1. Articles from Orazio Valsecchi

    1-13 of 13
    1. Mechanism of luminal patency of the self-expanding sideguard sidebranch stent: Evaluation by intravascular ultrasound and optical coherence tomography

      Mechanism of luminal patency of the self-expanding sideguard sidebranch stent: Evaluation by intravascular ultrasound and optical coherence tomography

      Background : The Cappella Sideguard (CS) sidebranch stent is a self-expanding, thin-strut, nitinol device with anatomic flaring at the sidebranch ostium designed to treat bifurcation lesions. Objective : To evaluate the mechanism of long-term lumen patency of the novel, self-expanding CS sidebranch stent compared to a balloon-expandable stent in the main vessel. Methods : We performed intravascular ultrasound (IVUS) post-intervention and at follow-up in 24 CS stents and in 28 balloon-expandable drug-eluting stents deployed in the corresponding main vessel. Thirteen patients also had optical coherence tomography (OCT) at follow-up to evaluate neointimal hyperplasia and strut coverage. Results : CS stent area at the sidebranch ...

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    2. 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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    3. 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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    4. 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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    5. 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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    6. 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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    7. 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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    8. 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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    9. 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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    10. 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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    11. 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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    12. 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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    13. 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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    1-13 of 13
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    1. (13 articles) Giulio Guagliumi
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    Optical Coherence Tomography Assessment of In Vivo Vascular Response After Implantation of Overlapping Bare-Metal and Drug-Eluting Stents 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 a New-Generation Paclitaxel-Eluting Stent With an Ultrathin Biodegradable Abluminal Polymer: Optical Coherence Tomography Drug-Eluting Stent Investigation (OCTDESI) Optical coherence tomography in ST-elevation myocardial infarction treated with novel drug-eluting stent: preprocedural, post implant and 2-month follow-up findings 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) 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) Examination of the In Vivo Mechanisms of Late Drug-Eluting Stent Thrombosis: Findings From Optical Coherence Tomography and Intravascular Ultrasound Imaging Impact of different stent alloys on human vascular response to everolimus-eluting stent. An optical coherence tomography study. The OCTEVEREST Duke University Engineering Professor Sina Farsiu Elected Fellow of the IEEE PhotoniCare Takes First Place at the 2019 HealthTECH Startup Competition Close Assessment and Testing for Chronic Graft Versus Host Disease, CATCH Study GaAs-Based InPBi Quantum Dots for High Efficiency Super-Luminescence Diodes