1. Articles from mario albertucci

    1-21 of 21
    1. 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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    2. Flying through the coronary easily

      Flying through the coronary easily

      Optical coherence tomography (OCT) has been waived as a breakthrough in coronary imaging. With its superb resolution in the range of 10–20 µm, OCT has proven to be a valuable technique in guiding coronary interventions [1–3]. Apart from this, among other intracoronary technical solutions, OCT certainly has the greatest potential in studying atherosclerosis in vivo, and identifying subjects with vulnerable lesions which leave patients prone to developing hard coronary events. Among the steps that enabled OCT to gain such credibility, the adoption of the non-occlusive techniques to acquire images has certainly played an instrumental role [4, 5]. Subsequently ...

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      Mentions: Francesco Prati
    3. 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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    4. New techniques of intravessel imaging in coronary atherosclerosis

      New techniques of intravessel imaging in coronary atherosclerosis

      Intravascular imaging modalities are currently adopted to circumvent angiographic limitations. The present overview is aimed at describing the principal techniques used by an interventional cardiologist to assess both coronary atherosclerotic plaques and stent deployment results. Optical coherence tomography (OCT), intravascular ultrasound (IVUS), and near-infrared spectroscopy are currently available to address these issues. These techniques are characterized by specific advantages and limitations, making each of those applicable for specific purposes. Offline software programmes have been developed to further characterize plaque tissue, highlighting the macrophage presence or unfold coronary stent in a three-dimensional view by a carpet view. Although IVUS and OCT ...

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      Mentions: Francesco Prati
    5. Suboptimal stent deployment is associated with subacute stent thrombosis: Optical Coherence Tomography insights from a multicenter matched study. From the CLI Foundation investigators: the CLI-THRO study

      Suboptimal stent deployment is associated with subacute stent thrombosis: Optical Coherence Tomography insights from a multicenter matched study. From the CLI Foundation investigators: the CLI-THRO study

      Background Acute or sub-acute stent thrombosis (ST) is a well described complication usually causing acute coronary syndromes (ACS) and in the worst case scenario sudden cardiac death. In this study we aimed at exploring the potential role of optical coherence tomography (OCT) in the understanding of the mechanism of ST. Methods Twenty-one consecutive patients, after ACS due to a definite sub-acute ST, were assessed with OCT and matched 1:2 with 42 patients undergoing OCT for scheduled follow-up. OCT assessment was focused on features indicative of non-optimal stent deployment: under-expansion, malapposition, edge dissection and reference lumen narrowing. Results OCT revealed ...

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    6. Quantification of manual thrombus removal in patients with acute coronary syndromes: a study exploiting serial frequency domain-optical coherence tomography

      Quantification of manual thrombus removal in patients with acute coronary syndromes: a study exploiting serial frequency domain-optical coherence tomography

      Aims: Thrombus aspiration is useful in improving myocardial reperfusion in comparison to conventional percutaneous coronary intervention in patients with acute myocardial infarction. Nonetheless, assessment of thrombus aspiration efficacy is lacking. Aim of this study was to quantify by frequency domain optical coherence tomography (OCT) the amount of thrombus removal in patients with acute coronary syndromes undergoing manual thrombus aspiration, correlating it with the actual size of the retrieved material. Methods: Twenty-five consecutive patients with acute coronary syndrome were enrolled. OCT assessment of thrombotic lesions was performed before and after thrombus aspiration and repeated after stent deployment. OCT thrombus assessment was ...

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      Mentions: Francesco Prati
    7. Searching Between the Plaques Layers to Understand the Past and Predict the Future ∗

      Searching Between the Plaques Layers to Understand the Past and Predict the Future ∗

      The layers of the earth and the fossils hidden within the rocks reveal to the geologist the secrets of the past, sending him back for a trip millions of years long. Pathologists and nowadays cardiologists try to do the same, interrogating the vessel wall and atherosclerotic plaques, looking for the missing pieces of the complex puzzle that determine the pathophysiology of myocardial infarction and sudden death. Tian et al. 1 should be congratulated for their effort to collect new insights on the “in vivo” anatomy of coronary lesions, using a complex approach combining intravascular ultrasound and optical coherence tomography (OCT ...

