1. Articles from Patrick W. Serruys

    73-96 of 154 « 1 2 3 4 5 6 7 »
    1. OCT in Coronary Bifurcations (Book Chapter)

      OCT in Coronary Bifurcations (Book Chapter)

      The geometric and anatomical complexity of bifurcations makes its systematic scientific approach very challenging. Optical coherence tomography (OCT) is able to depict accurately the plaque distribution around the bifurcation, to provide valuable information to tailor the procedure in each specific case, and to assess the result after stenting. Some guidelines are proposed for the systematic study of bifurcations with OCT, assessing the apposition, tissue coverage, the presence of overlap or multi-layer segments, the presence of non-apposed side-branch struts, the scaffolding of the carina and the shoulder, and the access to the side branch.

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    2. Ten-year follow-up of the IGAKI-TAMAI stent. A posthumous tribute to the scientific work of Dr. Hideo Tamai.

      Ten-year follow-up of the IGAKI-TAMAI stent. A posthumous tribute to the scientific work of Dr. Hideo Tamai.

      A 59-year old male with a history of controlled hyperlipidaemia, hypertension and diabetes mellitus presented with a recurrence of angina pectoris.  Previously, in August 2000, two overlapping 4 mm by 12 mm igaki-Tamai stents had been implanted in his proximal right  coronary artery...

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    3. Differences in Neointimal Thickness Between the Adluminal and the Abluminal Sides of Malapposed and Side-Branch Struts in a Polylactide Bioresorbable Scaffold: Evidence In Vivo About the Abluminal Healing Process

      Differences in Neointimal Thickness Between the Adluminal and the Abluminal Sides of Malapposed and Side-Branch Struts in a Polylactide Bioresorbable Scaffold: Evidence In Vivo About the Abluminal Healing Process

      Objectives: The goal of this study was to describe the neointimal healing on the abluminal side (ABL) of malapposed (ISA) struts and nonapposed side-branch (NASB) struts in terms of coverage by optical coherence tomography (OCT) and in comparison with the adluminal side (ADL).Background: The neointimal healing on the ABL of ISA and NASB struts has never to our knowledge been explored in vivo and could be involved in the correction of acute malapposition. The bioresorbable vascular scaffold (BVS) is made of a translucent polymer that enables imaging of the ABL with OCT. Methods: Patients enrolled in the ABSORB B ...

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    4. Three-Dimensional Coronary Tomographic Reconstructions Using In Vivo Intracoronary Optical Frequency Domain Imaging in the Setting of Acute Myocardial Infarction: The Clinical Perspective

      Three-Dimensional Coronary Tomographic Reconstructions Using In Vivo Intracoronary Optical Frequency Domain Imaging in the Setting of Acute Myocardial Infarction: The Clinical Perspective

      Optical coherence tomography (OCT) is a light-based imaging modality with superior spatial resolution ( ~15 μm) compared to other intracoronary imaging systems currently used in vivo, such as intravascular ultrasonography ( ~100 μm) and angioscopy ( ~150 μm). OCT technology uses a similar algorithm as intravascular ultrasound (IVUS) to reconstruct two-dimensional (2-D) tomographic images, measuring the time delay of the reflected infrared light beam from the biological tissues. The earlier time-domain OCT technology has been replaced by frequency-domain OCT (FD-OCT); more recently, optical frequency domain imaging (OFDI), a variant of FD-OCT, has been introduced. OFDI is an intravascular imaging modality that is capable ...

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    5. Residual atherothrombotic material after stenting in acute myocardial infarction — An optical coherence tomographic evaluation

      Residual atherothrombotic material after stenting in acute myocardial infarction — An optical coherence tomographic evaluation

      Background Thrombus aspiration (TA) in patients with ST segment elevation myocardial infarction (STEMI) results in a better myocardial perfusion. Optical coherence tomography (OCT) after stenting in STEMI, however, often reveals residual atherothrombotic material. We assessed the feasibility of quantification of residual atherothrombotic burden and its relation to indices of myocardial perfusion. The effect of TA on residual in-stent atherothrombotic burden (ATB) is explored. Methods and results Forty patients with STEMI within 12h of symptom onset, underwent OCT after stent implantation. No complication related to the invasive imaging was detected and all cases had good image quality. All 40 cases revealed ...

