1. Articles from francesco prati

    25-48 of 89 « 1 2 3 4 »
    1. Comparison between intermediate and severe coronary stenoses and clinical outcomes of an OCT-guided PCI strategy

      Comparison between intermediate and severe coronary stenoses and clinical outcomes of an OCT-guided PCI strategy

      Aims: We compared optical coherence tomography (OCT) features of intermediate and severe coronary stenoses in patients with stable angina and acute coronary syndrome (ACS), and tested the clinical impact of an OCT-based strategy for treating intermediate stenoses. Methods: The study enrolled 135 consecutive patients with either ACS or stable angina and a single de-novo coronary stenosis. Patients were divided into two groups: intermediate stenosis defined as quantitative coronary angiography percentage narrowing less than 70%, or presence of angiographic vessel haziness and severe stenosis with percentage narrowing more than 70%. OCT was performed to assess features of plaque vulnerability and to ...

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      Mentions: Francesco Prati
    2. Serial optical coherence tomography imaging of ACS-causing culprit plaques

      Serial optical coherence tomography imaging of ACS-causing culprit plaques

      Aims: The aim of this study was to understand better the mechanisms of repair of plaque complications causing acute coronary syndrome. Methods and results: We used OCT in the acute phase and at follow-up (one to seven months) to investigate the plaque healing in 10 culprit plaques: five ruptured fibrous cap (RFC) and five intact fibrous cap (IFC) which were not treated with stent deployment and caused ST-segment elevation myocardial infarction (n=8) and non-STEMI (n=2). At follow-up OCT, the margins of the evacuated cavity in RFC plaques showed a smooth surface and a morphology similar to that of ...

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    3. Error propagation in the characterization of atheromatic plaque types based on imaging

      Error propagation in the characterization of atheromatic plaque types based on imaging

      Imaging systems transmit and acquire signals and are subject to errors including: error sources, signal variations or possible calibration errors. These errors are included in all imaging systems for atherosclerosis and are propagated to methodologies implemented for the segmentation and characterization of atherosclerotic plaque. In this paper, we present a study for the propagation of imaging errors and image segmentation errors in plaque characterization methods applied to 2D vascular images. More specifically, the maximum error that can be propagated to the plaque characterization results is estimated, assuming worst-case scenarios. The proposed error propagation methodology is validated using methods applied to ...

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    4. Optical Coherence Tomography for the Assessment of Coronary Artery Disease

      Optical Coherence Tomography for the Assessment of Coronary Artery Disease

      Angiography remains the gold standard for assessment of atherosclerotic impairment of coronary arteries and for guidance of coronary intervention. Angiography, as a main limitation, only depicts the luminal narrowings caused by coronary plaques, without showing the structures located beneath, such as the atherosclerotic lesions or the vessel wall. Intravascular imaging modalities are currently adopted to circumvent angiographic limitations. Optical coherence tomography (OCT)) is a novel imaging technique that uses infrared lights and can study atherosclerotic plaques and stented segments with extreme accuracy. Compared to intravascular ultrasound (IVUS) , OCT has a much higher resolution; this is at the expense of the ...

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      Mentions: Francesco Prati
    5. Impact of drug-eluting balloon (pre- or post-) dilation on neointima formation in de novo lesions treated by bare-metal stent: the IN-PACT CORO trial

      Impact of drug-eluting balloon (pre- or post-) dilation on neointima formation in de novo lesions treated by bare-metal stent: the IN-PACT CORO trial

      The efficacy of DEB in modifying the high restenosis risk associated with BMS implantation is doubtful. Optical coherence tomography (OCT) may allow precise assessment of neointimal formation after stent implantation. We performed a single-center, prospective, 1:2 randomized trial comparing BMS implantation alone (BMS group) vs. additional DEB (DEB group). DEB patients were further randomized 1:1 to DEB before stenting (pre-DEB group), or after stenting (post-DEB group). Primary endpoint was OCT-assessed neointimal hyperplasia (expressed both as mean in-stent neointimal area and as percentage obstruction of the mean stent area) at 6 months. Secondary endpoints were the percentage of uncovered ...

