1. Articles from Himanshu Rai

    1-11 of 11

    1. Stent Optimization Using Optical Coherence Tomography and Its Prognostic Implications After Percutaneous Coronary Intervention

      Explore Home | AHA/ASA Journals Cardiology
      Stent Optimization Using Optical Coherence Tomography and Its Prognostic Implications After Percutaneous Coronary Intervention

      Background Stent underexpansion has been known to be associated with worse outcomes. We sought to define optical coherence tomography assessed optimal stent expansion index (SEI), which associates with lower incidence of follow-up major adverse cardiac events (MACEs). Methods and Results A total of 315 patients (involving 370 lesions) who underwent optical coherence tomography-aided coronary stenting were retrospectively included. SEI was calculated separately for equal halves of each stented segment using minimum stent area/mean reference lumen area ([proximal reference area+distal reference area]/2). The smaller of the 2 was considered to be the SEI of that case. Follow-up MACE ...

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      Mentions: Technical University of Munich

    2. Optical coherence tomography tissue coverage and characterization at six months after implantation of bioresorbable scaffolds versus conventional everolimus eluting stents in the ISAR-Absorb MI trial

      Explore Home - Springer Cardiology
      Optical coherence tomography tissue coverage and characterization at six months after implantation of bioresorbable scaffolds versus conventional everolimus eluting stents in the ISAR-Absorb MI trial

      Purpose: Data regarding vessel healing by optical coherence tomography (OCT) after everolimus-eluting bioresorbable scaffolds (BRS) or everolimus-eluting metallic stent (EES) implantation in acute myocardial infarction (AMI) patients is scarce. We compared OCT findings after BRS or EES implantation in patients with AMI enrolled in a randomized trial. Methods: In ISAR-Absorb MI, AMI patients were randomized to BRS or EES implantation, with 6-8 month angiographic follow-up. This analysis includes patients who underwent OCT during surveillance angiography. Tissue characterization was done using grey-scale signal intensity analysis. The association between OCT findings and target lesion failure (TLF) at 2 years was investigated. Results ...

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      Mentions: Technical University of Munich

    3. Super High-Pressure Balloon versus Scoring Balloon to Prepare Severely Calcified Coronary Lesions: The ISAR-CALC Randomized Trial

      Explore eurointervention.pcronline.com Cardiology
      Super High-Pressure Balloon versus Scoring Balloon to Prepare Severely Calcified Coronary Lesions: The ISAR-CALC Randomized Trial

      Aims: The comparative efficacy of balloon-based techniques to prepare severely calcified coronary lesions before stenting remains poorly studied. We sought to compare stent expansion following preparation of severely calcified coronary lesions with either super high-pressure balloon or scoring balloon. Methods and results: In this randomized, open-label trial 74 patients with severely calcified coronary lesions were enrolled at 5 centers in Germany and Switzerland. After unsuccessful lesion preparation with standard non-compliant balloon (<30% reduction of baseline diameter stenosis), participants were randomized to pre-dilation with either super high-pressure balloon or scoring balloon before drug-eluting stent (DES) implantation. The primary endpoint of the ...

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    4. Differential immunological signature at the culprit site distinguishes acute coronary syndrome with intact from acute coronary syndrome with ruptured fibrous cap: results from the prospective translational OPTICO-ACS study

      Explore Journals Cardiology
      Differential immunological signature at the culprit site distinguishes acute coronary syndrome with intact from acute coronary syndrome with ruptured fibrous cap: results from the prospective translational OPTICO-ACS study

      Aims  Acute coronary syndromes with intact fibrous cap (IFC-ACS), i.e. caused by coronary plaque erosion, account for approximately one-third of ACS. However, the underlying pathophysiological mechanisms as compared with ACS caused by plaque rupture (RFC-ACS) remain largely undefined. The prospective translational OPTICO-ACS study programme investigates for the first time the microenvironment of ACS-causing culprit lesions (CL) with intact fibrous cap by molecular high-resolution intracoronary imaging and simultaneous local immunological phenotyping. Methods and results  The CL of 170 consecutive ACS patients were investigated by optical coherence tomography (OCT) and simultaneous immunophenotyping by flow cytometric analysis as well as by effector ...

