1. Articles from Santiago Jiménez-Valero

    1-17 of 17
    1. Influence of neoatherosclerosis on prognosis and treatment response in patients with in-stent restenosis

      Influence of neoatherosclerosis on prognosis and treatment response in patients with in-stent restenosis

      Introduction and objectives Neoatherosclerosis is one of the causes of in-stent restenosis (ISR). Our objective was to evaluate the influence of neoatherosclerosis on prognosis and treatment response in patients with ISR. Methods This is a pooled analysis of the optical coherence tomography (OCT)-substudies of 2 multicenter, randomized clinical trials, RIBS IV and V, comparing treatment with paclitaxel-coated balloon vs everolimus-eluting stent in patients with ISR. OCT evaluation was performed at baseline and at 6 to 9 months. Neoatherosclerosis was defined in baseline OCT as neointima with calcified or lipid content. We evaluated the angiographic and OCT results at 6 ...

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    2. Influence of neoatherosclerosis on prognosis and treatment response in patients with in-stent restenosis

      Influence of neoatherosclerosis on prognosis and treatment response in patients with in-stent restenosis

      Introduction and objectives Neoatherosclerosis is one of the causes of in-stent restenosis (ISR). Our objective was to evaluate the influence of neoatherosclerosis on prognosis and treatment response in patients with ISR. Methods This is a pooled analysis of the optical coherence tomography (OCT)-substudies of 2 multicenter, randomized clinical trials , RIBS IV and V, comparing treatment with paclitaxel-coated balloon vs everolimus-eluting stent in patients with ISR. OCT evaluation was performed at baseline and at 6 to 9 months. Neoatherosclerosis was defined in baseline OCT as neointima with calcified or lipid content. We evaluated the angiographic and OCT results at 6 ...

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    3. Longitudinal Stent Deformation: Precise Diagnosis With Optical Coherence Tomography

      Longitudinal Stent Deformation: Precise Diagnosis With Optical Coherence Tomography

      Longitudinal stent deformation (LSD), defined as the distortion or shortening of a stent in the longitudinal axis following successful stent deployment, has been recognized as an important complication of coronary angioplasty. It is caused by impact on a deployed stent by a device (such as a guide catheter or guide-catheter extension) or secondary devices (such as postdilation balloons) as a result of guidewire bias as well as the inherent mechanical properties of the stent itself. This complication may be difficult to detect angiographically, and the use of intravascular ultrasound or optical coherence tomography (OCT) can help confirm the diagnosis and ...

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    4. Novel catheter enabling simultaneous radiofrequency ablation and optical coherence reflectometry

      Novel catheter enabling simultaneous radiofrequency ablation and optical coherence reflectometry

      A novel radiofrequency ablation catheter has been developed with integrated custom designed optics, enabling real-time monitoring of radiofrequency ablation procedures through polarization-sensitive optical coherence reflectometry. The optics allow for proper tissue illumination through a view-port machined in the catheter tip, thus providing lesion depth control over the RF ablation treatment. The system was verified in an in-vitro model of swine myocardium. Optical performance and thermal stability was confirmed after more than 25 procedures, without any damage to the optical assembly induced by thermal stress or material degradation. The use of this catheter in RF ablation treatments may make possible to ...

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    5. Neoatherosclerosis as the Cause of Very Late Bare-metal Stent Restenosis: Optical Coherence Tomography Evaluation

      Neoatherosclerosis as the Cause of Very Late Bare-metal Stent Restenosis: Optical Coherence Tomography Evaluation

      To the Editor, A man aged 49 years, ex-smoker with a family history of premature ischemic heart disease, attended the emergency department after 1 month with clinical symptoms of progressive angina following even minimal exertion. In 2001, he had presented non-Q wave acute myocardial infarction and undergone conventional bare-metal stent (BMS) implantation in the mid left anterior descending artery. In 2007, a coronary angiogram for exertional angina showed no stent restenosis. Following a change in treatment, he remained asymptomatic and recorded negative exercise test results until this admission in 2012. In view of symptoms of unstable angina, a fresh coronary ...

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    6. Stent Thrombosis in Ostial Lesion: Diagnosis and Treatment Guided by Optical Coherence Tomography

      Stent Thrombosis in Ostial Lesion: Diagnosis and Treatment Guided by Optical Coherence Tomography

      To the Editor , Optical coherence tomography (OCT) is an intracoronary diagnostic technique of particular interest for characterization of the atheromatous plaque and assessment of the outcome of stenting by percutaneous coronary intervention. We present a case of stent thrombosis in which OCT provided very useful information for arriving at the diagnosis, understanding the thrombotic mechanism, deciding on the most appropriate therapeutic strategy, and guiding percutaneous coronary intervention. The patient was a 65-year-old man, referred for primary angioplasty due to inferolateral acute myocardial infarction with onset 3 h earlier. He had completely discontinued double antiplatelet therapy 1 week earlier. Eight months ...

