1. Articles from Davide Capodanno

    1-24 of 35 1 2 »
    1. Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Intervent

      Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Intervent

      This consensus document is the second of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near infrared spectroscopy (NIRS)-IVUS. Beyond guidance of stent selection and optimization of deployment, invasive imaging facilitates angiographic interpretation and may guide treatment in acute coronary syndrome. Intravascular imaging can provide additional important diagnostic information when confronted with angiographically ambiguous lesions and allows assessment of plaque morphology enabling identification of vulnerability characteristics. This second document focuses on useful ...

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    2. Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Intervent

      Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Intervent

      This consensus document is the second of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near infrared spectroscopy (NIRS)-IVUS. Beyond guidance of stent selection and optimization of deployment, invasive imaging facilitates angiographic interpretation and may guide treatment in acute coronary syndrome. Intravascular imaging can provide additional important diagnostic information when confronted with angiographically ambiguous lesions and allows assessment of plaque morphology enabling identification of vulnerability characteristics. This second document focuses on useful ...

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    3. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions

      Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions

      his Consensus Document is the first of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The first document appraises the role of intracoronary imaging to guide percutaneous coronary interventions (PCIs) in clinical practice. Current evidence regarding the impact of intracoronary imaging guidance on cardiovascular outcomes is summarized, and patients or lesions most likely to derive clinical benefit from an imaging-guided intervention are identified. The relevance of the use of IVUS or OCT prior ...

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    4. Clinical Outcomes Following Intravascular Imaging-Guided Versus Coronary Angiography–Guided Percutaneous Coronary Intervention With Stent Implantation

      Clinical Outcomes Following Intravascular Imaging-Guided Versus Coronary Angiography–Guided Percutaneous Coronary Intervention With Stent Implantation

      Objectives The authors sought to explore the comparative clinical efficacy of different imaging modalities for guiding percutaneous coronary interventions (PCI). Background Coronary angiography (CA) is the standard imaging modality for intraprocedural guidance of PCI. Intracoronary imaging techniques, including intravascular ultrasound (IVUS) and optical coherence tomography (OCT), can overcome some limitations of CA. Methods Comprehensive hierarchical Bayesian network meta-analysis of randomized clinical trials and adjusted observational studies comparing clinical outcomes of PCI with stent implantation guided by CA, IVUS, or OCT. Results A total of 31 studies encompassing 17,882 patients were included. Compared with CA guidance, the risks of all-cause ...

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    5. Vascular response and healing profile of everolimus-eluting bioresorbable vascular scaffolds for percutaneous treatment of chronic total coronary occlusions: A one-year optical coherence tomography analysis from the GHOST-CTO registry

      Vascular response and healing profile of everolimus-eluting bioresorbable vascular scaffolds for percutaneous treatment of chronic total coronary occlusions: A one-year optical coherence tomography analysis from the GHOST-CTO registry

      Background Bioresorbable vascular scaffolds (BVS) have been heralded with potential benefits that are especially desired in long lesions, including chronic total occlusions (CTOs). Procedural feasibility and mid-term outcomes of BVS in CTOs have been reported. However, there is still a paucity of data regarding the vascular and healing response to BVS in CTOs evaluated by optical coherence tomography (OCT). Methods This study included prospectively 21 patients who had a CTO lesion treated with a BVS. Angiography and OCT scan were recorded at either post-implantation and 1-year follow-up. Quantitative coronary angiography and OCT analyses were performed by an independent core laboratory ...

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    6. Report of an ESC-EAPCI Task Force on the evaluation and use of bioresorbable scaffolds for percutaneous coronary intervention: executive summary

      Report of an ESC-EAPCI Task Force on the evaluation and use of bioresorbable scaffolds for percutaneous coronary intervention: executive summary

      BRS require careful lesion assessment, to determine the need and extent of lesion preparation, as well as to select the appropriate size and length of the device. The use of pre-and post-procedural intracoronary imaging (Intravascular ultrasound, optical coherence tomography), as well as online quantitative coronary angiography, is encouraged to optimize device implantation. The use of BRS in heavily calcified vessels is strongly discouraged. Bioresorbable scaffolds should be avoided in stenoses with reference diameter smaller than 2.5 mm and in ostial lesions.

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    7. Effects of statins on plaque rupture assessed by optical coherence tomography in patients presenting with acute coronary syndromes: insights from the optical coherence tomography (OCT)-FORMIDABLE registry

      Effects of statins on plaque rupture assessed by optical coherence tomography in patients presenting with acute coronary syndromes: insights from the optical coherence tomography (OCT)-FORMIDABLE registry

      Aims Chronic pre-treatment with statins may reduce mortality and morbidity in patients experiencing acute coronary syndromes (ACS), but mechanisms accounting for these findings are not completely understood. Methods and results The optical coherence tomography (OCT)-Formidable registry retrospectively enrolled 285 consecutive patients with ACS undergoing OCT in 9 European centres. Mean age was 60.4 ± 12.8 years, 148 (51.9%) patients had hyperlipemia, 45 (15.8%) diabetes mellitus and 142 (49.8%) presented with ST Segment Elevation Myocardial Infarction (STEMI). Patients were stratified according to statin prescription: 150 (52.6%) were on chronic pre-treatment with statins before ACS and ...

