1. Articles from vasile sirbu

    1-26 of 26
    1. Optical Coherence Tomography Findings in Patients with Coronary Stent Thrombosis: A Report of the PREvention of Late Stent Thrombosis by an Interdisciplinary Global European Effort (PRESTIGE) Consortium

      Optical Coherence Tomography Findings in Patients with Coronary Stent Thrombosis: A Report of the PREvention of Late Stent Thrombosis by an Interdisciplinary Global European Effort (PRESTIGE) Consortium

      Background —Stent thrombosis (ST) is a serious complication following coronary stenting. Intravascular optical coherence tomography (OCT) may provide insights into mechanistic processes leading to ST. We performed a prospective, multicenter study to evaluate OCT findings in patients with ST. Methods —Consecutive patients presenting with ST were prospectively enrolled in a registry using a centralized telephone registration system. After angiographic confirmation of ST, OCT imaging of the culprit vessel was performed with frequency domain OCT. Clinical data were collected according to a standardized protocol. OCT acquisitions were analyzed at a core laboratory. Dominant and contributing findings were adjudicated by an imaging ...

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    2. The OPTIS Integrated System: real-time, co-registration of angiography and optical coherence tomography

      The OPTIS Integrated System: real-time, co-registration of angiography and optical coherence tomography

      The efficacy of an IVUS-guided stent implantation strategy to improve acute results and clinical outcome has been described previously. OCT is another technique which allows high-resolution intracoronary imaging. However, the use of invasive imaging modalities to guide PCI has, as yet, played a limited role in current clinical practice. This may be partly explained by the expertise required for interpretation and clinical decision making. We present a novel technology which enables real-time co-registration of OCT images with angiography. This will simplify matching cross-sectional images to their geographic position on the angiogram, thereby facilitating imaging-guided PCI.

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    3. Impact of Culprit Plaque and Atherothrombotic Components on Incomplete Stent Apposition in Patients With ST-Elevation Myocardial Infarction Treated With Everolimus-Eluting Stents – An OCTAVIA Substudy –

      Impact of Culprit Plaque and Atherothrombotic Components on Incomplete Stent Apposition in Patients With ST-Elevation Myocardial Infarction Treated With Everolimus-Eluting Stents – An OCTAVIA Substudy –

      Background: The role of culprit plaque and related atherothrombotic components on incomplete stent apposition (ISA) occurrence after primary percutaneous coronary intervention (p-PCI) is unknown. Methods and Results: ST-segment elevation myocardial infarction (STEMI) patients undergoing p-PCI with an everolimus-eluting stent were prospectively investigated with optical coherence tomography (OCT) of the infarct-related artery before, after stenting and at 9 months. OCT data, aspirated thrombus and serum inflammatory biomarkers were analyzed. 114 patients with 114 lesions were evaluated. Acute ISA occurred in 82 lesions (71.9%), preferentially in larger vessels with a median area of 0.2 mm 2 . The presence of thrombus ...

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    4. Mechanisms of Atherothrombosis and Vascular Response to Primary Percutaneous Coronary Intervention in Women Versus Men With Acute Myocardial Infarction : Results of the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angiop

      Mechanisms of Atherothrombosis and Vascular Response to Primary Percutaneous Coronary Intervention in Women Versus Men With Acute Myocardial Infarction : Results of the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angiop

      Objectives This study sought to assess in vivo sex differences in the pathophysiology of ST-segment elevation myocardial infarction (STEMI) and vascular response to primary percutaneous coronary intervention (PCI). Background There is no consensus on whether differences in the pathophysiology of STEMI and response to primary PCI between women and men reflect biological factors as opposed to differences in age. Methods In this prospective, multicenter study, 140 age-matched men and women with STEMI undergoing primary PCI with everolimus-eluting stent were investigated with intravascular optical coherence tomography, histopathology-immunohistochemistry of thrombus aspirates, and serum biomarkers. Primary endpoints were the percentages of culprit plaque ...

