1. Articles from francesco prati

    49-72 of 89 « 1 2 3 4 »
    1. 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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    2. Fully automated calcium detection using optical coherence tomography

      Fully automated calcium detection using optical coherence tomography

      Optical Coherence Tomography (OCT) is a new invasive technology for performing high-resolution cross-sectional imaging of the coronary arteries. In OCT images only Calcified plaque (CA) components can be accurately depicted as light penetrates hard tissue. In this work we present an automated method for detecting CA in OCT images. The method is fully automated as no user intervention is needed and includes three steps. In the first step the region between the lumen and the maximum penetration depth of OCT from the lumen border is determined. In the second step the region is classified into 3 clusters using the K-means ...

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    3. Optical coherence tomography criteria for defining functional severity of intermediate lesions: a comparative study with FFR

      Optical coherence tomography criteria for defining functional severity of intermediate lesions: a comparative study with FFR

      Fractional flow reserve (FFR) is the gold standard in the assessment of severity of the coronary stenosis. The aim of the study was to compare optical coherence tomography (OCT) obtained intermediate coronary lesions lumen areas measurements with FFR assessments, with the goal to develop an OCT threshold to identify significant coronary stenosis. 48 patients (mean age 65 ± 10 years) was enrolled for the study. Within this population, 71 intermediate coronary lesions were investigated using both FFR and OCT. High dose bolus of Adenosine (120 μg) was used to obtain coronary hyperemia. OCT imaging was performed using non-occlusive technique to assess ...

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    4. OCT Guidance to Improve Clinical Outcome of Coronary Interventions: What Have We Learnt?

      OCT Guidance to Improve Clinical Outcome of Coronary Interventions: What Have We Learnt?

      Optical coherence tomography (OCT) is the current state-of-the-art intravascular imaging technique which so far has been mainly used for research purpose. The clinical impact of an OCT-guided percutaneous coronary intervention is a field of controversy, although recent non randomized data has shown its potential clinical benefit. Many features that are clearly visualized by OCT are missed by both angiography and other intravascular imaging techniques due to their limited resolution. On the contrary, OCT allows visualization of detailed morphological characteristics of both atherosclerotic plaque and stent. This may translate in an improved clinical outcome of OCT-guided procedures. This article reviews the ...

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      Mentions: Francesco Prati
    5. Long-term Morphofunctional Remodeling of Internal Thoracic Artery Grafts: A Frequency-Domain Optical Coherence Tomography Study

      Long-term Morphofunctional Remodeling of Internal Thoracic Artery Grafts: A Frequency-Domain Optical Coherence Tomography Study

      Background— Internal thoracic arteries (ITAs) are frequently anastomosed to the coronary circulation for bypass grafting. The purpose of this research was to investigate in vivo the long-term morphofunctional changes of ITAs after their use as coronary artery bypass conduits, by comparing the morphological features and vasoreactivity of the grafted left ITA (LITA) with the native, nonharvested right ITA (RITA) in the same patient. Methods and Results— At least 10 years after surgery, in 10 patients, LITA graft and nonharvested RITA were assessed by quantitative angiography and frequency-domain optical tomography. Endothelium-dependent and independent vasodilation was tested by selective infusion of acetylcholine ...

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    6. A “Stable” Coronary Plaque Rupture Documented by Repeated OCT Studies

      A “Stable” Coronary Plaque Rupture Documented by Repeated OCT Studies

      Letter to the Editor. Angiographic and OCT Findings at Baseline and 6 Months Later Coronary angiography of the left anterior descending (LAD) coronary artery and frequency domain-optical coherence tomography (FD-OCT) of the ruptured plaque at the first assessment (A, B, C) and second assessment (D, E, F) . (A) Angiography shows a de novo coronary stenosis (red arrow) located distally compared with the previous stented segment (blue line) . (B) FD-OCT cross-section shows the mid portion of the ruptured plaque (asterisk) characterized by a smooth floor and ruptured fibrous cap (arrows) . Arrowheads indicate side branches. (C) FD-OCT cross-section shows the distal portion ...

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      Mentions: Francesco Prati
    7. 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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    8. Iatrogenic coronary ostial stenosis of left main stem following aortic valve replacement: Visualization with optical coherence tomography

      Iatrogenic coronary ostial stenosis of left main stem following aortic valve replacement: Visualization with optical coherence tomography

      Iatrogenic coronary ostial stenosis following aortic valve replacement (AVR) occurs in up to 3.4% of cases and usually presents within the first 6 months following surgery. We present the case of an 85 year old man who developed an acute coronary syndrome 2 months following AVR. Coronary angiography revealed a severe de novo lesion in the left main stem, which, on optical coherence tomography, was shown to be due to severe intimal hyperplasia. The most likely underlying mechanism is vessel wall trauma caused by the rigid tip cannula used for administration of cardioplegia solution. Surgeons should be aware of ...

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    9. Severity of coronary atherosclerosis in patients with a first acute coronary event: a diabetes paradox

      Severity of coronary atherosclerosis in patients with a first acute coronary event: a diabetes paradox

      Aims We aimed to compare coronary artery disease (CAD) at the time of a first acute coronary syndrome (ACS) in type II diabetic and non-diabetic patients by coronary angiography and by optical coherence tomography (OCT). Methods and results Two different patient populations with a first ACS were enrolled for the angiographic (167 patients) and the OCT (72 patients) substudy. Angiographic CAD severity was assessed by Bogaty, Gensini, and Sullivan scores, whereas collateral development towards the culprit vessel was assessed by the Rentrop score. Optical coherence tomography plaque features were evaluated at the site of the minimum lumen area (MLA) and ...

