1. Articles from Ranil de Silva

    1-12 of 12
    1. Plaque Burden Influences Accurate Classification of Fibrous Cap Atheroma by In-Vivo Optical Coherence Tomography in a Porcine Model of Advanced Coronary Atherosclerosis

      Plaque Burden Influences Accurate Classification of Fibrous Cap Atheroma by In-Vivo Optical Coherence Tomography in a Porcine Model of Advanced Coronary Atherosclerosis

      Aims: In-vivo validation of coronary optical coherence tomography (OCT) against histology and the effects of plaque burden (PB) on plaque classification remain unreported. We investigated this in a porcine model with human-like coronary atherosclerosis. Methods and results: Five female Yucatan D374Y-PCSK9 transgenic hypercholesterolemic mini-pigs were implanted with a coronary shear-modifying stent to induce advanced atherosclerosis. OCT frames (n=201) were obtained 34 weeks after implantation. Coronary arteries were perfusion-fixed, serially sectioned and co-registered with OCT using a validated algorithm. Lesions were adjudicated using the Virmani classification and PB assessed from histology. OCT had a high sensitivity, but modest specificity (92 ...

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    2. Intracoronary Imaging

      Intracoronary Imaging

      Two intracoronary imaging techniques are routinely available to complement angiography in the management of coronary artery disease, namely intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The former has been in clinical use for >25 years and has directly informed the fundamentals of atherosclerotic plaque composition and arterial remodelling, as well as contemporary optimal stent implantation technique. 1 , 2 The latter, introduced 10 years ago, has only been more widely adopted with the development of the frequency domain (FD)-OCT imaging, which enables complete image acquisition over a 6–10 cm segment during a 3–5 s pullback period obtaining ...

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    3. Inducing Persistent Flow Disturbances Accelerates Atherogenesis and Promotes Thin Cap Fibroatheroma Development in D374Y-PCSK9 Hypercholesterolemic Minipigs

      Inducing Persistent Flow Disturbances Accelerates Atherogenesis and Promotes Thin Cap Fibroatheroma Development in D374Y-PCSK9 Hypercholesterolemic Minipigs

      Background— Although disturbed flow is thought to play a central role in the development of advanced coronary atherosclerotic plaques, no causal relationship has been established. We evaluated whether inducing disturbed flow would cause the development of advanced coronary plaques, including thin cap fibroatheroma. Methods and Results— D374Y -PCSK9 hypercholesterolemic minipigs (n=5) were instrumented with an intracoronary shear-modifying stent (SMS). Frequency-domain optical coherence tomography was obtained at baseline, immediately poststent, 19 weeks, and 34 weeks, and used to compute shear stress metrics of disturbed flow. At 34 weeks, plaque type was assessed within serially collected histological sections and coregistered to ...

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    4. ABSORB Biodegradable Stents Versus Second-Generation Metal Stents : A Comparison Study of 100 Complex Lesions Treated Under OCT Guidance

      ABSORB Biodegradable Stents Versus Second-Generation Metal Stents : A Comparison Study of 100 Complex Lesions Treated Under OCT Guidance

      Objectives The aim of this study was to compare the acute performance of the PLLA ABSORB bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) with second-generation metal drug-eluting stents (DES) in complex coronary artery lesions. Background Thick polymer-based BVS have different mechanical properties than thin second-generation DES. Data on the acute performance of BVS are limited to simple coronary lesions treated in trials with strict inclusion criteria. Methods Fifty complex coronary lesions (all type American College of Cardiology/American Heart Association B2-C) treated with a BVS undergoing a final optical coherence tomography (OCT) examination were compared with an equal ...

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    5. Optical coherence tomography characteristics of in-stent restenosis are different between first and second generation drug eluting stents ☆

      Optical coherence tomography characteristics of in-stent restenosis are different between first and second generation drug eluting stents ☆

      Aims Characterization of neointimal tissue is essential to understand the pathophysiology of in-stent restenosis (ISR) after drug eluting stent (DES) implantation. Using optical coherence tomography (OCT), we compared the morphologic characteristics of ISR between first and second generation DES. Methods and Results OCT was performed in 66 DES-ISR, defined as > 50% angiographic diameter stenosis within the stented segment. Patients with ISR of first generation sirolimus-eluting stents (SES), paclitaxel eluting stents (PES) and second generation zotarolimus-eluting stents (ZES), everolimus-eluting stents (EES) and biolimus-eluting stents (BES) were enrolled. Quantitative and qualitative ISR tissue analysis was performed at 1-mm intervals along the entire ...