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    5. Coronary artery disease in systemic sclerosis not clinically apparent: findings from optical coherence tomography

      Coronary artery disease in systemic sclerosis not clinically apparent: findings from optical coherence tomography

      A 42-year-old female was referred for intermittent effort angina. She had low body mass index, no coronary risk factors and an unremarkable past medical history except for a Raynaud's phenomenon. Owing to a normal exercise stress test ( Panel A ), symptoms were initially attributed to anxiety. However, a 24h-EKG monitoring revealed diffuse ST-segment depression during …

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    6. Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention

      Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention

      We compared intravascular ultrasound (IVUS) and 2 different generations of optical coherence tomography (OCT)—time-domain OCT (TD-OCT) and frequency-domain OCT (FD-OCT)—for the assessment of coronary disease and percutaneous coronary intervention (PCI) using stents. Background OCT is a promising light-based intravascular imaging modality with higher resolution than IVUS. However, the paucity of data on OCT image quantification has limited its application in clinical practice. Methods A total of 227 matched OCT and IVUS pull backs were studied. One hundred FD-OCT and IVUS pull backs in nonstented (n = 56) and stented (n = 44) vessels were compared. Additionally, 127 matched TD-OCT and ...

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    7. Volumetric assessment of lesion severity with optical coherence tomography: relationship with fractional flow reserve

      Volumetric assessment of lesion severity with optical coherence tomography: relationship with fractional flow reserve

      Aims: Frequency-domain optical coherence tomography (FD-OCT) provides a rapid tomographic scan of a coronary vessel, with an accurate reconstruction of its lumen profile. An FD-OCT-based metric that corresponds more closely with physiological significance of lesions may enable more precise guidance of interventional procedures. The aim of this feasibility study was to evaluate a new method for quantifying coronary lesion severity that estimates hyperaemic flow resistance of branched vessel segments imaged by FD-OCT. Methods and results: An analytical flow model was developed that relates fractional flow reserve (FFR) to the vascular resistance ratio (VRR), a measure of blood flow resistance derived ...

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    8. Optical coherence tomography evidence of endothelial erosion as a cause of ST-segment elevation myocardial infarction

      Optical coherence tomography evidence of endothelial erosion as a cause of ST-segment elevation myocardial infarction

      High-resolution intracoronary imaging provided relevant insights into the field of pathophysiology of acute coronary syndromes (ACS). Human autopsy studies have shown that endothelial erosion may lead to intravascular thrombosis and acute myocardial infarction. We report the case of a 51-year-old woman presenting with ST-segment elevation ACS. In this patient, frequency domain optical coherence tomography (FD-OCT) was performed into the infarct-related artery, showing in-vivo findings suggestive of endothelial erosion, associated with no flow-obstructing luminal thrombus. In this rare case, endothelial erosion, and subsequent thrombosis, in the proximal third of the artery has probably caused embolization and thrombotic occlusion in the mid ...

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      Mentions: Vasile Sirbu
    9. The Role of Optical Coherence Tomography in Clarifying the Mechanisms for Dobutamine Stress Echocardiography-Induced Takotsubo Cardiomyopathy

      The Role of Optical Coherence Tomography in Clarifying the Mechanisms for Dobutamine Stress Echocardiography-Induced Takotsubo Cardiomyopathy

      Takotsubo cardiomyopathy is a clinical disorder characterized by a transient dilatation and akynesis or dyskinesis of the left ventricular (LV) apex, mimicking an anterior wall acute myocardial infarction in the absence of significant coronary artery disease (CAD). It typically occurs during an episode of severe emotional or physical stress. Recent reports suggested the potential of dobutamine stress echocardiography (DSE) in inducing the aforementioned syndrome. The transient dysfunction of the LV does not fit any known coronary distribution. Furthermore, there is no obstructive CAD demonstrated at angiography to account for the observed dysfunction. Consequently, the pathophysiology of this syndrome is still ...

