1. Articles from hiroyuki okura

    1-26 of 26
    1. Usefulness of longitudinal reconstructed optical coherence tomography images for predicting the need for the reverse wire technique during coronary bifurcation interventions

      Usefulness of longitudinal reconstructed optical coherence tomography images for predicting the need for the reverse wire technique during coronary bifurcation interventions

      Objectives The aim is to investigate the usefulness of longitudinal reconstructed optical coherence tomography (OCT) images in selecting the reverse wire (RW) technique for inserting a guidewire into a side branch (SB). Background It is sometimes necessary to protect the SB with a guidewire to prevent SB complications in PCI for bifurcation lesions. The RW is a novel method for guidewire insertion into an extremely angulated SB when the standard antegrade wire (AW) approach is difficult. Methods This retrospective study included 46 consecutive patients who underwent OCT‐guided PCI in bifurcation lesions with significant SB stenosis. Patients were divided into ...

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    2. Plaque modification of severely calcified coronary lesions by scoring balloon angioplasty using Lacrosse non-slip element: insights from an optical coherence tomography evaluation

      Plaque modification of severely calcified coronary lesions by scoring balloon angioplasty using Lacrosse non-slip element: insights from an optical coherence tomography evaluation

      Percutaneous coronary intervention (PCI) for heavily calcified lesions is challenging because these lesions are resistant to balloon dilatation and stenting. Lacrosse non-slip element (NSE) may have the potential to dilate heavily calcified lesions. We aimed to investigate predictors of successful lesion modification using Lacrosse NSE angioplasty via optical coherence tomography (OCT)-guided PCI. We investigated 32 patients with severe target lesion calcification treated with OCT-guided PCI. Successful lesion modification was defined as the complete fracture of calcification after Lacrosse NSE angioplasty. Before PCI, 172 segments with calcification were identified. After pre-dilatation using Lacrosse NSE, successful lesion modification was achieved in ...

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    3. Two-year vascular responses to drug-eluting stents with biodegradable polymer versus durable polymer: An optical coherence tomography sub-study of the NEXT

      Two-year vascular responses to drug-eluting stents with biodegradable polymer versus durable polymer: An optical coherence tomography sub-study of the NEXT

      Background This study aimed to compare very late vascular response after stent implantation between everolimus-eluting stent (EES) with a thin, non-adhesive, durable, biocompatible fluorinated polymer and biolimus-eluting stent (BES) with a biodegradable polymer by optical coherence tomography (OCT). Methods and results In the NOBORI-BES Versus XIENCE V/PROMUS-EES Trial (NEXT), a formal OCT substudy investigated 48 patients (27 EES-treated lesions in 23 patients and 28 BES-treated lesions in 25 patients) with 2-year (18–30 months) follow-up imaging at 18 centers. The percentage of uncovered strut by neointima was significantly lower in EES compared with BES (2.1 ± 4.7% vs ...

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    4. Impact of branching angle on neointimal coverage of drug-eluting stents implanted in bifurcation lesions

      Impact of branching angle on neointimal coverage of drug-eluting stents implanted in bifurcation lesions

      Objectives: To investigate the impact of branching angle (BA) on neointimal coverage of drug-eluting stents (DESs) in bifurcation lesions. Background: Previous experimental studies indicated that BA influences the local flow turbulence and wall shear stress, which are associated with neointimal coverage of DESs. Methods: Fifty-five bifurcation lesions in 47 patients were evaluated by serial optical coherence tomography (OCT) before DES implantation and at follow-up. Neointimal coverage was assessed in cross-sectional OCT images containing the side branch; regions including the side branch ostium (SO) and vessel wall (VW) were assessed separately. BA was measured using angiography (Angio-BA) and longitudinal OCT imaging ...