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    7. Usefulness of intracoronary imaging techniques in the percutaneous treatment of in-stent restenosis

      Usefulness of intracoronary imaging techniques in the percutaneous treatment of in-stent restenosis

      We report a case of very late bare-metal stent restenosis, in which assessment by two intracoronary imaging techniques (intravascular ultrasound and optical coherence tomography) revealed the underlying mechanism (neoatherosclerosis) and facilitated percutaneous treatment (direct bare-metal stent-in-stent). We also take the opportunity to briefly describe the advantages and limitations of both techniques in this pathology.

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    8. Utility of optical coherence tomography and intravascular ultrasound for the evaluation of coronary lesions

      Utility of optical coherence tomography and intravascular ultrasound for the evaluation of coronary lesions

      Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) are imaging methods used in the diagnosis of coronary lesions. IVUS is widely used in interventional cardiology laboratories, but OCT is now increasingly used. Conventional coronary angiography can identify different types of coronary lesions but sometimes is unable to diagnose them correctly. Both intravascular imaging methods are useful for better interpretation of these lesions, and can accurately diagnose ruptured plaques, thrombosis, stent restenosis and hazy images. However, the resolution of OCT is ten times higher than IVUS, and so an accurate diagnosis cannot always be achieved with ultrasound imaging. We present three ...

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    9. Renal artery fibromuscular dysplasia: in vivo optical coherence tomography insights

      Renal artery fibromuscular dysplasia: in vivo optical coherence tomography insights

      A 66-year-old woman with long-term essential hypertension presented with poorly controlled blood pressure in spite of six antihypertensive drugs. Percutaneous renal denervation was indicated as a treatment of resistant arterial hypertension. Renal angiography showed ‘strings of beads’ appearance characteristic of fibromuscular dysplasia (FMD) in the mid-segment of the right …

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    10. Utility of Optical Coherence Tomography to Assess a Hazy Intracoronary Image after Percutaneous Coronary Intervention

      Utility of Optical Coherence Tomography to Assess a Hazy Intracoronary Image after Percutaneous Coronary Intervention

      Although its use in daily practice is not common, optical coherence tomography (OCT) is a powerful research tool in invasive cardiology. This report describes a hazy angiography image after percutaneous coronary intervention that has been assessed using OCT. Based on the results of the OCT, the patient underwent an elective coronary angioplasty with standard anticoagulation. After implantation of the stent, an intracoronary hazy image was seen on angiography. The use of OCT permitted a correct diagnosis and a successful treatment. This paper provides a discussion of the advantages and disadvantages of OCT, and a comparison with intravascular ultrasound.

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    11. Optical Coherence Tomography in Spontaneous Coronary Dissection and in the Complications Following Percutaneous Treatment

      Optical Coherence Tomography in Spontaneous Coronary Dissection and in the Complications Following Percutaneous Treatment

      A 53-year-old man who had recently abandoned triple antihypertensive therapy was referred by his healthcare center following a first episode of angina at rest, which coincided with a significant increase in blood pressure (180/100 mmHg) and was accompanied by diffuse transitory ST-segment depression. Coronary angiography showed tapering of the proximal-middle segment of the median branch, which intracoronary nitroglyc-erin failed to modify ( Fig. 1A). As spontaneous coronary dissection (SCD) was suspected, optical coherence tomography (OCT) was used to study the vessel after unfractionated heparin (85 U/kg) was administered. The OCT confirmed focal intimal rupture (Fig. 1Aa) and revealed a ...

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    12. Spontaneous coronary artery dissection evaluated by optical coherence tomography

      Spontaneous coronary artery dissection evaluated by optical coherence tomography

      A 42-year-old woman underwent coronary angiography for acute coronary syndrome. It showed a progressive narrowing from the middle segment of the left anterior descending artery. Optical coherence tomography (OCT) confirmed the angiographic suspicion of spontaneous coronary dissection. OCT also revealed different patterns of subjacent disease, imperceptible to the angiography: areas of intramural hematoma with blood stasis, progressive compromise of the true lumen, and areas with active flow through the false lumen. It also detected the distal guidewire going out from the true to the false lumen, a feature of capital importance to lead an eventual coronary intervention.

