1. Articles from hironori kitabata

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    1. Intracoronary pressure increase due to contrast injection for optical coherence tomography imaging

      Intracoronary pressure increase due to contrast injection for optical coherence tomography imaging

      Background Optical coherence tomography (OCT) requires intracoronary injection of contrast media to remove blood from the field of view during image acquisition. Contrast injection may cause a temporal increase in intracoronary pressure. The aim of this study was to compare the intracoronary pressure during contrast injection between OCT and coronary angiography . Methods We measured intracoronary pressure by using a pressure guidewire during contrast injection for OCT and angiography in 30 coronary arteries (mean fractional flow reserve = 0.90 ± 0.03). Contrast media was injected into coronary artery through the guiding catheter by using a mechanical injector pump. Results Intracoronary pressure ...

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    2. Imaging assessment and accuracy in coronary artery autopsy: comparison of frequency-domain optical coherence tomography with intravascular ultrasound and histology

      Imaging assessment and accuracy in coronary artery autopsy: comparison of frequency-domain optical coherence tomography with intravascular ultrasound and histology

      ptical coherence tomography (OCT) is a coronary artery imaging technique with high resolution. Second-generation frequency-domain OCT (FD-OCT) technology allows safer and faster clinical application compared with first-generation time-domain OCT (TD-OCT). Only limited validation studies compare FD-OCT with other modes of analysis: histology, which is the current gold standard, and intravascular ultrasound (IVUS). This study therefore aims to demonstrate the accuracy of FD-OCT images compared with IVUS and histology. FD-OCT and IVUS images were acquired from 203 segments from 31 coronary arteries obtained at autopsy from 20 cadavers. Of these, 30 randomly-selected pairs were used to create three classifications of plaque ...

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    3. Stabilization of High Risk Coronary Plaque on Optical Coherence Tomography and Near-Infrared Spectroscopy by Intensive Lipid-Lowering Therapy With Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitor

      Stabilization of High Risk Coronary Plaque on Optical Coherence Tomography and Near-Infrared Spectroscopy by Intensive Lipid-Lowering Therapy With Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitor

      A 70-year-old woman with hypertension and dyslipidemia underwent drug-eluting stent implantation in the mid-left anterior descending artery (LAD) due to acute coronary syndrome (ACS). Optical coherence tomography (OCT) during the index procedure showed lipid-rich plaque in non-culprit lesions of the proximal LAD and mid-right coronary artery (Figure B,E). Near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) showed plaque with high lipid burden in both sites (Figure C,F). Intensive lipid-lowering therapy with combined strong statin and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor was started after the index procedure. Scheduled 10-month follow-up OCT and NIRS-IVUS showed increase in minimum fibrous cap thickness ...

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    4. Comparison between Optical COherence tomography guidance and Angiography guidance in percutaneous coronary intervention (COCOA): Study protocol for a randomized controlled trial

      Comparison between Optical COherence tomography guidance and Angiography guidance in percutaneous coronary intervention (COCOA): Study protocol for a randomized controlled trial

      Background Optical coherence tomography (OCT) is increasingly used as an adjunct to coronary angiography for guiding percutaneous coronary intervention (PCI). The current consensus on PCI is that the large final stent area offers the best chance of a good late clinical outcome. Since OCT provides more accurate information about the coronary artery and implanted stents, OCT-guided stent implantation is expected to achieve greater stent expansion than angiography guidance alone. Therefore, we designed the COCOA (Comparison between Optical COherence tomography guidance and Angiography guidance in percutaneous coronary intervention) study to evaluate whether OCT-guided stent implantation would result in a minimum stent ...