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      Mentions: Vasile Sirbu
    10. Impact of different stent alloys on human vascular response to everolimus-eluting stent. An optical coherence tomography study. The OCTEVEREST

      Impact of different stent alloys on human vascular response to everolimus-eluting stent. An optical coherence tomography study. The OCTEVEREST

      Background: New generation drug-eluting stents (DES) incorporate thinner struts and novel alloys to improve clinical performance. Nevertheless, the impact of novel stent materials and designs on human vascular response to DES remains elusive. We sought to evaluate the in-vivo coronary artery response to platinum-chromium (PtCr) versus cobalt-chromium (CoCr) stents featuring the same durable polymer and antiproliferative drug by optical coherence tomography (OCT). Methods and Results: A total of 42 patients with de novo lesions in native coronary vessels was treated with PtCr-everolimus eluting stent (EES) (n=21) or CoCr-EES (n=21). Angiography, intravascular ultrasound, and OCT were performed at the ...

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    11. 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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    12. Serial Assessment of Coronary Artery Response to Paclitaxel-Eluting Stents Using Optical Coherence Tomography

      Serial Assessment of Coronary Artery Response to Paclitaxel-Eluting Stents Using Optical Coherence Tomography

      Background—The paucity of longitudinal, serial high-resolution imaging studies has limited our understanding of in vivo arterial response to drug-eluting stents. We sought to investigate the human coronary response to paclitaxel-eluting stent implantation, using serial optical coherence tomography assessments. Methods and Results—Thirty patients with at least 2 significant coronary lesions in different vessels were treated with a paclitaxel-eluting stent. The most severe stenosis (lesion A) was treated at the initial procedure, and the second target vessel (lesion B) was stented 3 months later. Optical coherence tomography was performed at baseline, 3-, and 9-month follow-up for lesions A and baseline ...

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    13. Examination of the In Vivo Mechanisms of Late Drug-Eluting Stent Thrombosis: Findings From Optical Coherence Tomography and Intravascular Ultrasound Imaging

      Examination of the In Vivo Mechanisms of Late Drug-Eluting Stent Thrombosis: Findings From Optical Coherence Tomography and Intravascular Ultrasound Imaging
      Objectives: This study investigated the role of uncovered stent struts on late stent thrombosis (LST) after drug-eluting stent (DES) implantation with optical coherence tomography (OCT). Background: Autopsy studies have identified delayed healing and lack of endothelialization of DES struts as the hallmarks of LST. DES strut coverage has not previously been examined in vivo in patients with LST. Methods: We studied 54 patients, including 18 with DES LST (median 615 days after implant) undergoing emergent percutaneous coronary interventions and 36 matched DES control subjects undergoing routine repeat OCT and intravascular ultrasound (IVUS) who did not experience LST for 3 years ...
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    14. Impact of Drug Release Kinetics on Vascular Response to Different Zotarolimus-Eluting Stents Implanted in Patients With Long Coronary Stenoses: The LongOCT Study (Optical Coherence Tomography in Long Lesions)

      Impact of Drug Release Kinetics on Vascular Response to Different Zotarolimus-Eluting Stents Implanted in Patients With Long Coronary Stenoses: The LongOCT Study (Optical Coherence Tomography in Long Lesions)
      Objectives We assessed the in vivo vascular response to a new generation of zotarolimus-eluting stents (ZES) with prolonged drug release (Resolute ZES-SR, Medtronic Vascular, Santa Rosa, California) compared with ZES with faster kinetics (Endeavor ZES-FR, Medtronic Vascular) by optical coherence tomography. Background Local drug release kinetics has been implicated with antirestenosis efficacy of drug-eluting stents. However, the impact of different release kinetics on vascular response of diseased human coronary arteries remains to be investigated. Methods The study population consisted of 43 patients with long lesions in native coronary vessels treated with multiple overlapping ZES. Twenty-one patients treated with ZES-SR were ...
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    15. The impact of an eccentric intravascular ImageWire during coronary optical coherence tomography imaging

