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  1. Optical Coherence Tomography Assessment Of The Acute Effects Of Stent Implantation On The Vessel Wall. A Systematic Quantitative Approach

    Explore Article Heart (Aug 9 2009) Cardiology

    Objective: To observe and characterise vessel injury post-stenting using optical coherence tomography (OCT), to propose a systematic OCT classification for periprocedural vessel trauma, to evaluate its frequency in stable vs unstable patients and to assess its clinical impact during the hospitalization period. Setting: stenting causes vessel injury. Design and interventions: All consecutive patients in whom OCT was performed after stent implantation were included in the study. Qualitative and quantitative assessment of, tissue prolapse, intrastent dissection and edge dissection were performed. Results: Seventy-three patients (80 vessels) were analyzed. Tissue prolapse within the stented segment was visible in 78/80 vessels (97.5%). Median ... (Read Full Article)

    Comment on Article Mentions:   Thoraxcenter at Erasmus University Medical Center   Patrick W. Serruys   Evelyn Regar

  2. Virtual histology and optical coherence tomography: from research to a broad clinical application

    Explore Article Heart (Jul 27 2009) Cardiology

    Invasive coronary imaging techniques have improved our understanding of atherosclerosis and helped us to evaluate the effectiveness of new drugs and new intravascular devices. We have adopted and integrated them rapidly into our clinical decision making process in the catheterisation laboratory. So far, only significant lesions in the coronary angiogram have been treated either by percutaneous coronary intervention (PCI) or coronary bypass artery grafting (CABG), while normal looking coronary segments in angiography have been regarded as "disease-free", and mild/moderate stenoses as "non-treatable" by PCI or CABG; from these non-significantly diseased areas, acute coronary events may potentially arise. In response to ... (Read Full Article)

    Comment on Article Mentions:   Thoraxcenter at Erasmus University Medical Center   Patrick W. Serruys   Evelyn Regar

  3. Optical coherence tomography patterns of stent restenosis

    Explore Article American Heart Journal (Jul 23 2009) Cardiology

    Background Stent restenosis is an infrequent but poorly understood clinical problem in the drug-eluting stent era. The aim of the study was to evaluate the morphologic characteristics of stent restenosis by optical coherence tomography (OCT). Methods Patients (n = 24, 25 vessels) presenting with angiographically documented stent restenosis were included. Quantitative OCT analysis consisted of lumen and stent area measurement and calculation of restenotic tissue area and burden. Qualitative restenotic tissue analysis included assessment of tissue structure, backscattering and symmetry, visible microvessels, lumen shape, and presence of intraluminal material. Results By angiography, restenosis was classified as diffuse, focal, and at ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Evelyn Regar   Héctor M. García-García

  4. Reproducibility of quantitative optical coherence tomography for stent analysis

    Explore Article eurointervention.org (Jul 5 2009) Cardiology

    Aims: To assess the inter- and intra- observer reproducibility for strut count, strut apposition and strut tissue coverage measurements with optical coherence tomography (OCT).Methods and results: Ten drug-eluting stents (244 frames, 1712 struts) imaged with OCT nine months after implantation were analysed by two independent analysts. One of the analysts repeated the analysis of five stents (120 frames, 795 struts) one week later. Offline analysis was performed with the proprietary LightLab Imaging software. The number of struts was counted and lumen and stent area contours were traced. Tissue coverage thickness was measured at 360 degrees of vessel circumference and in ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Evelyn Regar   Héctor M. García-García

  5. The Risk of Stent Thrombosis in Patients With Acute Coronary Syndromes Treated With Bare-Metal and Drug-Eluting Stents

    Explore Article interventions.onlinejacc.org (Jun 16 2009) Cardiology

    Objectives: We aimed to evaluate the risk of definite stent thrombosis with bare-metal stents (BMS) and drug-eluting stents (DES) in patients treated for acute coronary syndromes. Background: Acute coronary syndromes (ACS) have been reported as increasing the risk for stent thrombosis. Methods: Between January 2000 and December 2005, 5,816 consecutive patients underwent percutaneous coronary intervention for de novo lesions with a single stent type. These patients consisted of 3 sequential groups of BMS (n = 2,248), sirolimus-eluting stents (n = 822) and paclitaxel-eluting stents (n = 2,746). In total, 3,485 patients presented with an ACS. Results: After a median follow-up ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Héctor M. García-García   Thoraxcenter at Erasmus University Medical Center

  6. Incomplete Stent Apposition and Delayed Tissue Coverage Are More Frequent in Drug-Eluting Stents Implanted During Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction Than in Drug-Eluting Stents Implanted for Stable/Un

    Explore Article interventions.onlinejacc.org (May 17 2009) Cardiology

    Objectives The aim of this study was to compare the frequency of incomplete stent apposition (ISA) and struts not covered by tissue at long-term follow-up (as assessed by optical coherence tomography [OCT]) in drug-eluting stents (DES) implanted during primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) versus DES implanted for unstable and stable angina. Background Incomplete stent apposition and the absence of strut endothelialization might be linked to stent thrombosis. DES implanted for STEMI might have a higher risk of thrombosis. Methods Consecutive patients in whom OCT was performed at least 6 months after DES implantation were ... (Read Full Article)

    Comment on Article Mentions:   Peter Barlis   University of Melbourne   Patrick W. Serruys

