1. Articles from Alessio La Manna

    1-23 of 23
    1. Prevalence and quantitative assessment of macrophages in coronary plaques

      Prevalence and quantitative assessment of macrophages in coronary plaques

      Although optical coherence tomography (OCT) proved to be able to identify macrophage clusters, there are no available data on the possibility to obtain reproducible measurements of their circumferential extension and location. The purpose of the present post-hoc analysis of the CLIMA study was to revise the clinical and demographic variables of patients having coronary plaques with macrophages and to investigate the reproducibility of their quantitative assessment. A total of 577 patients out of 1003 undergoing OCT showed macrophage accumulation. Three groups were identified; group 1 (426 patients) without macrophages, group 2 (296) patients with low macrophage content (less than median ...

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    2. Cracking the Plaque With Coronary Lithotripsy: Mechanistic Insights From Optical Coherence Tomography

      Cracking the Plaque With Coronary Lithotripsy: Mechanistic Insights From Optical Coherence Tomography

      A 38-year-old male underwent successful recanalization of a chronic total occlusion (CTO) in a bare-metal stented segment of the mid right coronary artery (RCA) via retrograde approach. However, the in-stent restenotic lesion was undilatable despite pressure up to 35 atm with non-compliant (NC) OPN balloons (SIS Medical AG). The patient was discharged with plans for a future attempt. Six months later, coronary angiography revealed patency of the RCA with residual severe in-stent restenosis. Predilation with a 2.5 x 15 mm OPN NC balloon up to 35 atm confirmed the undilatable restenotic lesion with dog-boning effect. Therefore, coronary lithoplasty with ...

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    3. Prospective evaluation of drug eluting self‐apposing stent for the treatment of unprotected left main coronary artery disease: 1‐year results of the TRUNC study

      Prospective evaluation of drug eluting self‐apposing stent for the treatment of unprotected left main coronary artery disease: 1‐year results of the TRUNC study

      Objectives To assess long‐term safety and efficacy of the Xposition S self‐apposing stent in the treatment of unprotected left main coronary artery (ULMCA) disease. Background Percutaneous intervention with stents has emerged as a valid alternative to surgical revascularization to treat ULMCA disease. Conventional balloon‐expandable stents face technical challenges, particularly in large left main diameter requiring extensive optimization and side branch access in distal bifurcation. Xposition S allows for optimal apposition, bridging diameter differences, and allows expansion to vessel diameters up to 6.0 mm. Methods Between June 2016 and July 2017, 205 patients were enrolled in this ...

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    4. Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: the CLIMA study

      Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: the CLIMA study

      Aims The CLIMA study, on the relationship between c oronary p l aque morphology of the left anter i or descending artery and twelve m onths clinic a l outcome, was designed to explore the predictive value of multiple high-risk plaque features in the same coronary lesion [minimum lumen area (MLA), fibrous cap thickness (FCT), lipid arc circumferential extension, and presence of optical coherence tomography (OCT)-defined macrophages] as detected by OCT. Composite of cardiac death and target segment myocardial infarction was the primary clinical endpoint. Methods and results From January 2013 to December 2016, 1003 patients undergoing OCT evaluation ...

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    5. Role of optical coherence tomography in identifying sub-optimal stent positioning and predicting major adverse cardiac events in a comparative study with angiography: a CLIO-OPCI II sub-study

      Role of optical coherence tomography in identifying sub-optimal stent positioning and predicting major adverse cardiac events in a comparative study with angiography: a CLIO-OPCI II sub-study

      Background Quantitative coronary angiography (QCA) is the gold standard for evaluating correct stenting, despite its limitation in recognizing features indicative of suboptimal deployment. This subanalysis of the CLI-OPCI II registry addressed the role of optical coherence tomography (OCT) to verify whether suboptimal OCT deployment occurs in the presence of an optimal angiographic result. Patients and methods We retrospectively analyzed 125 lesions in the 105 patients with major adverse cardiac events of the CLI-OPCI II . Every lesion was evaluated with OCT and angiography , including visual and QCA assessment. Optimal angiographic result was defined as residual stenosis of less than 30% at ...