      The impact of an eccentric intravascular ImageWire during coronary optical coherence tomography imaging
      Optical Coherence Tomography (OCT) provides high-resolution imaging which enables characterisation of atherosclerosis and vascular response to injury, but to ensure optimal analysis, one must realise potential sources of image distortion. We designed a series of analysesl, using coronary stents as a model, to investigate the influence of wire position on OCT-derived vascular images.
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    16. Strut Coverage and Late Malapposition With Paclitaxel-Eluting Stents Compared With Bare Metal Stents in Acute Myocardial Infarction: OCT Substudy of the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI)

      Strut Coverage and Late Malapposition With Paclitaxel-Eluting Stents Compared With Bare Metal Stents in Acute Myocardial Infarction: OCT Substudy of the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI)
      Background— The safety of drug-eluting stents in ST-segment elevation myocardial infarction (STEMI) continues to be debated. Pathological studies have demonstrated an association between uncovered struts and subsequent stent thrombosis. Optical coherence tomography can detect stent strut coverage in vivo on a micron-scale level. We therefore used optical coherence tomography to examine strut coverage in patients with STEMI treated with paclitaxel-eluting stents (PES) and bare metal stents (BMS). Methods and Results— In the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, patients with STEMI were randomized 3:1 to PES or BMS implantation. In a formal substudy ...
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    17. Optical coherence tomography in ST-elevation myocardial infarction treated with novel drug-eluting stent: preprocedural, post implant and 2-month follow-up findings

      Optical coherence tomography in ST-elevation myocardial infarction treated with novel drug-eluting stent: preprocedural, post implant and 2-month follow-up findings
      The use of drug-eluting stents (DES) allowed the reduction in the need for repeat revascularization. At the culprit site in acute myocardial infarction patients treated with first-generation DES, the interaction between the eluted drug and the underlying necrotic core may generate different patterns of pathologic vessel response and delayed healing. A new generation DES intrepide elutes trapidil. Its modes of action are neither cytotoxic nor cytostatic, and may promote normal re-endothelialization. Due to its high resolution, optical coherence tomography (OCT) allows accurate detection of thrombus deposition and stent strut coverage at follow-up. Intravascular ultrasound (IVUS) has enhanced tissue penetration and ...
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    18. Angiographic, IVUS and OCT evaluation of the long-term impact of coronary disease severity at the site of overlapping drug-eluting and bare metal stents: a substudy of the ODESSA trial

      Angiographic, IVUS and OCT evaluation of the long-term impact of coronary disease severity at the site of overlapping drug-eluting and bare metal stents: a substudy of the ODESSA trial
      Background A potentially adverse vascular response to overlapping drug eluting stents (DES) has been suggested in current research. Objective To evaluate the impact of baseline disease severity at the site of stent overlap. Methods and results This is a substudy of ODESSA, a prospective, randomised controlled trial designed to evaluate healing of overlapping stents. 71/77 patients with a total of 86 overlapping stents were studied: 25 sirolimus, 24 paclitaxel, 26 zotarolimus-eluting stents; and 11 bare metal stents (BMS). Patients were categorised into high-grade stenosis (HGS, ≥70% diameter stenosis) and low-grade stenosis (LGS, <70%) at the site of stent overlap ...
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    19. Strut Coverage and Vessel Wall Response to a New-Generation Paclitaxel-Eluting Stent With an Ultrathin Biodegradable Abluminal Polymer: Optical Coherence Tomography Drug-Eluting Stent Investigation (OCTDESI)