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    6. Reproducibility of qualitative assessment of stent struts coverage by optical coherence tomography

      Reproducibility of qualitative assessment of stent struts coverage by optical coherence tomography

      Abstract  Assessment of stent strut coverage by optical coherence tomography (OCT) is not standardized. The methodology most commonly used is based on a visual binary qualitative assessment (strut covered or not). However, the influence of magnification (zoom setting) to the inter- and intra-observer agreements has not yet been evaluated. Aim of our study was therefore to evaluate the agreements of this approach, taking into account various zoom settings. 126 struts from 10 selected frames were independently evaluated by four observers using a stepwise approach increasing the zoom setting as following: (1) full view of the lumen (FV), (2) half view ...

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    7. Response to Letter Regarding Article, “Delayed Coverage in Malapposed and Side-Branch Struts With Respect to Well-Apposed Struts in Drug-Eluting Stents: In Vivo Assessment With Optical Coherence Tomography”

      Response to Letter Regarding Article, “Delayed Coverage in Malapposed and Side-Branch Struts With Respect to Well-Apposed Struts in Drug-Eluting Stents: In Vivo Assessment With Optical Coherence Tomography”

      We appreciate the interest shown by Dr Pérez de Prado and colleagues in our article.1 Nonapposed side-branch struts have been excluded from most optical coherence tomography (OCT) studies, probably not because they were deemed “unsuitable to be covered,” but because incorporating nonapposed side-branch struts into the standard analysis increases its complexity and cost. Not surprisingly, experimental models and clinical OCT studies coincide to report that most nonapposed side-branch struts are covered as well-apposed struts, but the former are in disadvantage with respect to the latter to get covered. However, the coverage of nonapposed side-branch struts might not “come necessarily ...

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    8. Impact of Statin Therapy on Plaque Characteristics as Assessed by Serial OCT, Grayscale and Integrated Backscatter–IVUS

      Impact of Statin Therapy on Plaque Characteristics as Assessed by Serial OCT, Grayscale and Integrated Backscatter–IVUS

      Objectives: The purpose of this study was to evaluate the effect of statin treatment on coronary plaque composition and morphology by optical coherence tomography (OCT), grayscale and integrated backscatter (IB) intravascular ultrasound (IVUS) imaging. Background: Although previous studies have demonstrated that statins substantially improve cardiac mortality, their precise effect on the lipid content and fibrous cap thickness of atherosclerotic coronary lesions is less clear. While IVUS lacks the spatial resolution to accurately assess fibrous cap thickness, OCT lacks the penetration of IVUS. We used a combination of OCT, grayscale and IB-IVUS to comprehensively assess the impact of pitavastatin on plaque ...

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    9. Vascular Tissue Reaction to Acute Malapposition in Human Coronary Arteries: Sequential Assessment With Optical Coherence Tomography

      Vascular Tissue Reaction to Acute Malapposition in Human Coronary Arteries: Sequential Assessment With Optical Coherence Tomography

      Background—The vascular tissue reaction to acute incomplete stent apposition (ISA) is not well known. The aim of this study was to characterize the vascular response to acute ISA in vivo and to look for predictors of incomplete healing. Methods and Results—Optical coherence tomography studies of 66 stents of different designs, implanted in 43 patients enrolled in 3 randomized trials, were analyzed sequentially after implantation and at 6 to 13 months. Seventy-eight segments with acute ISA were identified in 36 of the patients and matched with the follow-up study by use of fiduciary landmarks. The morphological pattern of healing ...