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    6. Long-term consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study

      Long-term consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study

      Aims: The role of intra-procedural Optical Coherence Tomography (OCT) on long-term clinical outcome of percutaneous coronary interventions (PCI) remains undefined. Methods and results: In the context of the multicenter Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) registry, we compared long-term PCI outcome of 1211 patients from 13 independent OCT-experienced centers according to end-procedural OCT findings. OCT assessment revealed suboptimal stent implantation in 30.9% of lesions, with increased prevalence in patients experiencing device-oriented cardiovascular events (DoCE) (52.8% vs. 28.0%, p<0.001). At median follow-up of 833 (quartiles 415-1447) days, in-stent minimum lumen ...

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    7. Long-tem consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study

      Long-tem consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study

      Aims: The role of intra-procedural Optical Coherence Tomography (OCT) on long-term clinical outcome of percutaneous coronary interventions (PCI) remains undefined. Methods and results: In the context of the multicenter Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) registry, we compared long-term PCI outcome of 1211 patients from 13 independent OCT-experienced centers according to end-procedural OCT findings. OCT assessment revealed suboptimal stent implantation in 30.9% of lesions, with increased prevalence in patients experiencing device-oriented cardiovascular events (DoCE) (52.8% vs. 28.0%, p<0.001). At median follow-up of 833 (quartiles 415-1447) days, in-stent minimum lumen ...

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    8. 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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    9. Clinical Impact of OCT Findings During PCI: The CLI-OPCI II Study

      Clinical Impact of OCT Findings During PCI: The CLI-OPCI II Study

      Objectives The goal of this study was to assess the clinical impact of optical coherence tomography (OCT) findings during percutaneous coronary intervention (PCI). Background OCT provides unprecedented high-definition visualization of plaque/stent structures during PCI; however, the impact of OCT findings on outcome remains undefined. Methods In the context of the multicenter CLI-OPCI (Centro per la Lotta contro l’Infarto–Optimisation of Percutaneous Coronary Intervention) registry, we retrospectively analyzed patients undergoing end-procedural OCT assessment and compared the findings with clinical outcomes. Results A total of 1,002 lesions (832 patients) were assessed. Appropriate OCT assessment was obtained in 98.2 ...

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    10. 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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    11. 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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    12. Stent-related defects in patients presenting with stent thrombosis: differences at optical coherence tomography between subacute and late/very late thrombosis in the Mechanism Of Stent Thrombosis (MOST) study

      Stent-related defects in patients presenting with stent thrombosis: differences at optical coherence tomography between subacute and late/very late thrombosis in the Mechanism Of Stent Thrombosis (MOST) study

      Aims: Subacute, late, and very late stent thrombosis (ST) may occur after stent implantation, but they are characterised by different underlying pathophysiological mechanisms. We sought to appraise differences between subacute and late/very late ST at the thrombus site by optical coherence tomography (OCT). The Mechanism Of Stent Thrombosis (MOST) study was a prospective multicentre non-randomised registry which enrolled six subacute ST and six controls (subacute ST study), and 17 late/very late ST and 17 controls (late/very late ST study). Methods and results: Patients with subacute ST had a minimum stent area at the thrombus site of 2 ...

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    13. 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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    14. Angiography alone versus angiography plus optical coherence tomography to guide decision-making during percutaneous coronary intervention: the Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) study

      Angiography alone versus angiography plus optical coherence tomography to guide decision-making during percutaneous coronary intervention: the Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) study

      Aims: Angiographic guidance for percutaneous coronary intervention (PCI) has substantial limitations. The superior spatial resolution of optical coherence tomography (OCT) could translate into meaningful clinical benefits. We aimed to compare angiographic guidance alone versus angiographic plus OCT guidance for PCI. Methods and results: Patients undergoing PCI with angiographic plus OCT guidance (OCT group) were compared with matched patients undergoing PCI with angiographic only guidance (Angio group) within 30 days. The primary endpoint was the one-year rate of cardiac death or myocardial infarction (MI). A total of 670 patients were included, 335 in the OCT group and 335 in the Angio ...