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    5. Impact of stent platform on longitudinal stent deformation: an in vivo frequency domain optical coherence tomography study

      Impact of stent platform on longitudinal stent deformation: an in vivo frequency domain optical coherence tomography study

      Recently, longitudinal coronary stent deformation has been highlighted as a possible cause of drug-eluting stent failure. Although bench tests and in vivo studies have demonstrated difference in longitudinal stent strength among the stents with different platforms, its clinical impact is still unknown. Furthermore, it is unknown if modified stent platform favorably affect the incidence of stent deformation. The aim of this study was to investigate the longitudinal deformation of the everolimus-eluting stents (EES) with different stent platforms by using frequency domain optical coherence tomography (FD-OCT). Seventy-eight lesions treated with EES (Xience Prime: n = 26, Promus element: n = 29, Promus premier ...

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    6. Thin-cap fibroatheroma and large calcification at the proximal stent edge correlate with a high proportion of uncovered stent struts in the chronic phase

      Thin-cap fibroatheroma and large calcification at the proximal stent edge correlate with a high proportion of uncovered stent struts in the chronic phase

      Objective: A high proportion of uncovered stent struts is associated with late stent thrombosis after drug-eluting stent (DES) implantation, which frequently results in myocardial infarction or death. However, the predictors of uncovered stent struts remain unknown. Here, using optical coherence tomography (OCT), we studied the baseline tissue characteristics of the target coronary segment and evaluated their influence on the neointimal coverage of the strut in the chronic phase. Methods: We analyzed 118 coronary lesions treated with OCT-guided DES implantation. OCT examinations of target lesions were performed before and after DES implantation, and tissue characteristics were evaluated within 5 mm outer ...

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    7. High Platelet Reactivity and Intrastent Thrombi Assessed by OCT After DES

      High Platelet Reactivity and Intrastent Thrombi Assessed by OCT After DES

      High platelet reactivity (HPR) on clopidogrel may be related to stent thrombosis after drug-eluting stent (DES) implantation (1) . To investigate the relationship between HPR and intrastent thrombi following DES implantation, 202 lesions treated with DES from 109 patients were studied. Coronary angiography and optical coherence tomography (OCT) examination were performed as parts of routine follow-up examination at our institution except for the presence of renal dysfunction or congestive heart failure. OCT imaging and platelet function test were performed at 6 to 9 months (median 202 days). Dual antiplatelet therapy with aspirin and clopidogrel was started before stent implantation and continued ...

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    8. Detection of Plaque Neovascularization by Optical Coherence Tomography: Ex Vivo Feasibility Study and In Vivo Observation in Patients With Angina Pectoris

      Detection of Plaque Neovascularization by Optical Coherence Tomography: Ex Vivo Feasibility Study and In Vivo Observation in Patients With Angina Pectoris

      Abstract: Objectives. The purposes of this study were: (1) to assess the feasibility of optical coherence tomography (OCT) for detecting neovascularization; and (2) to clarify the impact of plaque neovascularization on coronary vessel behavior over time. Background. Plaque neovascularization may be related to plaque vulnerability. Methods. In an ex vivo study, a total of 55 coronary plaques from 31 human cadavers were examined by OCT. Plaque neovascularization was diagnosed based on the presence or absence of microchannels (MCs) by OCT. In an in vivo study, we explored 83 major coronary arteries from 42 patients with angina pectoris. A total of ...

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    9. In-stent neointimal characteristics and late neointimal response after drug-eluting stent implantation: A preliminary observation

      In-stent neointimal characteristics and late neointimal response after drug-eluting stent implantation: A preliminary observation

      Background Progressive neointimal proliferation may lead to late restenosis and/or neoatherosclerosis after drug-eluting stent (DES) implantation. Late neointimal response may be different among different tissue characteristics. The aim of this study was to assess impact of in-stent neointimal characteristics on late neointimal response following DES implantation. Methods Serial (median 270 days and median 551 days after stent implantation) optical coherence tomography (OCT) examinations were performed in 42 stented lesions from 26 patients. In-stent neointimal tissue was categorized as either homogeneous or heterogeneous neointima based on the OCT appearance at 1st follow-up. Serial changes in neointimal area (NIA) were compared ...