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      Mentions: Francesco Prati
    10. OCT-Based Diagnosis and Management of STEMI Associated With Intact Fibrous Cap

      OCT-Based Diagnosis and Management of STEMI Associated With Intact Fibrous Cap

      In autopsy studies, at least 25% of thrombotic coronary occlusions are caused by plaque erosion in which thrombus often overlies atherosclerotic plaque without evident disruption of the fibrous cap. We performed optical coherence tomography imaging after aspiration thrombectomy and identified plaque erosion as the cause in 31 patients presenting with ST-segment elevation myocardial infarction. Plaque erosion was identified when the fibrous cap of the culprit lesion was intact. Based on clinical criteria, 40% of patients with subcritically occlusive plaque were treated with dual antiplatelet therapy without percutaneous revascularization (group 1), and the remaining 60% of patients underwent angioplasty and stenting ...

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    11. Optical coherence tomography guided in-stent thrombus removal in patients with acute coronary syndromes

      Optical coherence tomography guided in-stent thrombus removal in patients with acute coronary syndromes

      The persistence of thrombus inside stent struts is a frequent event in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI), and this phenomenon might be associated with an increased risk of stent thrombosis. We sought to quantify by means of optical coherence tomography (OCT) the presence of in-stent thrombus after achievement of an optimal angiographic result in patients with ACS undergoing PCI. In addition, we evaluated the feasibility and safety of an OCT-guided strategy of in-stent thrombus removal. Eighty consecutive patients with ACS undergoing PCI were treated with two different strategies equally divided into two groups: angio-guided ...

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    12. 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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    13. Transcatheter renal sympathetic ablation for resistant hypertension: in vivo insights in humans from optical coherence tomography

      Transcatheter renal sympathetic ablation for resistant hypertension: in vivo insights in humans from optical coherence tomography

      Hypertension represents a major health problem, with resistant hypertension being defined as uncontrolled blood pressure despite the use of optimal doses of ≥3 antihypertensive agents . Patients with resistant hypertension often have an increased renal sympathetic nerve activity, and building upon the historical experience with surgical renal sympathetic denervation, transcatheter radiofrequency ablation has been recently proposed . The safety profile of this novel technique appears satisfactory , but there is still limited insight on how such denervation works. We hereby report on two patients who underwent transcatheter ablation at our center, in whom optical coherence tomography (OCT) was concomitantly performed to provide more ...

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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. Imaging of intraplaque haemorrhage

      Imaging of intraplaque haemorrhage

      Intraplaque hemorrhage (IPH) is an important co-factor for plaque progression and rupture. So far noninvasive MRI has shown promise for the in-vivo identification of IPH and for the prediction of plaque instability. Intravascular imaging techniques such as intravascular ultrasound or optical coherence tomography (OCT) cannot distinguish between IPH and other plaque components. However, OCT has the unique ability to identify microvessels located in the lipid core of atherosclerotic plaque due to its high resolution (around 20 μm). Microvessels are known to be the main source of blood extravasation due to their anatomically compromised structure. Coronary plaques with a high microvessel ...

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      Mentions: Francesco Prati
    16. 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
    17. 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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    18. 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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    19. Expert review document part 2: methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures

      Expert review document part 2: methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures

      Introduction This document is complementary to an Expert Review Document on Optical Coherence Tomography (OCT) for the study of coronary arteries and atherosclerosis.1 The goal of this companion manuscript is to provide a practical guide framework for the appropriate use and reporting of the novel frequency domain (FD) OCT imaging to guide interventional procedures, with a particular interest on the comparison with intravascular ultrasound (IVUS).1–4 Technique for optical coherence tomography imaging In the OCT Expert Review Document on Atherosclerosis, a comprehensive description of the physical principles for OCT imaging and time domain (TD) catheters (St Jude Medical ...

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    20. 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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    21. Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies: A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

      Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies: A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

      Objectives: The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease.Background: Intravascular optical coherence tomography (IVOCT) is a catheter-based modality that acquires images at a resolution of 10 μm, enabling visualization of blood vessel wall microstructure in vivo at an unprecedented level of detail. IVOCT devices are now commercially available worldwide, there is an active user base, and ...

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    22. 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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    23. High Levels of Systemic Myeloperoxidase Are Associated With Coronary Plaque Erosion in Patients With Acute Coronary Syndromes: A Clinicopathological Study

      High Levels of Systemic Myeloperoxidase Are Associated With Coronary Plaque Erosion in Patients With Acute Coronary Syndromes: A Clinicopathological Study

      Background— Systemic levels of myeloperoxidase predict prognosis in patients with acute coronary syndromes and are considered a marker of plaque vulnerability. It is not known whether myeloperoxidase is associated with different coronary morphologies (ie, rupture or erosion of the culprit lesion) in patients with acute coronary syndrome. Methods and Results— Twenty-five consecutive patients (aged 67±11 years; 15 men [60%]; 13 [52%] with non–ST-segment elevation acute coronary syndrome and 12 [48%] with acute ST-segment elevation myocardial infarction) were enrolled. Optical coherence tomography classified the culprit lesion as ruptured in 18 (72%) or eroded in 7 patients (28%) and detected ...

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