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    15. A Self-Expandable Coronary Stent System to Treat Complex Coronary Stenosis Complicated by Poststenotic Aneurysm: An Optical Coherence Tomographic Evidence-Based Case Report

      A Self-Expandable Coronary Stent System to Treat Complex Coronary Stenosis Complicated by Poststenotic Aneurysm: An Optical Coherence Tomographic Evidence-Based Case Report
      Coronary artery aneurysm is a relatively uncommon disorder characterized by coronary artery dilatation with diameter that exceeds 50% of the normal adjacent segments with atherosclerosis being the most common etiology.1 Aneurysms can be adjacent to a stenosis in a post- or prestenotic location. Both anatomical conditions are technically challenging regarding their percutaneous treatment because of the large discrepancy in size between the stenotic and dilated segments, and require careful choice of the most appropriate technique and device. We have successfully treated a coronary stenosis complicated by a poststenotic aneurysm in a 60-year-old patient with atypical angina using a novel ...
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    16. Detection of very early stent healing after primary angioplasty: an optical coherence tomographic observational study of chromium cobaltum and first-generation drug-eluting stents. The DETECTIVE Study

      Detection of very early stent healing after primary angioplasty: an optical coherence tomographic observational study of chromium cobaltum and first-generation drug-eluting stents. The DETECTIVE Study

      Background Lack of stent coverage appears to be associated with stent thrombosis, a problem of particular concern in patients with ST elevation myocardial infarction (STEMI). Methods The DETECTIVE European Multicenter Registry was set up to address the early modality of stent healing in the setting of STEMI. The Registry compared, with an early optical coherence tomography (OCT) evaluation performed at 3–7 days, the patterns of coverage and apposition of the first generation of drug-eluting stents (DESs) and cobalt chromium non-drug-eluting stents (CCSs) that were deployed in culprit lesions and in non-culprit segments. The Registry included only patients with a ...

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    17. Head-to-head comparison of early vessel healing by optical coherence tomography after implantation of different stents in the same patient

      Head-to-head comparison of early vessel healing by optical coherence tomography after implantation of different stents in the same patient
      Objectives: Strut coverage represents the most powerful morphometric predictor of stent thrombosis and the best surrogate indicator of endothelization. The aim of this study was to get new insights on temporal patterns of vessel healing after stenting with different types of stent. Methods: Optical coherence tomography (OCT) was used to investigate the early strut coverage of lesions treated with CATANIA (CAT) stent, drug-eluting stent (DES) or cobalt-chromium bare metal stent (BMS). Two cohorts of 10 and 24 patients underwent OCT follow-up at 7-10 and 28-32 days after stenting, respectively. In each cohort, patients were randomly assigned to receive a CAT ...
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    18. Local Delivery Versus Intracoronary Infusion of Abciximab in Patients With Acute Coronary Syndromes

      Local Delivery Versus Intracoronary Infusion of Abciximab in Patients With Acute Coronary Syndromes
      Objectives We investigated whether local abciximab delivery to the site of intracoronary thrombus is more effective than intracoronary bolus infusion in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention and downstream clopidogrel administration. Background The intracoronary route of administration does not allow an optimal contact between the plaque components and abciximab, which is rapidly washed out by the coronary flow. Methods A total of 50 patients with ACS and a significant lesion in the culprit artery indicative of local thrombosis were randomly assigned to receive local intracoronary delivery of abciximab through a dedicated perfusion catheter or intracoronary infusion ...
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    19. Rapid Evaluation of Vessel HEaling After AngiopLasty (REVEAL) trial: rationale, objectives and design

      Background: Novel approaches to modify stents have been developed to address the limitations of bare-metal stents (BMS) and drug-eluting stent (DES), aiming for ideal features, such as decreased restenosis rates with decreased thrombogenicity and without the need for long-term dual antiplatelet therapy. Rationale: The Assessment of The LAtest Non-Thrombogenic Angioplasty Stent (ATLANTA) trial was the first-in-man study to show the safety and efficacy of the Polyzene-F coated CATANIA stent (CeloNova BioSciences, Newnan, Georgia, USA) as an alternative to both BMS and DES. The stent was found to be associated with a good clinical outcome with no vessel thrombosis and a ...
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    20. ClearWayRX System to reduce intracoronary thrombus in patients with acute coronary syndromes according to Optical Coherence Tomography after Abciximab Intracoronary Local infusion trial (COCTAIL): study rationale and design

