1. Articles from Roxana Mehran

    1-13 of 13
    1. Side branch fractional flow reserve after provisional stenting of calcified bifurcation lesions: The ORBID‐FFR study

      Side branch fractional flow reserve after provisional stenting of calcified bifurcation lesions: The ORBID‐FFR study

      Objectives We examined the incidence of side branch (SB) compromise after provisional stenting of calcified bifurcation lesions treated with rotational atherectomy (RA) or cutting balloon angioplasty (CBA) and the utility of optical coherence tomography (OCT) to detect functionally significant SB stenoses. Background The comparative impact of RA versus CBA on SB compromise and functional significance remains poorly characterized. Methods Seventy‐one consecutive patients with 71 calcified bifurcation lesions with angiographically intermediate SB stenoses were randomized to RA (n = 35) or CBA (n = 36). The primary endpoint was SB compromise defined as SB diameter stenosis ≥70%, SB dissection or thrombolysis in ...

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    2. Nonculprit Lesion Plaque Morphology in Patients With ST-Segment–Elevation Myocardial Infarction: Results From the COMPLETE Trial Optical Coherence Tomography Substudys

      Nonculprit Lesion Plaque Morphology in Patients With ST-Segment–Elevation Myocardial Infarction: Results From the COMPLETE Trial Optical Coherence Tomography Substudys

      Background: Complete revascularization with routine percutaneous coronary intervention of nonculprit lesions after primary percutaneous coronary intervention improves outcomes in ST-segment–elevation myocardial infarction. Whether this benefit is associated with nonculprit lesion vulnerability is unknown. Methods: In a prospective substudy of the COMPLETEs trial (Complete vs Culprit-Only Revascularization to Treat Multi-Vessel Disease After Early PCI for STEMI), we performed optical coherence tomography of at least 2 coronary arteries before nonculprit lesion percutaneous coronary intervention in 93 patients with ST-segment–elevation myocardial infarction and multivessel disease; and the ST-segment–elevation myocardial infarction culprit vessel if there was unstented segment amenable to imaging ...

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    3. Procedural and one-year outcomes of patients treated with orbital and rotational atherectomy with mechanistic insights from optical coherence tomography

      Procedural and one-year outcomes of patients treated with orbital and rotational atherectomy with mechanistic insights from optical coherence tomography

      Aims: We sought to evaluate procedural complications and one-year clinical outcomes for patients who underwent percutaneous coronary intervention (PCI) with orbital (OA) and rotational atherectomy (RA). Methods and results: From a total of 13,467 patients who underwent PCI in our hospital between January 2013 and June 2016, 1,149 consecutive patients were treated with atherectomy for moderately-severely calcified lesions (184 with OA, 965 with RA). Procedural complications were similarly observed in the two groups except for higher dissection and perforation rates with OA. Major adverse cardiovascular events (MACE) were defined as the composite of death, myocardial infarction or target ...

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    4. Procedural and One-Year Outcomes of Patients Treated with Orbital and Rotational Atherectomy with Mechanistic Insights from Optical Coherence Tomography

      Procedural and One-Year Outcomes of Patients Treated with Orbital and Rotational Atherectomy with Mechanistic Insights from Optical Coherence Tomography

      Aims: We sought to evaluate procedural complications and 1-year clinical outcomes for patients who underwent percutaneous coronary intervention (PCI) with orbital (OA) and rotational atherectomy (RA). Methods and results: From a total of 13,467 patients who underwent PCI in our hospital between January 2013 and June 2016, 1149 consecutive patients were treated with atherectomy for moderately-severely calcified lesions (184 with OA, 965 with RA). Procedural complications were similarly observed in 2 groups except for higher dissection and perforation rates with OA. Major adverse cardiovascular events (MACE) were defined as the composite of death, myocardial infarction and target lesion revascularization ...

