1. Articles from Vikas Thondapu

    1-13 of 13
    1. Spatial Distribution of Vulnerable Plaques: Comprehensive In Vivo Coronary Plaque Mapping

      Spatial Distribution of Vulnerable Plaques: Comprehensive In Vivo Coronary Plaque Mapping

      Objectives The authors performed a comprehensive analysis on the distribution of coronary plaques with different phenotypes from our 3-vessel optical coherence tomography (OCT) database. Background Previous pathology studies demonstrated that thin-cap fibroatheroma (TCFA) is localized in specific segments of the epicardial coronary arteries. A detailed description of in vivo coronary plaques of various phenotypes has not been reported. Methods OCT images of all 3 coronary arteries in 131 patients were analyzed every 1 mm to assess plaque phenotype and features of vulnerability. In addition, plaques were divided into tertiles according to percent area stenosis (%AS). Results Among 534 plaques identified ...

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    2. High Spatial Endothelial Shear Stress Gradient Independently Predicts Site of Acute Coronary Plaque Rupture and Erosion

      High Spatial Endothelial Shear Stress Gradient Independently Predicts Site of Acute Coronary Plaque Rupture and Erosion

      Aims To investigate local haemodynamics in the setting of acute coronary plaque rupture and erosion. Methods and Results Intracoronary optical coherence tomography performed in 37 patients with acute coronary syndromes caused by plaque rupture (n = 19) or plaque erosion (n = 18) was used for 3D reconstruction and computational fluid dynamic simulation. Endothelial shear stress (ESS), spatial ESS gradient (ESSG), and oscillatory shear index (OSI) were compared between plaque rupture and erosion through mixed-effects logistic regression. Lipid, calcium, macrophages, layered plaque, and cholesterol crystals were also analysed. By multivariable analysis, only high ESSG (odds ratio [OR] 5.29, 95% confidence interval ...

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    3. Predictors for layered coronary plaques: an optical coherence tomography study

      Predictors for layered coronary plaques: an optical coherence tomography study

      Healed coronary plaques, morphologically characterized by a layered pattern, are signatures of previous plaque disruption and healing. Recent optical coherence tomography (OCT) studies showed that layered plaque is associated with vascular vulnerability. However, factors associated with layered plaques have not been studied. The aim of this study was to investigate predictors for layered plaque at the culprit plaques and at non-culprit plaques. Patients with coronary artery disease who underwent pre-intervention OCT imaging of the culprit lesion were included. Layered plaques were defined as plaques with one or more layers of different optical density and a clear demarcation from underlying components ...

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    4. Comprehensive In Vivo Coronary Plaque Mapping: A 3-Vessel Optical Coherence Tomography Study

      Comprehensive In Vivo Coronary Plaque Mapping: A 3-Vessel Optical Coherence Tomography Study

      Background Previous pathology studies demonstrated that thin-cap fibroatheroma (TCFA) is localized in specific segments of the epicardial coronary arteries. A detailed description of in vivo coronary plaques of various phenotypes has not been reported. Objectives We performed a comprehensive analysis on the distribution of coronary plaques with different phenotypes from our 3-vessel optical coherence tomography (OCT) database. Methods OCT images of all 3 coronary arteries in 131 patients were analyzed every 1 mm to assess plaque phenotype and features of vulnerability. In addition, plaques were divided into tertiles according to percent area stenosis (%AS). Results Among 534 plaques identified in ...

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    5. Characteristics of non-culprit plaques in acute coronary syndrome patients with layered culprit plaque

      Characteristics of non-culprit plaques in acute coronary syndrome patients with layered culprit plaque

      Aims  Layered plaques represent signs of previous plaque destabilization. A recent study showed that acute coronary syndrome (ACS) patients with layered culprit plaque have more vulnerability at the culprit lesion and systemic inflammation. We aimed to compare the characteristics of non-culprit plaques between patients with or without layered plaque at the culprit lesion. We also evaluated the characteristics of layered non-culprit plaques, irrespective of culprit plaque phenotype. Methods and results We studied ACS patients who had undergone pre-intervention optical coherence tomography (OCT) imaging. The number of non-culprit lesions was evaluated on coronary angiogram and morphological characteristics of plaques were studied ...

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    6. Angiographic features of patients with coronary plaque erosion

      Angiographic features of patients with coronary plaque erosion

      Background Although an in vivo diagnosis of coronary plaque erosion has become possible by optical coherence tomography (OCT), angiographic characteristics of erosion have not been studied. The aim of this study was to investigate the angiographic features of plaque erosion in patients with non-ST elevation acute coronary syndromes (NSTE-ACS). Methods Patients with NSTE-ACS who underwent OCT of the culprit lesion were collected at 11 institutions from 6 countries. Patients were classified as erosion or non-erosion based on OCT images. Angiographic features of both groups were compared. Results Among 494 cases with NSTE-ACS, 242 had plaque erosion and 252 had non-erosion ...

