1. Articles from Marco Costa

    1-17 of 17
    1. Mobilization of progenitor cells and assessment of vessel healing after second generation drug-eluting stenting by optical coherence tomography

      Mobilization of progenitor cells and assessment of vessel healing after second generation drug-eluting stenting by optical coherence tomography

      Background Bone marrow-derived progenitor cells likely contribute to both endothelial- and smooth muscle cell-dependent healing responses in stent-injured vessel sites. This study aimed to assess mobilization of progenitor cells and vessel healing after zotarolimus-eluting (ZES) and everolimus-eluting (EES) stents. Methods and results In 63 patients undergoing coronary stent implantation, we measured circulating CD34 + CD133 + CD45low cells and serum levels of biomarkers relevant to stem cell mobilization . In 31 patients of them, we assessed vessel healing within the stented segment using optical coherence tomography (OCT) imaging. The CD34 + CD133 + CD45low cells increased 68 ± 59% 7 days after bare metal stent (BMS ...

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    2. The REMEDEE-OCT Study : An Evaluation of the Bioengineered COMBO Dual-Therapy CD34 Antibody–Covered Sirolimus-Eluting Coronary Stent Compared With a Cobalt-Chromium Everolimus-Eluting Stent in Patients With Acute Coronary Syndromes: Insights From Optical

      The REMEDEE-OCT Study : An Evaluation of the Bioengineered COMBO Dual-Therapy CD34 Antibody–Covered Sirolimus-Eluting Coronary Stent Compared With a Cobalt-Chromium Everolimus-Eluting Stent in Patients With Acute Coronary Syndromes: Insights From Optical

      Objectives The aim of the present study was to evaluate vascular healing of the bioengineered COMBO Dual Therapy Stent compared with a cobalt-chromium (CoCr) everolimus-eluting stent (EES) as assessed by optical coherence tomography in patients with acute coronary syndromes. Background CD34+ cells promote endothelial repair after vascular injury. The bioengineered COMBO Dual Therapy Stent combines CD34+ cell–capturing technology with abluminal sirolimus release, but more data from clinical studies evaluating the vascular response are needed. Methods In a prospective randomized multicenter clinical trial, 60 patients with acute coronary syndromes were randomized 1:1 to COMBO or CoCr EES implantation. The ...

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    3. Three-dimensional registration of intravascular optical coherence tomography and cryo-image volumes for microscopic-resolution validation

      Three-dimensional registration of intravascular optical coherence tomography and cryo-image volumes for microscopic-resolution validation

      Evidence suggests high-resolution, high-contrast, 100    frames / s 100  frames/s intravascular optical coherence tomography (IVOCT) can distinguish plaque types, but further validation is needed, especially for automated plaque characterization. We developed experimental and three-dimensional (3-D) registration methods to provide validation of IVOCT pullback volumes using microscopic, color, and fluorescent cryo-image volumes with optional registered cryo-histology. A specialized registration method matched IVOCT pullback images acquired in the catheter reference frame to a true 3-D cryo-image volume. Briefly, an 11-parameter registration model including a polynomial virtual catheter was initialized within the cryo-image volume, and perpendicular images were extracted, mimicking IVOCT image acquisition ...

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    4. 3D registration of intravascular optical coherence tomography and cryo-image volumes for microscopic-resolution validation

      3D registration of intravascular optical coherence tomography and cryo-image volumes for microscopic-resolution validation

      High resolution, 100 frames/sec intravascular optical coherence tomography (IVOCT) can distinguish plaque types, but further validation is needed, especially for automated plaque characterization. We developed experimental and 3D registration methods, to provide validation of IVOCT pullback volumes using microscopic, brightfield and fluorescent cryoimage volumes, with optional, exactly registered cryo-histology. The innovation was a method to match an IVOCT pullback images, acquired in the catheter reference frame, to a true 3D cryo-image volume. Briefly, an 11-parameter, polynomial virtual catheter was initialized within the cryo-image volume, and perpendicular images were extracted, mimicking IVOCT image acquisition. Virtual catheter parameters were optimized to ...

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    5. Coronary optical coherence tomography: A practical overview of current clinical applications

      Coronary optical coherence tomography: A practical overview of current clinical applications

      Coronary optical coherence tomography has emerged as the most powerful in-vivo imaging modality to evaluate vessel structure in detail. It is a useful research tool that provides insights into the pathogenesis of coronary artery disease. This technology has an important clinical role that is still being developed. We review the evidence on the wide spectrum of potential clinical applications for coronary optical coherence tomography, which encompass the successive stages in coronary artery disease management: accurate lesion characterization and quantification of stenosis, guidance for the decision to perform percutaneous coronary intervention and subsequent planning, and evaluation of immediate and long-term results ...

