1. Articles from Evelyn Regar

    1-24 of 124 1 2 3 4 5 6 »
    1. Serial Assessment of Strut Coverage of Biodegradable Polymer Drug-Eluting Stent at 1, 2, and 3 Months After Stent Implantation by Optical Frequency Domain Imaging

      Serial Assessment of Strut Coverage of Biodegradable Polymer Drug-Eluting Stent at 1, 2, and 3 Months After Stent Implantation by Optical Frequency Domain Imaging

      Background— To assess the vessel-healing pattern of Ultimaster drug-eluting stent using optical frequency domain imaging. Our hypothesis is that biodegradable polymer-based drug-eluting technology allows complete very early strut coverage. Methods and Results— The DISCOVERY 1TO3 study (Evaluation With OFDI of Strut Coverage of Terumo New Drug Eluting Stent With Biodegradable Polymer at 1, 2, and 3 Months) is a prospective, single-arm, multicenter study. A total of 60 patients with multivessel disease requiring staged procedure at 1 month were treated with Ultimaster. Optical frequency domain imaging was acquired at baseline, 1, 2, and 3 months. The primary end point is optical ...

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    2. First serial optical coherence tomography assessment at baseline, 12 and 24 months in STEMI patients treated with the second generation ABSORB™ bioresorbable vascular scaffold

      First serial optical coherence tomography assessment at baseline, 12 and 24 months in STEMI patients treated with the second generation ABSORB™ bioresorbable vascular scaffold

      Aims: The aim of the study was to assess the vascular healing response after Absorb bioresorbable vascular scaffold (BVS) implantation in patients with ST segment elevation myocardial infarction (STEMI) utilizing truly serial optical coherence tomography (OCT) examination at baseline, 12- and 24-months. Methods and results: This is the single-centre, prospective, longitudinal study with baseline, 12- and 24-month OCT evaluation of 18 STEMI patients treated with 22 Absorb BVS implantation. The healing pattern was evaluated based upon lumen area, neointimal hyperplasia, strut coverage and apposition. The lumen area decreased at 12 months compared to baseline (8.52± 1.69 mm2 vs ...

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    3. Intravascular imaging for characterization of coronary atherosclerosis

      Intravascular imaging for characterization of coronary atherosclerosis

      This short review surveys recent developments in coronary intravascular imaging technologies. We present an outline of the applications of intravascular imaging for guidance of percutaneous coronary interventions and imaging of atherosclerosis, along with emerging clinical evidence for use. Imaging of tissue composition is important for understanding the relation between the presence of a lesion and clinical sequelae. We describe the recent innovations to enable imaging of unstable atherosclerotic plaques, focusing on the emergence of experimental multimodal imaging technology.

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    4. Intracoronary optical coherence tomography: Clinical and research applications and intravascular imaging software overview

      Intracoronary optical coherence tomography: Clinical and research applications and intravascular imaging software overview

      By providing valuable information about the coronary artery wall and lumen, intravascular imaging may aid in optimizing interventional procedure results and thereby could improve clinical outcomes following percutaneous coronary intervention (PCI). Intravascular optical coherence tomography (OCT) is a light-based technology with a tissue penetration of approximately 1 to 3 mm and provides near histological resolution. It has emerged as a technological breakthrough in intravascular imaging with multiple clinical and research applications. OCT provides detailed visualization of the vessel following PCI and provides accurate assessment of post-procedural stent performance including detection of edge dissection, stent struts apposition, tissue prolapse, and healing ...