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    10. Calcified plaque ablated by rotational atherectomy visualised by optical coherence tomography

      Calcified plaque ablated by rotational atherectomy visualised by optical coherence tomography

      This paper also includes accompanying supplementary data published online at: http://www.pcronline.com/eurointervention/86th_issue/62 Calcification is visualised by optical coherence tomography (OCT) as a well-delineated, signal-poor region with sharp borders. A 63-year-old female patient with stable angina underwent percutaneous coronary intervention. OCT (C7 Dragonfly™, ILUMIEN™ OCT system; St. Jude Medical, St. Paul, MN, USA) showed lumen narrowing with heavily calcified plaque (Figure 1A) . Rotational atherectomy (RA) was performed using a 2 mm burr (Rotablator™ Rotational Atherectomy System; Boston Scientific, Marlborough, MA, USA). After RA, OCT clearly visualised the calcified segment ablated by the 2 mm burr as

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    11. Assessment of vascular response after drug-eluting stents implantation in patients with diabetes mellitus: an optical coherence tomography sub-study of the J-DESsERT

      Assessment of vascular response after drug-eluting stents implantation in patients with diabetes mellitus: an optical coherence tomography sub-study of the J-DESsERT

      Even in the drug-eluting stent era, diabetes mellitus (DM) patients have high incidences of restenosis and repeat revascularization after percutaneous coronary intervention. The aim of this study was to compare vascular response after stent implantation between sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) by using optical coherence tomography (OCT) in DM patients as well as in non-DM patients. In the Japan-Drug Eluting Stents Evaluation; a Randomized Trial (J-DESsERT), the OCT sub-study enrolled 75 patients who underwent 8 months follow-up imaging after SES or PES implantation. Mean neointimal hyperplasia (NIH) thickness was significantly thinner in SES than PES in the DM ...

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    12. Vessel Response After First- and Second-Generation Drug-Eluting Stent Detected by Optical Coherence Tomography – Pathological Background and Clinical Importance -

      Vessel Response After First- and Second-Generation Drug-Eluting Stent Detected by Optical Coherence Tomography – Pathological Background and Clinical Importance -

      Editorial. Although drug-eluting stents (DES) have dramatically decreased restenosis and target lesion revascularization rates, very late stent thrombosis has emerged as a new problem related to first-generation DES. Abnormal inflammatory vessel response to the polymer has been considered responsible for the development of stent thrombosis.1 Pathological examinations have revealed that in-stent neointima after implantation of a first-generation DES may contain inflammatory cells and fibrin. Recently, optical coherence tomography (OCT) has become widely available as a high resolution intracoronary imaging modality for detecting coronary plaque, providing the detailed morphological features related to unfavorable

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    13. Vascular Response to Drug-Eluting Stent With Biodegradable vs. Durable Polymer

      Vascular Response to Drug-Eluting Stent With Biodegradable vs. Durable Polymer

      Background: The aim of the present study was to compare vascular healing response between everolimus-eluting stent (EES) and biolimus-eluting stent (BES) using optical coherence tomography (OCT). Methods and Results: In the NOBORI Biolimus-Eluting Versus XIENCE V/PROMUS Everolimus-Eluting Stent Trial (NEXT), a formal OCT substudy investigated 91 patients (55 EES-treated lesions in 48 patients and 51 BES-treated lesions in 43 patients) with 8–12 months follow-up imaging at 18 centers. A total of 980 frames with 8,996 struts in EES and 907 frames with 8,745 struts in BES were analyzed. Mean neointima thickness in EES and BES was ...

