1. Articles from Patrick W. Serruys

    97-120 of 155 « 1 2 3 4 5 6 7 »
    1. 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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    2. 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

      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

      Background— Pathology studies on fatal cases of very late stent thrombosis have described incomplete neointimal coverage as common substrate, in some cases appearing at side-branch struts. Intravascular ultrasound studies have described the association between incomplete stent apposition (ISA) and stent thrombosis, but the mechanism explaining this association remains unclear. Whether the neointimal coverage of nonapposed side-branch and ISA struts is delayed with respect to well-apposed struts is unknown. Methods and Results— Optical coherence tomography studies from 178 stents implanted in 99 patients from 2 randomized trials were analyzed at 9 to 13 months of follow-up. The sample included 38 sirolimus-eluting ...

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    3. Assessment of Coronary Atherosclerosis Progression and Regression at Bifurcations Using Combined IVUS and OCT

      Assessment of Coronary Atherosclerosis Progression and Regression at Bifurcations Using Combined IVUS and OCT

      Objectives The aim of this study was to evaluate the progression of atherosclerotic coronary plaques at bifurcations, using combined intravascular ultrasound–virtual histology (IVUS-VH) and optical coherence tomography (OCT). Background Pathological findings reveal that atherosclerotic plaques characterized by the presence of large necrotic cores (NCs) with fibrous cap thicknesses < 65 µm are more prone to rupture. Accuracy in the detection of high-risk plaques could be improved by the combined use of IVUS-VH and OCT. Methods IVUS-VH and OCT are 2 imaging modalities with different lateral resolutions and different depths of penetration. To provide a precise matching of the images, bifurcations ...

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    4. Paclitaxel-coated balloon in combination with bare metal stent for treatment of de novo coronary lesions: an optical coherence tomography first-in-human randomised trial, balloon first vs. stent first

      Paclitaxel-coated balloon in combination with bare metal stent for treatment of de novo coronary lesions: an optical coherence tomography first-in-human randomised trial, balloon first vs. stent first
      Aims: To test the efficacy of sequential application of drug-coated balloon (DCB) and bare metal stent (BMS) for treatment of de novo coronary lesions, comparing the sequence of application (DCB first vs. BMS first).
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    5. Healing of a coronary artery dissection detected by intravascular ultrasound and optical coherence tomography.

      Healing of a coronary artery dissection detected by intravascular ultrasound and optical coherence tomography.
      A 56 year old woman, active smoker with no other cardiovascular risk factors was admitted to hospital to undergo elective angioplasty on the proximal circumflex artery. A bioresorbable scaffold was implanted. Post-implantation IVUS showed a residual coronary dissection at the distal edge of the scaffold. In addition, OCT was performed showing an intimal flap reaching the first frame proxi8mal to the take-off of the side branch distal to the scaffold.
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    6. Coronary CT angiographic characteristics of culprit lesions in acute coronary syndromes not related to plaque rupture as defined by optical coherence tomography and angioscopy

      Coronary CT angiographic characteristics of culprit lesions in acute coronary syndromes not related to plaque rupture as defined by optical coherence tomography and angioscopy

      Aims Pathological and clinical optical coherence tomography (OCT) studies have indicated that acute coronary syndrome (ACS) lesions have either ruptured fibrous caps (RFC-ACS) or intact fibrous caps (IFC-ACS). Although computed tomographic (CT) angiographic characteristics of RFC-ACS include low-attenuation plaques and positive plaque remodelling, features associated with IFC-ACS have not been previously described. The aim of this study was to assess the CT characteristics of IFC-ACS lesions. Methods and results Seventy-four patients with ACS/stable angina consented to multimodality imaging, of which 66 underwent CT angiography. Of these, 57 culprit lesions in 57 patients were evaluated with sufficient image quality from ...

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    7. NIRS and IVUS for Characterization of Atherosclerosis in Patients Undergoing Coronary Angiography

      NIRS and IVUS for Characterization of Atherosclerosis in Patients Undergoing Coronary Angiography
      Objectives: The aim of this study was to compare the findings of near-infrared spectroscopy (NIRS), intravascular ultrasound (IVUS) virtual histology (VH), and grayscale IVUS obtained in matched coronary vessel segments of patients undergoing coronary angiography. Background: Intravascular ultrasound VH has been developed to add tissue characterization to the grayscale IVUS assessment of coronary plaques. Near-infrared spectroscopy is a new imaging technique able to identify lipid core-containing coronary plaques (LCP). Methods: We performed NIRS and IVUS-VH pullbacks in a consecutive series of 31 patients with a common region of interest (ROI) between 2 side branches. For each ROI, we analyzed the ...
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    8. Tissue coverage of a hydrophilic polymer-coated zotarolimus-eluting stent vs. a fluoropolymer-coated everolimus-eluting stent at 13-month follow-up: an optical coherence tomography substudy from the RESOLUTE All Comers trial

