1. Articles from toshio imanishi

    1-24 of 46 1 2 »
    1. 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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    2. 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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    3. 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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    4. 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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    5. Association between P-selectin Glycoprotein Ligand-1 and Pathogenesis in Acute Coronary Syndrome Assessed by Optical Coherence Tomography

      Association between P-selectin Glycoprotein Ligand-1 and Pathogenesis in Acute Coronary Syndrome Assessed by Optical Coherence Tomography

      Objective Although monocytes appear to be actively involved in the onset of acute coronary syndrome (ACS), they are heterogenous in human peripheral blood. How up-regulation of monocyte subsets leads to coronary plaque rupture followed by thrombus formation remains unclear. Recent studies have shown that P-selectin glycoprotein ligand-1 (PSGL-1) is involved in monocyte activation in patients with thrombus formation. We therefore investigated the relationship between the expression of PSGL-1 on monocyte subsets and thrombus formation using frequency-domain optical coherence tomography (FD-OCT) in patients with ACS. Methods We enrolled a total of 100 individuals in this study: patients with acute myocardial infarction ...

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    6. 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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    7. 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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    8. 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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    9. 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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    10. Clinical Significance of Low Signal Intensity Area Surrounding Stent Struts Identified by Optical Coherence Tomography

      Clinical Significance of Low Signal Intensity Area Surrounding Stent Struts Identified by Optical Coherence Tomography

      Previous intravascular ultrasound studies have shown that echolucent neointimal hyperplasia occasionally appears after bare-metal stent (BMS) or sirolimus-eluting stent (SES) implantation. Optical coherence tomography (OCT) studies have also demonstrated that paclitaxel-eluting stent (PES) restenosis exhibited similar images showing low signal intensity areas (LSIA) surrounding stent struts and three-layer appearance (TLA). The aim of the present study was to investigate the clinical significance of LSIA on OCT images in various types of stents. Fifty nine consecutive patients who underwent scheduled follow-up coronary angiography and OCT were enrolled. There was no significant difference in the prevalence of LSIA among the 3 stent ...

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    11. Difference in neointimal appearance between early and late restenosis after sirolimus-eluting stent implantation assessed by optical coherence tomography

      Difference in neointimal appearance between early and late restenosis after sirolimus-eluting stent implantation assessed by optical coherence tomography

      Objectives: Late in-stent restenosis (ISR) is an important clinical issue in the drug-eluting stent era. Autopsy studies have reported different underlying mechanisms between early ISR and late ISR. The aim of the present study was to compare the neointimal tissue appearance between early ISR (<1 year) and late ISR (>1 year) after sirolimus-eluting stent (SES) implantation using optical coherence tomography (OCT). Materials and methods: We examined the neointimal tissue appearance in 48 ISR lesions after SES implantation [30 early ISR lesions (8±1 months after stenting) and 18 late ISR lesions (34±14 months after stenting)] by OCT. ISR was ...

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    12. Fatty streak assessed by optical coherence tomography: early atherosclerosis detection

      Fatty streak assessed by optical coherence tomography: early atherosclerosis detection

      Macrophage plays a crucial role for atherosclerotic plaque and its measurement is important. Fatty streak consists of macrophage foam cells, but its assessment by optical coherence tomography (OCT) has not been established in vivo. These images were derived from an aorta of Watanabe heritable hyperlipidaemia rabbit ex vivo. OCT...

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    13. Optical Coherence Tomography-Derived Anatomical Criteria for Functionally Significant Coronary Stenosis Assessed by Fractional Flow Reserve

      Optical Coherence Tomography-Derived Anatomical Criteria for Functionally Significant Coronary Stenosis Assessed by Fractional Flow Reserve

      Background: For the identification of functionally significant coronary artery disease, there have not been any dedicated optical coherence tomography (OCT) studies reported previously, although OCT can clearly detect coronary vessel lumina at higher resolution than intravascular ultrasound (IVUS). Methods and Results: OCT and fractional flow reserve (FFR) measurements were performed in 62 intermediate coronary lesions in 59 patients. FFR was calculated as the ratio of distal coronary pressure divided by proximal coronary pressure during maximal hyperemia. FFR <0.75 was used as the threshold for diagnosing functionally significant stenosis. Minimal lumen area (MLA), minimal lumen diameter (MLD) and percent lumen ...

