1. Articles from Aloke V. Finn

    1-15 of 15
    1. Detection of Cholesterol Crystals by Optical Coherence Tomography

      Detection of Cholesterol Crystals by Optical Coherence Tomography

      Aim: To determine the ability of optical frequency domain imaging (OFDI)/optical coherence tomography (OCT) imaging systems to visualize presence of cholesterol crystals (CCR) in human atherosclerotic coronary arteries. Methods and Results: We performed ex vivo imaging by OFDI/OCT of human coronary arteries. A total of 559 cross-sectional images from 45 autopsy cases were co-registered with histology and 117 histologic sections showed presence of necrotic core with cholesterol clefts (CC). We modified a previously used OFDI/OCT definition for identification of CCRs which we now define as a linear and discreet high intensity signal (bright area) within the plaque ...

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    2. Covering our tracks – optical coherence tomography to assess vascular healing

      Covering our tracks – optical coherence tomography to assess vascular healing

      Over the better part of two decades, lessons learned from stent failure have led to technical advances that have resulted in current-generation metallic drug-eluting stents (DES) with very low rates of target lesion failure (TLF) and stent thrombosis 1 . Continued efforts have been directed at achieving iterative improvements in the design of DES to enhance adaptive vascular healing following vascular injury. By promoting early strut coverage with minimal neointimal hyperplasia but a functioning endothelial layer, stent thrombosis may be minimised and, by reducing the inflammatory response to the foreign

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    3. Are characteristics of plaque erosion defined by optical coherence tomography similar to true erosion in pathology?

      Are characteristics of plaque erosion defined by optical coherence tomography similar to true erosion in pathology?

      Plaque erosion occurs without cap disruption where flowing blood comes into direct contact with intimal surface lacking endothelial cells. 1 In both clinical studies using intravascular imaging and autopsy data from subjects dying suddenly, plaque erosion is the second most common cause of coronary thrombus. In our recent pathological analysis of autopsies from subjects dying suddenly, plaque rupture was the most frequent causes of coronary thrombus (60%), the second most frequent was...

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    4. Histopathological Differential Diagnosis of Optical Coherence Tomographic Image Interpretation After Stenting

      Histopathological Differential Diagnosis of Optical Coherence Tomographic Image Interpretation After Stenting

      Objectives The aim of this study was to identify histological features that correlate with terms commonly used to describe optical coherence tomographic (OCT) and optical frequency-domain imaging (OFDI) images of stented vessels, by means of a histopathological validation study using stented human coronary arteries. Background OCT imaging and OFDI are used to evaluate vascular responses to stent implantation. Descriptive terms such as “peristrut low attenuation” and “heterogeneous” have been used to describe neointimal characteristics that may have clinical relevance. However, only limited histopathological correlations are available. Methods Using the CVPath stent registry, 19 cases were identified in whom implantation duration ...

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    5. Malapposition: is it a major cause of stent thrombosis?

      Malapposition: is it a major cause of stent thrombosis?

      Stent thrombosis (ST) is a devastating complication associated with a high morbidity and mortality in patients who have undergone percutaneous coronary intervention (PCI) for coronary heart disease (CHD). In-hospital mortalities of patients suffering from ST have been reported to be as high as 7.9% for acute ST (AST; occurring <24 h after PCI) and subacute ST (SAST; occurring within 30 days after PCI), 3.8% for late ST (LST; occurring within the first year after PCI), and 3.6% for very late ST (VLST; occurring 1 year after PCI). 1 Recently, longer duration (30 months) of dual antiplatelet therapy ...

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    6. Illuminating Culprit Plaque Histology by Optical Coherence Tomography : Shedding New Light on Old Insights

      Illuminating Culprit Plaque Histology by Optical Coherence Tomography : Shedding New Light on Old Insights

      Coronary atherosclerosis continues to be major cause of death in the developed world ( (1) ). Although we have known for at least a century that fissures and ruptures of coronary arteries are the cause of coronary thrombosis and, in the last 2 decades, that plaque erosion and calcified nodule are additional causes of thrombosis, our ability to use this knowledge in a real-time fashion to affect the treatment of patients with acute coronary syndromes (ACS) has been limited ( (2) ). Although angiography-guided percutaneous coronary intervention (PCI) has become the standard of care for treatment of ACS, it provides little understanding of culprit ...

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      Mentions: Emory University
    7. Computational Fluid Dynamics Simulations of Hemodynamics in Plaque Erosion

      Computational Fluid Dynamics Simulations of Hemodynamics in Plaque Erosion

      We investigated whether local hemodynamics were associated with sites of plaque erosion and hypothesized that patients with plaque erosion have locally elevated WSS magnitude in regions where erosion has occurred. We generated 3D, patient-specific models of coronary arteries from biplane angiographic images in 3 human patients with plaque erosion diagnosed by optical coherence tomography. Using computational fluid dynamics, we simulated pulsatile blood flow and calculated both wall shear stress (WSS) and oscillatory shear index (OSI). We also investigated anatomic features of plaque erosion sites by examining branching and local curvature in X-ray angiograms of barium-perfused autopsy hearts. Neither high nor ...