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      Mentions: Francesco Prati
    8. Intravascular Ultrasound Versus Optical Coherence Tomography Guidance

      Intravascular Ultrasound Versus Optical Coherence Tomography Guidance

      IVUS Versus Angiography Guidance for DES PlacementFirst Author/Study (Ref. #), Year (Study)nStudy PopulationStudy DesignIVUS Criteria for Optimal ExpansionCriteria FulfilledMain Outcome MeasuresResultsRoy et al. (2), 20081,768De novo native coronary lesions, restenotic and SVG lesionsSingle-center registryDiscretion of the treating operator—Definite stent thrombosis and MACE at 12 monthsIVUS better (stent thrombosis and TLR)Classen et al. (3), 2011 (MATRIX)1,504 (SES)De novo native coronary and restenotic lesionsMulticenter registryDiscretion of the treating operator—30-day, 1-yr, and 2-yr rates of death/MI, MACE, and stent thrombosisIVUS betterPark et al. (4), 2009682Left main lesionsMulticenter registryDiscretion of the treating operator3-yr mortalityIVUS betterChieffo ...

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    9. Randomized trial of standard versus ClearWay-infused abciximab and thrombectomy in myocardial infarction: rationale and design of the COCTAIL II study

      Randomized trial of standard versus ClearWay-infused abciximab and thrombectomy in myocardial infarction: rationale and design of the COCTAIL II study

      Background: Patients with ST-elevation myocardial infarction (STEMI) are at substantial risk of suboptimal procedural results and late adverse events. Angiography and optical coherence tomography (OCT) studies have identified residual coronary thrombus and microcirculatory injury as potential culprits for these adverse outcomes. We hypothesized that coronary thrombectomy and local infusion of glycoprotein IIb/IIIa inhibitors by means of a dedicated infusion device can synergistically improve results of percutaneous coronary intervention (PCI) for STEMI, as appraised by OCT. Methods: A total of 128 patients with STEMI will be randomized, to one of the following: abciximab infusion with the ClearWay coronary catheter (C ...

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    10. Association Between Proximal Stent Edge Positioning on Atherosclerotic Plaques Containing Lipid Pools and Postprocedural Myocardial Infarction (from the CLI-POOL Study)

      Association Between Proximal Stent Edge Positioning on Atherosclerotic Plaques Containing Lipid Pools and Postprocedural Myocardial Infarction (from the CLI-POOL Study)

      Postprocedural myocardial infarction is an ominous complication of percutaneous coronary intervention (PCI). Despite several patient, lesion, and procedural factors that may affect its occurrence and severity, it is unclear if implanting a stent edge on a coronary lipid pool, as appraised by optical coherence tomography (OCT), adversely affects outcomes. The aim of this study was to assess the association between postprocedural myocardial infarction and the implantation of a stent edge on a lipid pool, as assessed by OCT. A database was screened for patients without ongoing myocardial infarctions; who underwent PCI with stenting for single, native, de novo lesions; without ...

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    11. 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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    12. Optical Coherence Tomography (OCT) (Book Chapter)

      Optical Coherence Tomography (OCT) (Book Chapter)

      OCT is a new promising imaging modality allowing better definition of the surface morphology of coronary lesions and largely improved assessment of the immediate and late outcomes of coronary interventions. Further studies are needed to define the role of this atraumatic high-precision technology in clinical practice and particularly in guidance and follow-up of coronary interventions.

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      Mentions: Francesco Prati
    13. Reproducibility of Coronary Optical Coherence Tomography for Lumen and Length Measurements in Humans (The CLI-VAR [Centro per la Lotta contro l'Infarto-VARiability] Study)

      Reproducibility of Coronary Optical Coherence Tomography for Lumen and Length Measurements in Humans (The CLI-VAR [Centro per la Lotta contro l'Infarto-VARiability] Study)

      Frequency-domain optical coherence tomography (FD-OCT) is becoming a useful diagnostic tool for coronary imaging for quantitative coronary analysis. Second-generation FD-OCT produces detailed coronary lumen images. However, the reproducibility of coronary measurements using FD-OCT in humans has not been thoroughly explored. Our goal was to determine the intraobserver, interobserver, and interpullback reproducibility of the in vivo FD-OCT measurements of the lumen area and/or lesion length. Twenty-five patients undergoing coronary angioplasty were included. In all subjects, FD-OCT pullbacks (20 mm/s) were acquired twice from the same coronary segment different from the target lesion, at an interval of 5 minutes, with ...

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    14. Reproducibility of Coronary Optical Coherence Tomography for Lumen and Length Measurements in Humans (The CLI-VAR [Centro per la Lotta contro l'Infarto-VARiability] Study)

      Reproducibility of Coronary Optical Coherence Tomography for Lumen and Length Measurements in Humans (The CLI-VAR [Centro per la Lotta contro l'Infarto-VARiability] Study)

      Frequency-domain optical coherence tomography (FD-OCT) is becoming a useful diagnostic tool for coronary imaging for quantitative coronary analysis. Second-generation FD-OCT produces detailed coronary lumen images. However, the reproducibility of coronary measurements using FD-OCT in humans has not been thoroughly explored. Our goal was to determine the intraobserver, interobserver, and interpullback reproducibility of the in vivo FD-OCT measurements of the lumen area and/or lesion length. Twenty-five patients undergoing coronary angioplasty were included. In all subjects, FD-OCT pullbacks (20 mm/s) were acquired twice from the same coronary segment different from the target lesion, at an interval of 5 minutes, with ...