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    7. Coronary optical coherence tomography-derived virtual fractional flow reserve (FFR): anatomy and physiology all-in-one | European Heart Journal

      Coronary optical coherence tomography-derived virtual fractional flow reserve (FFR): anatomy and physiology all-in-one | European Heart Journal

      Most invasive coronary imaging modalities only provide anatomical information from which physiologic significance is inferred. Fractional flow reserve (FFR) and other physiologic indices of lesion severity are more reliable methods to identify physiologically significant lesions. Currently, accomplishing both anatomic and physiologic interrogation of an intermediate coronary stenosis requires the use of multiple devices within the coronary artery. Coronary angiography, optical coherence tomography (OCT), and FFR were performed in a left anterior descending artery harbouring an intermediate lesion. Quantitative coronary angiography (QAngio XA 7.3, Medis, the Netherlands) and OCT analysis were performed (QIvus 3.0, Medis, the Netherlands). Angiography and ...

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    8. Biomechanical stress in coronary atherosclerosis: emerging insights from computational modelling

      Biomechanical stress in coronary atherosclerosis: emerging insights from computational modelling

      Coronary plaque rupture is the most common cause of vessel thrombosis and acute coronary syndrome. The accurate early detection of plaques prone to rupture may allow prospective, preventative treatment; however, current diagnostic methods remain inadequate to detect these lesions. Established imaging features indicating vulnerability do not confer adequate specificity for symptomatic rupture. Similarly, even though experimental and computational studies have underscored the importance of endothelial shear stress in progressive atherosclerosis, the ability of shear stress to predict plaque progression remains incremental. This review examines recent advances in image-based computational modelling that have elucidated possible mechanisms of plaque progression and rupture ...

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    9. Advances in three-dimensional coronary imaging and computational fluid dynamics: is virtual fractional flow reserve more than just a pretty picture?

      Advances in three-dimensional coronary imaging and computational fluid dynamics: is virtual fractional flow reserve more than just a pretty picture?

      Percutaneous coronary intervention (PCI) has shown a high success rate in the treatment of coronary artery disease. The decision to perform PCI often relies on the cardiologist’s visual interpretation of coronary lesions during angiography. This has inherent limitations, particularly due to the low resolution and two-dimensional nature of angiography. State-of-the-art modalities such as three-dimensional quantitative coronary angiography, optical coherence tomography and invasive fractional flow reserve (FFR) may improve clinicians’ understanding of both the anatomical and physiological importance of coronary lesions. While invasive FFR is the gold standard technique for assessment of the haemodynamic significance of coronary lesions, recent studies ...

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    10. Optical coherence tomography to evaluate coronary stent implantation and complications

      Optical coherence tomography to evaluate coronary stent implantation and complications

      Coronary optical coherence tomography (OCT) is now an established imaging technique in many catheterization laboratories worldwide. With its near-histological view of the vessel wall and lumen interface, it offers unprecedented imaging quality to improve our understanding of the pathophysiology of atherosclerosis, plaque vulnerability, and vascular biology. Not only is OCT used to accurately detect atherosclerotic plaque and optimize stent position, but it can further characterize plaque composition, quantify stent apposition, and assess stent tissue coverage. Given that its resolution of 15 μm is well above that of angiography and intravascular ultrasound, OCT has become the invasive imaging method of choice ...

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    1-13 of 13
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    Optical coherence tomography to evaluate coronary stent implantation and complications Serial three-dimensional optical coherence tomography to assess contained coronary artery perforation Advances in three-dimensional coronary imaging and computational fluid dynamics: is virtual fractional flow reserve more than just a pretty picture? Optical coherence tomography guiding intervention in acute coronary syndrome Biomechanical stress in coronary atherosclerosis: emerging insights from computational modelling Coronary optical coherence tomography-derived virtual fractional flow reserve (FFR): anatomy and physiology all-in-one | European Heart Journal Endothelial Shear Stress and Plaque Erosion: A Computational Fluid Dynamics and Optical Coherence Tomography Study Angiographic features of patients with coronary plaque erosion Characteristics of non-culprit plaques in acute coronary syndrome patients with layered culprit plaque High Spatial Endothelial Shear Stress Gradient Independently Predicts Site of Acute Coronary Plaque Rupture and Erosion Postdoctoral Openings in Biomedical Optics and Retinal Imaging Laboratory at University of Illinois at Chicago Devices and arrangements for performing coherence range imaging using a common path interferometer