  7. First case of stenting of a vulnerable plaque in the Secritt I trial—the dawn of a new era?

    Explore Article Nature Publishing Group (Apr 22 2009) Cardiology

    Background. A 63-year-old man presented with class II anginal symptoms. Investigations. Cardiac catheterization, intravascular ultrasound (IVUS) virtual histology, optical coherence tomography and off-line palpography. Diagnosis. The patient was diagnosed as having a culprit lesion in the left circumflex artery and a vulnerable plaque in the left anterior descending artery. Management. The culprit lesion was treated with two overlapping drug-eluting stents. The vulnerable plaque was then treated with a self-expanding stent tailored to shield vulnerable plaques (vProtect® Luminal Shield). After dilatation of the stent with a low-pressure balloon, IVUS and optical coherence tomography showed excellent apposition of the stent to the ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Evelyn Regar   Héctor M. García-García

  8. In Vivo Assessment of High-Risk Coronary Plaques at Bifurcations With Combined Intravascular Ultrasound and Optical Coherence Tomography

    Explore Article imaging.onlinejacc.org (Apr 12 2009) Cardiology

    Objectives: This study sought to evaluate the in vivo frequency and distribution of high-risk plaques (i.e., necrotic core rich) at bifurcations using a combined plaque assessment with intravascular ultrasound–virtual histology (IVUS-VH) and optical coherence tomography (OCT). Background Pathological examinations have shown that atherosclerotic plaque rich in necrotic core is prone to develop at bifurcations. High-risk plaque detection could be improved by the combined use of a technique able to detect necrotic core (IVUS-VH) and a high-resolution technique that allows the measurement of the fibrous cap thickness (OCT). Methods: From 30 patients imaged with IVUS-VH and OCT, 103 bifurcations were selected. ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Evelyn Regar   Thoraxcenter at Erasmus University Medical Center

  9. A bioabsorbable everolimus-eluting coronary stent system (ABSORB): 2-year outcomes and results from multiple imaging methods

    Explore Article TheLancet.com (Mar 15 2009) Cardiology

    Background: Drug-eluting metallic coronary stents predispose to late stent thrombosis, prevent late lumen vessel enlargement, hinder surgical revascularisation, and impair imaging with multislice CT. We assessed the safety of the bioabsorbable everolimus-eluting stent (BVS). Methods: 30 patients with a single de-novo coronary artery lesion were followed up for 2 years clinically and with multiple imaging methods: multislice CT, angiography, intravascular ultrasound, derived morphology parameters (virtual histology, palpography, and echogenicity), and optical coherence tomography (OCT). Findings: Clinical data were obtained from 29 of 30 patients. At 2 years, the device was safe with no cardiac deaths, ischaemia-driven target lesion revascularisations, or ... (Read Full Article)

    Comment on Article Mentions:   Evelyn Regar   Nico Bruining   Yoshinobu Onuma

  10. Quantitative Ex Vivo and In Vivo Comparison of Lumen Dimensions Measured by Optical Coherence Tomography and Intravascular Ultrasound in Human Coronary Arteries

    Explore Article Elsevier (Feb 13 2009) Cardiology

    Quantitative Ex Vivo and In Vivo Comparison of Lumen Dimensions Measured by Optical Coherence Tomography and Intravascular Ultrasound in Human Coronary Arteries Introduction and objectives. The relationship between the lumen dimensions obtained in human coronary arteries using intravascular ultrasound (IVUS) and those obtained using optical coherence tomography (OCT) is not well understood. The objectives were to compare the lumen measurement obtained ex vivo in human coronary arteries using IVUS, OCT, and histomorphometry, and in vivo in patients using IVUS and OCT with and without balloon occlusion. Methods. Ex vivo study: the lumen areas of matched anatomical sections of human coronary arteries were measured using IVUS, OCT, and histology. In vivo study: the lumen areas in matched sections were measured using IVUS and ... (Read Full Article)

    Comment on Article Mentions:   LightLab Imaging   Patrick W. Serruys   Lightlab ImageWire

  11. Multi-modality intra-coronary plaque characterization: A pilot study☆

    Explore Article International Journal of Cardiology (Sep 9 2008) Cardiology

    Background The risk of rupture and subsequent thrombosis of the atherosclerotic coronary plaques is related to the presence of necrotic core with high lipid content. We conducted an exploratory pilot trial to compare the capability for lipid tissue detection using four intra-coronary diagnostic techniques: greyscale intravascular ultrasound (GS IVUS), IVUS radiofrequency data (IVUS RFD) analysis, optical coherence tomography (OCT) and intravascular magnetic resonance spectroscopy (IVMR). Methods Twenty-four matched target plaques were analyzed with the 4 techniques in non-culprit lesions in five patients with stable angina. Following IVUS pullback, OCT and IVMR was performed. Plaque composition was assessed using established criteria ... (Read Full Article)

    Comment on Article Mentions:   Peter Barlis   Royal Brompton Hospital   Patrick W. Serruys

  12. Feasibility of combined use of intravascular ultrasound radiofrequency data analysis and optical coherence tomography for detecting thin-cap fibroatheroma

    Explore Article Oxford Journals (Apr 30 2008) Cardiology

    Aims To evaluate the feasibility of the combined use of virtual histology (VH)-intravascular ultrasound (IVUS) and optical coherence tomography (OCT) for detecting in vivo thin-cap fibroatheroma (TCFA). Methods and results In 56 patients with angina, 126 plaques identified by IVUS findings were analysed using both VH-IVUS and OCT. IVUS-derived TCFA was defined as an abundant necrotic core (>10% of the cross-sectional area) in contact with the lumen (NCCL) and %plaque-volume >40%. OCT-derived TCFA was defined as a fibrous cap thickness of Conclusion Neither modality alone is sufficient for detecting TCFA. The combined use of OCT and VH-IVUS might be a ... (Read Full Article)

    Comment on Article Mentions:   Patrick W. Serruys   Thoraxcenter at Erasmus University Medical Center   Héctor M. García-García

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