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      Mentions: Abbott
    6. Intracoronary Optical Coherence Tomography: Experience and Indications for Clinical Use

      Intracoronary Optical Coherence Tomography: Experience and Indications for Clinical Use

      Optical coherence tomography (OCT) is a light based technology that provides very high spatial resolution images. OCT has been initially employed as a research tool to investigate plaque morphology and stent strut coverage. The introduction of frequency domain OCT, allowing fast image acquisition during a prolonged contrast injection via the guiding catheter, has made OCT applicable for guidance of coronary interventions. In this manuscript the various applications of OCT are reviewed, from assessment of plaque vulnerability and severity to characteristics of unstable lesions and thrombus burden to stent optimization and evaluation of late results

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    7. 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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    8. Automatic detection of coronary stent struts in intravascular OCT imaging

      Automatic detection of coronary stent struts in intravascular OCT imaging

      Optical coherence tomography (OCT) is a light-based, high resolution imaging technique to guide stent deployment procedure for stenosis. OCT can accurately differentiate the most superficial layers of the vessel wall as well as stent struts and the vascular tissue surrounding them. In this paper, we automatically detect the struts of coronary stents present in OCT sequences. We propose a novel method to detect the strut shadow zone and accurately segment and reconstruct the strut in 3D. The estimation of the position of the strut shadow zone is the key requirement which enables the strut segmentation. After identification of the shadow ...

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    9. Optical coherence tomography: from research to practice

      Optical coherence tomography: from research to practice

      Optical coherence tomography (OCT) is a high-resolution imaging technique with great versatility of applications. In cardiology, OCT has remained hitherto as a research tool for characterization of vulnerable plaques and evaluation of neointimal healing after stenting. However, OCT is now successfully applied in different clinical scenarios, and the introduction of frequency domain analysis simplified its application to the point it can be considered a potential alternative to intravascular ultrasound for clinical decision-making in some cases. This article reviews the use of OCT for assessment of lesion severity, characterization of acute coronary syndromes, guidance of intracoronary stenting, and evaluation of long-term ...

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    10. Simple versus complex approaches to treating coronary bifurcation lesions: direct assessment of stent strut apposition by optical coherence tomography.

      Simple versus complex approaches to treating coronary bifurcation lesions: direct assessment of stent strut apposition by optical coherence tomography.
      Introduction and objectives. Stenting of coronary bifurcation lesions carries an increased risk of stent deformation and malapposition. Anatomical and pathological observations indicate that the high stent thrombosis rate in bifurcations is due to malapposition of stent struts. Methods. Strut apposition was assessed with optical coherence tomography (OCT) in bifurcation lesions treated either using the simple technique of stent implantation in the main vessel only or a complex technique (i.e. Culotte’s). A strut was regarded as malapposed if the gap between its endoluminal surface and the vessel wall was greater than its thickness plus an OCT resolution error margin ...
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    11. Optical coherence tomography assessment of a new dedicated bifurcation stent

      Optical coherence tomography assessment of a new dedicated bifurcation stent
      Dedicated bifurcation stents should facilitate deployment and improved coverage of bifurcational lesions. We used optical coherence tomography (OCT) to assess bifurcation lesions treated with a dedicated stent implanted in the side branch (SB) in conjunction with drug eluting stents in the main vessel (MV) in a culotte-like fashion.
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    1-12 of 12
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    Optical coherence tomography assessment of a new dedicated bifurcation stent Simple versus complex approaches to treating coronary bifurcation lesions: direct assessment of stent strut apposition by optical coherence tomography. Optical coherence tomography: from research to practice Automatic detection of coronary stent struts in intravascular OCT imaging 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 Optical coherence tomography for guidance of distal cell recrossing in bifurcation stenting: choosing the right cell matters Intracoronary Optical Coherence Tomography: Experience and Indications for Clinical Use Optical coherence tomography characteristics of in-stent restenosis are different between first and second generation drug eluting stents ☆ ABSORB Biodegradable Stents Versus Second-Generation Metal Stents : A Comparison Study of 100 Complex Lesions Treated Under OCT Guidance Inducing Persistent Flow Disturbances Accelerates Atherogenesis and Promotes Thin Cap Fibroatheroma Development in D374Y-PCSK9 Hypercholesterolemic Minipigs Normative data and associations of Optical Coherence Tomography Angiography measurements of the macula: The Singapore Malay Eye Study Automatic Segmentation and Measurement of Choroid Layer in High Myopia for OCT Imaging Using Deep Learning