1. Articles from Gary S. Mintz

    25-48 of 89 « 1 2 3 4 »
    1. Utility of intracoronary imaging in the cardiac catheterization laboratory: comprehensive evaluation with intravascular ultrasound and optical coherence tomography

      Utility of intracoronary imaging in the cardiac catheterization laboratory: comprehensive evaluation with intravascular ultrasound and optical coherence tomography

      Background Intracoronary imaging is an important tool for guiding decision making in the cardiac catheterization laboratory. Sources of data We have reviewed the latest available evidence in the field to highlight the various potential benefits of intravascular imaging. Areas of agreement Coronary angiography has been considered the gold standard test to appropriately diagnose and manage patients with coronary artery disease, but it has the inherent limitation of being a 2-dimensional x-ray lumenogram of a complex 3-dimensional vascular structure. Areas of controversy There is well-established inter- and intra-observer variability in reporting coronary angiograms leading to potential variability in various management strategies ...

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    2. Intracoronary Optical Coherence Tomography 2018 : Current Status and Future Directions

      Intracoronary Optical Coherence Tomography 2018 : Current Status and Future Directions

      The advent of intravascular imaging has been a significant advancement in visualization of coronary arteries, particularly with optical coherence tomography (OCT) that allows for high-resolution imaging of intraluminal and transmural coronary structures. Accumulating data support a clinical role for OCT in a multitude of clinical scenarios, including assessing the natural history of atherosclerosis and modulating effects of therapies, mechanisms of acute coronary syndromes, mechanistic insights into the effects of novel interventional devices, and optimization of percutaneous coronary intervention. In this state-of-the-art review, we provide an overview of the published data on the clinical utility of OCT, highlighting the areas that ...

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    3. IVUS-Guided Versus OCT-Guided Coronary Stent Implantation: A Critical Appraisal

      IVUS-Guided Versus OCT-Guided Coronary Stent Implantation: A Critical Appraisal

      Procedural guidance with intravascular ultrasound (IVUS) imaging improves the clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) by: 1) informing the necessity for lesion preparation; 2) directing appropriate stent sizing to maximize the final stent area and minimize geographic miss; 3) selecting the optimal stent length to cover residual disease adjacent to the lesion, thus minimizing geographic miss; 4) guiding optimal stent expansion; 5) identifying acute complications (edge dissection, stent malapposition, tissue protrusion); and 6) clarifying the mechanism of late stent failure (stent thrombosis, neointimal hyperplasia, stent underexpansion or fracture, or neoatherosclerosis). Optical coherence tomography (OCT) provides similar information ...

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    4. An optical coherence tomography study of neointimal morphology and strut coverage at different time intervals from implantation of biodegradable polymer-coated sirolimus-eluting stents

      An optical coherence tomography study of neointimal morphology and strut coverage at different time intervals from implantation of biodegradable polymer-coated sirolimus-eluting stents

      Objectives The aim of the study was to capture the evolution of neointima after implantation of a biodegradable polymer–coated, sirolimus–eluting, cobalt–chromium coronary stent system (BP-DES). Background Optical coherence tomography (OCT) suggests that in-stent neointimal morphology influences clinical outcomes after DES implantation. Methods Sixty patients treated with single BP-DES implantation were examined by quantitative coronary angiography (QCA) and OCT at 3, 6, and 12-month follow-up. Results Median late lumen loss by QCA (mm) was 0.04 (IQR 0, 0.08), 0.17 (IQR 0, 0.32), and 0.14 (IQR 0.07, 0.31) at 3, 6, and ...

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    5. Radial artery neointimal hyperplasia after transradial PCI—Serial optical coherence tomography volumetric study

      Radial artery neointimal hyperplasia after transradial PCI—Serial optical coherence tomography volumetric study

      Aims Transradial catheterization (TRC) is a dominant access site for coronary catheterization and percutaneous coronary interventions (PCI) in many centers. Previous studies reported higher intimal thickness of the radial artery (RA) wall in patients with a previous history of TRC. In this investigation the aim was to assess the intimal changes of RA using the optical coherence tomography (OCT) intravascular imaging in a serial manner. Methods and results 100 patients with the diagnosis of non-ST-elevation myocardial infarction (nSTEMI) treated by PCI were enrolled (6 patients were excluded from this analysis because of occluded RA at follow-up [2 patients] and insufficient ...

