1. Articles from Fabrizio D'Ascenzo

    1-14 of 14
    1. Coronary artery plaque rupture and erosion: Role of wall shear stress profiling and biological patterns in acute coronary syndromes

      Coronary artery plaque rupture and erosion: Role of wall shear stress profiling and biological patterns in acute coronary syndromes

      Aims Wall shear stress (WSS) is involved in coronary artery plaque pathological mechanisms and modulation of gene expression. This study aims to provide a comprehensive haemodynamic and biological description of unstable (intact-fibrous-cap, IFC, and ruptured-fibrous-cap, RFC) and stable (chronic coronary syndrome, CCS) plaques and investigate any correlation between WSS and molecular pathways. Methods and results We enrolled 24 CCS and 25 Non-ST Elevation Myocardial Infarction-ACS patients with IFC ( n = 11) and RFC ( n = 14) culprit lesions according to optical coherence tomography analysis. A real-time PCR primer array was performed on peripheral blood mononuclear cells for 17 different molecules whose expression ...

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    2. Optical coherence tomography, intravascular ultrasound or angiography guidance for distal left main coronary stenting. The ROCK cohort II study

      Optical coherence tomography, intravascular ultrasound or angiography guidance for distal left main coronary stenting. The ROCK cohort II study

      Objectives: to test the safety and efficacy of intravascular imaging and specifically optical coherence tomography (OCT) as a diagnostic tool for left main angioplasty and analyze the mid-term outcome accordingly. Background: Clinical data and international guidelines recommend the use of intravascular imaging ultrasound (IVUS) to guide left main (LM) angioplasty. Despite early experience using OCT in this setting is encouraging, the evidence supporting its use is still limited. Methods: ROCK II is a multicenter, investigator-driven, retrospective European study to compare the performance of IVUS and OCT versus angiography in patients undergoing distal-LM stenting. The primary study endpoint was target-lesion failure ...

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    3. Mismatch between morphological and functional assessment of the length of coronary artery disease

      Mismatch between morphological and functional assessment of the length of coronary artery disease

      Background Morphological evaluation of coronary lesion length is a paramount step during invasive assessment of coronary artery disease. Likewise, the extent of epicardial pressure losses can be measured using longitudinal vessel interrogation with fractional flow reserve (FFR) pullbacks. We aimed to quantify the mismatch in lesion length between morphological (based on quantitative coronary angiography, QCA, and optical coherence tomography, OCT) and functional evaluations. Methods This is a prospective and multicenter study of patients evaluated by QCA, OCT and motorized fractional flow reserve pullbacks (mFFR). The difference in lesion length between the morphological and functional evaluations was referred to as morphological-functional ...

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    4. Comparison between functional and intravascular imaging approaches guiding percutaneous coronary intervention: A network meta‐analysis of randomized and propensity matching studies

      Comparison between functional and intravascular imaging approaches guiding percutaneous coronary intervention: A network meta‐analysis of randomized and propensity matching studies

      Background The optimal approach to guide percutaneous coronary intervention (PCI) has yet to be defined. The aim of this study was to compare functional driven (fractional flow reserve) versus intravascular imaging (intravascular ultrasound, IVUS, and/or optical coherence tomography, OCT) versus standard (coronary angiography only, CA)‐guided PCI. Methods Randomized controlled trials (RCTs) and propensity score weight‐matched studies (PSWMs) comparing FFR versus IVUS versus OCT versus CA‐guided PCI were included. Major adverse cardiovascular event (MACE; a composite end point of death or myocardial infarction [MI] or revascularization) was the primary endpoint, whereas definite stent thrombosis (ST) and single ...

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    5. Clinical impact of optical coherence tomography findings on culprit plaque in acute coronary syndrome: The OCT‐FORMIDABLE study registry

      Clinical impact of optical coherence tomography findings on culprit plaque in acute coronary syndrome: The OCT‐FORMIDABLE study registry

      Background Aim of this study was to evaluate the clinical impact of the culprit plaque features assessed by optical coherence tomography (OCT) in patients with acute coronary syndrome (ACS). Methods The OCT‐FORMIDABLE register enrolled retrospectively all consecutive patients who perform OCT on culprit plaque in patients with ACS in nine European centres. The primary endpoint was the prevalence of culprit plaque rupture (CPR) in patients experiencing major adverse cardiovascular events (MACEs). Secondary endpoint was the prevalence necrotic core with macrophage infiltrations (NCMI) in the patients experiencing MACEs. Results Two‐hundred and nine patients were included in the study. Mean ...