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    14. A unique feature of thin flat thrombus visualised by optical coherence tomography

      A unique feature of thin flat thrombus visualised by optical coherence tomography

      Optical coherence tomography (OCT) has recently been developed as a high-resolution intravascular imaging modality, detecting small abnormal structures in the coronary lumen that could not be visualised by intravascular ultrasound (IVUS). A 77-year-old man died with acute myelogenous leukemia. After he died, the coronary artery was imaged by OCT (ImageWire; LightLab Imaging, Westford, MA, USA) and IVUS (Atlantis SR Pro, 40 MHz; Boston Scientific, Natick, MA, USA). OCT clearly demonstrated a thin flat structure in the coronary lumen ( Figure 1A , Moving image 1 ) but not in the IVUS image. This unique structural feature was demonstrated in corresponding histological images ( Figure ...

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    15. Unusual peri-stent strut contrast staining 6 years after sirolimus-eluting stent implantation: an “ant colony-like” appearance

      Unusual peri-stent strut contrast staining 6 years after sirolimus-eluting stent implantation: an “ant colony-like” appearance

      A 60-year-old man with a previous history of sirolimus-eluting stent implantation was admitted because of chest pain. Coronary angiography revealed nonsignificant in-stent luminal narrowing at the previously stented segment with an unusual linear peri-stent strut contrast staining. Frequency-domain optical coherence tomography showed a cavity at the segment connecting to the coronary lumen at the distal part of the stent. This unusual “ant-colony”-like appearance of the stented segment may be a subtype of the incomplete stent apposition and/or interstrut hollows.

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    16. Recurrence of late incomplete stent apposition after very late stent thrombosis following drug-eluting stent implantation

      Recurrence of late incomplete stent apposition after very late stent thrombosis following drug-eluting stent implantation

      A 48-year old man was admitted to our hospital because of chest pain 20 months after sirolimus-eluting stent implantation to his left anterior descending coronary artery. A coronary angiogram showed a thrombosis of the stented segment, which was successfully treated with bare-metal stent implantation. One month later, optical coherence tomography (OCT) demonstrated late-acquired incomplete stent apposition (ISA) in the stented segment. Additional dilatation was performed using a 4.5 mm balloon. Eleven months later, OCT and intravascular ultrasound images revealed recurrent ISA as a result of progressive vessel remodeling. Serial observation of the stented segment with late-acquired ISA is necessary ...

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    17. Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies: A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

      Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies: A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

      Objectives: The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease.Background: Intravascular optical coherence tomography (IVOCT) is a catheter-based modality that acquires images at a resolution of 10 μm, enabling visualization of blood vessel wall microstructure in vivo at an unprecedented level of detail. IVOCT devices are now commercially available worldwide, there is an active user base, and ...

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    18. Natural History of Stent Edge Dissection, Tissue Protrusion and Incomplete Stent Apposition Detectable Only on Optical Coherence Tomography After Stent Implantation

      Natural History of Stent Edge Dissection, Tissue Protrusion and Incomplete Stent Apposition Detectable Only on Optical Coherence Tomography After Stent Implantation
      Background: The clinical impact of stent edge dissection, tissue protrusion, and incomplete stent apposition (ISA) after stent implantation, detectable only on optical coherence tomography (OCT), is still unknown because the natural course has not been investigated. Methods and Results: All consecutive patients with angina pectoris in whom both intravascular ultrasound (IVUS) and OCT were performed immediately after stenting and at follow-up were included in the present study. The natural history of OCT-detected stent edge dissection, tissue protrusion, and ISA during follow-up was investigated. A total of 36 patients with 39 lesions was analyzed. At baseline, OCT showed 12 stent edge ...
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    19. Plaque Characteristics of Thin-Cap Fibroatheroma Evaluated by OCT and IVUS

