1. Articles from Ravinay Bhindi

    1-12 of 12
    1. Wire bias in coronary measurement using optical coherence tomography

      Wire bias in coronary measurement using optical coherence tomography

      OCT is widely used for accurate coronary stent sizing; however, the impact of coronary tortuosity or guide wire weight on the accuracy of OCT in assessing coronary dimensions is not known. This study sought to determine whether guide wire properties impact on coronary diameter and length estimation by optical coherence tomography (OCT) in tortuous segments of coronary artery. OCT coronary diameters were determined in selected patients with tortuous arteries before and after removal of a supportive guide wire to obtain unobscured images. In addition, a coronary model was created with lumen diameters of 1.7–4.8 mm. This was ...

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    2. Optical coherence tomography: not quite ready

      Optical coherence tomography: not quite ready

      Intravascular imaging has revolutionised the way coronary intervention has been viewed. Both intravascular ultrasound (IVUS) and, to a greater degree, optical coherence tomography (OCT), allow exquisite assessment of the luminal wall and structure to a near-histological tissue assessment level. OCT also allows detailed assessment of stent characteristics and, in particular, of adequacy of deployment and early identification of procedural complications, such as edge dissections. Although this level of imaging provides invaluable information for the interventionalist, data are scarce for its use in clinical practice to improve outcomes.

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    3. Culprit plaque morphology in STEMI – an optical coherence tomography study: insights from the TOTAL-OCT substudy

      Culprit plaque morphology in STEMI – an optical coherence tomography study: insights from the TOTAL-OCT substudy

      Aims: Our aim was to compare stenosis severity and plaque content between STEMI culprit lesions with intact fibrous cap (IFC) and those with plaque rupture (PR) in a prospective study. Methods and results: We evaluated 93 patients undergoing OCT and thrombectomy as part of a prospective substudy of the TOTAL (ThrOmbecTomy versus PCI ALone) trial. Culprit lesion morphology was assessable by OCT in 70/93 (75.3%). IFC was found in 31 (44.3%), PR in 34 (48.6%) and calcified nodule in five (7.1%) patients. Following thrombectomy, OCT demonstrated similar lumen area stenosis in IFC (79.3%) and ...

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    4. Optical Coherence Tomography–Guided Percutaneous Coronary Intervention in ST-Segment–Elevation Myocardial Infarction A Prospective Propensity–Matched Cohort of the Thrombectomy Versus Percutaneous Coronary Intervention Alone Trial

      Optical Coherence Tomography–Guided Percutaneous Coronary Intervention in ST-Segment–Elevation Myocardial Infarction A Prospective Propensity–Matched Cohort of the Thrombectomy Versus Percutaneous Coronary Intervention Alone Trial

      BACKGROUND: Patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment-elevation myocardial infarction are at increased risk for adverse events. It is unclear if image guidance by optical coherence tomography (OCT) can improve outcomes in these patients. We compared OCT-guided versus angiography-guided primary PCI for ST-segment-elevation myocardial infarction among patients in the Thrombectomy Versus PCI Alone (TOTAL) trial. METHODS AND RESULTS: Among 10 732 patients enrolled in the TOTAL trial, OCT was used for PCI guidance as a part of a prospective substudy in 214 patients. Using 2:1 propensity matching, we identified 428 patients in the trial who had PCI ...

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    5. The effect of coronary artery plaque composition, morphology and burden on Absorb bioresorbable vascular scaffold expansion and eccentricity — A detailed analysis with optical coherence tomography

      The effect of coronary artery plaque composition, morphology and burden on Absorb bioresorbable vascular scaffold expansion and eccentricity — A detailed analysis with optical coherence tomography

      Aims Suboptimal stent expansion correlates with adverse cardiac events. There is limited information regarding Absorb bioresorbable vascular scaffold (BVS) expansion characteristics. Optical coherence tomography (OCT) allows for high-resolution assessment of plaque morphology, composition and assessment of BVS expansion. This study evaluates coronary plaque composition, morphology and burden and their effect on Absorb BVS expansion using OCT. Methods and results Two thousand three hundred and thirty four frames totalling 462.6 mm of BVS from twenty OCT-guided BVS implantations were examined. 200 μm longitudinal cross-sections of each BVS were analysed for lumen contours and plaque characteristics. The relationship between each plaque ...

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    6. Feasibility and repeatability of optical coherence tomography measurements of pre-stent thrombus burden in patients with STEMI treated with primary PCI

      Feasibility and repeatability of optical coherence tomography measurements of pre-stent thrombus burden in patients with STEMI treated with primary PCI

      AIMS: Intracoronary thrombus is disrupted by stent deployment and confounded by the development of intrastent plaque prolapse. This study aims at investigating the feasibility and repeatability of thrombus quantification prior to stent implantation using optical coherence tomography (OCT) in ST-segment elevation myocardial infarction (STEMI) patients. METHODS AND RESULTS: Patients were enrolled in an OCT substudy of the TOTAL trial (a randomized trial of routine aspiration ThrOmbecTomy with PCI vs. PCI ALone in patients with STEMI undergoing primary PCI) of aspiration thrombectomy or percutaneous coronary intervention (PCI) alone in primary PCI (PPCI) of STEMI. Using OCT, thrombus burden (TB) and other ...