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    5. EuroIntervention Automated characterisation of lipid core plaques in vivo by quantitative optical coherence tomography tissue type imaging

      EuroIntervention Automated characterisation of lipid core plaques in vivo by quantitative optical coherence tomography tissue type imaging

      Aims: Qualitative criteria for plaque tissue characterisation by OCT are well established, but quantitative methods lack systematic validation in vivo . High optical attenuation coefficient µ t has been associated with unstable plaque features, such as lipid core. The purpose of this study was to validate optical coherence tomography (OCT) attenuation imaging for tissue characterisation in vivo , specifically to detect lipid core in coronary atherosclerotic plaques, and to evaluate quantitatively the ability of OCT attenuation imaging to differentiate thin-cap (TCFA) and thick-cap fibroatheroma (FA). Methods and results: We prospectively enrolled 85 patients undergoing imaging of a native coronary segment by both OCT ...

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    6. Shedding light on the mechanisms of stent thrombosis with optical coherence tomography

      Shedding light on the mechanisms of stent thrombosis with optical coherence tomography

      Since the introduction of mechanical devices for the treatment of stenotic coronary artery disease, stent thrombosis (ST) has been an issue of major clinical concern. It is an uncommon but serious complication with high mortality and morbidity that almost always presents as death or myocardial infarction (MI), usually with electrocardiographic ST-segment elevation ( 1 ). Inadequate stent expansion and undersizing of a stent has been recognized as the main reason for acute and subacute ST ( 2 ) following stent implantation. Souteyrand et al . ( 3 ) have done a great job at confirming these findings with the use of optical coherence tomography (OCT). It is ...

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    7. Comparison of acute expansion of bioresorbable vascular scaffolds versus metallic drug-eluting stents in different degrees of calcification

      Comparison of acute expansion of bioresorbable vascular scaffolds versus metallic drug-eluting stents in different degrees of calcification

      Objectives The acute expansion of bioresorbable vascular scaffolds (BRS) and drug-eluting stents (DES) in lesions with different extent of calcification was compared by Optical Coherence Tomography (OCT). Background The acute mechanical performance of polymeric BRS in calcified lesions is poorly understood. Methods Acute device performance in lesions treated with either BRS( N  = 50) or DES ( N  = 50) was compared using Optical Coherence Tomography (OCT). According to angiographic degree of calcification the lesions were divided in three groups: no/mild, moderate and heavy calcification. Device performance was assessed with the following parameters by OCT: mean scaffold area, eccentricity index (EI), symmetry ...

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    8. The OPTIS Integrated System: real-time, co-registration of angiography and optical coherence tomography

      The OPTIS Integrated System: real-time, co-registration of angiography and optical coherence tomography

      The efficacy of an IVUS-guided stent implantation strategy to improve acute results and clinical outcome has been described previously. OCT is another technique which allows high-resolution intracoronary imaging. However, the use of invasive imaging modalities to guide PCI has, as yet, played a limited role in current clinical practice. This may be partly explained by the expertise required for interpretation and clinical decision making. We present a novel technology which enables real-time co-registration of OCT images with angiography. This will simplify matching cross-sectional images to their geographic position on the angiogram, thereby facilitating imaging-guided PCI.

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    9. Optical coherence tomography attenuation imaging for lipid core detection: an ex-vivo validation study

      Optical coherence tomography attenuation imaging for lipid core detection: an ex-vivo validation study

      Lipid-core atherosclerotic plaques are associated with disease progression, procedural complications, and cardiac events. Coronary plaque lipid can be quantified in optical coherence tomography (OCT) pullbacks by measurement of lipid arcs and lipid lengths; parameters frequently used in clinical research, but labor intensive and subjective to analyse. In this study, we investigated the ability of quantitative attenuation, derived from intravascular OCT, to detect plaque lipid. Lipid cores are associated with a high attenuation coefficient. We compared the index of plaque attenuation (IPA), a local quantitative measure of attenuation, to the manually measured lipid score (arc and length) on OCT images, and ...