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    15. Early vessel healing of the Avantgarde cobalt-chromium coronary stent: the ON-GARDE OCT study

      Early vessel healing of the Avantgarde cobalt-chromium coronary stent: the ON-GARDE OCT study

      Introduction: Uncoverage and malapposition of stent struts at optical coherence tomography (OCT) have been associated with stent thrombosis. Stent uncoverage by OCT is being used as a surrogate to address the propensity of a stent to develop thrombosis. We aimed to appraise early vessel healing in patients with ST-elevation myocardial infarction (STEMI) treated with the novel Avantgarde stent. Methods: Patients with STEMI and multivessel disease were enrolled. The stent deployed on the infarct-related artery was imaged by frequency domain-OCT during deferred intervention (4-7 days apart). The primary end-point was the percentage of uncovered struts. Secondary end-points were the percentage of ...

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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. Safety and feasibility of frequency domain optical coherence tomography to guide decision making in percutaneous coronary intervention

      Safety and feasibility of frequency domain optical coherence tomography to guide decision making in percutaneous coronary intervention
      The purpose of this single centre registry is to assess safety and feasibility of the frequency domain optical coherence tomography (FD-OCT) system during coronary interventions. Ninety patients with unstable or stable coronary artery disease were included in this study
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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. Comparison of optical coherence tomography and intravascular ultrasound for the assessment of in-stent tissue coverage after stent implantation

      Comparison of optical coherence tomography and intravascular ultrasound for the assessment of in-stent tissue coverage after stent implantation
      At present there exists no direct comparative data for the detection of in-stent tissue coverage as assessed by intravascular ultrasound (IVUS) and optical coherence tomography (OCT) in clinical settings. To explore this subject, we investigated the correlation between the IVUS and OCT measurements derived from a contemporary population.
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    20. From Bench to Bedside - A Novel Technique of Acquiring OCT Images

      Background Optical coherence tomography (OCT), a high resolution intravascular imaging technique, requires blood displacement for reliable image acquisition and the current technique uses a soft occlusion balloon plus saline injection in the coronary artery. A non-occlusive technique based on manual infusion of a viscous iso-osmolar solution has been developed and tested and validated through a 2-phase study. Methods and Results OCT assessment was performed with the M2 LightLab OCT (LightLab Imaging, Westford, MA, USA) image-wire in 3 swine by infusing 30 ml of each of 3 solutions differing in viscosity, osmolarity and electrolytic composition (A: iodixanol 320 and Lactated Ringer ...
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    21. Safety and feasibility of a new non-occlusive technique for facilitated intracoronary optical coherence tomography (OCT) acquisition in various clinical and anatomical scenarios

      Safety and feasibility of a new non-occlusive technique for facilitated intracoronary optical coherence tomography (OCT) acquisition in various clinical and anatomical scenarios
      To facilitate OCT images acquisition we developed a novel, simplified, non-occulsive technique based on manual infusion of a viscous isosmolar solution. The aims of the present study was to address the safety and efficacy of non-occulsive OCT images acquisition modality in a patient population with comples coronary lesions, and in various clinical sceanarios.
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    1-21 of 21
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    Safety and feasibility of a new non-occlusive technique for facilitated intracoronary optical coherence tomography (OCT) acquisition in various clinical and anatomical scenarios Comparison of optical coherence tomography and intravascular ultrasound for the assessment of in-stent tissue coverage after stent implantation Local Delivery Versus Intracoronary Infusion of Abciximab in Patients With Acute Coronary Syndromes Safety and feasibility of frequency domain optical coherence tomography to guide decision making in percutaneous coronary intervention 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 Early vessel healing of the Avantgarde cobalt-chromium coronary stent: the ON-GARDE OCT study Reproducibility of Coronary Optical Coherence Tomography for Lumen and Length Measurements in Humans (The CLI-VAR [Centro per la Lotta contro l'Infarto-VARiability] 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 Intravascular Ultrasound Versus Optical Coherence Tomography Guidance The multi-spectral signal properties of multiple reference optical coherence tomography (Thesis) Calibration-free time-stretch optical coherence tomography with large imaging depth Does Projection Artifact Removal Improve Visualization of Images in Optical Coherence Tomography Angiography?