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    5. Effect of Early Pitavastatin Therapy on Coronary Fibrous-Cap Thickness Assessed by Optical Coherence Tomography in Patients With Acute Coronary Syndrome : The ESCORT Study

      Effect of Early Pitavastatin Therapy on Coronary Fibrous-Cap Thickness Assessed by Optical Coherence Tomography in Patients With Acute Coronary Syndrome : The ESCORT Study

      Objectives The aim of the present study was to assess the effect of early statin therapy on fibrous-cap thickness in coronary plaques of patients with acute coronary syndrome (ACS) by using optical coherence tomography. Background Statins can contribute to the stabilization of coronary plaques. Methods This is a prospective, randomized, active-controlled, single-center study. Patients with ACS and untreated dyslipidemia were enrolled and randomly allocated (ratio 1:1) to either the early statin group (received pitavastatin 4 mg/day from baseline) or the late statin group (received pitavastatin 4 mg/day from 3 weeks after the baseline). Optical coherence tomography was ...

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    6. Optical Coherence Tomography Predictors for Edge Restenosis After Everolimus-Eluting Stent Implantation

      Optical Coherence Tomography Predictors for Edge Restenosis After Everolimus-Eluting Stent Implantation

      Background— Stent edge restenosis (SER) remains a potential limitation of drug-eluting stents. The aim of this study was to determine optical coherence tomography (OCT) predictors for angiographic late SER after everolimus-eluting stent implantation. Methods and Results— We retrospectively analyzed 319 patients who underwent OCT immediately after everolimus-eluting stent implantation and scheduled 9- to 12-month follow-up angiography. The binary angiographic SER rate was 10% (32/319) in the patients, 8.4% (32/382) in lesions, and 4.4% (33/744) in stent edge segments. In the stent edge segments at post stenting, OCT-derived lipidic plaque (61% versus 20%; P <0.001 ...

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    7. Assessment of Vascular Response after Stent Implantation by Intracoronary Optical Coherence Tomograph

      Assessment of Vascular Response after Stent Implantation by Intracoronary Optical Coherence Tomograph

      Optical coherence tomography (OCT) is a high resolution (10-20 μm) imaging modality that provides microscopic visualization of the coronary artery including vascular response after stent implantation. Compared to conventional intravascular ultrasound, OCT can more clearly identify findings immediately after stent implantation, such as tissue protrusion, stent edge dissection, and incomplete stent strut apposition. Furthermore, OCT allows clinicians to accurately assess the late acquired stent malapposition and strut coverage which could be a surrogate marker for stent thrombosis after drug-eluting stent (DES) implantation. OCT can evaluate not only the extent and amount of neointima but also the tissue characteristics of neointimal ...

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    8. Optimal threshold of postintervention minimum stent area to predict in-stent restenosis in small coronary arteries: An optical coherence tomography analysis

      Optimal threshold of postintervention minimum stent area to predict in-stent restenosis in small coronary arteries: An optical coherence tomography analysis

      Objectives The aim of this study was to determine the best threshold of postintervention minimum stent area (MSA) assessed by optical coherence tomography (OCT) to predict long-term in-stent restenosis (ISR) for 2.5 mm-diameter everolimus-eluting stents (EES). Background Percutaneous coronary intervention (PCI) for small coronary arteries remains challenging. Stent underexpansion is a strong predictor of late ISR. Methods We performed a retrospective analysis of 69 lesions in 69 patients undergoing PCI with 2.5 mm-diameter stents using OCT for the assessment of postintervention MSA and subsequent 9-month angiographic follow-up. Results The rates of angiographic ISR and target lesion revascularization were ...

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    9. Feasibility of Optical Coronary Tomography in Quantitative Measurement of Coronary Arteries With Lipid-Rich Plaque

      Feasibility of Optical Coronary Tomography in Quantitative Measurement of Coronary Arteries With Lipid-Rich Plaque

      Background: The aim of the present study was to evaluate the feasibility of optical coherence tomography (OCT) for measurement of vessel area in coronary arteries with lipid-rich plaque as compared with intravascular ultrasound (IVUS). Methods and Results: We investigated 80 coronary artery segments with lipid-rich plaque on OCT and non-attenuated plaque on IVUS. According to the lipid arc on OCT, the plaques were classified into 4 groups: group 1, lipid arc ≤90°; group 2, 90°<lipid arc≤180°; group 3, 180°<lipid arc≤270°; group 4, lipid arc >270°. Vessel circular arcs that could not be identified due to OCT ...