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    10. In vivo characterisation of bioresorbable vascular scaffold strut interfaces using optical coherence tomography with Gaussian line spread function analysis

      In vivo characterisation of bioresorbable vascular scaffold strut interfaces using optical coherence tomography with Gaussian line spread function analysis
      Optical coherence tomography (OCT) of a bioresorbable vascular scaffold (BVS) produces a highly reflective signal outlining struts. This signal interferes with the measurement of strut thickness, as the boundaries cannot be accurately identified, and with the assessment of coverage, because the neointimal backscattering convolutes that of the polymer, frequently making them indistinguishable from one another. We hypothesise that Gaussian line spread functions (LSFs) can facilitate identification of strut boundaries, improving the accuracy of strut thickness measurements and coverage assessment. Methods and results: Forty-eight randomly selected BVS struts from 12 patients in the ABSORB Cohort B clinical study and four Yucatan ...
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    11. Circumferential evaluation of the neointima by optical coherence tomography after ABSORB bioresorbable vascular scaffold implantation: Can the scaffold cap the plaque?

      Circumferential evaluation of the neointima by optical coherence tomography after ABSORB bioresorbable vascular scaffold implantation: Can the scaffold cap the plaque?

      Objective To quantify the circumferential healing process at 6 and 12 months following scaffold implantation. Background The healing process following stent implantation consists of tissue growing on the top of and in the space between each strut. With the ABSORB bioresorbable vascular scaffold (BVS), the outer circumference of the scaffold is detectable by optical coherence tomography (OCT), allowing a more accurate and complete evaluation of the intra-scaffold neointima. Methods A total of 58 patients (59 lesions), who received an ABSORB BVS 1.1 implantation and a subsequent OCT investigation at 6 (n = 28 patients/lesions) or 12 (n = 30 patients ...

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    12. Head to head comparison of optical coherence tomography, intravascular ultrasound echogenicity and virtual histology for the detection of changes in polymeric struts over time: insights from the ABSORB trial

      Head to head comparison of optical coherence tomography, intravascular ultrasound echogenicity and virtual histology for the detection of changes in polymeric struts over time: insights from the ABSORB trial

      Aims: To analyse and to compare the changes in the various optical coherence tomography (OCT), echo-genicity intravascular ultrasound virtual histology (VH) of the everolimus-eluting bioresorbable scaffold (ABSORB) degradation parameters during the first 12 months after ASOERB implantation.

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    13. Head-to-Head Comparison of the Neointimal Response Between Metallic and Bioresorbable Everolimus-Eluting Scaffolds Using Optical Coherence Tomography

      Head-to-Head Comparison of the Neointimal Response Between Metallic and Bioresorbable Everolimus-Eluting Scaffolds Using Optical Coherence Tomography

      The metallic everolimus drug-eluting stents (DES) and polymeric everolimus bioresorbable vascular scaffolds (BVS) are coated with the same antiproliferative drug. It is uncertain if, during the bioresorption process, the neointimal response of everolimus BVS differs from that of everolimus DES. A total of 31 lesions treated with a single everolimus BVS, and 19 lesions treated with everolimus DES and imaged with optical coherence tomography at 1 year, were investigated. Neointimal response was assessed as a percentage of uncovered struts, neointimal thickness, in-stent/scaffold area obstruction, and pattern of neointima. Both scaffolds presented with similar neointimal response. However, the everolimus BVS ...

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    14. Three-dimensional optical frequency domain imaging in conventional percutaneous coronary intervention: the potential for clinical application

      Three-dimensional optical frequency domain imaging in conventional percutaneous coronary intervention: the potential for clinical application

      Two-dimensional (2D) frequency domain optical coherence tomography (FD-OCT) has enhanced our understanding of coronary atherosclerotic disease and is increasingly being used in conventional percutaneous coronary intervention (PCI) to elucidate mechanisms of disease and improve our understanding of complex coronary anatomy. Since the first report of three-dimensional (3D) OCT applied in human coronary vessels,1 the technology has rapidly progressed.2–10 Currently, the main limitation of this technology is the need for off-line creation of 3D reconstructions—prototypes of current generation ‘real time’ (i.e. available peri-procedurally at the ‘push-of-a-button’) remain experimental, work in progress, and are limited by relatively ...