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    10. Everolimus-Eluting Bioresorbable Vascular Scaffolds implanted in Coronary Bifurcation Lesions

      Everolimus-Eluting Bioresorbable Vascular Scaffolds implanted in Coronary Bifurcation Lesions

      Background Limited data are available on bioresorbable vascular scaffolds (BVS) performance in bifurcations lesions and on the impact of BVS wider struts on side-branch impairment. Methods Patients with at least one coronary bifurcation lesion involving a side-branch ≥2 mm in diameter and treated with at least one BVS were examined. Procedural and angiographic data were collected and a dedicated methodology for off-line quantitative coronary angiography (QCA) in bifurcation was applied (eleven-segment model), to assess side-branch impairment occurring any time during the procedure. Two- and three-dimensional QCA was used. Optical coherence tomography (OCT) analysis was performed in a subgroup of patients ...

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    11. Fusion of fibrous cap thickness and wall shear stress to assess plaque vulnerability in coronary arteries: a pilot study

      Fusion of fibrous cap thickness and wall shear stress to assess plaque vulnerability in coronary arteries: a pilot study

      Purpose Identification of rupture-prone plaques in coronary arteries is a major clinical challenge. Fibrous cap thickness and wall shear stress are two relevant image-based risk factors, but these two parameters are generally computed and analyzed separately. Accordingly, combining these two parameters can potentially improve the identification of at-risk regions. Therefore, the purpose of this study is to investigate the feasibility of the fusion of wall shear stress and fibrous cap thickness of coronary arteries in patient data. Methods Fourteen patients were included in this pilot study. Imaging of the coronary arteries was performed with optical coherence tomography and with angiography ...

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    12. Heartbeat OCT and Motion-Free 3D In Vivo Coronary Artery Microscopy

      Heartbeat OCT and Motion-Free 3D In Vivo Coronary Artery Microscopy

      Intravascular optical coherence tomography (IV-OCT) has gained widespread use over the past few years, offering highly detailed images of coronary artery pathologies and interventions (1) . In contrast to the cross-sectional view, longitudinal sections and 3-dimensional (3D) renderings are affected by cardiac motion artifacts and undersampling, complicating interpretation and measurements (2) . We developed Heartbeat OCT, a new OCT method that achieves up to 4,000 frames/s imaging speed for isotropically sampled volume datasets acquired within the diastolic phase of 1 cardiac cycle to restore 3D IV-OCT image fidelity. In this research letter, we present the first in vivo data acquired ...

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    13. Optical Coherence Tomography in Grafts (Book Chapter)

      Optical Coherence Tomography in Grafts (Book Chapter)

      Coronary artery bypass graft (CABG) is a commonly used surgery to treat patients with complex artery disease. Long-term outcome of specifically saphenous vein grafts (SVG) is considered unfavorable, while it is the most commonly used conduit. The SVG is prone to occlude and half of the patients will develop vein graft failure (VGF) within 10 years. VGF is the result of the accelerated atherosclerosis that differs from what is seen in native coronaries. Revascularization of SVGs is considered challenging, due to their challenging anatomy and embolic nature. Optical coherence tomography (OCT) imaging is an invasive imaging technique that can be ...

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    14. Safety of optical coherence tomography in daily practice: a comparison with intravascular ultrasound

      Safety of optical coherence tomography in daily practice: a comparison with intravascular ultrasound

      Aims Previous studies have reported the safety and feasibility of both time-domain optical coherence tomography (TD-OCT) and Fourier-domain OCT (FD-OCT) in highly selected patients and clinical settings. However, the generalizability of these data is limited, and data in unselected patient populations reflecting a routine cathlab practice are lacking. We compared safety of intracoronary FD-OCT imaging to intravascular ultrasound (IVUS) imaging in a large real-world series of consecutive patients who underwent invasive imaging during coronary catheterization in our centre. Methods and results This is a prospective, single-centre registry of patients scheduled for coronary angiography or intervention undergoing intracoronary imaging with FD-OCT ...

