1. Articles from Giuseppe Biondi-Zoccai

    1-22 of 22
    1. Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: the CLIMA study

      Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: the CLIMA study

      Aims The CLIMA study, on the relationship between c oronary p l aque morphology of the left anter i or descending artery and twelve m onths clinic a l outcome, was designed to explore the predictive value of multiple high-risk plaque features in the same coronary lesion [minimum lumen area (MLA), fibrous cap thickness (FCT), lipid arc circumferential extension, and presence of optical coherence tomography (OCT)-defined macrophages] as detected by OCT. Composite of cardiac death and target segment myocardial infarction was the primary clinical endpoint. Methods and results From January 2013 to December 2016, 1003 patients undergoing OCT evaluation ...

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    2. Optical coherence tomography compared with fractional flow reserve guided approach in acute coronary syndromes: A propensity matched analysis

      Optical coherence tomography compared with fractional flow reserve guided approach in acute coronary syndromes: A propensity matched analysis

      Aim To compare in patients with ACS (Acute Coronary Syndromes) a PCI (Percutaneous Coronary Intervention) approach based on FFR (Fractional Flow Reserve) vs. one based on OCT (Optical Coherence Tomography). Methods and Results Consecutive patients admitted for ACS and treated with a PCI approach based on OCT or on FFR (recruited in two different studies) were compared and matched with propensity score analysis. Target Lesion revascularization (TLR) was the primary end point, while major adverse cardiovascular events [MACEs defined as the composite of death from cardiac causes, non- fatal MI, clinically driven target vessel revascularization (TVR), or re-hospitalization due to ...

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    3. Impact of an optical coherence tomography guided approach in acute coronary syndromes: A propensity matched analysis from the international FORMIDABLE-CARDIOGROUP IV and USZ registry

      Impact of an optical coherence tomography guided approach in acute coronary syndromes: A propensity matched analysis from the international FORMIDABLE-CARDIOGROUP IV and USZ registry

      Aim. To determine the potential clinical impact of OCT (Optical Coherence Tomography) during primary percutaneous coronary intervention in patients presenting with ACS (Acute Coronary Syndrome). Methods and Results. FORMIDABLE is a multicentre retrospective registry enrolling all patients presenting with ACS and treated with an OCT-guided approach, while the USZ registry enrolled patients treated with a standard angiography guided approach. Multivariate adjustment was performed via a propensity score matching. The number stents useds was the primary outcome, while the incidence of MACE (a composite of death, myocardial infarction, target vessel revascularization, and stent thrombosis) was the secondary endpoint. A total of ...

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    4. Optical coherence tomography evaluation of intermediate-term healing of different stent types: systemic review and meta-analysis

      Optical coherence tomography evaluation of intermediate-term healing of different stent types: systemic review and meta-analysis

      Aims The intermediate-term incidence of strut malapposition (SM) and uncovered struts (US), and the degree of neointimal thickness (NIT) according to stent type have not been characterized. Methods and results All studies of >50 patients in which optical coherence tomography was performed between 6 and 12 months after stent implantation were included. The incidences of SM and US were the co-primary end points, while NIT was the secondary end point. A total of 458 citations were initially appraised at the abstract level, and 11 full-text studies (280 652 analysed struts, 921 patients) were assessed. The 6–12 months incidences of ...

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    5. 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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    6. Prevalence and predictors of culprit plaque rupture at OCT in patients with coronary artery disease: a meta-analysis

      Prevalence and predictors of culprit plaque rupture at OCT in patients with coronary artery disease: a meta-analysis

      Aims The prevalence of plaque rupture at the culprit lesion identified by optical coherence tomography (OCT) in different clinical subset of patients undergoing coronary angiography and its clinical predictors remain to be defined. Methods All studies including patients with OCT evaluation of the culprit coronary plaque were included. The prevalence of culprit plaque rupture (CPR) and thin-cap fibro-atheroma (TCFA) were the primary endpoints. The factors associated with these findings were studied in a subset of patients with different clinical presentations [ST-elevation myocardial (STEMI) vs. nonST-elevation myocardial infarction (NSTEMI) vs. unstable angina (UA) vs. stable angina pectoris (SAP)]. Results One hundred ...

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    7. Accuracy of intravascular ultrasound and optical coherence tomography in identifying functionally significant coronary stenosis according to vessel diameter: A meta-analysis of 2,581 patients and 2,807 lesions

      Accuracy of intravascular ultrasound and optical coherence tomography in identifying functionally significant coronary stenosis according to vessel diameter: A meta-analysis of 2,581 patients and 2,807 lesions

      Introduction Accuracy of intracoronary imaging to discriminate functionally significant coronary stenosis according to vessel diameter remains to be defined. Methods PubMed, Scopus, and Google Scholar were systematically searched for studies assessing diagnostic accuracy (area under the receiver operating characteristic curve [AUC], the primary end point) and sensitivity and specificity (the secondary end points) of minimal luminal area (MLA) or of minimal luminal diameter (MLD) derived from intravascular ultrasound (IVUS) or optical coherence tomography (OCT) to detect functionally significant stenosis as determined with fractional flow reserve (FFR). Results Fifteen studies were included, 2 with 110 patients analyzing only left main (LM ...