      Strut Coverage and Vessel Wall Response to a New-Generation Paclitaxel-Eluting Stent With an Ultrathin Biodegradable Abluminal Polymer: Optical Coherence Tomography Drug-Eluting Stent Investigation (OCTDESI)
      Background—Polymer-coated drug-eluting stents are effective in preventing restenosis but have been associated with delayed healing and incomplete strut coverage. It is unknown whether paclitaxel-eluting stents (PES) with minimal biodegradable abluminal coating enhances strut coverage while preventing neointimal hyperplasia. Using optical coherence tomography (OCT) as a primary imaging modality, we assessed the proportion of uncovered struts at 6-month follow-up in PES coated with durable versus ultrathin (<1 µ m) biodegradable abluminal polymers. Methods and Results—In this pilot trial, 60 patients with de novo lesions (25 mm) in native coronary vessels were randomly assigned to receive either TAXUS Liberté PES ...
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    20. Strut Coverage and Vessel Wall Response to Zotarolimus-Eluting and Bare-Metal Stents Implanted in Patients With ST-Segment Elevation Myocardial Infarction: The Octami (Optical Coherence Tomography in Acute Myocardial Infarction) Study

      Strut Coverage and Vessel Wall Response to Zotarolimus-Eluting and Bare-Metal Stents Implanted in Patients With ST-Segment Elevation Myocardial Infarction: The Octami (Optical Coherence Tomography in Acute Myocardial Infarction) Study
      Objectives Using optical coherence tomography, we assessed the proportion of uncovered struts at 6-month follow-up in zotarolimus-eluting stents (ZES), specifically Endeavor (Medtronic CardioVascular, Santa Rosa, California) stents, and identical bare-metal stents (BMS) implanted in patients with ST-segment elevation myocardial infarction (STEMI). Background Sirolimus- and paclitaxel-eluting stents implanted in STEMI have been associated with delayed healing and incomplete strut coverage. ZES are associated with a more complete and uniform strut coverage in stable patients, but whether this holds true also after STEMI is unknown. Methods Forty-four patients with STEMI who underwent primary PCI were randomized to ZES or BMS (3:1 ...
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    21. Optical coherence tomography (OCT) strut-level analysis of drug-eluting stents (DES) in human coronary bifurcations

      Optical coherence tomography (OCT) strut-level analysis of drug-eluting stents (DES) in human coronary bifurcations
      Aims: We sought to evaluate the vascular response of stent struts deployed in bifurcation segments using optical coherence tomography (OCT). Conclusions: This study demonstrates a variable patter of strut coverage in the bifurcation among stent technologies, with a high percentage of PES floating struts remaining uncovered at 6-month follow-up.
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    22. Optical Coherence Tomography Assessment of In Vivo Vascular Response After Implantation of Overlapping Bare-Metal and Drug-Eluting Stents

      Optical Coherence Tomography Assessment of In Vivo Vascular Response After Implantation of Overlapping Bare-Metal and Drug-Eluting Stents
      Objectives We designed a randomized trial exploiting optical coherence tomography (OCT) to assess coverage and apposition of overlapping bare-metal stents (BMS) and drug-eluting stents (DES) in human coronary arteries. Background Overlapping DES impair healing in animals. Optical coherence tomography allows accurate in vivo assessment of stent strut coverage and apposition. Methods Seventy-seven patients with long coronary stenoses were randomized to overlapping sirolimus-eluting stents (SES), paclitaxel-eluting stents (PES), zotarolimus-eluting stents (ZES), or BMS. The primary goal of the study was to determine the rate of uncovered/malapposed struts in overlap versus nonoverlap segments, according to stent type, at 6-month follow-up with ...
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    23. Assessment of Heterogeneity of Strut-Level Neointima Hyperplasia After Stent Implantation by Optical Coherence Tomography

