1. Articles from nobuo nakamura

    1-15 of 15
    1. 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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    2. Relation of Microchannel Structure Identified by Optical Coherence Tomography to Plaque Vulnerability in Patients With Coronary Artery Disease

      Relation of Microchannel Structure Identified by Optical Coherence Tomography to Plaque Vulnerability in Patients With Coronary Artery Disease
      Increased neovascularization in atherosclerotic plaques is associated with plaque vulnerability. The high resolution of optical coherence tomography (OCT) might provide a chance to directly visualize plaque neovascularization in vivo. The aim of the present study was to investigate the relation between microchannels in culprit plaques identified by OCT and plaque vulnerability in patients with coronary artery disease. A total of 63 consecutive patients with coronary artery disease who had undergone both OCT and intravascular ultrasound before any interventions to examine culprit lesion morphologies were enrolled. Microchannel was defined as a no-signal tubuloluminal structure on the cross-sectional optical coherence tomographic image ...
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    3. Feasibility of Noninvasive Assessment of Thin-Cap Fibroatheroma by Multidetector Computed Tomography

      Objectives The purpose of this study was to investigate whether multidetector computed tomography (MDCT) can noninvasively help assess thin-cap fibroatheroma (TCFA). Background Plaque rupture and thrombus formation play key roles in the onset of acute coronary syndrome. TCFA is recognized as a precursor lesion for plaque rupture, and MDCT angiography can potentially help identify plaques prone to rupture. Methods We enrolled 105 patients with coronary artery disease (acute coronary syndromes, n = 31; stable angina pectoris, n = 74). Culprit lesions were assessed by both MDCT and optical coherence tomography (OCT). Patients were divided into a TCFA and a non-TCFA group according ...
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    4. Advantage of next-generation frequency-domain optical coherence tomography compared with conventional time-domain system in the assessment of coronary lesion

      Background: Intracoronary optical coherence tomography (OCT) is a high-resolution imaging modality used for evaluation of coronary lesion morphology. However, current time-domain OCT (TD-OCT) have a number of limitations with regard to both procedural usage and safety in the clinical setting. The next-generation frequency-domain OCT (FD-OCT), which has a much faster frame rate and pullback speed than TD-OCT, is expected to overcome these limitations. The aim of this study was to evaluate the feasibility and usability of next generation FD-OCT in the assessment of coronary lesions. Methods: A comparison study was performed between FD-OCT and TD-OCT from the aspect of usability ...
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    5. Head to head comparison between the conventional balloon occlusion method and the non-occlusion method for optical coherence tomography

      Abstract: Background: Optical coherence tomography (OCT) has been introduced as a high-resolution imaging modality for the coronary arteries. The current OCT system, however, has a serious limitation in that the image acquisition method requires a soft balloon occlusion to avoid signal scattering from red blood cells.Purpose: The purpose of this study was to compare OCT images from the conventional balloon occlusion method and a non-occlusion image acquisition method, the continuous-flushing method, in the clinical setting.Methods: OCT was performed with the conventional balloon occlusion method and the continuous-flushing method sequentially in 23 patients with stable angina. The image quality ...
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    6. Relationship Between Coronary Arterial Remodeling, Fibrous Cap Thickness and High-Sensitivity C-Reactive Protein Levels in Patients With Acute Coronary Syndrome

      Thin-capped fibroatheroma (TCFA) is a recognized precursor lesion for acute coronary syndrome (ACS). Positive remodeling (PR) is the predominant pattern of arterial remodeling in patients with ACS. The aim of this study was to evaluate the relationship between coronary arterial remodeling, fibrous cap thickness and high-sensitivity C-reactive protein (hs-CRP) concentration in patients with ACS. Methods and Results: The 47 consecutive ACS patients were enrolled in this study. Arterial remodeling of culprit plaque was assessed by intravascular ultrasound, and fibrous cap thickness was measured by optical coherence tomography. The remodeling index (RI) was calculated as lesion divided by the reference external ...
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    7. Lipid-rich plaque and myocardial perfusion after successful stenting in patients with non-ST-segment elevation acute coronary syndrome: an optical coherence tomography study

      Aims: Although some recent guidelines recommend an early invasive strategy for non-ST-segment elevation acute coronary syndrome (NSTEACS), several studies have failed to identify any benefit for very early intervention for NSTEACS. The no-reflow phenomenon may inhibit the expected benefit from very early recanalization for NSTEACS subjects. The aim of this study was to investigate whether optical coherence tomography (OCT) could predict no-reflow in patients with NSTEACS. Methods and results: This study comprised 83 consecutive patients with NSTEACS who underwent OCT and successful emergent primary stenting. On the basis of post-stent TIMI flow, patients were divided into two groups: no-reflow group ...
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    8. Various Types of Plaque Disruption in Culprit Coronary Artery Visualized by Optical Coherence Tomography in a Patient With Unstable Angina

      A 58-year-old man underwent cardiac catheterization for unstable angina. The coronary angiogram revealed severe stenosis of the right coronary artery. Although 20-MHz, phased-array intravascular ultrasound (IVUS) only visualized eccentric, low echoic plaque at the culprit site, optical coherence tomography (OCT) clearly revealed ruptured plaque and an intraluminal thrombus. OCT also revealed a small ruptured plaque and an eroded plaque with intraluminal thrombi in a distal site remote from the culprit lesion, neither of which was visualized by IVUS.
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    9. Morphology of Exertion-Triggered Plaque Rupture in Patients With Acute Coronary Syndrome. An Optical Coherence Tomography Study