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    8. Late self-apposition with one-year persisting uncoverage of malapposed bioresorbable polymeric struts

      Late self-apposition with one-year persisting uncoverage of malapposed bioresorbable polymeric struts

      This case reports the fate of a post-procedural incomplete struts apposition (ISA) of an Absorb bioresorbable scaffold. The 12-month optical coherence tomography showed the complete ISA resolution, apparently mediated by the passive reclining of struts from the lumen to the vessel wall. The lastly apposed struts appeared still uncovered, persisting a potential procedure-related mechanism of very late scaffold thrombosis.

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    9. Impact of Culprit Plaque and Atherothrombotic Components on Incomplete Stent Apposition in Patients With ST-Elevation Myocardial Infarction Treated With Everolimus-Eluting Stents – An OCTAVIA Substudy –

      Impact of Culprit Plaque and Atherothrombotic Components on Incomplete Stent Apposition in Patients With ST-Elevation Myocardial Infarction Treated With Everolimus-Eluting Stents – An OCTAVIA Substudy –

      Background: The role of culprit plaque and related atherothrombotic components on incomplete stent apposition (ISA) occurrence after primary percutaneous coronary intervention (p-PCI) is unknown. Methods and Results: ST-segment elevation myocardial infarction (STEMI) patients undergoing p-PCI with an everolimus-eluting stent were prospectively investigated with optical coherence tomography (OCT) of the infarct-related artery before, after stenting and at 9 months. OCT data, aspirated thrombus and serum inflammatory biomarkers were analyzed. 114 patients with 114 lesions were evaluated. Acute ISA occurred in 82 lesions (71.9%), preferentially in larger vessels with a median area of 0.2 mm 2 . The presence of thrombus ...

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    10. Embolization of Fractured Bioresorbable Scaffold Struts Insights From 2- and 3-Dimensional Optical Coherence Tomography

      Embolization of Fractured Bioresorbable Scaffold Struts Insights From 2- and 3-Dimensional Optical Coherence Tomography

      A 58-year-old diabetic man underwent implantation of 3 overlapping Absorb bioresorbable vascular scaffolds (BVS) (2.5/28, 2.5/28, and 3.0/28 mm) (Abbott Vascular, Santa Clara, California) in a heavily calcified left anterior descending artery stenosis. Optical coherence tomography (OCT) revealed multiple fractures of the 3.0/28 BVS, leading to in-scaffold implantation of a zotarolimus-eluting stent (ZES) ( Figures 1A and 1B ). The 4-month angiography showed a severe edge in ZES restenosis treated with another stent. The OCT revealed an unexpected disappearance of BVS struts ( Figure 1C ) in the ZES segment and a nonocclusive cluster of polymeric ...

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    11. 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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    12. Cyphering the Mechanism of Late Failure of Bioresorbable Vascular Scaffolds in Percutaneous Coronary Intervention of the Left Main Coronary Artery

      Cyphering the Mechanism of Late Failure of Bioresorbable Vascular Scaffolds in Percutaneous Coronary Intervention of the Left Main Coronary Artery

      A 48-year-old woman with history of multiple percutaneous coronary interventions and bypass grafting on the left anterior descending coronary artery presented with unstable angina. Coronary angiography showed a patent left internal mammary artery and de novo critical stenoses of the mid-shaft left main and the unprotected left circumflex coronary artery (LCX). Both lesions were treated with 2 nonoverlapping bioresorbable vascular scaffolds (BVS) (Absorb, Abbott Vascular, Santa Clara, California) 3.5 × 12 mm at 16 atm and 3.0 × 18 mm at 12 atm, respectively. Optical coherence tomography (OCT) confirmed good expansion and apposition of the BVS (Figure 1 ). A short ...

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    13. One-year coverage by optical coherence tomography of a bioresorbable scaffold neocarina: is it safe to discontinue dual antiplatelet therapy?

      One-year coverage by optical coherence tomography of a bioresorbable scaffold neocarina: is it safe to discontinue dual antiplatelet therapy?

      This is a case reporting on the 1-year coverage status of side-branch bioresorbable vascular scaffold (BVS) struts protruding in main vessels. The 1-year optical coherence tomography demonstrated a tissue neocarina forming over protruding BVS struts, although the coverage was widely inhomogeneous and perhaps still incomplete in some portions, thus leading to cautious extension of dual antiplatelet therapy beyond one year.