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    15. Feature Of The Week 12/06/2015: Heartbeat Optical Coherence Tomography

      Feature Of The Week 12/06/2015: Heartbeat Optical Coherence Tomography

      Intravascular optical coherence tomography (IV-OCT) has gained widespread use over the past few years, offering highly detailed images of the coronary artery pathologies and interventions. In contrast to the cross-sectional view, longitudinal sections and three-dimensional (3D) renderings are affected by cardiac motion artifacts and undersampling, complicating interpretation and measurements. We developed Heartbeat OCT, a new OCT method that overcomes these issues. This study aims to demonstrate in vivo Heartbeat OCT in a preclinical setting, imaging eliminating cardiac motion artifacts, undersampling and non-uniform rotational distortion, to generate high-quality OCT volumes. Using a micro motor actuated catheter and a MHz sweep rate ...

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    16. Heartbeat OCT: in vivo intravascular megahertz-optical coherence tomography

      Heartbeat OCT: in vivo intravascular megahertz-optical coherence tomography

      Cardiac motion artifacts, non-uniform rotational distortion and undersampling affect the image quality and the diagnostic impact of intravascular optical coherence tomography (IV-OCT). In this study we demonstrate how these limitations of IV-OCT can be addressed by using an imaging system that we called “Heartbeat OCT”, combining a fast Fourier Domain Mode Locked laser, fast pullback, and a micromotor actuated catheter, designed to examine a coronary vessel in less than one cardiac cycle. We acquired in vivo data sets of two coronary arteries in a porcine heart with both Heartbeat OCT, working at 2.88 MHz A-line rate, 4000 frames/s ...

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    17. Incidence and potential mechanism of resolved, persistent and newly acquired malapposition three days after implantation of self-expanding or balloon-expandable stents in a STEMI population: insights from optical coherence tomography in the APPOSITION II

      Incidence and potential mechanism of resolved, persistent and newly acquired malapposition three days after implantation of self-expanding or balloon-expandable stents in a STEMI population: insights from optical coherence tomography in the APPOSITION II

      Aims: The aim of the current study was to investigate the frequency and mechanisms of sequential incomplete stent apposition (ISA) changes such as persistent, resolved or newly acquired ISA during the first three days after primary PCI (pPCI) in a matched segment-level analysis, with the comparison between self-expanding and balloon-expandable stents assessed by optical coherence tomography (OCT). Methods and results: The current analysis is a substudy of the APPOSITION II study that included 69 patients (self-expanding: 35, balloon-expandable: 34) using serial optical coherence tomography (OCT) post procedure and three days after pPCI. In order to evaluate a temporal change in ...

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    18. Comparative analysis method of permanent metallic stents (XIENCE) and bioresorbable poly-L-lactic (PLLA) scaffolds (Absorb) on optical coherence tomography at baseline and follow-up

      Comparative analysis method of permanent metallic stents (XIENCE) and bioresorbable poly-L-lactic (PLLA) scaffolds (Absorb) on optical coherence tomography at baseline and follow-up

      Aims: Fully bioresorbable Absorb poly-L-lactic-acid (PLLA) scaffolds (Abbott Vascular, Santa Clara, CA, USA) are a novel approach for the treatment of coronary narrowing. Due to the translucency of the material (PLLA), the optical coherence tomography (OCT) measurement methods used in the ABSORB trials were unique but not applicable for permanent metallic stents. When the Absorb scaffold and metallic stents are compared in the context of randomised trials, it is challenging to compare the two devices using the conventional methods. The primary purpose of this report is to explain the biases in conventional methodologies applied for metallic stents and for PLLA ...

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    19. An Unusual Complication After Bioresorbable Scaffold Implantation Visualization of Intramural Hematoma by Optical Coherence Tomography

      An Unusual Complication After Bioresorbable Scaffold Implantation Visualization of Intramural Hematoma by Optical Coherence Tomography

      A 68-year-old man was treated in our catheterization laboratory for ST-segment elevation myocardial infarction. He had undergone 3.5 × 18-mm bioresorbable vascular scaffold (BVS) implantation in the proximal left anterior descending coronary artery for stable angina in another institution 2 days before. At presentation, angiography showed a filling defect located >5 mm distally to the scaffolded segment ( Figure 1A ). An attempt at thrombus aspiration was performed, without retrieving any aspiration material, and the angiographic image remained unchanged ( Figure 1B ). Optical coherence tomography (OCT) was performed and revealed the absence of intraluminal thrombus, but the presence of an occlusive intramural hematoma ...