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    10. Comparison of vascular response between everolimus-eluting stent and bare metal stent implantation in ST-segment elevation myocardial infarction assessed by optical coherence tomography

      Comparison of vascular response between everolimus-eluting stent and bare metal stent implantation in ST-segment elevation myocardial infarction assessed by optical coherence tomography

      Aims The long-term safety of second-generation everolimus-eluting stents (EESs) in ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of this study was to evaluate the late vascular response after stent implantation in STEMI between EES and bare-metal stent (BMS) by using optical coherence tomography (OCT). Methods and results A prospective OCT examination was performed in 102 patients at 10 months after stent implantation for treatment of STEMI. A total of 1253 frames with 12 772 struts in 61 EESs and 776 frames with 8594 struts in 41 BMSs were analysed. There were no significant differences in the percentage of ...

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    11. Effect of Atorvastatin Therapy on Fibrous Cap Thickness in Coronary Atherosclerotic Plaque as Assessed by Optical Coherence Tomography The EASY-FIT Study

      Effect of Atorvastatin Therapy on Fibrous Cap Thickness in Coronary Atherosclerotic Plaque as Assessed by Optical Coherence Tomography The EASY-FIT Study

      Background The detailed mechanism of plaque stabilization by statin therapy is not fully understood. Objectives The aim of this study was to assess the effect of lipid-lowering therapy with 20 mg/day of atorvastatin versus 5 mg/day of atorvastatin on fibrous cap thickness in coronary atherosclerotic plaques by using optical coherence tomography (OCT). Methods Seventy patients with unstable angina pectoris and untreated dyslipidemia were randomized to either 20 mg/day or 5 mg/day of atorvastatin therapy. OCT was performed to assess intermediate nonculprit lesions at baseline and 12-month follow-up. Results Serum low-density lipoprotein cholesterol level was significantly lower ...

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    12. Impact of Eicosapentaenoic Acid Treatment on the Fibrous Cap Thickness in Patients with Coronary Atherosclerotic Plaque: An Optical Coherence Tomography Study

      Impact of Eicosapentaenoic Acid Treatment on the Fibrous Cap Thickness in Patients with Coronary Atherosclerotic Plaque: An Optical Coherence Tomography Study

      Aim : Previous clinical trials have demonstrated the effectiveness of eicosapentaenoic acid (EPA) in preventing cardiovascular events. The aim of the present study was to investigate the effects of EPA treatment on the accumulation of coronary atherosclerotic plaque using optical coherence tomography (OCT). Methods : A total of 46 acute coronary syndrome (ACS) patients without dyslipidemia were divided into two groups: those who received 1,800 mg/day of EPA ( n =15) or the control group ( n =31). Serial OCT examinations were performed at baseline and after eight months of follow-up. The target for the OCT analysis was non-culprit plaque with a ...

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    13. Assessment of Coronary Atherosclerosis using Optical Coherence Tomography

      Assessment of Coronary Atherosclerosis using Optical Coherence Tomography

      Optical coherence tomography (OCT) is a catheter-based imaging system that uses near-infrared light to produce cross-sectional images of the coronary arteries. With its extraordinarily high resolution (10-20 μ m), OCT allows clinicians to observe various morphological features of coronary atherosclerosis in vivo . For example, intimal thickening presents as homogeneous, signal-rich regions on OCT, while fibroatheroma with a lipid-rich necrotic core is characterized by the presence of signal-poor regions with a diffuse border. Furthermore, plaque rupture is detected in 50〜70% of culprit lesions of acute coronary syndrome (ACS), and plaque erosion develops over areas of intimal thickening and/or thick-cap fibroatheroma ...