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    5. Validation and application of OCT tissue attenuation index for the detection of neointimal foam cells

      Explore Home - Springer Cardiology
      Validation and application of OCT tissue attenuation index for the detection of neointimal foam cells

      Neointimal infiltration with foamy macrophages is recognized as an early and important sign of de-novo atherosclerosis after stent implantation (neoatherosclerosis). Recent histopathological studies have proven that automated quantification of signal attenuation using intravascular optical coherence tomography (OCT) imaging allows for sensitive identification of macrophages in native atherosclerotic disease. Whether this is true for neointimal foam cells in the setting of neoatherosclerosis remains unknown. Autopsy samples of stented coronary arteries (n = 13 cases) were evaluated by histology and OCT. After co-registration with histology, the attenuation rate of emitted laser light was measured in regions with and without neointimal foamy macrophages relative ...

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      Mentions: Technical University of Munich

    6. Mechanism of Drug-Eluting Absorbable Metal Scaffold Restenosis: A Serial Optical Coherence Tomography Study

      Explore Home | AHA/ASA Journals Cardiology
      Mechanism of Drug-Eluting Absorbable Metal Scaffold Restenosis: A Serial Optical Coherence Tomography Study

      Background: The pathomechanisms underlying restenosis of the bioabsorbable sirolimus-eluting metallic scaffold (Magmaris) remain unknown. Using serial optical coherence tomography, we investigated causes of restenosis, including the contribution of late scaffold recoil versus neointimal hyperplasia. Methods: Patients enrolled in BIOSOLVE-II undergoing serial angiography and optical coherence tomography (post-intervention and follow-up: 6 months and/or 1 year) were analyzed. Patients were divided into 2 groups according to angiographic in-scaffold late lumen loss (LLL) <0.5 or ≥0.5 mm. End points were late absolute scaffold recoil and neointimal hyperplasia area as assessed by optical coherence tomography. Results: Serial data were available for ...

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      Mentions: University of Bern

    7. Optical coherence tomography tissue coverage and characterization with grey-scale signal intensity analysis after bifurcation stenting with new generation bioabsorbable polymer drug-eluting stent

      Explore ScienceDirect Cardiology
      Optical coherence tomography tissue coverage and characterization with grey-scale signal intensity analysis after bifurcation stenting with new generation bioabsorbable polymer drug-eluting stent

      Purpose Bifurcation stenting is thought to be associated with delayed healing and a subsequent risk of stent failure. The aim of this study was to further evaluate healing of thin-strut bioabsorbable polymer everolimus-eluting stents (EES) post bifurcation stenting by optical coherence tomography (OCT) including grey-scale signal intensity (GSI) analysis. Methods Patients receiving bifurcation stenting with a planned two-stent approach using EES with OCT follow-up at 3–6 months post-stenting were included in this study. Morphometric analysis of contiguous cross-sections was performed at 1 mm longitudinal intervals within the stented segment. GSI analysis of neointimal regions of interest (ROI) overlying stent ...

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      Mentions: Technical University of Munich

    8. Qualitative and quantitative neointimal characterization by optical coherence tomography in patients presenting with in-stent restenosis

      Explore Home - Springer Cardiology
      Qualitative and quantitative neointimal characterization by optical coherence tomography in patients presenting with in-stent restenosis

      Aims To describe optical coherence tomography (OCT) findings in patients with in-stent restenosis (ISR) and determine predictors of neointimal patterns and neoatherosclerosis. Methods and results Patients undergoing OCT prior to PCI for ISR in three European centres were included. Analyses were performed in a core laboratory. Qualitative and quantitative [gray-scale signal intensity (GSI)] neointima analyses were performed on a per quadrant basis. A total of 107 patients were included. Predominantly homogeneous lesions included 4.5% (0.0–14.3) non-homogeneous quadrants, while predominantly non-homogeneous ones included 28.1% (20.3–37.5) homogeneous quadrants. Mean GSI values differed significantly between ...