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    6. Culprit plaque characteristics in younger versus older patients with acute coronary syndromes: An optical coherence tomography study from the FORMIDABLE registry

      Culprit plaque characteristics in younger versus older patients with acute coronary syndromes: An optical coherence tomography study from the FORMIDABLE registry

      Objectives Culprit plaque characteristics in young patients who experience an Acute Coronary Syndrome (ACS) evaluated by OCT (Optical Coherence Tomography) have to be defined. The OCT-FORMIDABLE is a multicentre retrospective registry enrolling consecutive patients with ACS who performed OCT in 9 European centres. Methods Patients were divided in two groups according to age at presentation: juvenile-ACS (age ≤ 50 years) and not juvenile-ACS (age > 50 years). Primary end-point was the prevalence of plaque rupture (PR). Secondary end point was the prevalence of thin cap fibro atheroma (TCFA), fibrocalcific and fibrotic plaque. Results 285 patients were included, 71 (24.9%) in juvenile-ACS ...

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    7. Optical coherence tomography compared with fractional flow reserve guided approach in acute coronary syndromes: A propensity matched analysis

      Optical coherence tomography compared with fractional flow reserve guided approach in acute coronary syndromes: A propensity matched analysis

      Aim To compare in patients with ACS (Acute Coronary Syndromes) a PCI (Percutaneous Coronary Intervention) approach based on FFR (Fractional Flow Reserve) vs. one based on OCT (Optical Coherence Tomography). Methods and Results Consecutive patients admitted for ACS and treated with a PCI approach based on OCT or on FFR (recruited in two different studies) were compared and matched with propensity score analysis. Target Lesion revascularization (TLR) was the primary end point, while major adverse cardiovascular events [MACEs defined as the composite of death from cardiac causes, non- fatal MI, clinically driven target vessel revascularization (TVR), or re-hospitalization due to ...

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    8. Impact of an optical coherence tomography guided approach in acute coronary syndromes: A propensity matched analysis from the international FORMIDABLE-CARDIOGROUP IV and USZ registry

      Impact of an optical coherence tomography guided approach in acute coronary syndromes: A propensity matched analysis from the international FORMIDABLE-CARDIOGROUP IV and USZ registry

      Aim. To determine the potential clinical impact of OCT (Optical Coherence Tomography) during primary percutaneous coronary intervention in patients presenting with ACS (Acute Coronary Syndrome). Methods and Results. FORMIDABLE is a multicentre retrospective registry enrolling all patients presenting with ACS and treated with an OCT-guided approach, while the USZ registry enrolled patients treated with a standard angiography guided approach. Multivariate adjustment was performed via a propensity score matching. The number stents useds was the primary outcome, while the incidence of MACE (a composite of death, myocardial infarction, target vessel revascularization, and stent thrombosis) was the secondary endpoint. A total of ...

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    9. Optical coherence tomography evaluation of intermediate-term healing of different stent types: systemic review and meta-analysis

      Optical coherence tomography evaluation of intermediate-term healing of different stent types: systemic review and meta-analysis

      Aims The intermediate-term incidence of strut malapposition (SM) and uncovered struts (US), and the degree of neointimal thickness (NIT) according to stent type have not been characterized. Methods and results All studies of >50 patients in which optical coherence tomography was performed between 6 and 12 months after stent implantation were included. The incidences of SM and US were the co-primary end points, while NIT was the secondary end point. A total of 458 citations were initially appraised at the abstract level, and 11 full-text studies (280 652 analysed struts, 921 patients) were assessed. The 6–12 months incidences of ...

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    10. Disappearing stent but persisting problems? Optical coherence tomography assessment of intra-scaffold restenosis

      Disappearing stent but persisting problems? Optical coherence tomography assessment of intra-scaffold restenosis

      A 72-year-old male who had performed 13 months earlier a percutaneous coronary intervention (PCI) for unstable angina with 3 overlapping bioresorbable vascular scaffolds (BVSs) (Abbott Vascular, Santa Clara, California) in a long lesion of the left anterior descending (LAD), presented with new onset effort angina. Coronary angiography revealed significant focal in-scaffold restenosis of the distal LAD (Fig. 1, black arrow). Optical coherence tomography (OCT) imaging (Fig. 2) showed good expansion of the scaffolds with minimum neointima coverage (A, D), except for a focal under-expansion with severe prominent neointimal hyperplasia located in the body of the distal scaffold (B, C).