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    20. Utility of Optical Coherence Tomography Imaging with Angiographic Co-registration for the Guidance of Percutaneous Coronary Intervention

      Utility of Optical Coherence Tomography Imaging with Angiographic Co-registration for the Guidance of Percutaneous Coronary Intervention

      Intracoronary optical coherence tomography (OCT) is a light-based imaging modality able to visualise with high resolution (~10 μm) the vascular morphology and the acute and chronic effects of intervention with intracoronary devices. 1,2 OCT could therefore find application in the guidance of percutaneous coronary intervention (PCI), allowing a thorough preprocedural lesion assessment, which enables accurate device sizing, selection of the vessel segment requiring treatment, and, thus, efficient planning of the implantation strategy (see Table 1 ). 3 Moreover, it can be used for the assessment of the acute procedural result, allowing the estimation of stent expansion and vessel injury. Consequently ...

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    21. Multimodality Intra-Arterial Imaging Assessment of the Vascular Trauma Induced by Balloon-Based and Nonballoon-Based Renal Denervation Systems

      Multimodality Intra-Arterial Imaging Assessment of the Vascular Trauma Induced by Balloon-Based and Nonballoon-Based Renal Denervation Systems

      Background— Renal denervation is a new treatment considered for several possible indications. As new systems are introduced, the incidence of acute renal artery wall injury with relation to the denervation method is unknown. We investigated the acute repercussion of renal denervation on the renal arteries of patients treated with balloon-based and nonballoon-based denervation systems by quantitative angiography, intravascular ultrasound, and optical coherence tomography (OCT). Methods and Results— Twenty-five patients (50 renal arteries) underwent bilateral renal denervation with 5 different systems, 3 of which balloon-based (Paradise [n=5], Oneshot [n=6], and Vessix V2 [n=5)]) and 2 nonballoon-based (Symplicity [n ...

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    22. Use of Intracoronary imaging in ST Elevation Myocardial Infarction with coronary artery aneurysm and very late stent thrombosis

      Use of Intracoronary imaging in ST Elevation Myocardial Infarction with coronary artery aneurysm and very late stent thrombosis

      The use of Optical Coherence Tomography (OCT)-guided percutaneous coronary intervention (PCI) has been described in ST-Elevation Myocardial Infarction (STEMI) involving relatively simple culprit lesions [1]. Coronary artery aneurysms have a reported incidence of up to 4.9% among coronary angiograms performed and may present clinically as STEMI either from thrombus formation or embolic phenomena [2]. There has been limited experience described regarding the use of OCT in STEMI with an aneurysm in the infarct related artery (IRA).

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    23. Angiographic and Optical Coherence Tomography Insights Into Bioresorbable Scaffold Thrombosis: Single-Center Experience

      Angiographic and Optical Coherence Tomography Insights Into Bioresorbable Scaffold Thrombosis: Single-Center Experience

      Background— As bioresorbable vascular scaffolds (BVSs) are being increasingly used in complex real-world lesions and populations, BVS thrombosis cases have been reported. We present angiographic and optical coherence tomography (OCT) findings in a series of patients treated in our center for definite bioresorbable scaffold thrombosis. Methods and Results— Up to June 2014, 14 patients presented with definite BVS thrombosis in our center. OCT was performed in 9 patients at the operator’s discretion. Angiographic and OCT findings were compared with a control group comprising 15 patients with definite metallic stent thrombosis. In the BVS group, time interval from index procedure ...

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    1-24 of 124 1 2 3 4 5 6 »
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