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    6. Serial 3-Vessel Optical Coherence Tomography and Intravascular Ultrasound Analysis of Changing Morphologies Associated With Lesion Progression in Patients With Stable Angina Pectoris

      Serial 3-Vessel Optical Coherence Tomography and Intravascular Ultrasound Analysis of Changing Morphologies Associated With Lesion Progression in Patients With Stable Angina Pectoris

      Background— Optical coherence tomographic (OCT) morphologies associated with lesion progression are not well studied. The aim of this study was to determine the morphological change for untreated lesion progression using both OCT and intravascular ultrasound (IVUS). Methods and Results— We used baseline and 8-month follow-up 3-vessel OCT and IVUS to assess 127 nonculprit lesions (IVUS plaque burden ≥40%) in 45 patients with stable angina after target lesion treatment. Lesion progression was defined as an IVUS lumen area decrease >0.5 mm 2 . A layered pattern was identified as a superficial layer that had a different optical intensity and a clear ...

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    7. In Vivo Calcium Detection by Comparing Optical Coherence Tomography, Intravascular Ultrasound, and Angiography

      In Vivo Calcium Detection by Comparing Optical Coherence Tomography, Intravascular Ultrasound, and Angiography

      Objectives The aim of this study was to evaluate optical coherence tomography (OCT) and intravascular ultrasound (IVUS) versus coronary angiography in the assessment of target lesion calcification and its effect on stent expansion. Background IVUS is more sensitive than angiography in the detection of coronary artery calcium, but the relationship among IVUS, OCT, and angiography has not been studied. Methods Overall, 440 lesions (440 patients with stable angina) underwent OCT- and IVUS-guided stent implantation. Coronary calcification was evaluated using: 1) angiography; 2) IVUS (maximum calcium angle and the surface pattern); and 3) OCT (mean and maximum calcium angle, calcium length ...

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    8. Prevalence, Predictors, and Clinical Presentation of a Calcified Nodule as Assessed by Optical Coherence Tomography

      Prevalence, Predictors, and Clinical Presentation of a Calcified Nodule as Assessed by Optical Coherence Tomography

      Objectives This study sought to determine the anatomic characteristics and clinical presentation associated with a calcified nodule (CN) as assessed by optical coherence tomography. Background CN is an unusual but demonstrable cause of acute coronary syndromes (ACS). Methods We studied 889 de novo culprit lesions in 889 patients (48% ACS) who underwent optical coherence tomography before intervention. CN was defined as an eruptive accumulation of nodular calcification (small fractured calcifications). Using quantitative coronary angiography, the change in the angle of the lesion between diastole and systole was measured (angiographic Δ angle). Results CN was seen in 4.2% of all lesions ...

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    9. EuroIntervention Characteristics of early versus late in-stent restenosis in second-generation drug-eluting stents: an optical coherence tomography study

      EuroIntervention Characteristics of early versus late in-stent restenosis in second-generation drug-eluting stents: an optical coherence tomography study

      Aims: In-stent restenosis (ISR) is an important cause of drug-eluting stent (DES) failure and target vessel revascularisation. In this study we aimed to evaluate differences between early and late-presenting restenosis in second-generation DES using optical coherence tomography (OCT). Methods and results: Overall, 171 cases of second-generation DES ISR with a follow-up OCT minimum lumen area <3.0 mm 2 were included: 33.3% of patients (n=57) had early ISR, and 66.7% (n=114) had late ISR (duration from stent implantation >1 year). Minimum stent area (MSA) <4.0 mm 2 , neointimal thickness <100 µm, and heterogeneous neointimal hyperplasia ...

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    10. The Curious Incident of Spotty Calcium (in Unstable Atherosclerotic Plaque)

      The Curious Incident of Spotty Calcium (in Unstable Atherosclerotic Plaque)

      Intravascular imaging studies – initially using intravascular ultrasound (IVUS) and more recently using optical coherence tomography (OCT) – as well an non-invasive imaging using multidetector computed tomography (CT) have reported spotty calcification – small calcium deposits within an atherosclerotic plaque – to be a distinct morphologic finding of both plaque instability in patients with acute coronary syndrome (ACS) and future atheroma progression even in patients with stable coronary artery disease.

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    11. Optical coherence tomography-guided PCI – Authors' reply

      Optical coherence tomography-guided PCI – Authors' reply

      We read with interest the Correspondence by Rahman Shah regarding our 2016 ILUMIEN III: OPTIMIZE PCI trial. 1 In nearly all previous studies of percutaneous coronary intervention (PCI) guided by intravascular ultrasound (IVUS) or optical coherence tomography (OCT), the most important predictor of follow-up events was the minimum stent area, followed by edge dissections and untreated disease. 2 , 3 Nine randomised trials 4 have compared IVUS guidance versus angiography guidance for PCI with drug-eluting stents (DES). IVUS guidance improved event-free survival by achieving larger acute stent dimensions than angiography guidance. 4 Therefore, before embarking on a definitive trial comparing OCT-guided ...