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    14. Difference of Ruptured Plaque Morphology between Asymptomatic Coronary Artery Disease and Non-ST Elevation Acute Coronary Syndrome Patients: an Optical Coherence Tomography Study

      Difference of Ruptured Plaque Morphology between Asymptomatic Coronary Artery Disease and Non-ST Elevation Acute Coronary Syndrome Patients: an Optical Coherence Tomography Study

      Background Autopsy studies have reported that rupture of a thin-cap fibroatheroma and subsequent thrombus formation is the major mechanism leading to acute coronary syndrome (ACS). However, it is not clear why only some plaque ruptures lead to ACS. Optical coherence tomography (OCT) is a high-resolution imaging modality which is capable of investigating detailed coronary plaque morphology in vivo. The objective of this study was to determine whether ruptured plaque morphology assessed by OCT differs between asymptomatic coronary artery disease (CAD) and non-ST elevation acute coronary syndrome (NSTEACS). Methods We examined ruptured plaque morphology using OCT in 80 patients, 33 with ...

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    15. Intra-Stent Tissue Evaluation within Bare Metal and Drug-Eluting Stents > 3 Years since Implantation in Patients with Mild to Moderate Neointimal Proliferation Using Optical Coherence Tomography and Virtual Histology Intravascular Ultrasound

      Intra-Stent Tissue Evaluation within Bare Metal and Drug-Eluting Stents > 3 Years since Implantation in Patients with Mild to Moderate Neointimal Proliferation Using Optical Coherence Tomography and Virtual Histology Intravascular Ultrasound

      Objective: We aimed to compare neointimal tissue characteristics between bare-metal stents (BMS) and drug-eluting stents (DES) at long-term follow-up using optical coherence tomography (OCT) and virtual histology intravascular ultrasound (VH-IVUS). Background: Neoatherosclerosis in neointima has been reported in BMS and in DES. Methods: Thirty patients with 36 stented lesions [BMS (n = 17) or DES (n = 19)] > 3 years after implantation were prospectively enrolled. OCT and VH-IVUS were performed and analyzed independently. Stents with ≥ 70% diameter stenosis were excluded. Results: The median duration from implantation was 126.0 months in the BMS group and 60.0 months in the DES group ...

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    16. Comparison of longitudinal geometric measurement in human coronary arteries between frequency-domain optical coherence tomography and intravascular ultrasound

      Comparison of longitudinal geometric measurement in human coronary arteries between frequency-domain optical coherence tomography and intravascular ultrasound

      Previous studies have demonstrated the higher accuracy of frequency-domain optical coherence tomography (FD-OCT) for quantitative measurements in comparison with intravascular ultrasound (IVUS). However, those analyses were based on the cross-sectional images. The aim of this study was to assess the accuracy of FD-OCT for longitudinal geometric measurements of coronary arteries in comparison with IVUS. Between October 2011 and March 2012, we performed prospective FD-OCT and IVUS examinations in consecutive 77 patients who underwent percutaneous coronary intervention with single stent. Regression analysis and Bland-Altman analysis revealed an excellent correlation between the FD-OCT-measured stent lengths and IVUS-measured stent lengths (r = 0.986 ...

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    17. Serial Observation of Drug-Eluting Absorbable Metal Scaffold Multi-Imaging Modality Assessment

      Serial Observation of Drug-Eluting Absorbable Metal Scaffold Multi-Imaging Modality Assessment

      Background— The drug-eluting absorbable metal scaffold has demonstrated feasibility, safety, and promising clinical and angiographic outcomes at 12 months in human coronary arteries. This study aimed to evaluate the degradation rate and long-term vascular responses to drug-eluting absorbable metal scaffold. Methods and Results— BIOSOLVE-I was a multicenter, single-arm, first-in-man trial assessing the safety and performance of drug-eluting absorbable metal scaffold in 46 patients with coronary artery disease. Patients who underwent serial invasive imaging, such as quantitative coronary angiography, intravascular ultrasound, and optical coherence tomography, at 6 and 12 months were included in this study. From postimplantation to follow-up, arterial curvature ...