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    6. Parameter estimation of atherosclerotic tissue optical properties from three-dimensional intravascular optical coherence tomography

      Parameter estimation of atherosclerotic tissue optical properties from three-dimensional intravascular optical coherence tomography

      We developed robust, three-dimensional methods, as opposed to traditional A-line analysis, for estimating the optical properties of calcified, fibrotic, and lipid atherosclerotic plaques from in vivo coronary artery intravascular optical coherence tomography clinical pullbacks. We estimated attenuation μ t and backscattered intensity I 0 from small volumes of interest annotated by experts in 35 pullbacks. Some results were as follows: noise reduction filtering was desirable, parallel line (PL) methods outperformed individual line methods, root mean square error was the best goodness-of-fit, and α -trimmed PL ( α -T-PL) was the best overall method. Estimates of μ t were calcified ( 3.84 ± 0.95     mm − 1 ...

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    7. Mechanisms of Atherothrombosis and Vascular Response to Primary Percutaneous Coronary Intervention in Women Versus Men With Acute Myocardial Infarction : Results of the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angiop

      Mechanisms of Atherothrombosis and Vascular Response to Primary Percutaneous Coronary Intervention in Women Versus Men With Acute Myocardial Infarction : Results of the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angiop

      Objectives This study sought to assess in vivo sex differences in the pathophysiology of ST-segment elevation myocardial infarction (STEMI) and vascular response to primary percutaneous coronary intervention (PCI). Background There is no consensus on whether differences in the pathophysiology of STEMI and response to primary PCI between women and men reflect biological factors as opposed to differences in age. Methods In this prospective, multicenter study, 140 age-matched men and women with STEMI undergoing primary PCI with everolimus-eluting stent were investigated with intravascular optical coherence tomography, histopathology-immunohistochemistry of thrombus aspirates, and serum biomarkers. Primary endpoints were the percentages of culprit plaque ...

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    8. Segmentation and quantification for intravascular optical coherence tomography images

      Segmentation and quantification for intravascular optical coherence tomography images

      A system and related methods for automatic or semi-automatic segmentation and quantification of blood vessel structure and physiology, including segmentation and quantification of lumen, guide wire, vessel wall, calcified plaques, fibrous caps, macrophages, metallic and bioresorbable stents are described, and including visualization of results. Calcified plaque segmentation can be used to estimate the distribution of superficial calcification and inform strategies stenting. Volumetric segmentation and quantification of fibrous caps can provide more comprehensive information of the mechanisms behind plaque rupture. Quantification of macrophages can aid diagnosis and prediction of unstable plaque and associated acute coronary events. Automated detection and quantification of ...

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    9. 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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    10. 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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    11. Impact of Drug Release Kinetics on Vascular Response to Different Zotarolimus-Eluting Stents Implanted in Patients With Long Coronary Stenoses: The LongOCT Study (Optical Coherence Tomography in Long Lesions)

      Impact of Drug Release Kinetics on Vascular Response to Different Zotarolimus-Eluting Stents Implanted in Patients With Long Coronary Stenoses: The LongOCT Study (Optical Coherence Tomography in Long Lesions)
      Objectives We assessed the in vivo vascular response to a new generation of zotarolimus-eluting stents (ZES) with prolonged drug release (Resolute ZES-SR, Medtronic Vascular, Santa Rosa, California) compared with ZES with faster kinetics (Endeavor ZES-FR, Medtronic Vascular) by optical coherence tomography. Background Local drug release kinetics has been implicated with antirestenosis efficacy of drug-eluting stents. However, the impact of different release kinetics on vascular response of diseased human coronary arteries remains to be investigated. Methods The study population consisted of 43 patients with long lesions in native coronary vessels treated with multiple overlapping ZES. Twenty-one patients treated with ZES-SR were ...
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    12. Optical coherence tomography endpoints in stent clinical investigations: strut coverage

      Optical coherence tomography endpoints in stent clinical investigations: strut coverage
      Late stent thrombosis (LST) and very LST (VLST) are infrequent complications after drug-eluting stent (DES) implantation, but they carry a significant risk for patients. Delayed healing, which may be represented by incomplete stent coverage, has been observed in necropsy vessel specimens treated with DES. As a result, in vivo assessment of stent coverage, as well as stent apposition using optical coherence tomography (OCT), have been recently used as surrogate safety endpoints in clinical trials testing DES platforms. By adopting strut coverage assessed by OCT, one can assess the safety profile of the new generation of DES in preregistration studies. This ...
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    13. Strut Coverage and Vessel Wall Response to Zotarolimus-Eluting and Bare-Metal Stents Implanted in Patients With ST-Segment Elevation Myocardial Infarction: The Octami (Optical Coherence Tomography in Acute Myocardial Infarction) Study