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    11. Prevalence and predictors of culprit plaque rupture at OCT in patients with coronary artery disease: a meta-analysis

      Prevalence and predictors of culprit plaque rupture at OCT in patients with coronary artery disease: a meta-analysis

      Aims The prevalence of plaque rupture at the culprit lesion identified by optical coherence tomography (OCT) in different clinical subset of patients undergoing coronary angiography and its clinical predictors remain to be defined. Methods All studies including patients with OCT evaluation of the culprit coronary plaque were included. The prevalence of culprit plaque rupture (CPR) and thin-cap fibro-atheroma (TCFA) were the primary endpoints. The factors associated with these findings were studied in a subset of patients with different clinical presentations [ST-elevation myocardial (STEMI) vs. nonST-elevation myocardial infarction (NSTEMI) vs. unstable angina (UA) vs. stable angina pectoris (SAP)]. Results One hundred ...

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    12. All that glitters ain't gold! A case of embolic STEMI demonstrated by OCT

      All that glitters ain't gold! A case of embolic STEMI demonstrated by OCT

      We have read with interest the paper recently published by Duygu [1] discussing acute myocardial infarction caused by paradoxical coronary embolism. According to his consideration coronary angiography unfortunately remains an approximate rough method to evaluate coronary plaque. In the last years due to its high resolution Optical Coherence Tomography (OCT) [2] has been largely exploited in the evaluation and characterization of plaque features, both in stable and acute coronary artery disease.

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    13. Accuracy of intravascular ultrasound and optical coherence tomography in identifying functionally significant coronary stenosis according to vessel diameter: A meta-analysis of 2,581 patients and 2,807 lesions

      Accuracy of intravascular ultrasound and optical coherence tomography in identifying functionally significant coronary stenosis according to vessel diameter: A meta-analysis of 2,581 patients and 2,807 lesions

      Introduction Accuracy of intracoronary imaging to discriminate functionally significant coronary stenosis according to vessel diameter remains to be defined. Methods PubMed, Scopus, and Google Scholar were systematically searched for studies assessing diagnostic accuracy (area under the receiver operating characteristic curve [AUC], the primary end point) and sensitivity and specificity (the secondary end points) of minimal luminal area (MLA) or of minimal luminal diameter (MLD) derived from intravascular ultrasound (IVUS) or optical coherence tomography (OCT) to detect functionally significant stenosis as determined with fractional flow reserve (FFR). Results Fifteen studies were included, 2 with 110 patients analyzing only left main (LM ...

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    1-14 of 14
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    Accuracy of intravascular ultrasound and optical coherence tomography in identifying functionally significant coronary stenosis according to vessel diameter: A meta-analysis of 2,581 patients and 2,807 lesions All that glitters ain't gold! A case of embolic STEMI demonstrated by OCT Much ado about nothing: a case of diffuse vasospam without demonstration of plaque at optical coherence tomography in an STEMI patient Prevalence and predictors of culprit plaque rupture at OCT in patients with coronary artery disease: a meta-analysis Disappearing stent but persisting problems? Optical coherence tomography assessment of intra-scaffold restenosis Optical coherence tomography evaluation of intermediate-term healing of different stent types: systemic review and meta-analysis Impact of an optical coherence tomography guided approach in acute coronary syndromes: A propensity matched analysis from the international FORMIDABLE-CARDIOGROUP IV and USZ registry Optical coherence tomography compared with fractional flow reserve guided approach in acute coronary syndromes: A propensity matched analysis Culprit plaque characteristics in younger versus older patients with acute coronary syndromes: An optical coherence tomography study from the FORMIDABLE registry Clinical impact of optical coherence tomography findings on culprit plaque in acute coronary syndrome: The OCT‐FORMIDABLE study registry A Deep Learning Framework for the Detection and Quantification of Reticular Pseudodrusen and Drusen on Optical Coherence Tomography Quantitative assessment of textural features in the early detection of diabetic retinopathy with optical coherence tomography angiography