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    14. Optical Coherence Tomography Assessment of Late Intra-Scaffold Dissection - A New Challenge of Bioresorbable Scaffolds

      Optical Coherence Tomography Assessment of Late Intra-Scaffold Dissection - A New Challenge of Bioresorbable Scaffolds

      A 48-year-old man was admitted because of a non–ST-segment elevation myocardial infarction. Fifteen months previously, he had received a 3.0 × 28-mm bioresorbable vascular scaffold (BVS) (Absorb, Abbott Vascular, Santa Clara, California) in the mid-left anterior descending coronary artery for stable angina. Coronary angiography showed a focal in-scaffold restenosis (Figure 1 ). Optical coherence tomography (OCT) (Ilumien, St. Jude Medical, Saint Paul, Minnesota) revealed a heterogeneous pattern consisting of neointimal hyperplasia (Figure 1 ), mural white thrombus (Figure 1 ), and lipidic plaque with attenuation (Figure 1 ). OCT after pre-dilation with a 2.0 × 15-mm semicompliant balloon showed outer migration of scaffold ...

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    15. New Insights on acute expansion and longitudinal elongation of bioresorbable vascular scaffolds In-Vivo and at bench test: A note of caution on reliance to compliance charts and nominal length

      New Insights on acute expansion and longitudinal elongation of bioresorbable vascular scaffolds In-Vivo and at bench test: A note of caution on reliance to compliance charts and nominal length

      Objectives : We performed systematic optical coherence tomography (OCT) analyses after BVS implantation in a “real world” setting aiming at evaluating scaffold expansion and longitudinal integrity. Background : A comprehensive elucidation of bioresorbable vascular scaffolds´ (BVS) acute performance in the “real-world” setting is lacking Methods : Acute BVS expansion compared with compliance chart information and longitudinal integrity were assessed in 29 patients (32 lesions) by OCT. In addition, bench experiments with 4 scaffolds were performed with different combinations of deployment pressures and tube stiffness. Results : Scaffold underexpansion, using compliance chart information as reference, was observed in 97% of OCT cross-sections in vivo; however ...

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    16. Mechanisms of Atherothrombosis and Vascular Response to Primary Percutaneous Coronary Intervention in Women Versus Men With Acute Myocardial Infarction : Results of the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angiop

      Mechanisms of Atherothrombosis and Vascular Response to Primary Percutaneous Coronary Intervention in Women Versus Men With Acute Myocardial Infarction : Results of the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angiop

      Objectives This study sought to assess in vivo sex differences in the pathophysiology of ST-segment elevation myocardial infarction (STEMI) and vascular response to primary percutaneous coronary intervention (PCI). Background There is no consensus on whether differences in the pathophysiology of STEMI and response to primary PCI between women and men reflect biological factors as opposed to differences in age. Methods In this prospective, multicenter study, 140 age-matched men and women with STEMI undergoing primary PCI with everolimus-eluting stent were investigated with intravascular optical coherence tomography, histopathology-immunohistochemistry of thrombus aspirates, and serum biomarkers. Primary endpoints were the percentages of culprit plaque ...

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    17. Mechanisms, Pathophysiology, and Clinical Aspects of Incomplete Stent Apposition

      Mechanisms, Pathophysiology, and Clinical Aspects of Incomplete Stent Apposition

      Incomplete stent apposition (ISA) is characterized by the lack of contact of at least 1 stent strut with the vessel wall in a segment not overlying a side branch; it is more commonly found in drug-eluting stents than bare-metal stents. The accurate diagnosis of ISA, initially only possible with intravascular ultrasound, can currently be performed with higher accuracy by optical coherence tomography, which also enables strut-level assessment due to its higher axial resolution. Different circumstances related both to the index procedure and to vascular healing might influence ISA occurrence. Although several histopathology and clinical studies linked ISA to stent thrombosis ...

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    18. Initial experience of percutaneous coronary intervention in bifurcations with bioresorbable vascular scaffolds using different techniques — Insights from optical coherence tomography

      Initial experience of percutaneous coronary intervention in bifurcations with bioresorbable vascular scaffolds using different techniques — Insights from optical coherence tomography

      Percutaneous coronary intervention (PCI) of coronary artery bifurcations (CABs) is associated with increased risk of drug-eluting stent (DES) failure when compared with non-CAB PCI . Although still a controversial topic, the risk of adverse events seems particularly increased when two – rather than one – DESs are implanted . Indeed, the preferred strategy recommended by the current guidelines, when feasible, is one stent technique .

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    19. First-in-human description of everolimus-eluting bioabsorbable vascular scaffold implantation for the treatment of drug-eluting stent failure: Insights from optical coherence tomography

      First-in-human description of everolimus-eluting bioabsorbable vascular scaffold implantation for the treatment of drug-eluting stent failure: Insights from optical coherence tomography

      Drug-eluting stents (DES) markedly reduce new episodes of revascularization compared with bare-metal stents; nevertheless, the prevalence of DES in-stent restenosis (ISR) is not insignificant as a large population is treated with these devices worldwide . In addition, concerns regarding long-term safety of metallic DES stimulated investigators to seek for improvement of this therapy. Everolimus-eluting bioabsorbable vascular scaffolds (BVS, Abbott Vascular, Santa Clara, CA, USA) emerged as an interesting alternative, as they enable vessel scaffolding in short-term and anti-restenotic drug delivery, while avoiding long-term limitations of metallic DES (i.e., prolonged metal exposure to coronary circulation in case of delayed healing). Indeed ...

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    1-24 of 35 1 2 »
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