      Background: Optical coherence tomography (OCT) permits a highly accurate NIH assessment at each strut level within a cross-section. The aim of this study is to evaluate heterogeneity of NIH among different stents. Methods: Patients enrolled in ODESSA were assessed. ODESSA was a prospective randomized trial designed to evaluate strut coverage of overlapped (OLP) vs. non-OLP stent segments for the treatment of de-novo, native coronary artery stenosis with four different stent types: Sirolimus-eluting stent (SES); Paclitaxel-eluting stent (PES); Zotarolimus-eluting stent (ZES); and Liberte BMS (BMS). Distance between strut and lumen was measured in every 5 frames (0.3mm) along the stented ...
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    24. Unhealed Plaque Ruptures After Stenting in Acute Myocardial Infarction Assessed by Intracoronary Optical Coherence Tomography: Incidence, Predictors, and Clinical Implication

      Backgrounds: Non healing after stenting a ruptured thin capped fibroatheroma in acute myocardial infarction (AMI) has been suggested to be a possible cause of late stent thrombosis. Optical coherence tomography (OCT) provides detailed information of ruptured plaques and stent strut coverage. We used OCT to assess the incidence, predictors, and implications of residual plaque rupture after stenting in AMI. Methods: The HORIZONS-AMI trial was a prospective, multicenter, dual arm factorial trial in which pts with AMI were randomized to different antithrombotic regimens and paclitaxel-eluting TAXUS stents vs. bare metal EXPRESS stents (3:1). Clinical follow-up was performed at 12 months ...
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    25. Optical coherence tomography: High resolution intravascular imaging to evaluate vascular healing after coronary stenting

      The risk of late stent thrombosis represents a major concern for patients treated with drug-eluting stents (DES). Delayed healing and incomplete stent coverage were commonly observed in pathologic specimens of vessels treated with DES. In-situ assessment of the stent coverage has been limited by the low spatial resolution of current image modalities. Optical coherence tomography (OCT) enables real-time, full tomographic, in-vivo visualization of coronary vessel microstructure. Struts coverage and vessel response of DES compared to BMS are the most immediate clinical applications of OCT. Thickness of coverage and strut apposition can be quantified at micron-scale level with a resolution 10-30 ...
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    1-26 of 26
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    1. (26 articles) Vasile Sirbu
    2. (24 articles) Giulio Guagliumi
    3. (18 articles) Giuseppe Musumeci
    4. (17 articles) Ospedali Riuniti di Bergamo
    5. (16 articles) Case Western Reserve University
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    Optical Coherence Tomography Assessment of In Vivo Vascular Response After Implantation of Overlapping Bare-Metal and Drug-Eluting Stents Optical coherence tomography (OCT) strut-level analysis of drug-eluting stents (DES) in human coronary bifurcations Strut Coverage and Vessel Wall Response to a New-Generation Paclitaxel-Eluting Stent With an Ultrathin Biodegradable Abluminal Polymer: Optical Coherence Tomography Drug-Eluting Stent Investigation (OCTDESI) Angiographic, IVUS and OCT evaluation of the long-term impact of coronary disease severity at the site of overlapping drug-eluting and bare metal stents: a substudy of the ODESSA trial Strut Coverage and Late Malapposition With Paclitaxel-Eluting Stents Compared With Bare Metal Stents in Acute Myocardial Infarction: OCT Substudy of the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) The impact of an eccentric intravascular ImageWire during coronary optical coherence tomography imaging Impact of Drug Release Kinetics on Vascular Response to Different Zotarolimus-Eluting Stents Implanted in Patients With Long Coronary Stenoses: The LongOCT Study (Optical Coherence Tomography in Long Lesions) 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 Normative data and minimally detectable change for inner retinal layer thicknesses using a semi-automated OCT image segmentation pipeline Acoustic Radiation Force Optical Coherence Elastography Advances in Optical Coherence Tomography and Confocal Laser Endomicroscopy in Pulmonary Diseases To Evaluate the Effect of Chronic Obstructive Pulmonary Disease on Retinal and Choroidal Thicknesses Measured by Optical Coherence Tomography