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      Mentions: San Carlos University Hospital Technical University of Munich

    9. Optical coherence tomography revisited: imaging and imagination

      Explore eurointervention.org Cardiology
      Optical coherence tomography revisited: imaging and imagination

      Optical coherence tomography (OCT) was introduced into cardiovascular imaging in 1997 1 , emerging as a spin-off from an original scientific invention within the field of ophthalmology to enable imaging of retinal microstructures including arterioles and to facilitate detection of early degenerative changes of retinopathies. Consequently, OCT was praised as being a ground-breaking imaging technology which provides a far superior resolution as compared to the already established ultrasound-based imaging system (intravascular ultrasound [IVUS]). As such, it provides high-resolution tomographic images (10-20 µm), which enable recognition of atherosclerotic plaque patterns 2 , 3 , and can be used to identify high-risk lesions including their ...

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      Mentions: Technical University of Munich

    10. Very late scaffold thrombosis: insights from optical coherence tomography and histopathology

      Explore eurointervention.org Cardiology
      Very late scaffold thrombosis: insights from optical coherence tomography and histopathology

      A 79-year-old male patient had a 2.5×12 mm bioresorbable vascular scaffold (Absorb™ BVS; Abbott Vascular, Santa Clara, CA, USA) implanted in the setting of the RIBS VI study protocol for in-stent restenosis of a 3×9 mm bare metal stent (AVE S670; Medtronic, Minneapolis, MN, USA) in January 2015, at which time point the patient presented with stable angina and positive exercise stress test (index procedure). The Absorb BVS was implanted with predilatation at 20 atmospheres (atm) accompanied by post-dilatation with a non-compliant balloon (2.5×10 mm) at 26 atm. The patient was maintained on dual antiplatelet ...

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      Mentions: Technical University of Munich

    11. Very Late Scaffold Thrombosis: Insights from Optical Coherence Tomography and Histopathology

      Explore eurointervention.org Cardiology
      Very Late Scaffold Thrombosis: Insights from Optical Coherence Tomography and Histopathology

      Aims: to investigate and understand the mechanisms of very late scaffold thrombosis 13 months following implantation in the setting of bare metal in-stent restenosis. Methods and results: we collected consecutive angiography, optical coherence tomography and full autopsy evaluation in a 79-year old patients presenting with cardiogenic shock and undergoing rescue PCI after suffering very late scaffold thrombosis. Combined assessment of angiography, optical coherence tomography and histopathology revealed heterogenous vascular healing 13 months following implantation of a bioresorbable vascular scaffold with presence of scaffold struts fully integrated into neointimal tissue while others remained uncovered and malapposed. Furthermore, plaque rupture within the ...

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      Mentions: Technical University of Munich
    1-11 of 11
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    1. (8 articles) Technical University of Munich
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    Very Late Scaffold Thrombosis: Insights from Optical Coherence Tomography and Histopathology Very late scaffold thrombosis: insights from optical coherence tomography and histopathology Optical coherence tomography revisited: imaging and imagination Qualitative and quantitative neointimal characterization by optical coherence tomography in patients presenting with in-stent restenosis Optical coherence tomography tissue coverage and characterization with grey-scale signal intensity analysis after bifurcation stenting with new generation bioabsorbable polymer drug-eluting stent Mechanism of Drug-Eluting Absorbable Metal Scaffold Restenosis: A Serial Optical Coherence Tomography Study Validation and application of OCT tissue attenuation index for the detection of neointimal foam cells Differential immunological signature at the culprit site distinguishes acute coronary syndrome with intact from acute coronary syndrome with ruptured fibrous cap: results from the prospective translational OPTICO-ACS study Super High-Pressure Balloon versus Scoring Balloon to Prepare Severely Calcified Coronary Lesions: The ISAR-CALC Randomized Trial Optical coherence tomography tissue coverage and characterization at six months after implantation of bioresorbable scaffolds versus conventional everolimus eluting stents in the ISAR-Absorb MI trial Optical coherence tomography findings in patients with transfusion-dependent β-thalassemia Higher-order regression three-dimensional motion-compensation method for real-time optical coherence tomography volumetric imaging of the cornea