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    8. Stent-related defects in patients presenting with stent thrombosis: differences at optical coherence tomography between subacute and late/very late thrombosis in the Mechanism Of Stent Thrombosis (MOST) study

      Stent-related defects in patients presenting with stent thrombosis: differences at optical coherence tomography between subacute and late/very late thrombosis in the Mechanism Of Stent Thrombosis (MOST) study

      Aims: Subacute, late, and very late stent thrombosis (ST) may occur after stent implantation, but they are characterised by different underlying pathophysiological mechanisms. We sought to appraise differences between subacute and late/very late ST at the thrombus site by optical coherence tomography (OCT). The Mechanism Of Stent Thrombosis (MOST) study was a prospective multicentre non-randomised registry which enrolled six subacute ST and six controls (subacute ST study), and 17 late/very late ST and 17 controls (late/very late ST study). Methods and results: Patients with subacute ST had a minimum stent area at the thrombus site of 2 ...

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    9. Randomized trial of standard versus ClearWay-infused abciximab and thrombectomy in myocardial infarction: rationale and design of the COCTAIL II study

      Randomized trial of standard versus ClearWay-infused abciximab and thrombectomy in myocardial infarction: rationale and design of the COCTAIL II study

      Background: Patients with ST-elevation myocardial infarction (STEMI) are at substantial risk of suboptimal procedural results and late adverse events. Angiography and optical coherence tomography (OCT) studies have identified residual coronary thrombus and microcirculatory injury as potential culprits for these adverse outcomes. We hypothesized that coronary thrombectomy and local infusion of glycoprotein IIb/IIIa inhibitors by means of a dedicated infusion device can synergistically improve results of percutaneous coronary intervention (PCI) for STEMI, as appraised by OCT. Methods: A total of 128 patients with STEMI will be randomized, to one of the following: abciximab infusion with the ClearWay coronary catheter (C ...

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    10. OCT-Based Diagnosis and Management of STEMI Associated With Intact Fibrous Cap

      OCT-Based Diagnosis and Management of STEMI Associated With Intact Fibrous Cap

      In autopsy studies, at least 25% of thrombotic coronary occlusions are caused by plaque erosion in which thrombus often overlies atherosclerotic plaque without evident disruption of the fibrous cap. We performed optical coherence tomography imaging after aspiration thrombectomy and identified plaque erosion as the cause in 31 patients presenting with ST-segment elevation myocardial infarction. Plaque erosion was identified when the fibrous cap of the culprit lesion was intact. Based on clinical criteria, 40% of patients with subcritically occlusive plaque were treated with dual antiplatelet therapy without percutaneous revascularization (group 1), and the remaining 60% of patients underwent angioplasty and stenting ...

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    11. Optical coherence tomography guided in-stent thrombus removal in patients with acute coronary syndromes

      Optical coherence tomography guided in-stent thrombus removal in patients with acute coronary syndromes

      The persistence of thrombus inside stent struts is a frequent event in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI), and this phenomenon might be associated with an increased risk of stent thrombosis. We sought to quantify by means of optical coherence tomography (OCT) the presence of in-stent thrombus after achievement of an optimal angiographic result in patients with ACS undergoing PCI. In addition, we evaluated the feasibility and safety of an OCT-guided strategy of in-stent thrombus removal. Eighty consecutive patients with ACS undergoing PCI were treated with two different strategies equally divided into two groups: angio-guided ...

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    12. Association Between Proximal Stent Edge Positioning on Atherosclerotic Plaques Containing Lipid Pools and Postprocedural Myocardial Infarction (from the CLI-POOL Study)

      Association Between Proximal Stent Edge Positioning on Atherosclerotic Plaques Containing Lipid Pools and Postprocedural Myocardial Infarction (from the CLI-POOL Study)

      Postprocedural myocardial infarction is an ominous complication of percutaneous coronary intervention (PCI). Despite several patient, lesion, and procedural factors that may affect its occurrence and severity, it is unclear if implanting a stent edge on a coronary lipid pool, as appraised by optical coherence tomography (OCT), adversely affects outcomes. The aim of this study was to assess the association between postprocedural myocardial infarction and the implantation of a stent edge on a lipid pool, as assessed by OCT. A database was screened for patients without ongoing myocardial infarctions; who underwent PCI with stenting for single, native, de novo lesions; without ...