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    5. Differences in optical coherence tomography findings between an endothelial progenitor cell-capture sirolimuseluting stent and a paclitaxel-eluting stent: insights from the OCT substudy of the REMEDEE first-in-man trial

      Differences in optical coherence tomography findings between an endothelial progenitor cell-capture sirolimuseluting stent and a paclitaxel-eluting stent: insights from the OCT substudy of the REMEDEE first-in-man trial

      Aims: First-generation DES are associated with delayed endothelial coverage and poor stent healing, increasing the risk of late stent thrombosis, late catch-up and neoatherosclerosis. This observational REMEDEE substudy aimed to examine differences in vascular healing by OCT between the EPC-capture sirolimus-eluting COMBO stent and a paclitaxel-eluting stent (TAXUS). Methods and results: A subset of 33 patients (COMBO=23, TAXUS=10) with de novo coronary artery lesions in the REMEDEE study had OCT examination at the nine-month angiographic follow-up. Betweenstent differences of OCT strut coverage, apposition, and neointimal morphology were compared by a core laboratory. Four thousand eight hundred and seventy-five ...

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    6. Evaluation of Early Healing Profile and Neointimal Transformation Over 24 Months Using Longitudinal Sequential Optical Coherence Tomography Assessments and 3-Year Clinical Results of the New Dual-Therapy Endothelial Progenitor Cell Capturing Sirolimus-Elu

      Evaluation of Early Healing Profile and Neointimal Transformation Over 24 Months Using Longitudinal Sequential Optical Coherence Tomography Assessments and 3-Year Clinical Results of the New Dual-Therapy Endothelial Progenitor Cell Capturing Sirolimus-Elu

      Background— Current monotherapy drug-eluting stents are associated with impaired healing, neoatherosclerosis, and late stent thrombosis. The healing profile and neointimal transformation of the first dual-therapy endothelial progenitor cell–capturing sirolimus-eluting stent are unknown. Methods and Results— In this prospective, single-center study, 61 patients treated with the Combo stent had optical coherence tomography at baseline, early follow-up (4 monthly groups in a 1:2:2:1 ratio from 2 to 5 months), 9 months, and 24 months. Optical coherence tomography early strut coverage increased from 77.1% to 92.5% to 92.7% to 94.9% between 2 and 5 months ...

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    7. Plaque morphology predictors of side branch occlusion after provisional stenting in coronary bifurcation lesion: Results of optical coherence tomography bifurcation study (ORBID)

      Plaque morphology predictors of side branch occlusion after provisional stenting in coronary bifurcation lesion: Results of optical coherence tomography bifurcation study (ORBID)

      Objectives The aim of this study was to identify the predictors of side branch (SB) ostial stenosis developed after provisional stenting of the main vessel (MV) using optical coherence tomography (OCT). Background Provisional stenting remains the main approach to treatment of bifurcation lesions; however, it may result in the narrowing of SB ostium. There is little information about underlying plaque morphology of the MV lesion and its potential impact on the SB after provisional stenting. Methods Patients with stable coronary disease with angiographic MV lesion not involving SB were included in a prospective single center study. The primary outcome was ...

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    8. Stable coronary artery disease: revascularisation and invasive strategies

      Stable coronary artery disease: revascularisation and invasive strategies

      Stable coronary artery disease is the most common clinical manifestation of ischaemic heart disease and a leading cause of mortality worldwide. Myocardial revascularisation is a mainstay in the treatment of symptomatic patients or those with ischaemia-producing coronary lesions, and reduces ischaemia to a greater extent than medical treatment. Documentation of ischaemia and plaque burden is fundamental in the risk stratification of patients with stable coronary artery disease, and several invasive and non-invasive techniques are available (eg, fractional flow reserve or intravascular ultrasound) or being validated (eg, instantaneous wave-free ratio and optical coherence tomography). The use of new-generation drug-eluting stents and ...