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    13. Effectiveness of cutting balloon angioplasty for a calcified coronary lesion. Evaluation by optical coherence tomography and intravascular ultrasound

      Effectiveness of cutting balloon angioplasty for a calcified coronary lesion. Evaluation by optical coherence tomography and intravascular ultrasound
      We report the case of a 76-year-old female patient with unstable angina. Coronary angiography showed a calcified lesion in the proximal anterior descending artery segment (Figure 1A). The lesion was assessed by optical coherence tomography (OCT) and intravascular ultrasound (IVUS), which showed an eccentric fibrocalcific plaque with negative remodeling (Figure 2A and B) and a minimum luminal area of 2.8 mm2.
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    14. Subacute Drug-Eluting Stent Thrombosis Caused by Stent Underexpansion: Evaluation by Optical Coherence Tomography

      Subacute Drug-Eluting Stent Thrombosis Caused by Stent Underexpansion: Evaluation by Optical Coherence Tomography
      We present the case report of a patient presenting with ST segment elevation myocardial infarction due to a subacute drug-eluting stent trombosis within the proximal segment of the left circumflex artery (LCX). Six days before a total chronic occlusion was treated at the mid segment of the LCX by overlapping two drug-eluting stents. Optical coherence tomography (OCT) was helpful to demonstrate stent underexpansion of the overlaping segment as the main mechanism of early stent thrombosis. This case is illustrative about the potential role of OCT to identify the mechanisms of ST and thus guiding the PCI procedure. Moreover, our case ...
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    15. Severe Coronary Spasm Induced by OCT Wire. There Are No Innocuous Procedures

      Severe Coronary Spasm Induced by OCT Wire. There Are No Innocuous Procedures
      We present the case of a 64-year-old male who underwent cardiac catheterization because of a positive stress test. No severe narrowings were visible in his left coronary system. His right coronary artery (RCA) (Figure 1) had two moderate narrowings located at the proximal and mid segments (arrowheads) and an image showing plaque ulceration at the distal segment. Evaluation with optical coherence tomography (OCT) of the RCA was proposed and performed using the Imagewire imaging catheter and the M2x Coronary Imaging System (LightLab Imaging, Westford, Massachusetts). The initial evaluation revealed a luminal area of 6 cm2 (Figure 1B) at the level ...
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    16. Very Late Drug-Eluting Stent Thrombosis Related to Incomplete Stent Endothelialization: In-Vivo Demonstration by Optical Coherence Tomography

      Very Late Drug-Eluting Stent Thrombosis Related to Incomplete Stent Endothelialization: In-Vivo Demonstration by Optical Coherence Tomography
      Very late drug-eluting stent (DES) thrombosis is a rare but potentially life-threatening event that has become a major cause of concern. Delayed arterial healing with incomplete endothelialization is probably a pivotal factor related with DES thrombosis. Optical coherence tomography (OCT) is a new high-resolution intracoronary imaging technique that allows detailed evaluation of stent neointimal coverage. We present a case of very late DES thrombosis that was evaluated with OCT, demonstrating incomplete endothelialization as the probable main mechanism of stent thrombosis. This case illustrates the ability of OCT for in-vivo identification of stent coverage and its potential role in the evaluation ...
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    1-17 of 17
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    1. (17 articles) Santiago Jiménez-Valero
    2. (13 articles) Hospital Universitario La Paz
    3. (4 articles) Abbot
    4. (3 articles) National Institutes of Health
    5. (2 articles) Nieves Gonzalo
    6. (2 articles) Fernando Alfonso
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    Very Late Drug-Eluting Stent Thrombosis Related to Incomplete Stent Endothelialization: In-Vivo Demonstration by Optical Coherence Tomography Severe Coronary Spasm Induced by OCT Wire. There Are No Innocuous Procedures Subacute Drug-Eluting Stent Thrombosis Caused by Stent Underexpansion: Evaluation by Optical Coherence Tomography Effectiveness of cutting balloon angioplasty for a calcified coronary lesion. Evaluation by optical coherence tomography and intravascular ultrasound Spontaneous coronary artery dissection evaluated by optical coherence tomography Optical Coherence Tomography in Spontaneous Coronary Dissection and in the Complications Following Percutaneous Treatment Utility of Optical Coherence Tomography to Assess a Hazy Intracoronary Image after Percutaneous Coronary Intervention Renal artery fibromuscular dysplasia: in vivo optical coherence tomography insights Utility of optical coherence tomography and intravascular ultrasound for the evaluation of coronary lesions Novel catheter enabling simultaneous radiofrequency ablation and optical coherence reflectometry Medical treatment of inflammatory punctual stenosis monitored by anterior segment optical coherence tomography Development and Validation of a Deep Learning System for Diagnosing Glaucoma Using Optical Coherence Tomography