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    13. Transcatheter renal sympathetic ablation for resistant hypertension: in vivo insights in humans from optical coherence tomography

      Transcatheter renal sympathetic ablation for resistant hypertension: in vivo insights in humans from optical coherence tomography

      Hypertension represents a major health problem, with resistant hypertension being defined as uncontrolled blood pressure despite the use of optimal doses of ≥3 antihypertensive agents . Patients with resistant hypertension often have an increased renal sympathetic nerve activity, and building upon the historical experience with surgical renal sympathetic denervation, transcatheter radiofrequency ablation has been recently proposed . The safety profile of this novel technique appears satisfactory , but there is still limited insight on how such denervation works. We hereby report on two patients who underwent transcatheter ablation at our center, in whom optical coherence tomography (OCT) was concomitantly performed to provide more ...

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    14. Angiography alone versus angiography plus optical coherence tomography to guide decision-making during percutaneous coronary intervention: the Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) study

      Angiography alone versus angiography plus optical coherence tomography to guide decision-making during percutaneous coronary intervention: the Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) study

      Aims: Angiographic guidance for percutaneous coronary intervention (PCI) has substantial limitations. The superior spatial resolution of optical coherence tomography (OCT) could translate into meaningful clinical benefits. We aimed to compare angiographic guidance alone versus angiographic plus OCT guidance for PCI. Methods and results: Patients undergoing PCI with angiographic plus OCT guidance (OCT group) were compared with matched patients undergoing PCI with angiographic only guidance (Angio group) within 30 days. The primary endpoint was the one-year rate of cardiac death or myocardial infarction (MI). A total of 670 patients were included, 335 in the OCT group and 335 in the Angio ...

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    15. Reproducibility of Coronary Optical Coherence Tomography for Lumen and Length Measurements in Humans (The CLI-VAR [Centro per la Lotta contro l'Infarto-VARiability] Study)

      Reproducibility of Coronary Optical Coherence Tomography for Lumen and Length Measurements in Humans (The CLI-VAR [Centro per la Lotta contro l'Infarto-VARiability] Study)

      Frequency-domain optical coherence tomography (FD-OCT) is becoming a useful diagnostic tool for coronary imaging for quantitative coronary analysis. Second-generation FD-OCT produces detailed coronary lumen images. However, the reproducibility of coronary measurements using FD-OCT in humans has not been thoroughly explored. Our goal was to determine the intraobserver, interobserver, and interpullback reproducibility of the in vivo FD-OCT measurements of the lumen area and/or lesion length. Twenty-five patients undergoing coronary angioplasty were included. In all subjects, FD-OCT pullbacks (20 mm/s) were acquired twice from the same coronary segment different from the target lesion, at an interval of 5 minutes, with ...

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    16. Reproducibility of Coronary Optical Coherence Tomography for Lumen and Length Measurements in Humans (The CLI-VAR [Centro per la Lotta contro l'Infarto-VARiability] Study)

      Reproducibility of Coronary Optical Coherence Tomography for Lumen and Length Measurements in Humans (The CLI-VAR [Centro per la Lotta contro l'Infarto-VARiability] Study)

      Frequency-domain optical coherence tomography (FD-OCT) is becoming a useful diagnostic tool for coronary imaging for quantitative coronary analysis. Second-generation FD-OCT produces detailed coronary lumen images. However, the reproducibility of coronary measurements using FD-OCT in humans has not been thoroughly explored. Our goal was to determine the intraobserver, interobserver, and interpullback reproducibility of the in vivo FD-OCT measurements of the lumen area and/or lesion length. Twenty-five patients undergoing coronary angioplasty were included. In all subjects, FD-OCT pullbacks (20 mm/s) were acquired twice from the same coronary segment different from the target lesion, at an interval of 5 minutes, with ...

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    17. Early vessel healing of the Avantgarde cobalt-chromium coronary stent: the ON-GARDE OCT study

      Early vessel healing of the Avantgarde cobalt-chromium coronary stent: the ON-GARDE OCT study

      Introduction: Uncoverage and malapposition of stent struts at optical coherence tomography (OCT) have been associated with stent thrombosis. Stent uncoverage by OCT is being used as a surrogate to address the propensity of a stent to develop thrombosis. We aimed to appraise early vessel healing in patients with ST-elevation myocardial infarction (STEMI) treated with the novel Avantgarde stent. Methods: Patients with STEMI and multivessel disease were enrolled. The stent deployed on the infarct-related artery was imaged by frequency domain-OCT during deferred intervention (4-7 days apart). The primary end-point was the percentage of uncovered struts. Secondary end-points were the percentage of ...

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    18. 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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    19. 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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    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 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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    1-22 of 22
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    1. (22 articles) