explore Article eurointervention.org (Nov 18 2009) Cardiology
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.
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Comment on Article Mentions: LightLab Imaging Patrick W. Serruys Héctor M. García-García
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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) Cardiology
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
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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) Cardiology
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
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Virtual histology and optical coherence tomography: from research to a broad clinical application
Explore Article Heart (Jul 27 2009) Cardiology
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
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Optical coherence tomography patterns of stent restenosis
Explore Article American Heart Journal (Jul 23 2009) Cardiology
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 Héctor M. García-García
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Reproducibility of quantitative optical coherence tomography for stent analysis
Explore Article eurointervention.org (Jul 5 2009) Cardiology
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 Héctor M. García-García
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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) Cardiology
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 Héctor M. García-García Thoraxcenter at Erasmus University Medical Center
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A Multicentre Evaluation of the Safety of Intra-Coronary Optical Coherence Tomography
Explore Article eurointervention.org (May 20 2009) Cardiology
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
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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) Cardiology
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
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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) Cardiology
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 Héctor M. García-García
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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) Cardiology
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
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Intracoronary optical coherence tomography and the evaluation of stents
Explore Article Expert Reviews (Mar 19 2009) Cardiology
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
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A bioabsorbable everolimus-eluting coronary stent system (ABSORB): 2-year outcomes and results from multiple imaging methods
Explore Article TheLancet.com (Mar 15 2009) Cardiology
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
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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) Cardiology
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
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Optical Coherence Tomography Findings At Two Years Follow Up In Fully Biodegradable Everolimus Eluting Stents
Explore Article Circulation (Nov 10 2008) Cardiology
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
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Multi-modality intra-coronary plaque characterization: A pilot study☆
Explore Article International Journal of Cardiology (Sep 9 2008) Cardiology
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
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Assessment of Culprit and Remote Coronary Narrowings Using Optical Coherence Tomography With Long-Term Outcomes
Explore Article American Journal of Cardiology (Aug 18 2008) Cardiology
Much currently known information about vulnerable plaque stems from postmortem studies that identified several characteristics making them prone to rupture, including the presence of a thin fibrous cap and a large lipid core. This study used optical coherence tomography (OCT) to assess culprit and remote coronary narrowings and investigate whether intracoronary OCT in living patients was able to visualize morphologic features associated with vulnerable plaque in postmortem studies. Twenty-three patients successfully underwent OCT before percutaneous coronary intervention. The culprit lesion and mild to moderate coronary narrowings remote from the target stenosis were investigated. Using OCT, the culprit lesion was found ... (Read Full Article)
Comment on Article Mentions: Peter Barlis Patrick W. Serruys Evelyn Regar
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Feasibility of combined use of intravascular ultrasound radiofrequency data analysis and optical coherence tomography for detecting thin-cap fibroatheroma
Explore Article Oxford Journals (Apr 30 2008) Cardiology
Aims To evaluate the feasibility of the combined use of virtual histology (VH)-intravascular ultrasound (IVUS) and optical coherence tomography (OCT) for detecting in vivo thin-cap fibroatheroma (TCFA). Methods and results In 56 patients with angina, 126 plaques identified by IVUS findings were analysed using both VH-IVUS and OCT. IVUS-derived TCFA was defined as an abundant necrotic core (>10% of the cross-sectional area) in contact with the lumen (NCCL) and %plaque-volume >40%. OCT-derived TCFA was defined as a fibrous cap thickness of Conclusion Neither modality alone is sufficient for detecting TCFA. The combined use of OCT and VH-IVUS might be a ... (Read Full Article)
Comment on Article Mentions: Patrick W. Serruys Thoraxcenter at Erasmus University Medical Center Héctor M. García-García
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A bioabsorbable everolimus-eluting coronary stent system for patients with single de-novo coronary artery lesions (absorb): a prospective open-label trial.
Explore Article NCBI HomePage (Mar 18 2008) Cardiology
BACKGROUND: A fully bioabsorbable drug-eluting coronary stent that scaffolds the vessel wall when needed and then disappears once the acute recoil and constrictive remodelling processes have subsided has theoretical advantages. The bioasorbable everolimus-eluting stent (BVS) has a backbone of poly-L-lactic acid that provides the support and a coating of poly-D,L-lactic acid that contains and controls the release of the antiproliferative agent everolimus. We assessed the feasibility and safety of this BVS stent. METHODS: In this prospective, open-label study we enrolled 30 patients who had either stable, unstable, or silent ischaemia and a single de-novo lesion that was suitable for treatment ... (Read Full Article)
Comment on Article Mentions: Héctor M. García-García Patrick W. Serruys Evelyn Regar
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Optical coherence tomography assessment of vulnerable plaque rupture: predilection for the plaque ‘shoulder’
Explore Article Oxford Journals (Mar 16 2008) Cardiology
Atherosclerosis as a disease entity remains an intensely researched field, given the tendency for considerable morbidity and mortality. This attention has given rise to exciting opportunities in developing tools aimed at early detection and possible targeting of specific therapeutic interventions. One such modality is optical coherence tomography (OCT (Read Full Article)
Comment on Article Mentions: Patrick W. Serruys Evelyn Regar Peter Barlis
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A novel approach for quantitative analysis of intracoronary optical coherence tomography: high inter-observer agreement with computer-assisted contour detection.
Explore Article NCBI HomePage (Mar 8 2008) Cardiology
A novel approach for quantitative analysis of intracoronary optical coherence tomography: high inter-observer agreement with computer-assisted contour detection. Catheter Cardiovasc Interv. 2008 Mar 6; Authors: Tanimoto S, Rodriguez-Granillo G, Barlis P, de Winter S, Bruining N, Hamers R, Knappen M, Verheye S, Serruys PW, Regar E Objective: This study aims to examine observer-related variability of quantitative optical coherence tomography (OCT) derived measurements from both in vitro and in vivo pullback data. Background: Intravascular OCT is a new imaging modality using infrared light and offering 10 times higher image resolution (15 mum) compared to intravascular ultrasound. The quantitative analysis of in ... (Read Full Article)
Comment on Article Mentions: Patrick W. Serruys Peter Barlis Thoraxcenter at Erasmus University Medical Center
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Diagnosis and treatment of coronary vulnerable plaques.
Explore Article NCBI HomePage (Feb 6 2008) Cardiology
Thin-capped fibroatheroma is the morphology that most resembles plaque rupture. Detection of these vulnerable plaques in vivo is essential to being able to study their natural history and evaluate potential treatment modalities and, therefore, may ultimately have an important impact on the prevention of acute myocardial infarction and death. Currently, conventional grayscale intravascular ultrasound, virtual histology and palpography data are being collected with the same catheter during the same pullback. A combination of this catheter with either thermography capability or additional imaging, such as optical coherence tomography or spectroscopy, would be an exciting development. Intravascular magnetic resonance imaging also holds ... (Read Full Article)
Comment on Article Mentions: Patrick W. Serruys Thoraxcenter at Erasmus University Medical Center Evelyn Regar







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