1. Articles from yangsoo jang

    1-24 of 78 1 2 3 4 »
    1. Optical Coherence Tomography for Coronary Bioresorbable Vascular Scaffold Implantation

      Optical Coherence Tomography for Coronary Bioresorbable Vascular Scaffold Implantation

      Background: We investigated whether optical coherence tomography (OCT) guidance would reduce nonoptimal bioresorbable vascular scaffold (BVS) deployment. Methods: This was a randomized controlled trial. Patients who required percutaneous coronary intervention for ischemic heart disease were recruited from 2 centers in Korea. The enrolled patients were randomly assigned to receive either OCT-guided BVS (Absorb; Abbott Vascular) implantation or angiography-guided BVS implantation using an optimized technique. The primary outcome was nonoptimal deployment, which was a composite outcome of the following parameters assessed by OCT: a minimal scaffold area <5 mm 2 , residual area stenosis >20%, incomplete apposition of the scaffold struts >5 ...

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    2. Impact of late stent malapposition after drug-eluting stent implantation on long-term clinical outcomes

      Impact of late stent malapposition after drug-eluting stent implantation on long-term clinical outcomes

      Background and aims The impact of late drug-eluting stent (DES) malapposition detected by optical coherence tomography (OCT) on long-term clinical outcomes has not been clearly established. We evaluated long-term clinical outcomes of late stent malapposition (LSM) detected by OCT in a qualified study population. Methods A total of 428 patients were selected from previous randomized OCT studies that evaluated the degree of strut coverage of different DESs at a 3–12-month follow-up OCT examination. These patients were assigned to one of two groups based on the presence (n = 136) or absence (n = 292) of LSM on follow-up OCT images (performed ...

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    3. Severe acute stent malapposition follow-up: 3-month and 12-month serial quantitative analyses by optical coherence tomography

      Severe acute stent malapposition follow-up: 3-month and 12-month serial quantitative analyses by optical coherence tomography

      Background Optical coherence tomography (OCT) was used to assess serial changes in severe acute stent malapposition (ASM) after drug-eluting stent (DES) implantation. Methods The maximal depth and axial lengths of ASM after DES implantation were serially quantified at percutaneous coronary intervention (PCI), and at 3 and 12-month follow-up, for 100 lesions in 96 patients. Severe ASM was defined as a maximal malapposed depth ≥400 μm or maximal malapposed axial length ≥1 mm. Results Of the 100 lesions, 23 lesions (23%) had a severe ASM depth at PCI. At 3 months, the maximal depth decreased to <400 μm in 12 of ...

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    4. Severe acute stent malapposition follow-up: 3-month and 12-month serial quantitative analyses by optical coherence tomography

      Severe acute stent malapposition follow-up: 3-month and 12-month serial quantitative analyses by optical coherence tomography

      Background Optical coherence tomography (OCT) was used to assess serial changes in severe acute stent malapposition (ASM) after drug-eluting stent (DES) implantation. Methods The maximal depth and axial lengths of ASM after DES implantation were serially quantified at percutaneous coronary intervention (PCI), and at 3 and 12-month follow-up, for 100 lesions in 96 patients. Severe ASM was defined as a maximal malapposed depth ≥400 μm or maximal malapposed axial length ≥1 mm. Results Of the 100 lesions, 23 lesions (23%) had a severe ASM depth at PCI. At 3 months, the maximal depth decreased to <400 μm in 12 of ...

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    5. Long‐Term Clinical Outcomes of Late Stent Malapposition Detected by Optical Coherence Tomography After Drug‐Eluting Stent Implantation

      Long‐Term Clinical Outcomes of Late Stent Malapposition Detected by Optical Coherence Tomography After Drug‐Eluting Stent Implantation

      Background The relationship between late stent malapposition (LSM) and adverse cardiovascular events is controversial. Studies are needed to evaluate long‐term (>5 years) clinical outcomes of LSM detected by optical coherence tomography (OCT) after drug‐eluting stent implantation. Methods and Results We investigated long‐term clinical outcomes of OCT‐detected LSM in 351 patients who received drug‐eluting stents and were examined by both poststent and follow‐up OCT (175±60 days after drug‐eluting stent implantation) from January 2009 to December 2011. LSM was observed in 99 patients (28%). We evaluated the cumulative rate of composite events (cardiovascular death ...

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    6. Early Follow-Up Optical Coherence Tomographic Findings of Significant Drug-Eluting Stent Malapposition

      Early Follow-Up Optical Coherence Tomographic Findings of Significant Drug-Eluting Stent Malapposition

      Background: Using optical coherence tomography, we evaluated early follow-up findings of significant stent malapposition (SSM) in patients treated with second-generation drug-eluting stent. Methods and Results: From the DETECT-OCT randomized trial (Determination of the Duration of the Dual Antiplatelet Therapy by the Degree of the Coverage of the Struts on Optical Coherence Tomography From the Randomized Comparison Between Everolimus- Versus Biolimus-Eluting Stent), a total of 386 patients (390 lesions) who underwent both postintervention and 3-month follow-up optical coherence tomography examinations were included for the present analysis. SSM was defined as a stent that had a strut with a maximal wall-to-strut distance ...

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    7. Randomized Comparison of Strut Coverage between Ticagrelor and Clopidogrel in Acute Myocardial Infarction at 3-Month Optical Coherence Tomography

      Randomized Comparison of Strut Coverage between Ticagrelor and Clopidogrel in Acute Myocardial Infarction at 3-Month Optical Coherence Tomography

      Purpose This study aimed to compare the effects of ticagrelor and clopidogrel on early neointimal healing assessed with optical coherence tomography (OCT) after drug-eluting stent (DES) implantation in patients with acute myocardial infarction (AMI). Materials and Methods AMI patients were randomly assigned to either the ticagrelor or clopidogrel arm. After DES implantation, OCT was performed to assess the percentages of uncovered struts immediately after procedure and 3 months later. Results Due to early termination, 83 patients out of 106 initially enrolled patients (24% of planned participants) underwent 3-month OCT. Differences in vascular healing patterns between the two groups, including percentage ...

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    8. Clinical Significance of Lipid-Rich Plaque Detected by Optical Coherence Tomography : A 4-Year Follow-Up Study

      Clinical Significance of Lipid-Rich Plaque Detected by Optical Coherence Tomography : A 4-Year Follow-Up Study

      Background Lipid-rich plaque (LRP) is thought to be a precursor to cardiac events. However, its clinical significance in coronary arteries has never been systematically investigated. Objectives This study investigated the prevalence and clinical significance of LRP in the nonculprit region of the target vessel in patients undergoing percutaneous coronary intervention (PCI). Methods The study included 1,474 patients from 20 sites across 6 countries undergoing PCI, who had optical coherence tomography (OCT) imaging of the target vessel. Major adverse cardiac events (MACE) were defined as a composite of cardiac death, acute myocardial infarction, and ischemia-driven revascularization. Patients were followed for ...

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    9. 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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    10. Assessing Computational Fractional Flow Reserve From Optical Coherence Tomography in Patients With Intermediate Coronary Stenosis in the Left Anterior Descending Artery

      Assessing Computational Fractional Flow Reserve From Optical Coherence Tomography in Patients With Intermediate Coronary Stenosis in the Left Anterior Descending Artery

      Background— Intravascular optical coherence tomography (OCT) imaging provides limited information on the functional assessment of coronary stenosis. We evaluated a new approach to OCT image–based computation modeling, which can be used to estimate the fractional flow reserve (FFR) in patients with intermediate coronary stenosis. Methods and Results— Ninety-two patients with intermediate diameter stenosis in the left anterior descending artery underwent both FFR measurement with pressure wires and OCT examination. Using the OCT data, a computational fluid dynamics algorithm was used to calculate the computational FFR (FFR OCT ). The diagnostic performance of the FFR OCT was assessed based on the ...

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    11. Development of Advanced Atherosclerotic Plaque by Injection of Inflammatory Proteins in a Rabbit Iliac Artery Model

      Development of Advanced Atherosclerotic Plaque by Injection of Inflammatory Proteins in a Rabbit Iliac Artery Model

      Purpose Appropriate animal models of atherosclerotic plaque are crucial to investigating the pathophysiology of atherosclerosis, as well as for the evaluation of the efficacy and safety of vascular devices. We aimed to develop a novel animal model that would be suitable for the study of advanced atherosclerotic lesions in vivo . Materials and Methods Atherosclerotic plaque was induced in 24 iliac arteries from 12 rabbits by combining a high cholesterol diet, endothelial denudation, and injection into the vessel wall with either saline (n=5), olive oil (n=6), or inflammatory proteins [n=13, high-mobility group protein B1 (HMGB1) n=8 and ...

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    12. Association between fractional flow reserve and coronary plaque characteristics assessed by optical coherence tomography

      Association between fractional flow reserve and coronary plaque characteristics assessed by optical coherence tomography

      Background The assessment of fractional flow reserve (FFR) in coronary lesions determines the strategy of percutaneous coronary intervention. However, the association between FFR and characteristics of the underlying coronary plaque has not been sufficiently investigated. Methods A total of 110 coronary lesions in 106 patients were evaluated using both FFR and optical coherence tomography (OCT). Coronary plaques were classified into fibrous, fibrocalcific, or fibroatheroma according to OCT evaluation at the site of minimal lumen area. Plaque microstructures such as cap thickness, macrophage accumulation, intimal vasculature, or cholesterol crystals were also evaluated. Results Lesions with FFR ≤ 0.8 showed a higher ...

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    13. Incidence and Clinical Significance of Poststent Optical Coherence Tomography Findings: One-Year Follow-Up Study From a Multicenter Registry

      Incidence and Clinical Significance of Poststent Optical Coherence Tomography Findings: One-Year Follow-Up Study From a Multicenter Registry

      Background— Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of poststent OCT findings are unknown. Methods and Results— A total of 900 lesions treated with 1001 stents in 786 patients who had postprocedure OCT imaging were analyzed to evaluate the incidence of poststent OCT findings and to identify the OCT predictors for device-oriented clinical end points, including cardiac death, target vessel–related myocardial infarction, target lesion revascularization, and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7% of lesions, and incomplete stent ...

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    14. Favorable effect of optimal lipid-lowering therapy on neointimal tissue characteristics after drug-eluting stent implantation: Qualitative optical coherence tomographic analysis

      Favorable effect of optimal lipid-lowering therapy on neointimal tissue characteristics after drug-eluting stent implantation: Qualitative optical coherence tomographic analysis

      Objective Serial follow-up optical coherence tomography (OCT) was used to evaluate the effect of optimal lipid-lowering therapy on qualitative changes in neointimal tissue characteristics after drug-eluting stent (DES) implantation. Methods DES-treated patients (n=218) who received statin therapy were examined with serial follow-up OCT. First and second follow-up OCT evaluations were performed approximately 6 and 18 months after the index procedure, respectively. Patients were divided into two groups, based on the level of low-density lipoprotein-cholesterol (LDL-C), which was measured at the second follow-up. The optimal lipid-lowering group (n=121) had an LDL-C reduction of ≥50% or an LDL-C level ≤70mg ...

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    15. In Vivo Demonstration of Frail Neointimal Tissue Embolization After Angioplasty With a Drug-Coated Balloon Confirmed by Optical Coherence Tomography and Histology

      In Vivo Demonstration of Frail Neointimal Tissue Embolization After Angioplasty With a Drug-Coated Balloon Confirmed by Optical Coherence Tomography and Histology

      A 60-year-old woman experienced exertional chest pain. She underwent percutaneous coronary intervention with a drug-eluting stent (Nobori, Terumo Corporation, Tokyo) at the midportion of the left anterior descending artery. In the 3-month follow-up angiography, there was an in-stent restenosis at the midportion of the left anterior descending artery, which was also the site of a previous stent implantation (arrow, Figure 1A). In optical coherence tomography, neointimal hyperplasia proliferation with a heterogeneous pattern was observed with a minimal lumen area of 1.7 mm 2 (asterisk, Figure 1A). Angioplasty with a drug-coated balloon (Sequent please; B. Braun, Melsungen, Germany) was performed ...

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    16. Incidence and Clinical Significance of Post-Stent OCT Findings: One Year Follow-Up Study From a Multicenter Registry

      Incidence and Clinical Significance of Post-Stent OCT Findings: One Year Follow-Up Study From a Multicenter Registry

      Background —Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of post-stent OCT findings are unknown. Methods and Results —A total of 900 lesions treated with 1001 stents in 786 patients who had post-procedure OCT imaging were analyzed to evaluate the incidence of post-stent OCT findings and to identify the OCT predictors for device-oriented clinical endpoints (DoCE), including cardiac death, target vessel-related myocardial infarction, target lesion revascularization (TLR) and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7% of lesions and incomplete stent ...

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    17. Comparison of Neoatherosclerosis and Neovascularization Between Patients With and Without Diabetes : An Optical Coherence Tomography Study

      Comparison of Neoatherosclerosis and Neovascularization Between Patients With and Without Diabetes : An Optical Coherence Tomography Study

      Objectives This study aimed to investigate the characteristics of neoatherosclerosis (NA) in patients with diabetes mellitus (DM) after drug-eluting stent (DES) implantation using optical coherence tomography. Background NA is an important substrate for stent failure. In vivo NA characteristics in DM patients have not been investigated. Methods A total of 397 patients with 452 DES who underwent follow-up optical coherence tomography examination after DES implantation were enrolled. Characteristics of NA were compared between DM and non-DM patients. Neovascularization was defined as signal-poor holes or tubular structures with a diameter of 50 to 300 μm. Results A total of 123 DES ...

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    18. Three-dimensional optical coherence tomographic analysis of eccentric morphology of the jailed side-branch ostium in coronary bifurcation lesions

      Three-dimensional optical coherence tomographic analysis of eccentric morphology of the jailed side-branch ostium in coronary bifurcation lesions

      Background The severity of angiographic diameter stenosis of the jailed side-branch ostium is usually overestimated over the three-dimensional (3D) optical coherence tomography (OCT)-measured actual stenosis. Using the 3D-OCT, morphologic changes in the jailed side-branch ostium were evaluated before and after a single stent crossover at coronary bifurcation lesions. Methods In 109 patients who received a single stent crossover at coronary bifurcation lesions, the pre- and post-intervention minimal lumen area (MLA) and the eccentricity of the jailed side-branch ostium were measured with 3D-OCT. The eccentricity index was defined as the ratio of maximal diameter/minimal diameter of the jailed side-branch ...

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    19. Automated measurement of stent strut coverage in intravascular optical coherence tomography

      Automated measurement of stent strut coverage in intravascular optical coherence tomography

      Optical coherence tomography (OCT) is a non-invasive, cross-sectional imaging modality that has become a prominent imaging method in percutaneous intracoronary intervention. We present an automated detection algorithm for stent strut coordinates and coverage in OCT images. The algorithm for stent strut detection is composed of a coordinate transformation from the polar to the Cartesian domains and application of second derivative operators in the radial and the circumferential directions. Local region-based active contouring was employed to detect lumen boundaries. We applied the method to the OCT pullback images acquired from human patients in vivo to quantitatively measure stent strut coverage. The ...

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    20. Optical Coherence Tomographic Observation of In-Stent Neoatherosclerosis in Lesions With More Than 50% Neointimal Area Stenosis After Second-Generation Drug-Elnuting Stent Implantation

      Optical Coherence Tomographic Observation of In-Stent Neoatherosclerosis in Lesions With More Than 50% Neointimal Area Stenosis After Second-Generation Drug-Elnuting Stent Implantation

      Background— Despite the enhanced properties of the second-generation drug-eluting stent (DES), its association with neoatherosclerosis has not been sufficiently evaluated. Therefore, we sought to evaluate and compare neoatherosclerosis in second-generation DESs to first-generation DESs. Methods and Results— A total of 212 DES-treated patients with >50% percent neointimal cross-sectional area stenosis were retrospectively enrolled from the Korean multicenter optical coherence tomography (OCT) registry. Within this population, 111 patients had a second-generation DES (40 zotarolimus, 36 everolimus, and 35 biolimus) and 101 patients had a first-generation (65 sirolimus and 36 paclitaxel) DES. Neoatherosclerosis on OCT was defined as neointima formation with the ...

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    21. Optical Coherence Tomographic Observation of In-Stent Neoatherosclerosis in Lesions With More Than 50% Neointimal Area Stenosis After Second-Generation Drug-Eluting Stent Implantation

      Optical Coherence Tomographic Observation of In-Stent Neoatherosclerosis in Lesions With More Than 50% Neointimal Area Stenosis After Second-Generation Drug-Eluting Stent Implantation

      Background— Despite the enhanced properties of the second-generation drug-eluting stent (DES), its association with neoatherosclerosis has not been sufficiently evaluated. Therefore, we sought to evaluate and compare neoatherosclerosis in second-generation DESs to first-generation DESs. Methods and Results— A total of 212 DES-treated patients with >50% percent neointimal cross-sectional area stenosis were retrospectively enrolled from the Korean multicenter optical coherence tomography (OCT) registry. Within this population, 111 patients had a second-generation DES (40 zotarolimus, 36 everolimus, and 35 biolimus) and 101 patients had a first-generation (65 sirolimus and 36 paclitaxel) DES. Neoatherosclerosis on OCT was defined as neointima formation with the ...

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    22. Eccentric morphology of jailed side-branch ostium after stent crossover in coronary bifurcation lesions: A three-dimensional optical coherence tomographic analysis

      Eccentric morphology of jailed side-branch ostium after stent crossover in coronary bifurcation lesions: A three-dimensional optical coherence tomographic analysis

      Background Angiographic stenosis of a jailed side-branch ostium is usually observed after a single-stent crossover at coronary bifurcation lesions. However, the stenosis severity is typically overestimated due to the limited information obtained from two-dimensional morphology by angiography. We evaluated the actual stenosis of jailed side-branch ostium using three-dimensional (3D) optical coherence tomography (OCT). Methods Using 3D reconstructions of OCT data, we analyzed minimal lumen area (MLA) and eccentricity of the jailed side-branch ostium in 41 patients who were treated with single stent crossover at coronary bifurcation lesions and subsequently underwent serial OCT follow-up. Results The MLA of jailed side-branch ostium ...

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    23. Serial randomized comparison of strut coverage between everolimus- vs. 1-generation sirolimus-eluting stents

      Serial randomized comparison of strut coverage between everolimus- vs. 1-generation sirolimus-eluting stents

      Background There has not been sufficient data to evaluate the serial vascular healing pattern after everolimus-eluting stent (EES) implantation. Using optical coherence tomography (OCT), serial changes in strut coverage were compared between EES and 1 st -generation sirolimus-eluting stents (SES). Methods Sixty patients were randomly assigned to receive either EES (n=30) or 1 st -generation SES (n=30) for coronary artery disease. Serial OCT evaluation at post-procedure, and 3- and 12-month follow-ups were performed in 50 patients with 54 stents (25 patients with 28 EES vs. 25 patients with 26 SES). The percentage of uncovered struts was defined as ...

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    24. Optical Coherence Tomographic Evaluation of the Effect of Cigarette Smoking on Vascular Healing after Sirolimus-Eluting Stent Implantation

      Optical Coherence Tomographic Evaluation of the Effect of Cigarette Smoking on Vascular Healing after Sirolimus-Eluting Stent Implantation

      Cigarette smoking is known to be deleterious to patients with coronary artery disease, however the effect of smoking on vascular responses after coronary drug-eluting stent implantation is unknown. We sought to examine vascular response after sirolimus-eluting stent (SES) implantation in patients with ongoing smoking using optical coherence tomography (OCT), compared with former smokers and nonsmokers. We identified 181 SESs in 140 subjects who underwent follow-up OCT imaging. Subjects were divided into 3 groups: current smokers (n = 28), former smokers (n = 35), and nonsmokers (n = 77). Stent strut coverage, neointimal characteristics, and strut malapposition were evaluated. The incidence of uncovered stent ...

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