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    18. Comparison of diagnostic accuracy between multidetector computed tomography and virtual histology intravascular ultrasound for detecting optical coherence tomography-derived fibroatheroma

      Comparison of diagnostic accuracy between multidetector computed tomography and virtual histology intravascular ultrasound for detecting optical coherence tomography-derived fibroatheroma

      Histopathological studies have reported that optical coherence tomography (OCT) can accurately detect fibroatheroma that is involved in not only culprit lesion of acute coronary syndrome but also no-reflow phenomenon after percutaneous coronary intervention. Studies have demonstrated superiority of OCT in plaque characterization and interruption of arterial wall component. At current, multidetector computed tomography (MDCT) and virtual histology intravascular ultrasound (VH-IVUS) are considered as alternative imaging devices for coronary plaque characterization. This study aimed to compare the diagnostic accuracy for detecting fibroatheroma between MDCT and VH-IVUS using OCT as the reference standard. Forty-three lesions from 27 patients assessed by MDCT, VH-IVUS ...

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    19. 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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    20. OCT Compared With IVUS in a Coronary Lesion Assessment The OPUS-CLASS Study

      OCT Compared With IVUS in a Coronary Lesion Assessment The OPUS-CLASS Study

      The aim of this study was to investigate the reliability of frequency domain optical coherence tomography (FD-OCT) for coronary measurements compared with quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS). Background Accurate luminal measurement is expected in FD-OCT because this technology offers high resolution and excellent contrast between lumen and vessel wall. Methods In 5 medical centers, 100 patients with coronary artery disease were prospectively studied by using angiography, FD-OCT, and IVUS. In addition, 5 phantom models of known lumen dimensions (lumen diameter 3.08 mm; lumen area 7.45 mm 2 ) were examined using FD-OCT and IVUS. Quantitative image ...

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    21. Inter-Scan Reproducibility of Geometric Coronary Artery Measurements Using Frequency-Domain Optical Coherence Tomography

      Inter-Scan Reproducibility of Geometric Coronary Artery Measurements Using Frequency-Domain Optical Coherence Tomography

      Frequency-domain optical coherence tomography (FD-OCT) is a novel technology which provides high-resolution cross-sectional images of coronary arteries. The aim of this study was to evaluate the inter-scan reproducibility of geometric FD-OCT measurements in the clinical setting. We examined 20 coronary lesions using FD-OCT. Following the FD-OCT image acquisition (1 st pullback), and after the disengagement and re-engagement of the guiding catheter, an additional acquisition (2 nd pullback) was performed using a new FD-OCT catheter. There was excellent correlation for minimum lumen area ( r = 0.99, P < 0.001), lesion length ( r = 0.99, P < 0.001) and lumen volume ( r ...

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    22. Coronary Superficial and Spotty Calcium Deposits in Culprit Coronary Lesions of Acute Coronary Syndrome as Determined by Optical Coherence Tomography

      Coronary Superficial and Spotty Calcium Deposits in Culprit Coronary Lesions of Acute Coronary Syndrome as Determined by Optical Coherence Tomography

      The characteristics of coronary artery calcium responsible for vulnerable plaque remain incompletely elucidated. We used optical coherence tomography to investigate the characteristics of coronary calcium in acute myocardial infarction (AMI), unstable angina pectoris (UAP), and stable angina pectoris (SAP). We evaluated calcium deposits in the culprit lesions (30-mm segment) using optical coherence tomography in 187 patients with AMI (n = 44), UAP (n = 73), or SAP (n = 70). The arc, area, and length of calcium were significantly smaller in those with AMI and UAP than in those with SAP (p <0.001). The number of spotty calcium deposits (with an arc ...

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