      Tissue coverage of a hydrophilic polymer-coated zotarolimus-eluting stent vs. a fluoropolymer-coated everolimus-eluting stent at 13-month follow-up: an optical coherence tomography substudy from the RESOLUTE All Comers trial

      Aims To compare the tissue coverage of a hydrophilic polymer-coated zotarolimus-eluting stent (ZES) vs. a fluoropolymer-coated everolimus-eluting stent (EES) at 13 months, using optical coherence tomography (OCT) in an ‘all-comers' population of patients, in order to clarify the mechanism of eventual differences in the biocompatibility and thrombogenicity of the devices. Methods and results Patients randomized to angiographic follow-up in the RESOLUTE All Comers trial (NCT00617084) at pre-specified OCT sites underwent OCT follow-up at 13 months. Tissue coverage and apposition were assessed strut by strut, and the results in both treatment groups were compared using multilevel logistic or linear regression, as ...

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    9. First-in-man evaluation of intravascular optical frequency domain imaging (OFDI) of Terumo: a comparison with intravascular ultrasound and quantitative coronary angiography

      First-in-man evaluation of intravascular optical frequency domain imaging (OFDI) of Terumo: a comparison with intravascular ultrasound and quantitative coronary angiography

      Aims: The objective of this study is to evaluate the feasibility and safety of imaging human coronary arteries in vivo by optical frequency domain imaging (OFDI) in comparison to intravascular ultrasound (IVUS). OFDI has been recently developed to overcome the limitations of conventional time-domain optical coherence tomography (OCT), namely the need for proximal balloon occlusion. The Terumo-OFDI system is capable of acquiring images with high-speed automated pullback (up to 40 mm/sec) and requires only a short injection (3-4 sec) of small amount of x-ray contrast (9-16 ml). Methods and results: Nineteen patients who underwent stent implantation were enrolled. IVUS ...

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    10. Agreement and reproducibility of gray-scale intravascular ultrasound and optical coherence tomography for the analysis of the bioresorbable vascular scaffold

      Agreement and reproducibility of gray-scale intravascular ultrasound and optical coherence tomography for the analysis of the bioresorbable vascular scaffold

      Objective:To report the agreement between grey-scale intravascular ultrasound (GS-IVUS) and optical coherence tomography (OCT) in assessing the bioresorbable vascular scaffolds (BVS) structures and their respective reproducibility.Background:BVS are composed of an erodible polymer. Ultrasound and light signals backscattered from polymeric material differs from metallic stents using GS-IVUS and OCT.Methods:Forty-five patients included in the ABSORB trial were treated with a 3.0x18 mm BVS and imaged with GS-IVUS 20 MHz and OCT post-implantation. Qualitative (ISA, side-branch struts, protrusion and dissections) and quantitative (number of struts, lumen and scaffold area) measurements were assessed by two investigators. The agreement ...

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    11. Evaluation with in vivo optical coherence tomography and histology of the vascular effects of the everolimus-eluting bioresorbable vascular scaffold at two years following implantation in a healthy porcine coronary artery model: implications of pilot resu

      Evaluation with in vivo optical coherence tomography and histology of the vascular effects of the everolimus-eluting bioresorbable vascular scaffold at two years following implantation in a healthy porcine coronary artery model: implications of pilot resu
      To quantify with in vivo OCT and histology, the device/vessel interaction after implantation of the bioresorbable vascular scaffold (BVS). We evaluated the area and thickness of the strut voids previously occupied by the polymeric struts, and the neointimal hyperplasia (NIH) area covering the endoluminal surface of the strut voids (NIH(EV)), as well as the NIH area occupying the space between the strut voids (NIH(BV)), in healthy porcine coronary arteries at 2, 3 and 4 years after implantation of the device. Twenty-two polymeric BVS were implanted in the coronary arteries of 11 healthy Yucatan minipigs that underwent OCT ...
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    12. 3-Dimensional reconstruction of a bifurcation lesion with double wire after implantation of a second generation everolimus-eluting bioresorbable vascular scaffold