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      Mentions: Francesco Prati
    6. 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
    7. Optical coherence tomography features of angiographic complex and smooth lesions in acute coronary syndromes

      Optical coherence tomography features of angiographic complex and smooth lesions in acute coronary syndromes

      Plaque rupture (PR) and superimposed thrombosis have been shown as the most frequent underlying substrate in acute coronary syndromes (ACS). Coronary angiography is a luminogram not able to define in vivo features of the culprit plaques. The aim of the study was to use optical coherence tomography (OCT) to investigate the pathology underlying complex (CL) and non-complex angiographic lesions (NCL). We retrospectively enrolled 107 ACS patients admitted to our institution; 83 with non-ST elevation ACS (NSTE-ACS) and 24 with ST-elevation myocardial infarction. Coronary angiography was performed and culprit lesions were classified according to Ambrose criteria into NCL (n = 47) and ...

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    8. Plaque rupture and intact fibrous cap assessed by optical coherence tomography portend different outcomes in patients with acute coronary syndrome

      Plaque rupture and intact fibrous cap assessed by optical coherence tomography portend different outcomes in patients with acute coronary syndrome

      Aims Patients presenting with acute coronary syndrome (ACS) may have different plaque morphologies at the culprit lesion. In particular, plaque rupture (PR) has been shown as the more frequent culprit plaque morphology in ACS. However, its prognostic value is still unknown. In this study, we evaluated the prognostic value of PR, compared with intact fibrous cap (IFC), in patients with ACS. Methods and results We enrolled consecutive patients admitted to our Coronary Care Unit for ACS and undergoing coronary angiography followed by interpretable optical coherence tomography (OCT) imaging. Culprit lesion was classified as PR and IFC by OCT criteria. Prognosis ...

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      Mentions: Francesco Prati
    9. Comparison of Strut Coverage at Six Months by Optical Coherence Tomography with Everolimus Eluting Stent or Bare-Metal Stent Restenosis –vs- Stenosis of Non-Stented Atherosclerotic Narrowing (from the DESERT Study)

      Comparison of Strut Coverage at Six Months by Optical Coherence Tomography with Everolimus Eluting Stent or Bare-Metal Stent Restenosis –vs- Stenosis of Non-Stented Atherosclerotic Narrowing (from the DESERT Study)

      Incomplete struts coverage is a predictor of late stent thrombosis after drug eluting stent (DES) implantation in atherosclerotic lesions. The process of struts coverage in DES implanted for bare-metal stent (BMS) restenosis has never been described. Thirty-two patients with stable coronary artery disease were consecutively selected, 11 with BMS restenosis (group A) and 21 with de-novo atherosclerotic lesions (group B). All patients underwent everolimus eluting stent implantation; coronary angiography and optical coherence tomography (OCT) were performed at 6-month follow-up. Percentage difference in struts coverage between the two groups was the primary end-point. A total of 85773 struts (17891 in group ...

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    10. Optical Coherence Tomography Assessment and Quantification of Intracoronary Thrombus: Status and Perspectives

      Optical Coherence Tomography Assessment and Quantification of Intracoronary Thrombus: Status and Perspectives

      Coronary angiography is the “golden standard” imaging technique in interventional cardiology and it is still widely used to guide interventions. A major drawback of this technique, however, is that it is inaccurate in the evaluation and quantification of intracoronary thrombus burden, a critical prognosticator and predictor of intraprocedural complications in acute coronary syndromes. The introduction of optical coherence tomography (OCT) holds the promise of overcoming this important limitation, as near-infrared light is uniquely sensitive to hemoglobin, the pigment of red blood cells trapped in the thrombus. This narrative review will focus on the use of OCT for the assessment, evaluation ...