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    14. Circulating malondialdehyde-modified low-density lipoprotein levels are associated with the presence of thin-cap fibroatheromas determined by optical coherence tomography in coronary artery disease

      Circulating malondialdehyde-modified low-density lipoprotein levels are associated with the presence of thin-cap fibroatheromas determined by optical coherence tomography in coronary artery disease

      Aims The importance of oxidized low-density lipoprotein (oxLDL) has been implicated in the process of plaque rupture. However, few previous studies demonstrated the relationship between plaque morphology and oxLDL. We evaluated the relationship between coronary plaque vulnerability assessed by optical coherence tomography (OCT) and circulating malondialdehyde-modified low-density lipoprotein (MDA-LDL). Methods and results OCT was used to determine plaque vulnerability in 102 patients with acute coronary syndrome (ACS; n = 53) and stable angina pectoris (SAP; n = 49). Circulating levels of MDA-LDL were measured by using enzyme-linked immunosorbent assay. Thin-cap fibroatheromas (TCFAs; defined as lipid-rich with plaque cap thickness

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    15. Effect of strut thickness on neointimal atherosclerotic change over an extended follow-up period (≥4 years) after bare-metal stent implantation: Intracoronary optical coherence tomography examination

      Effect of strut thickness on neointimal atherosclerotic change over an extended follow-up period (≥4 years) after bare-metal stent implantation: Intracoronary optical coherence tomography examination

      Background Neointima inside the bare-metal stents (BMSs) can transform into atherosclerotic tissue during an extended follow-up because of a persistent inflammatory reaction to the metal. We sought to investigate whether strut thickness may impact on the atherosclerotic change in neointima 4 years or more after BMS implantation using optical coherence tomography. Methods Forty-six stented lesions of 41 patients with BMS ≥4 years after implantation who underwent optical coherence tomography were enrolled in the study. The strut was defined as thin when less than 100 μm and thick when ≥100 μm. According to these criteria, stents were divided into 2 groups ...

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    16. Comparison of Contrast Media and Low-Molecular-Weight Dextran for Frequency-Domain Optical Coherence Tomography

      Comparison of Contrast Media and Low-Molecular-Weight Dextran for Frequency-Domain Optical Coherence Tomography

      Although an intracoronary frequency-domain optical coherence tomography (FD-OCT) system overcomes several limitations of the time-domain OCT (TD-OCT) system, the former requires injection of contrast media for image acquisition. The increased total amount of contrast media for FD-OCT image acquisition may lead to the impairment of renal function. The safety and usefulness of the non-occlusion method with low-molecular-weight dextran L (LMD-L) via a guiding catheter for TD-OCT image acquisition have been reported previously. The aim of the present study was to compare the image quality and quantitative measurements between contrast media and LMD-L for FD-OCT image acquisition in coronary stented lesions ...

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    17. Optical Coherence Tomography Analysis of Clinical and Subclinical

      Optical Coherence Tomography Analysis of Clinical and Subclinical

      Background: Coronary plaque ruptures occur not only in acute coronary syndrome (ACS) patients but also in non-ACS patients. There is a great interest in the reason why some plaque ruptures lead to ACS but others do not. We used optical coherence tomography (OCT) to identify anatomic features that lead to the development of culprit lesions causing ACS after plaque rupture.Methods: We assessed 102 plaque ruptures by using OCT and compared lesion morphologies betweensymptomatic plaque rupture in unstable angina pectoris (UAP; n=67) and silent plaque rupture in stable anginapectoris (SAP; n=35).Results: In the cross-sectional view, rupture was ...