      Plaque Characteristics of Thin-Cap Fibroatheroma Evaluated by OCT and IVUS
      Objectives The purpose of this study was to assess plaque characteristics of optical coherence tomography (OCT)-derived thin-cap fibroatheroma (TCFA) by integrated backscatter intravascular ultrasound (IB-IVUS). Background Radiofrequency signal-derived IVUS tissue characterization technology has become clinically available and provided objective and quantitative plaque characteristics of the coronary vessel wall. Integrated backscatter IVUS is one of the tissue characterization methods that can possibly provide quantitative plaque characteristics of the OCT-derived TCFA. Methods Eighty-one coronary lesions with plaque burden >40% were selected and analyzed with both IB-IVUS and OCT. The OCT-derived TCFA was defined as a presence of thin fibrous cap (<65 ...
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    20. Relationship Between Arterial and Fibrous Cap Remodeling: A Serial Three-Vessel Intravascular Ultrasound and Optical Coherence Tomography Study

      Relationship Between Arterial and Fibrous Cap Remodeling: A Serial Three-Vessel Intravascular Ultrasound and Optical Coherence Tomography Study
      Background—Positive arterial remodeling and thin fibrous cap are characteristics of rupture-prone or vulnerable plaque. The natural course of the fibrous cap thickness and the relationship between serial arterial remodeling and changes in fibrous cap thickness are unknown. Therefore, the purpose of this study was to evaluate the relationship between changes in fibrous cap thickness and arterial remodeling by using optical coherence tomography (OCT) and intravascular ultrasound (IVUS) during 6-month follow-up. Methods and Results—Both IVUS and OCT examinations were performed on 108 vessels from 36 patients with ischemic heart disease who underwent percutaneous coronary intervention. Fifty-eight fibroatheromas were selected ...
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    21. Frequency and Spatial Distribution of Thin-Cap Fibroatheroma Assessed by 3-Vessel Intravascular Ultrasound and Optical Coherence Tomography: An Ex Vivo Validation and an Initial In Vivo Feasibility Study

      Frequency and Spatial Distribution of Thin-Cap Fibroatheroma Assessed by 3-Vessel Intravascular Ultrasound and Optical Coherence Tomography: An Ex Vivo Validation and an Initial In Vivo Feasibility Study
      Background: The precursor of plaque rupture is known as thin cap fibroatheroma (TCFA). In the present study, the feasibility and accuracy of optical coherence tomography (OCT) for detecting the frequency and spatial distribution of TCFA was investigated ex vivo, and a 3-vessel OCT analysis was conducted to assess the feasibility of this modality in vivo. Methods and Results: In the ex vivo study, 108 coronary arterial segments from 38 human cadavers were examined by OCT, intravascular ultrasound (IVUS) and histology. The 3-vessel IVUS and OCT examinations were performed in 11 patients with acute coronary syndrome. By histological examination, 30 of ...
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    1-26 of 26
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    Frequency and Spatial Distribution of Thin-Cap Fibroatheroma Assessed by 3-Vessel Intravascular Ultrasound and Optical Coherence Tomography: An Ex Vivo Validation and an Initial In Vivo Feasibility Study Relationship Between Arterial and Fibrous Cap Remodeling: A Serial Three-Vessel Intravascular Ultrasound and Optical Coherence Tomography Study Assessment of the coronary calcification by optical coherence tomography Plaque Characteristics of Thin-Cap Fibroatheroma Evaluated by OCT and IVUS Natural History of Stent Edge Dissection, Tissue Protrusion and Incomplete Stent Apposition Detectable Only on Optical Coherence Tomography After Stent Implantation Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies: A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation Recurrence of late incomplete stent apposition after very late stent thrombosis following drug-eluting stent implantation Unusual peri-stent strut contrast staining 6 years after sirolimus-eluting stent implantation: an “ant colony-like” appearance A unique feature of thin flat thrombus visualised by optical coherence tomography Comparative study between intravitreal ranibizumab and triamcinolone treatment of diabetic macular edema as regard to optical coherence tomography changes and visual acuity What’s New in Optical Coherence Tomography Angiography for Glaucoma (Book Chapter) Looking into the Future: Optical Coherence Tomography for the Assessment of Cardiac Allograft Vasculopathy