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      Mentions: Francesco Prati
    11. Identification and quantification of macrophage presence in coronary atherosclerotic plaques by optical coherence tomography

      Identification and quantification of macrophage presence in coronary atherosclerotic plaques by optical coherence tomography

      Aims Vulnerable plaques are characterized by a high macrophage content. We investigated the optical coherence tomography (OCT) capability of identifying coronary plaque macrophage presence using tissue property indexes. Methods and results Fifteen epicardial coronary arteries were imaged by OCT and subsequently analysed by histology. Correlating OCT–histological sections were identified and regions of interest (ROIs) were selected on both atherosclerotic plaques and normal appearing vessel tracts. OCT-derived tissue property indexes named normalized standard deviation (NSD), signal attenuation, and granulometry index were applied on ROIs to identify inflamed ROIs defined as a macrophage percentage >10 by histology. Forty-three paired samples (OCT ...

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      Mentions: Francesco Prati
    12. 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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    13. Dual role of circulating endothelial progenitor cells in stent struts endothelialisation and neointimal regrowth: a substudy of the IN-PACT Coro trial

      Dual role of circulating endothelial progenitor cells in stent struts endothelialisation and neointimal regrowth: a substudy of the IN-PACT Coro trial

      Background Endothelialisation is a crucial event after percutaneous coronary intervention (PCI). Endothelial progenitor cells (EPC) are bone marrow derived elements with reparative properties. We aimed to assess the relationship between circulating EPC levels and stent neointimal hyperplasia (NIH) using frequency domain optical coherence tomography (FD-OCT). Methods Patients undergoing elective PCI to native vessels and randomized to bare metal stent (BMS) alone versus BMS plus drug coated balloon (DCB) were included. At six months, angiographic follow-up and FD-OCT were performed to measure percentage neointimal hyperplasia volume obstruction (%NIHV), and percentage of uncovered stent struts (%US). Venous blood samples were obtained before ...

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      Mentions: Francesco Prati
    14. Matching human pathology is essential for validating OCT imaging to detect high-risk plaques

      Matching human pathology is essential for validating OCT imaging to detect high-risk plaques

      We thank Mark Brezinski for his Correspondence ( Capabilities, limitations, and misconceptions of using OCT to assess vulnerable plaques . Nat. Rev. Cardiol. doi:10.1038/nrcardio.2014.62-c1 ) 1 on our Review ( Clinical classification of plaque morphology in coronary disease . Nat. Rev. Cardiol. 11 , 379 – 389 ; 2014 ), 2 and for his comments and clarifications. We agree that the phenomenon

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    15. Invasive management without stents in selected acute coronary syndrome patients with a large thrombus burden: a prospective study of optical coherence tomography guided treatment decisions

      Invasive management without stents in selected acute coronary syndrome patients with a large thrombus burden: a prospective study of optical coherence tomography guided treatment decisions

      Aims: To assess whether a strategy of invasive management without stents in selected acute coronary syndrome (ACS) patients with a large thrombus burden (LTB) might be feasible and safe. Methods and results: We performed a prospective non-randomised observational cohort study of invasive treatment decisions guided by optical coherence tomography (OCT) in selected ACS patients with LTB. Among 852 ACS patients who had undergone invasive coronary angiography, 101 (11.8%) patients with large thrombus burden on initial angiography underwent thrombectomy to restore TIMI 3 flow without stenting. All of these patients then had repeat angiography with OCT (days 0-2 [Group 1 ...

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      Mentions: Francesco Prati
    16. 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
    17. Mechanism of luminal patency of the self-expanding sideguard sidebranch stent: Evaluation by intravascular ultrasound and optical coherence tomography

      Mechanism of luminal patency of the self-expanding sideguard sidebranch stent: Evaluation by intravascular ultrasound and optical coherence tomography

      Background : The Cappella Sideguard (CS) sidebranch stent is a self-expanding, thin-strut, nitinol device with anatomic flaring at the sidebranch ostium designed to treat bifurcation lesions. Objective : To evaluate the mechanism of long-term lumen patency of the novel, self-expanding CS sidebranch stent compared to a balloon-expandable stent in the main vessel. Methods : We performed intravascular ultrasound (IVUS) post-intervention and at follow-up in 24 CS stents and in 28 balloon-expandable drug-eluting stents deployed in the corresponding main vessel. Thirteen patients also had optical coherence tomography (OCT) at follow-up to evaluate neointimal hyperplasia and strut coverage. Results : CS stent area at the sidebranch ...