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    9. A Prospective Natural-History Study of Coronary Atherosclerosis

      A Prospective Natural-History Study of Coronary Atherosclerosis
      Background Atherosclerotic plaques that lead to acute coronary syndromes often occur at sites of angiographically mild coronary-artery stenosis. Lesion-related risk factors for such events are poorly understood. Full Text of Background... Methods In a prospective study, 697 patients with acute coronary syndromes underwent three-vessel coronary angiography and gray-scale and radiofrequency intravascular ultrasonographic imaging after percutaneous coronary intervention. Subsequent major adverse cardiovascular events (death from cardiac causes, cardiac arrest, myocardial infarction, or rehospitalization due to unstable or progressive angina) were adjudicated to be related to either originally treated (culprit) lesions or untreated (nonculprit) lesions. The median follow-up period was 3.4 ...
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    10. Strut Coverage and Late Malapposition With Paclitaxel-Eluting Stents Compared With Bare Metal Stents in Acute Myocardial Infarction: OCT Substudy of the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI)

      Strut Coverage and Late Malapposition With Paclitaxel-Eluting Stents Compared With Bare Metal Stents in Acute Myocardial Infarction: OCT Substudy of the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI)
      Background— The safety of drug-eluting stents in ST-segment elevation myocardial infarction (STEMI) continues to be debated. Pathological studies have demonstrated an association between uncovered struts and subsequent stent thrombosis. Optical coherence tomography can detect stent strut coverage in vivo on a micron-scale level. We therefore used optical coherence tomography to examine strut coverage in patients with STEMI treated with paclitaxel-eluting stents (PES) and bare metal stents (BMS). Methods and Results— In the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, patients with STEMI were randomized 3:1 to PES or BMS implantation. In a formal substudy ...
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    11. Unhealed Plaque Ruptures After Stenting in Acute Myocardial Infarction Assessed by Intracoronary Optical Coherence Tomography: Incidence, Predictors, and Clinical Implication

      Backgrounds: Non healing after stenting a ruptured thin capped fibroatheroma in acute myocardial infarction (AMI) has been suggested to be a possible cause of late stent thrombosis. Optical coherence tomography (OCT) provides detailed information of ruptured plaques and stent strut coverage. We used OCT to assess the incidence, predictors, and implications of residual plaque rupture after stenting in AMI. Methods: The HORIZONS-AMI trial was a prospective, multicenter, dual arm factorial trial in which pts with AMI were randomized to different antithrombotic regimens and paclitaxel-eluting TAXUS stents vs. bare metal EXPRESS stents (3:1). Clinical follow-up was performed at 12 months ...
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    12. 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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    1-13 of 13
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    1. (5 articles) Cardiovascular Research Foundation
    2. (4 articles) Gary S. Mintz
    3. (3 articles) Columbia University
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    Strut Coverage and Late Malapposition With Paclitaxel-Eluting Stents Compared With Bare Metal Stents in Acute Myocardial Infarction: OCT Substudy of the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) A Prospective Natural-History Study of Coronary Atherosclerosis Expert consensus statement on the use of fractional flow reserve, intravascular ultrasound, and optical coherence tomography a consensus statement of the society of cardiovascular angiography and interventions Stable coronary artery disease: revascularisation and invasive strategies Plaque morphology predictors of side branch occlusion after provisional stenting in coronary bifurcation lesion: Results of optical coherence tomography bifurcation study (ORBID) Evaluation of Early Healing Profile and Neointimal Transformation Over 24 Months Using Longitudinal Sequential Optical Coherence Tomography Assessments and 3-Year Clinical Results of the New Dual-Therapy Endothelial Progenitor Cell Capturing Sirolimus-Elu Differences in optical coherence tomography findings between an endothelial progenitor cell-capture sirolimuseluting stent and a paclitaxel-eluting stent: insights from the OCT substudy of the REMEDEE first-in-man trial Procedural and One-Year Outcomes of Patients Treated with Orbital and Rotational Atherectomy with Mechanistic Insights from Optical Coherence Tomography Line-field confocal optical coherence tomography-Practical applications in dermatology and comparison with established imaging methods Optical coherence tomography detection of changes in inner retinal and choroidal thicknesses in patients with early retinitis pigmentosa Feasibility of combined optical coherence tomography and autofluorescence imaging for visualization of needle biopsy placement Characterization of microvascular tortuosity in retinal vein occlusion utilizing optical coherence tomography angiography