      Background and objective: Prompt reperfusion with percutaneous coronary intervention (PCI) in the setting of acute coronary syndromes (ACS) improves clinical outcomes through salvage of myocardial tissue. Although use of intracoronary glycoprotein IIb/IIIa inhibition with PCI can result in improved rates of normal epicardial flow and myocardial perfusion, several unmet needs remain. The purpose of this trial is to evaluate the efficacy and safety of an intracoronary bolus of abciximab delivered using the ClearWayRX Therapeutic Perfusion Catheter followed by a dosing regimen of intravenous abciximab infusion after PCI, compared with intracoronary abciximab infusion, via the guiding catheter, followed by a ...
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    21. Rapid Evaluation of Vessel hEaling After angiopLasty (reveal) study: an optical coherence tomography comparative study versus bare and drug-eluting stent at 7 and 30 days

      The aim of the present randomized study was to address vessel healing at 7 and 30 days after Polyzene-F stent deployment by using optical coherence tomography (OCT) and performing a comparison with two distinct groups of drug-eluting stents [DES: sirolimus eluting stent (SES) and paclitaxel eluting stent (PES), and bare metal stents (BMS)].
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    22. Optical Coherence Tomographic Results at Six-Month Follow-Up Evaluation of the Catania Coronary Stent System With NanoThin Polyzene-F Surface Modification (from the Assessment of The LAtest Non-Thrombogenic Angioplasty Stent [atlanta] Trial)

      Drug-eluting stents were devised as an answer to restenosis, but research has shown that the eluting drug can interfere with the blood vessel's healing process, thus increasing the risk of stent thrombosis. A stent coated with the new proprietary polymer Polyzene-F, is a novel technical solution that promises to decrease in-stent restenosis and tackle the risk of thrombosis. Fifty-five patients were enrolled in the first clinical human study (ATLANTA registry), addressing the short-term follow-up results of the CATANIA stent with Polyzene-F. As a part of the study protocol, 15 patients were randomly assigned to optical coherence tomographic (OCT) examination ...
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    23. First-in-Man 1-Year Clinical Outcomes of the Catania Coronary Stent System With Nanothin Polyzene-F in De Novo Native Coronary Artery Lesions: The Atlanta (Assessment of The Latest Non-Thrombogenic Angioplasty stent) Trial

      Objectives: This study sought to assess safety and efficacy of implantation of the Catania Coronary Stent System with Nanothin Polyzene-F (CeloNova BioSciences, Newnan, Georgia) in human coronary arteries with clinical data and comprehensive intracoronary imaging. Background: Novel approaches to modify stents (e.g., bioactive agents, coatings) have been developed to address the limitations of bare-metal and drug-eluting stents (e.g., restenosis, target lesion revascularization [TLR], late thrombosis). Methods: This first-in-man study using the Catania stent is a prospective, single center, nonrandomized, single-arm study of 55 patients with symptomatic ischemic heart disease with de novo, obstructive lesions of native coronary arteries ...
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    1-23 of 23
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    Local Delivery Versus Intracoronary Infusion of Abciximab in Patients With Acute Coronary Syndromes Head-to-head comparison of early vessel healing by optical coherence tomography after implantation of different stents in the same patient Detection of very early stent healing after primary angioplasty: an optical coherence tomographic observational study of chromium cobaltum and first-generation drug-eluting stents. The DETECTIVE Study A Self-Expandable Coronary Stent System to Treat Complex Coronary Stenosis Complicated by Poststenotic Aneurysm: An Optical Coherence Tomographic Evidence-Based Case Report Angiography alone versus angiography plus optical coherence tomography to guide decision-making during percutaneous coronary intervention: the Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) study Correlation between optical coherence tomography, multifocal electroretinogram findings and visual acuity in diabetic macular edema Ciliary body length revisited by anterior segment optical coherence tomography: implications for safe access to the pars plana for intravitreal injections Evaluation of retinal vascular structure after epiretinal membrane surgery by optical coherence tomography angiography Bivalirudin vs. Heparin on Radial Artery Thrombosis during Transradial Coronary Intervention: An Optical Coherence Tomography Study Superficial Calcification With Rotund Shape Is Associated With Carotid Plaque Rupture: An Optical Coherence Tomography Study Longitudinal retinal layer changes in preclinical Alzheimer’s disease Clinical expert consensus document on rotational atherectomy from the Japanese association of cardiovascular intervention and therapeutics