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    15. Spatial Distribution and Temporal Evolution of Scattering Centers by Optical Coherence Tomography in the Poly(L-Lactide) Backbone of a Bioresorbable Vascular Scaffold

      Spatial Distribution and Temporal Evolution of Scattering Centers by Optical Coherence Tomography in the Poly(L-Lactide) Backbone of a Bioresorbable Vascular Scaffold

      Scattering centers (SC) are often observed with optical coherence tomography (OCT) in some struts of bioresorbable vascular scaffolds (BVS). These SC might be caused by crazes in the polymer during crimp-deployment (more frequent at inflection points) or by other processes, such as physiological loading or hydrolysis (eventually increasing with time). The spatial distribution and temporal evolution of SC in BVS might help to understand their meaning. Methods and Results: Three patients were randomly selected from 12 imaged with Fourier-domain OCT at both baseline and 6 months in the ABSORB cohort B study (NCT00856856). Frame-by-frame analysis of the SC distribution was ...

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    16. Angiographic maximal luminal diameter and appropriate deployment of the everolimus-eluting bioresorbable vascular scaffold as assessed by optical coherence tomography: an ABSORB cohort B trial sub-study

      Angiographic maximal luminal diameter and appropriate deployment of the everolimus-eluting bioresorbable vascular scaffold as assessed by optical coherence tomography: an ABSORB cohort B trial sub-study

      Aims: Bioresorbable vascular scaffolds (BVS) present different mechanical properties as compared to metallic platform stents. Therefore, the standard procedural technique to achieve appropriate deployment may differ. Methods and results: Fifty-two lesions treated with 3x18 mm BVS were imaged with optical coherence tomography (OCT) post-implantation and screened for parameters suggestion non-optimal deployment.

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    17. Bioresorbable Polymeric Vascular Scaffolds: A Cautionary Tale

      Bioresorbable Polymeric Vascular Scaffolds: A Cautionary Tale
      The everolimus-eluting bioresorbable vascular scaffold (BVS, Abbott Vascular, Santa Clara, CA) is an exciting advance in percutaneous coronary intervention (PCI), providing a temporary coronary scaffold for at least 3 months and being resorbed by about 2 years. 1–3 Along with patient preference, potential advantages over metallic stents include restored vasomotion, reduced late thrombosis, and unimpaired imaging with computed tomography and magnetic resonance. However, advances in interventional devices may bring new challenges in the early days of the technology. A 78-year-old man with recent-onset angina was enrolled in the ABSORB Trial Cohort B Group 1.3 An obtuse marginal coronary ...
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    18. Long-term tissue coverage of a biodegradable polylactide polymer–coated biolimus-eluting stent: Comparative sequential assessment with optical coherence tomography until complete resorption of the polymer

      Long-term tissue coverage of a biodegradable polylactide polymer–coated biolimus-eluting stent: Comparative sequential assessment with optical coherence tomography until complete resorption of the polymer

      Background: Biolimus-eluting stents (BESs) with a biodegradable polymer in abluminal coating achieve more complete coverage at 9 months compared with sirolimus-eluting stents (SESs) with a durable polymer, as assessed by optical coherence tomography (OCT). Whether this advantage persists or augments after complete resorption of the polymer (>12 months) is unknown.Methods: The LEADERS trial compared the performance of BES with that of SES. Patients were randomly allocated to a sequential angiographic follow-up, including OCT in selected sites, at 9 and 24 months. Struts coverage was compared using Bayesian hierarchical models as the primary outcome for the OCT substudy.Results: Fifty-six ...