      3-Dimensional reconstruction of a bifurcation lesion with double wire after implantation of a second generation everolimus-eluting bioresorbable vascular scaffold
      The everolimus-eluting bioresorbable vascular scaffold (BVS) is one of the latest innovations in bioresorbable technology and has been investigated in the ABSORB Cohort A and B studies . The next generation BVS (BVS revision 1.1) is currently being investigated in the ongoing international, multicentre ABSORB EXTEND single arm study. Herein we present a case study from the ABSORB EXTEND single arm study involving the double wiring of a bifurcation lesion. We demonstrate 3-Dimensional (3-D) reconstructions of the main branch (MainB) and side branch (SideB), constructed using dedicated software from their respective using two-Dimensional (2-D) frequency domain optical coherence tomography (FD-OCT ...
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    13. Quantitative multi-modality imaging analysis of a fully bioresorbable stent: a head-to-head comparison between QCA, IVUS, and OCT

      Quantitative multi-modality imaging analysis of a fully bioresorbable stent: a head-to-head comparison between QCA, IVUS, and OCT

      The bioresorbable vascular stent (BVS) is totally translucent and radiolucent, leading to challenges when using conventional invasive imaging modalities. Agreement between quantitative coronary angiography (QCA), intravascular ultrasound (IVUS) and optical coherence tomography (OCT) in the BVS is unknown. Forty five patients enrolled in the ABSORB cohort B1 study underwent coronary angiography, IVUS and OCT immediately post BVS implantation, and at 6 months. OCT estimated stent length accurately compared to nominal length (95% CI of the difference: −0.19; 0.37 and −0.15; 0.47 mm2 for baseline and 6 months, respectively), whereas QCA incurred consistent underestimation of the same ...

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    14. Optical coherence tomography (OCT) of overlapping bioresorbable scaffolds: from bench-work to clinical application

      Optical coherence tomography (OCT) of overlapping bioresorbable scaffolds: from bench-work to clinical application

      Fully bioresorbable everolimus-eluting vascular scaffolds are a novel approach to treating coronary lesions. The ABSORB cohort A and cohort B trials investigated the implantation of 3 mm BV, up to a maximum length of 18 mm, in simple lesions only.

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    15. A Prospective Natural-History Study of Coronary Atherosclerosis

      A Prospective Natural-History Study of Coronary Atherosclerosis
      Background Atherosclerotic plaques that lead to acute coronary syndromes often occur at sites of angiographically mild coronary-artery stenosis. Lesion-related risk factors for such events are poorly understood. Full Text of Background... Methods In a prospective study, 697 patients with acute coronary syndromes underwent three-vessel coronary angiography and gray-scale and radiofrequency intravascular ultrasonographic imaging after percutaneous coronary intervention. Subsequent major adverse cardiovascular events (death from cardiac causes, cardiac arrest, myocardial infarction, or rehospitalization due to unstable or progressive angina) were adjudicated to be related to either originally treated (culprit) lesions or untreated (nonculprit) lesions. The median follow-up period was 3.4 ...
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    16. A comparative assessment by optical coherence tomography of the performance of the first and second generation of the everolimus-eluting bioresorbable vascular scaffolds

      A comparative assessment by optical coherence tomography of the performance of the first and second generation of the everolimus-eluting bioresorbable vascular scaffolds

      Aims The first generation of the everolimus-eluting bioresorbable vascular scaffold (BVS 1.0) showed an angiographic late loss higher than the metallic everolimus-eluting stent Xience V due to scaffold shrinkage. The new generation (BVS 1.1) presents a different design and manufacturing process than the BVS 1.0. This study sought to evaluate the differences in late shrinkage, neointimal response, and bioresorption process between these two scaffold generations using optical coherence tomography (OCT). Methods and results A total of 12 lesions treated with the BVS 1.0 and 12 selected lesions treated with the revised BVS 1.1 were imaged ...

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    17. Retrospective image-based gating of intracoronary optical coherence tomography: implications for quantitative analysis

      Retrospective image-based gating of intracoronary optical coherence tomography: implications for quantitative analysis
      Images acquired of coronary vessels during a pullback of time-domain optical coherence tomography (OCT) are influenced by the dynamics of the heart. This study explores the feasibility of applying an in-house developed retrospective image-based gating method for OCT and the influence of catheter dislocation and luminal changes during the cardiac cycle on the outcome of the quantitative OCT (QOCT).
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    18. Evaluation of the Second Generation of a Bioresorbable Everolimus Drug-Eluting Vascular Scaffold for Treatment of De Novo Coronary Artery Stenosis: Six-Month Clinical and Imaging Outcomes

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

      Background— The first generation of the bioresorbable everolimus drug-eluting vascular scaffold showed signs of shrinkage at 6 months, which largely contributed to late luminal loss. Nevertheless, late luminal loss was less than that observed with bare metal stents. To maintain the mechanical integrity of the device up to 6 months, the scaffold design and manufacturing process of its polymer were modified. Methods and Results— Quantitative coronary angiography, intravascular ultrasound with analysis of radiofrequency backscattering, and as an optional assessment, optical coherence tomography (OCT) were performed at baseline and at a 6-month follow-up. Forty-five patients successfully received a single bioresorbable everolimus ...