      Background—Plaque rupture and secondary thrombus formation play key roles in the onset of acute coronary syndrome (ACS). One pathological study suggested that the morphologies of plaque rupture differed between rest-onset and exertion-triggered rupture in men who experienced sudden death. The aim of the present study was to use optical coherence tomography to investigate the relationship in patients with ACS between the morphology of a ruptured plaque and the patient's activity at the onset of ACS. Methods and Results—The study population was drawn from 43 consecutive ACS patients (with or without ST-segment elevation) who underwent optical coherence tomography ...
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    10. Relationship between Coronary Arterial Remodeling and Fibrous Cap Thickness in Patients with Acute Coronary Syndrome

      The aim of this study was to evaluate the relationship between coronary arterial remodeling and the thickness of fibrous cap in patients with acute coronary syndrome (ACS). Thin-capped fibroatheroma is recognized as a precursor lesion for ACS. Positive remodeling (PR) is predominant pattern of arterial remodeling in patients with ACS. However, the relationship between PR and the thickness of fibrous cap has not been elucidated in vivo. We enrolled 41 patients with ACS who underwent both intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The arterial remodeling was assessed by IVUS and the thickness of fibrous cap was measured by ...
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    11. Natural Course of Lipid-rich Plaques Assessed with Combination of Intra-vascular Ultrasound and Optical Coherence Tomography

      Background Identification of coronary lesions with morphological characteristic of "rupture-prone plaques" is not sufficient. We examined the natural history of non-culprit lipid-rich plaques in patients with acute coronary syndrome (ACS). Methods Fifty patients with ACS who underwent percutaneous coronary intervention (PCI) were enrolled. We retrospectively assessed the extent of residual non-culprit lipid-rich plaques and these fibrous cap thickness (FCT) by use of intra-vascular ultrasound (IVUS) and optical coherence tomography (OCT), respectively, at baseline and after 9-months. Results During 9 months follow-up periods, the change in percent area volume (PAV) was 0.42±0.6% and the change in FCT was ...
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    12. Distribution and Frequency of Thin-Capped Fibroatheromas and Ruptured Plaques in the Entire Culprit Coronary Artery in Patients With Acute Coronary Syndrome as Determined by Optical Coherence Tomography

      The aim of this study was to investigate the distribution and frequency of thin-capped fibroatheromas (TCFAs) within the entire length of culprit coronary arteries in patients with acute coronary syndrome. Our population was drawn from 43 consecutive patients with acute coronary syndrome (with or without ST-segment elevation) who underwent optical coherence tomography to visualize the entire culprit coronary artery using a nonocclusive optical coherence tomographic technique. Patients were categorized divided into a TCFA group or a no-TCFA group on the basis of the optical coherence tomographic findings. There were no differences in baseline characteristics or angiographic findings between the 2 ...
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    13. Comparison of Vascular Response After Sirolimus-Eluting Stent Implantation Between Patients With Unstable and Stable Angina Pectoris: A Serial Optical Coherence Tomography Study

      A Serial Optical Coherence Tomography Study Objectives: The aim of the present study was to compare lesion morphologies after sirolimus-eluting stent (SES) implantation between patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) with the use of optical coherence tomography (OCT). Background: The lesion morphologies before and after coronary stenting have been proposed as important predictors of clinical outcome. The high resolution of OCT provides detailed information of coronary vessel wall. Methods: We enrolled 55 patients (UAP: n = 24, SAP: n = 31), and examined lesion morphologies by using OCT at pre- and post-SES implantation and 9 months' follow-up ...

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    14. Effect of statin therapy on coronary fibrous-cap thickness in patients with acute coronary syndrome: Assessment by optical coherence tomography study

      Background The thickness of coronary fibrous caps is a major determinant of vulnerable plaques. Several clinical trials have suggested that statin therapy could stabilize vulnerable plaques. Recently, optical coherence tomography (OCT) has been proposed as an effective histology-resolution imaging modality for assessing such micro-structural changes. Methods Forty AMI patients with hyperlipidemia were enrolled and underwent percutaneous coronary intervention (PCI). They were divided into two groups; statin treatment group (n = 23) or control group (n = 17). Serial OCT analyses were performed at baseline and 9-month follow-up for a non-PCI lipid-rich plaque lesion. Results The LDL-cholesterol level in the statin group was ...
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    15. Implication of Plaque Color Classification for Assessing Plaque Vulnerability

      Objectives: The purpose of this study was to assess the relationship between plaque color evaluated by coronary angioscopy and fibrous cap thickness estimated by optical coherence tomography (OCT) in vivo. Background: Yellow color intensity of coronary plaque evaluated by coronary angioscopy might be associated with plaque vulnerability. Methods: Seventy-seven coronary artery plaques in patients with acute coronary syndrome were observed by angioscopy and OCT. Plaque color was graded as white, light yellow, yellow, or intensive yellow. Results: There were significant differences among the groups classified by plaque color with respect to the fibrous cap thickness estimated by OCT: 389 ± 74 ...

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    1-15 of 15
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