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    7. Clinical utility of optical coherence tomography (OCT) in the optimisation of Absorb bioresorbable vascular scaffold deployment during percutaneous coronary intervention

      Clinical utility of optical coherence tomography (OCT) in the optimisation of Absorb bioresorbable vascular scaffold deployment during percutaneous coronary intervention

      Aims: The Absorb everolimus-eluting bioresorbable vascular scaffold (BVS) represents an important advance in percutaneous coronary intervention (PCI) technology. With increasing use of BVS, it is important to understand its expansion characteristics to ensure optimal scaffold deployment. Optical coherence tomography (OCT) has been shown to improve detection of intraprocedural complications compared with conventional intravascular imaging modalities. This study aimed to determine whether or not OCT, post successful angiographic BVS implantation, influenced decision making with regard to the need for further scaffold optimisation. Methods and results: Consecutive patients undergoing OCT-guided BVS implantation from August 2012 to March 2013 were reviewed to determine ...

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    8. Treatment of acute left internal mammary artery graft failure using a bio-absorbable scaffold, guided by 3-dimensional optical coherence tomography

      Treatment of acute left internal mammary artery graft failure using a bio-absorbable scaffold, guided by 3-dimensional optical coherence tomography

      A 42year old Caucasian male presented with sudden onset chest pain, associated with diaphoresis, and nausea. He had experienced similar brief episode earlier that week. Cardiac risk factors included hypercholesterolemia (fasting level 6.85mmol/l), uncompliant with statin therapy and a smoker of 10–15 cigarettes per day. He had recently been diagnosed with type II diabetes.

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    9. Treatment of a left anterior descending artery chronic total occlusion using a bio-absorbable scaffold, utilising optical coherence tomography

      Treatment of a left anterior descending artery chronic total occlusion using a bio-absorbable scaffold, utilising optical coherence tomography

      A 58year old Nepalese male presented with exertional chest pain. He had experienced similar symptoms 3months previously when out walking. Cardiac risk factors included undiagnosed hypercholesterolaemia (fasting level 8.7mmol/l) and a family history of ischaemic heart disease (mother, previous myocardial infarction). At the time of presentation ECG showed evidence of left bundle branch block (LBBB). High sensitivity troponin was negative. He underwent further risk stratification with an exercise stress ECG. He stopped at 6minutes of a Bruce protocol with chest pain and evidence of anterior J point ST depression (2mm), V1–6. Echocardiography revealed normal LV function. He ...

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    10. Use of optical coherence tomography to guide treatment of an undeployed stent trapped in the right coronary artery to cover a proximal stent outflow dissection

      Use of optical coherence tomography to guide treatment of an undeployed stent trapped in the right coronary artery to cover a proximal stent outflow dissection

      A 73 year old man with a background history of hypercholesterolaemia, type II diabetes, and peripheral vascular disease presented with Canadian Cardiac Society (CCS) class III symptoms. ECG revealed no significant changes and high-sensitivity troponin was negative. Further risk stratification with an exercise stress test was positive (2mm J-point ST depression II, III, AVF), and he was referred for diagnostic coronary angiography.

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    1-12 of 12
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    1. (2 articles) Tampere University of Technology
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    Overcoming Limited Depth Penetration of Optical Coherence Tomography With Wire Bias Use of optical coherence tomography to guide treatment of an undeployed stent trapped in the right coronary artery to cover a proximal stent outflow dissection Treatment of a left anterior descending artery chronic total occlusion using a bio-absorbable scaffold, utilising optical coherence tomography Treatment of acute left internal mammary artery graft failure using a bio-absorbable scaffold, guided by 3-dimensional optical coherence tomography Clinical utility of optical coherence tomography (OCT) in the optimisation of Absorb bioresorbable vascular scaffold deployment during percutaneous coronary intervention Spontaneous Coronary Artery Dissection Treated With Bio-Resorbable Vascular Scaffolds Guided By Optical Coherence Tomography Feasibility and repeatability of optical coherence tomography measurements of pre-stent thrombus burden in patients with STEMI treated with primary PCI Optical Coherence Tomography–Guided Percutaneous Coronary Intervention in ST-Segment–Elevation Myocardial Infarction A Prospective Propensity–Matched Cohort of the Thrombectomy Versus Percutaneous Coronary Intervention Alone Trial Culprit plaque morphology in STEMI – an optical coherence tomography study: insights from the TOTAL-OCT substudy Optical coherence tomography: not quite ready Selective retinex enhancement based on the clustering algorithm and block-matching 3D for optical coherence tomography images Artificial intelligence, the internet of things, and virtual clinics: ophthalmology at the digital translation forefront