      Strut Coverage and Vessel Wall Response to Zotarolimus-Eluting and Bare-Metal Stents Implanted in Patients With ST-Segment Elevation Myocardial Infarction: The Octami (Optical Coherence Tomography in Acute Myocardial Infarction) Study
      Objectives Using optical coherence tomography, we assessed the proportion of uncovered struts at 6-month follow-up in zotarolimus-eluting stents (ZES), specifically Endeavor (Medtronic CardioVascular, Santa Rosa, California) stents, and identical bare-metal stents (BMS) implanted in patients with ST-segment elevation myocardial infarction (STEMI). Background Sirolimus- and paclitaxel-eluting stents implanted in STEMI have been associated with delayed healing and incomplete strut coverage. ZES are associated with a more complete and uniform strut coverage in stable patients, but whether this holds true also after STEMI is unknown. Methods Forty-four patients with STEMI who underwent primary PCI were randomized to ZES or BMS (3:1 ...
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    14. Unhealed Plaque Ruptures After Stenting in Acute Myocardial Infarction Assessed by Intracoronary Optical Coherence Tomography: Incidence, Predictors, and Clinical Implication

      Backgrounds: Non healing after stenting a ruptured thin capped fibroatheroma in acute myocardial infarction (AMI) has been suggested to be a possible cause of late stent thrombosis. Optical coherence tomography (OCT) provides detailed information of ruptured plaques and stent strut coverage. We used OCT to assess the incidence, predictors, and implications of residual plaque rupture after stenting in AMI. Methods: The HORIZONS-AMI trial was a prospective, multicenter, dual arm factorial trial in which pts with AMI were randomized to different antithrombotic regimens and paclitaxel-eluting TAXUS stents vs. bare metal EXPRESS stents (3:1). Clinical follow-up was performed at 12 months ...
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    15. Expert review document on methodology, terminology, and clinical applications of optical coherence tomography: physical principles, methodology of image acquisition, and clinical application for assessment of coronary arteries and atherosclerosis

      Optical coherence tomography (OCT) is a novel intravascular imaging modality, based on infrared light emission, that enables a high resolution arterial wall imaging, in the range of 10–20 microns. This feature of OCT allows the visualization of specific components of the atherosclerotic plaques. The aim of the present Expert Review Document is to address the methodology, terminology and clinical applications of OCT for qualitative and quantitative assessment of coronary arteries and atherosclerosis.

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    16. Reproducibility of quantitative optical coherence tomography for stent analysis

      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 ...
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    1-17 of 17
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    1. (17 articles) Marco A. Costa
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    Strut Coverage and Vessel Wall Response to Zotarolimus-Eluting and Bare-Metal Stents Implanted in Patients With ST-Segment Elevation Myocardial Infarction: The Octami (Optical Coherence Tomography in Acute Myocardial Infarction) Study Optical coherence tomography endpoints in stent clinical investigations: strut coverage Impact of Drug Release Kinetics on Vascular Response to Different Zotarolimus-Eluting Stents Implanted in Patients With Long Coronary Stenoses: The LongOCT Study (Optical Coherence Tomography in Long Lesions) Expert review document part 2: methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures Comprehensive overview of definitions for optical coherence tomography-based plaque and stent analyses Mechanisms of Atherothrombosis and Vascular Response to Primary Percutaneous Coronary Intervention in Women Versus Men With Acute Myocardial Infarction : Results of the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angiop Parameter estimation of atherosclerotic tissue optical properties from three-dimensional intravascular optical coherence tomography In vivo evaluation of corneal biomechanical properties by optical coherence elastography at different cross-linking irradiances The Association of Optical Coherence Tomography Results With Neuroimaging Signs and Some Clinical Parameters in Idiopathic Intracranial Hypertension Low cost scalable monolithic common path probe design for the application in endoscopic optical coherence tomography Retinal and Choroidal Vascular Changes in Eyes with Pseudoexfoliation Syndrome: a Comparative Study Using Optical Coherence Tomography Angiography Longitudinal Detection of Radiation-Induced Peripapillary and Macular Retinal Capillary Ischemia Using Optical Coherence Tomography Angiography