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    18. Thin-Cap Fibroatheroma as High Risk Plaque for Microvascular Obstruction in Patients With Acute Coronary Syndrome

      Thin-Cap Fibroatheroma as High Risk Plaque for Microvascular Obstruction in Patients With Acute Coronary Syndrome
      Background—Plaque contents can cause microvascular impairment, which is an important determinant of clinical outcomes in patients with acute coronary syndrome (ACS). We hypothesized that percutaneous coronary intervention (PCI) for thin-cap fibroatheroma (TCFA) could easily disrupt the fibrous cap and expose the contents of plaque to coronary flow, possibly resulting in microvascular obstruction (MVO). The purpose of this study was to investigate whether TCFA was associated with MVO following PCI in patients with ACS. Methods and Results—We enrolled 115 patients with ACS who were successfully recanalized with PCI. The patients were divided into a ruptured plaque group (n=59 ...
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    19. Optical Coherence Tomography Analysis of Attenuated Plaques Detected by Intravascular Ultrasound in Patients with Acute Coronary Syndromes

      Optical Coherence Tomography Analysis of Attenuated Plaques Detected by Intravascular Ultrasound in Patients with Acute Coronary Syndromes

      Recent intravascular ultrasound (IVUS) studies have demonstrated that hypoechoic plaque with deep ultrasound attenuation despite absence of bright calcium is common in acute coronary syndrome. Such “attenuated plaque” may be an IVUS characteristic of unstable lesion. Methods. We used optical coherence tomography (OCT) in 104 patients with unstable angina to compare lesion characteristics between IVUS-detected attenuated plaque and nonattenuated plaque. Results. IVUS-detected attenuated plaque was observed in 41 (39%) patients. OCT-detected lipidic plaque (88% versus 49%,

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    20. Virtual Histology Intravascular Ultrasound Compared With Optical Coherence Tomography for Identification of Thin-Cap Fibroatheroma

      Virtual Histology Intravascular Ultrasound Compared With Optical Coherence Tomography for Identification of Thin-Cap Fibroatheroma

      Virtual histology intravascular ultrasound (VH-IVUS) allows detailed assessment of plaque composition in the clinical setting. Optical coherence tomography (OCT) has been developed as a high-resolution imaging method, which might be a promising technique to identify thin-cap fibroatheroma (TCFA) in vivo. The purpose of the present study was to evaluate the diagnostic accuracy of VH-IVUS to identify TCFA as determined by OCT.We examined 96 target lesions in patients with stable angina pectoris by using VH-IVUS and OCT. VH-IVUS derived TCFA was defined as a focal necrotic core-rich lesion without evident overlying fibrous tissue. OCT derived TCFA was defined as a ...

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    21. Difference of Culprit Lesion Morphologies Between ST-Segment Elevation Myocardial Infarction and Non-ST-Segment Elevation Acute Coronary Syndrome: An Optical Coherence Tomography Study

      Difference of Culprit Lesion Morphologies Between ST-Segment Elevation Myocardial Infarction and Non-ST-Segment Elevation Acute Coronary Syndrome: An Optical Coherence Tomography Study
      Objectives The aim of this study was to investigate the difference of culprit lesion morphologies assessed by optical coherence tomography (OCT) between ST-segment elevation myocardial infarction (STEMI) and non–ST-segment elevation acute coronary syndrome (NSTEACS). Background Autopsy studies have reported that rupture of a thin-cap fibroatheroma and subsequent thrombus formation is the most important mechanism leading to acute coronary syndrome (ACS). Optical coherence tomography is a high-resolution imaging modality that is capable of investigating detailed coronary plaque morphology in vivo. Methods We examined the culprit lesion morphologies by OCT in 89 consecutive patients with acute coronary syndrome (STEMI = 40; NSTEACS ...
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    22. Assessment by Optical Coherence Tomography of Stent Struts Across Side Branch – Comparison of Bare-Metal Stents and Drug-Eluting Stents –

      Assessment by Optical Coherence Tomography of Stent Struts Across Side Branch – Comparison of Bare-Metal Stents and Drug-Eluting Stents –
      Late stent thrombosis (LST) after drug-eluting stent (DES) implantation is a major clinical problem that has not been fully explained. Incomplete neointimal coverage of stent struts is an important morphometric predictor of LST, which may be associated with impaired healing and the absence of full coverage of struts at branch-point ostia. Optical coherence tomography (OCT) was performed to compare 3 types of stents placed across side branches. Methods and Results: At 9-month follow-up, the neointimal coverage of the struts of 58 stents across a side branch was measured by OCT (bare metal (BMS), n=20; sirolimus-eluting (SES), n=23; paclitaxel-eluting ...
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