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    12. Characteristics of Earlier Versus Delayed Presentation of Very Late Drug‐Eluting Stent Thrombosis: An Optical Coherence Tomographic Study

      Characteristics of Earlier Versus Delayed Presentation of Very Late Drug‐Eluting Stent Thrombosis: An Optical Coherence Tomographic Study

      Background The pathophysiology underlying very late drug‐eluting stent ( DES ) thrombosis is not sufficiently understood. Using optical coherence tomography, we investigated characteristics of very late stent thrombosis ( VLST ) according to different onset times. Methods and Results A total of 98 patients from 10 South Korean hospitals who underwent optical coherence tomography for evaluation of very late DES thrombosis were retrospectively included in analyses. VLST occurred at a median of 55.1 months after DES implantation. All patients were divided into 2 equal groups of earlier versus delayed presentation of VLST , according to median onset time. In total, 27 patients were ...

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    13. Characteristics of Early Versus Late In-Stent Restenosis in Second- Generation Drug-Eluting Stents: An Optical Coherence Tomography Study

      Characteristics of Early Versus Late In-Stent Restenosis in Second- Generation Drug-Eluting Stents: An Optical Coherence Tomography Study

      Aims: In-stent restenosis (ISR) is an important cause of DES failure and target vessel revascularization. We evaluated differences between early and late-presenting restenosis in second-generation drug-eluting stents (DES) using optical coherence tomography (OCT). Methods and results: Overall, 171 cases of second-generation DES ISR with a follow-up OCT minimum lumen area <3.0mm2 were included; 33.3% of patients (n=57) had early ISR; and 67.7% (n=114) had late ISR (duration from stent implantation >1 year). Minimum stent area (MSA) <4.0mm2, neointimal thickness <100µm, and heterogeneous neointimal hyperplasia (NIH) were more prevalent in early ISR, whereas NIH ...

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    14. Neoatherosclerosis assessed with optical coherence tomography in restenotic bare metal and first- and second-generation drug-eluting stents

      Neoatherosclerosis assessed with optical coherence tomography in restenotic bare metal and first- and second-generation drug-eluting stents

      Although reported in bare metal stents (BMS) and first-generation drug-eluting stents (DES), little is known about neoatherosclerosis in second-generation DES. We used optical coherence tomography to evaluate neoatherosclerosis among different stent generations. Overall, 274 in-stent restenosis (ISR) lesions (duration from implantation 56.9 ± 47.2 months) in 274 patients were assessed for the presence of neoatherosclerosis. Neoatherosclerosis was identified in 38.7% of lesions (106/274): 23.0% second-generation DES (38/165), 65.1% first-generation DES (54/83), and 53.8% BMS (14/26). In the neoatherosclerosis cohort (n = 106), more stent underexpansion or fracture/deformation was observed in second-generation ...

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      Mentions: Gary S. Mintz
    15. Coronary Plaque Characteristics in Hemodialysis-Dependent Patients as Assessed by Optical Coherence Tomography

      Coronary Plaque Characteristics in Hemodialysis-Dependent Patients as Assessed by Optical Coherence Tomography

      Coronary arteries in patients with chronic kidney disease (CKD) have been shown to exhibit more extensive atherosclerosis and calcium. We aimed to assess characteristics of coronary plaque in hemodialysis (HD)-dependent patients using optical coherence tomography (OCT). This was a multicenter, retrospective study of 124 patients with stable angina who underwent OCT imaging. Sixty-two HD-dependent patients who underwent pre-intervention OCT for coronary artery disease (CAD) were compared 1:1 with a cohort of patients without CKD, matched for age, diabetes mellitus, sex, and culprit vessel. Baseline characteristics were comparable. Pre-intervention OCT imaging identified 62 paired culprit, 53 paired non-culprit, and ...

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    16. Guiding Light: Insights Into Atherectomy by Optical Coherence Tomography

      Guiding Light: Insights Into Atherectomy by Optical Coherence Tomography

      Coronary calcification presents multiple technical challenges in percutaneous coronary intervention (PCI) and is associated with suboptimal procedural results and an increase in subsequent adverse clinical events (1) . Currently, there is no standardized evidence-based strategy for PCI of calcified coronary lesions. Decisions for the use of adjunctive atheroablation—shown to increase the acute procedural success rates (2) —are based on visual estimation of calcification severity on angiography (with its inherent limitations [3] ) or when delivery of devices is impeded by calcified deposits in the vessel wall. Although the so-called “rota-regret” remains common following suboptimal acute procedural results in calcified plaques not ...