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    18. Reproducibility of the Carpet View system: a novel technical solution for display and off line analysis of OCT images

      Reproducibility of the Carpet View system: a novel technical solution for display and off line analysis of OCT images

      The optical coherence tomography (OCT) evaluation of the stent anatomy requires the inspection of sequential cross section (CS). However stent coils cannot be appreciated in the conventional format as the OCT CS simply display stent struts, that are poorly representative of the stent architecture. The aim of the present study was to validate a new software ( Carpet View ), which unfolds the stented segment, reconstructing it as an open structure and displaying the stent meshwork. 21 patients were studied with frequency domain OCT after the deployment of different stents: seven bio-absorbable scaffolds (Dream), seven bare metal stent (Vision/Multilink8), seven drug ...

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      Mentions: Francesco Prati
    19. 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
    20. Clinical classification of plaque morphology in coronary disease

      Clinical classification of plaque morphology in coronary disease

      In published post-mortem pathological studies, more than two-thirds of acute coronary events are associated with the rupture of lipid-rich, voluminous, and outwardly remodelled plaques covered by attenuated and inflamed fibrous caps in the proximal part of coronary arteries. Superficial erosion of the plaques is responsible for most of the remaining events; the eroded plaques usually do not demonstrate much lipid burden, do not have thin fibrous caps, are not positively remodelled, and are not critically occlusive. Both noninvasive and invasive imaging studies have been performed to clinically define the plaque characteristics in acute coronary syndromes in an attempt to identify ...

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    21. Methodology for fully automated segmentation and plaque characterization in intracoronary optical coherence tomography images

      Methodology for fully automated segmentation and plaque characterization in intracoronary optical coherence tomography images

      Optical coherence tomography (OCT) is a light-based intracoronary imaging modality that provides high-resolution cross-sectional images of the luminal and plaque morphology. Currently, the segmentation of OCT images and identification of the composition of plaque are mainly performed manually by expert observers. However, this process is laborious and time consuming and its accuracy relies on the expertise of the observer. To address these limitations, we present a methodology that is able to process the OCT data in a fully automated fashion. The proposed methodology is able to detect the lumen borders in the OCT frames, identify the plaque region, and detect ...

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    22. 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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    23. Comprehensive overview of definitions for optical coherence tomography-based plaque and stent analyses

      Comprehensive overview of definitions for optical coherence tomography-based plaque and stent analyses

      Optical coherence tomography (OCT) is the current state-of-the-art intracoronary imaging modality that allows visualization of detailed morphological characteristics of both atherosclerotic plaque and stent. So far, three expert review documents have been released for standardization of OCT image analysis. In the real world, a variety of definitions are being used by different groups and by different core laboratories to analyze OCT findings because of different clinical/procedural contexts in which OCT research has been carried out. This comprehensive overview is aimed to summarize different applicable definitions used by different research groups in plaque and stent analysis using OCT. In addition ...

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    24. Serial Observation of Drug-Eluting Absorbable Metal Scaffold Multi-Imaging Modality Assessment

      Serial Observation of Drug-Eluting Absorbable Metal Scaffold Multi-Imaging Modality Assessment

      Background— The drug-eluting absorbable metal scaffold has demonstrated feasibility, safety, and promising clinical and angiographic outcomes at 12 months in human coronary arteries. This study aimed to evaluate the degradation rate and long-term vascular responses to drug-eluting absorbable metal scaffold. Methods and Results— BIOSOLVE-I was a multicenter, single-arm, first-in-man trial assessing the safety and performance of drug-eluting absorbable metal scaffold in 46 patients with coronary artery disease. Patients who underwent serial invasive imaging, such as quantitative coronary angiography, intravascular ultrasound, and optical coherence tomography, at 6 and 12 months were included in this study. From postimplantation to follow-up, arterial curvature ...

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