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    19. In vivo visualisation by three-dimensional optical coherence tomography of stress crazing of a bioresorbable vascular scaffold implanted for treatment of human coronary stenosis

      In vivo visualisation by three-dimensional optical coherence tomography of stress crazing of a bioresorbable vascular scaffold implanted for treatment of human coronary stenosis
      The concept of using bioresorbable intracoronary scaffolds in percutaneous coronary intervention has attracted interest since their inception, because the devices can overcome potential disadvantages of permanent metallic stents.
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    20. Evaluation of the Second Generation of a Bioresorbable Everolimus-Eluting Vascular Scaffold for the Treatment of De Novo Coronary Artery Stenosis: 12-Month Clinical and Imaging Outcomes

      Evaluation of the Second Generation of a Bioresorbable Everolimus-Eluting Vascular Scaffold for the Treatment of De Novo Coronary Artery Stenosis: 12-Month Clinical and Imaging Outcomes

      Objectives The aim of this study was to demonstrate that the prevention of early scaffold area shrinkage of the ABSORB BVS (Rev.1.1, Abbott Vascular, Santa Clara, California) was sustained and not simply delayed by a few months. Background With improved scaffold design and modified manufacturing process of its polymer, the second iteration of ABSORB (BVS 1.1) has improved performance to prevent a scaffold area reduction at 6 months. Methods Fifty-six patients were enrolled and received 57 ABSORB scaffolds. Quantitative coronary angiography, intravascular ultrasound (IVUS), analysis of radiofrequency backscattering, echogenicity and optical coherence tomography (OCT) were performed at ...

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    21. Serial Analysis of the Malapposed and Uncovered Struts of the New Generation of Everolimus-Eluting Bioresorbable Scaffold With Optical Coherence Tomography

      Serial Analysis of the Malapposed and Uncovered Struts of the New Generation of Everolimus-Eluting Bioresorbable Scaffold With Optical Coherence Tomography

      Objectives The aim of this study is to assess the serial changes in strut apposition and coverage of the bioresorbable vascular scaffolds (BVS) and to relate this with the presence of intraluminal masses at 6 months with optical coherence tomography (OCT). Background Incomplete strut/scaffold apposition (ISA) and uncovered struts are related to a higher risk of scaffold thrombosis. Bioresorbable vascular scaffolds can potentially avoid the risk of scaffold thrombosis because of its complete resorption. However, during the resorption period, the risk of scaffold thrombosis is unknown. Methods OCT was performed in 25 patients at baseline and 6 months. Struts ...

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    22. New Insights Into the Coronary Artery Bifurcation: Hypothesis-Generating Concepts Utilizing 3-Dimensional Optical Frequency Domain Imaging

      New Insights Into the Coronary Artery Bifurcation: Hypothesis-Generating Concepts Utilizing 3-Dimensional Optical Frequency Domain Imaging
      Coronary artery bifurcations are a common challenging lesion subset accounting for approximately 10% to 20% of all percutaneous coronary interventions. The provisional T-stenting approach is generally recommended as the first-line management of most lesions. Carina shift is suggested to be the predominant mechanism of side-branch pinching during provisional T-stenting and has been indirectly inferred from bench work and other intravascular imaging modalities. Offline 3-dimensional (3D) reconstructions of patients studied in the first-in-man trial of the high-frequency (160 frames/s) Terumo optical frequency domain imaging system were undertaken using volume-rendering software. Through a series of 3D reconstructions, several novel hypothesis-generating concepts ...
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    23. Optical coherence tomography (OCT) of overlapping bioresorbable scaffolds: from benchwork to clinical application

      Optical coherence tomography (OCT) of overlapping bioresorbable scaffolds: from benchwork to clinical application

      Fully bioresorbable everolimus-eluting vascular scaffolds (BVS: Abbott Vascular) are a novel approach to treating coronary lesions. The ABSORB cohort A and cohort B trials investigated the implantation of 3 mm BVS, up to a maximum length of 18 mm, in simple lesions only, The implantation of overlapping BVS in longer lesions has not previously been reported.

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    73-96 of 154 « 1 2 3 4 5 6 7 »
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