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    17. Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial

      Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial

      Background Percutaneous coronary intervention (PCI) is most commonly guided by angiography alone. Intravascular ultrasound (IVUS) guidance has been shown to reduce major adverse cardiovascular events (MACE) after PCI, principally by resulting in a larger postprocedure lumen than with angiographic guidance. Optical coherence tomography (OCT) provides higher resolution imaging than does IVUS, although findings from some studies suggest that it might lead to smaller luminal diameters after stent implantation. We sought to establish whether or not a novel OCT-based stent sizing strategy would result in a minimum stent area similar to or better than that achieved with IVUS guidance and better ...

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    18. Utility of near-infrared spectroscopy for detection of thin-cap neoatherosclerosis

      Utility of near-infrared spectroscopy for detection of thin-cap neoatherosclerosis

      Aims Near-infrared spectroscopy (NIRS) has been employed to assess the composition of the atherosclerotic plaques in native coronary arteries. However, little is known about the detection of neoatherosclerosis by NIRS in in-stent restenosis (ISR). The aim of the study was to assess the relationship between the distribution of lipid determined by NIRS and morphology of ISR on optical coherence tomography (OCT). Methods and results We performed both NIRS and OCT in 39 drug-eluting stents with ISR. Values of lipid-core burden index (LCBI) derived by NIRS were compared with the OCT-derived thickness of the fibrous cap covering neoatherosclerotic lesions. A total ...

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    19. Evaluation of Early Healing Profile and Neointimal Transformation Over 24 Months Using Longitudinal Sequential Optical Coherence Tomography Assessments and 3-Year Clinical Results of the New Dual-Therapy Endothelial Progenitor Cell Capturing Sirolimus-Elu

      Evaluation of Early Healing Profile and Neointimal Transformation Over 24 Months Using Longitudinal Sequential Optical Coherence Tomography Assessments and 3-Year Clinical Results of the New Dual-Therapy Endothelial Progenitor Cell Capturing Sirolimus-Elu

      Background— Current monotherapy drug-eluting stents are associated with impaired healing, neoatherosclerosis, and late stent thrombosis. The healing profile and neointimal transformation of the first dual-therapy endothelial progenitor cell–capturing sirolimus-eluting stent are unknown. Methods and Results— In this prospective, single-center study, 61 patients treated with the Combo stent had optical coherence tomography at baseline, early follow-up (4 monthly groups in a 1:2:2:1 ratio from 2 to 5 months), 9 months, and 24 months. Optical coherence tomography early strut coverage increased from 77.1% to 92.5% to 92.7% to 94.9% between 2 and 5 months ...

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    20. Understanding Why and When Optical Coherence Tomography Does Not Detect Vulnerable Plaques Is It Important?

      Understanding Why and When Optical Coherence Tomography Does Not Detect Vulnerable Plaques Is It Important?

      The goal of research into the in vivo detection of vulnerable plaques is to provide a clinician with a diagnostic tool that identifies vulnerable plaques prospectively to prevent acute events. This tool must have both a high positive predictive value and a high negative predictive value in the clinical setting (not just against histopathology) and cannot require specific expertise or core-laboratory analysis to determine whether a plaque should be treated pre-emptively—in other words, a yes/no, red light/green light, treat/don’t treat tool. Optical coherence tomography (OCT) has been proposed to be that tool. 1 OCT criteria ...

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    21. Spontaneous coronary artery dissection and healing documented by optical coherence tomography

      Spontaneous coronary artery dissection and healing documented by optical coherence tomography

      An otherwise healthy 57-year-old female patient with no risk factors for coronary artery disease presented to the emergency room with acute chest pain. The patient had been taking appetite suppressant (dimethylamylamine, Oxyelite Pro, (USP Labs) for the last 7 days. 1 , 2 Electrocardiography showed no abnormalities although both serum creatinine kinase-MB (3.59ng/mL) and troponin I (8,310pg/mL) were elevated. Coronary angiography revealed extensive and abrupt lumen narrowing in the obtuse marginal with a subtle intraluminal defect within the distal part of the vessel ( Figure 1 ). Optical coherence tomography (OCT), which is a novel near-infrared light based intravascular ...

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    25-48 of 89 « 1 2 3 4 »
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