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    8. Update on acute coronary syndromes: the pathologists' view

      Update on acute coronary syndromes: the pathologists' view

      Although mortality rates from coronary heart disease in the western countries have declined in the last few decades, morbidity caused by this disease is increasing and a substantial number of patients still suffer acute coronary syndrome (ACS) and sudden cardiac death. Acute coronary syndrome occurs as a result of myocardial ischaemia and its manifestations include acute myocardial infarction and unstable angina. Culprit plaque morphology in these patients varies from thrombosis with or without coronary occlusion to sudden narrowing of the lumen from intraplaque haemorrhage. The coronary artery plaque morphologies primarily responsible for thrombosis are plaque rupture, and plaque erosion, with ...

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    9. Ex Vivo Assessment of Vascular Response to Coronary Stents by Optical Frequency Domain Imaging

      Ex Vivo Assessment of Vascular Response to Coronary Stents by Optical Frequency Domain Imaging

      Objectives This study sought to examine the capability of optical frequency domain imaging (OFDI) to characterize various morphological and histological responses to stents implanted in human coronary arteries. Background A precise assessment of vascular responses to stents may help stratify the risk of future adverse events in patients who have been treated with coronary stents. Methods Fourteen human stented coronary segments with implant duration ≥1 month from 10 hearts acquired at autopsy were interrogated ex vivo by OFDI and intravascular ultrasound (IVUS). Comparison with histology was assessed in 134 pairs of images where the endpoints were to investigate: 1) accuracy ...

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      Mentions: Emory University
    10. Microvascular Obstruction Is Caused by Atherothrombosis in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

      Microvascular Obstruction Is Caused by Atherothrombosis in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

      The diagnosis of acute coronary syndrome (ACS) is primarily based on the mode of clinical presentation and is a term used for any conditions suggesting the acute induction of myocardial ischemia. The precise molecular and cellular triggers that lead to ACS remain poorly understood; however, histopathologic studies have illustrated several mechanisms that may explain the sudden onset of symptoms in ACS patients. The most common substrate underlying ACS is thought to be rupture of a vulnerable plaque that contains a necrotic core covered by a fibrous cap. The term, thin-cap fibroatheroma (TCFA) is used to describe vulnerable plaque because histomorphometric ...

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    11. IVUS and OCT: Either or Survivor...

      IVUS and OCT: Either or Survivor...

      Since its introduction over 20 years ago, intravascular ultrasound (IVUS) has become the dominant imaging technology, helping us to better understand vessel biology and guiding interventional procedures, and providing information on atherosclerosis progression or regression in clinical trials. During this time period, IVUS has survived many other intracoronary techniques that have fallen by the wayside. Recently, optical coherence tomography (OCT), a far higher resolution optical imaging technique, was approved for clinical use by the U.S. Food and Drug Administration. Suter et al. (1), in a State-of-the-Art review article in this issue of iJACC, have highlighted the relative merits of ...

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    12. Concept of Vulnerable/Unstable Plaque

      Concept of Vulnerable/Unstable Plaque

      Today’s concept of vulnerable plaque has evolved primarily from the early pioneering work uncovering the pivotal role of plaque rupture and coronary thrombosis as the major cause of acute myocardial infarction and sudden cardiac death. Since the first historical description of plaque rupture in 1844, several key studies by leading researchers and clinicians have lead to the current accepted views on lesion instability. Important to the complex paradigm of plaque destabilization and thrombosis are many discoveries beginning with the earliest descriptions of advanced plaques, reminiscent of abscesses encapsulated by fibrous tissue capable of rupture. It was not until the ...

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    1-15 of 15
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    1. (6 articles) Emory University
    2. (3 articles) Cardiovascular Research Foundation
    3. (3 articles) UC Irvine
    4. (2 articles) Columbia University
    5. (1 articles) University of Minnesota
    6. (1 articles) University of Maryland
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    Concept of Vulnerable/Unstable Plaque IVUS and OCT: Either or Survivor... Microvascular Obstruction Is Caused by Atherothrombosis in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention Late Loss and Neointimal Proliferation (Video) Ex Vivo Assessment of Vascular Response to Coronary Stents by Optical Frequency Domain Imaging Update on acute coronary syndromes: the pathologists' view Computational Fluid Dynamics Simulations of Hemodynamics in Plaque Erosion Illuminating Culprit Plaque Histology by Optical Coherence Tomography : Shedding New Light on Old Insights Malapposition: is it a major cause of stent thrombosis? Clinical Trials Critical for the Evaluation of Advanced Medical Imaging Tools Voxeleron Welcomes Manabu Tokunaga as new Director of Software Accuracy of Diabetic Retinopathy Staging with a Deep Convolutional Neural Network Using Ultra-Wide-Field Fundus Ophthalmoscopy and Optical Coherence Tomography Angiography