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    19. In vivo validation of a novel three-dimensional quantitative coronary angiography system (CardiOp-B™): comparison with a conventional two-dimensional system (CAAS II™) and with special reference to optical coherence tomography

      In vivo validation of a novel three-dimensional quantitative coronary angiography system (CardiOp-B™): comparison with a conventional two-dimensional system (CAAS II™) and with special reference to optical coherence tomography
      Aims: To validate a novel 3-D system (CardiOp-B) and compare the 2-D (CAAS II) and 3-D system in in vivo experimental settigns. The phantom lumen diamters were also assessed ex vivo by optical coherence tomography. The accurace of the 3-D system has not bee appreciated.
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    20. Intracoronary Optical Coherence Tomography and Histology at 1 Month and 2, 3, and 4 Years After Implantation of Everolimus-Eluting Bioresorbable Vascular Scaffolds in a Porcine Coronary Artery Model. An Attempt to Decipher the Human OCT Images in the ABSO

      Intracoronary Optical Coherence Tomography and Histology at 1 Month and 2, 3, and 4 Years After Implantation of Everolimus-Eluting Bioresorbable Vascular Scaffolds in a Porcine Coronary Artery Model. An Attempt to Decipher the Human OCT Images in the ABSO

      Background—With the use of optical coherence tomography (OCT), alterations of the reflectance characteristics of everolimus-eluting bioresorbable vascular scaffold (BVS) struts have been reported in humans. In the absence of histology, the interpretation of the appearances of the struts by OCT remains speculative. We therefore report OCT findings with corresponding histology in the porcine coronary artery model immediately after and at 28 days and 2, 3, and 4 years after BVS implantation. Methods and Results—Thirty-five polymeric BVS (3.0x12.0 mm) were singly implanted in the main coronary arteries of 17 pigs that underwent OCT and were then euthanized ...

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    21. Stent Thrombosis

      Stent Thrombosis
      Intense investigation continues on the pathobiology of stent thrombosis (ST) because of its morbidity and mortality. Because little advance has been made in outcomes following ST, ongoing research is focused on further understanding predictive factors as well as ST frequency and timing in various patient subsets, depending upon whether a drug-eluting stent or bare-metal stent has been implanted. Although the preventive role of antiplatelet therapies remains unchallenged, new data on genomics and variability in response to antiplatelet therapy, as well as the effects of novel therapeutic agents and duration of therapy, have become available. The goal remains identification of patients ...
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    22. Imaging of coronary atherosclerosis: intravascular ultrasound

      Imaging of coronary atherosclerosis: intravascular ultrasound
      Atherosclerosis is the main cause of coronary heart disease, which is today the leading cause of death worldwide and will continue to be the first in the world in 2030. In the formation of atherosclerotic coronary lesions, a critical primary step is the accumulation and oxidation of low-density lipoprotein (LDL) particles. Oxidized-LDL favours leucocyte recruitment and their activation, as well as cell death. This leads to generation of complex atherosclerotic plaques. These plaques have a high content of necrotic core, a thin inflamed fibrous cap (intense accumulation of macrophages) and scarce presence of smooth muscle cells (i.e. thin-capped fibroatheroma ...
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    23. Comparison of Acute Vessel Wall Injury After Self-Expanding Stent and Conventional Balloon-Expandable Stent Implantation: A Study with Optical Coherence Tomography

      Comparison of Acute Vessel Wall Injury After Self-Expanding Stent and Conventional Balloon-Expandable Stent Implantation: A Study with Optical Coherence Tomography
      Background. The acute impact in vivo from a self-expanding stent on the vessel wall has not been sufficiently evaluated. Objectives. We sought to compare acute in vivo injury on the vessel wall and the clinical impact between a self-expanding coronary stent and conventional balloon-expandable stents immediately after stent implantation. Methods. We included 40 patients (45 vessels) with stable or unstable angina who were assigned to either the self-expanding stent (vProtect® Luminal Shield) group (n = 9; Group 1) or the conventional balloon-expandable stent group (n = 36; Group 2). Optical coherence tomography (OCT) was performed after stent deployment, as were qualitative and ...
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    97-120 of 155 « 1 2 3 4 5 6 7 »
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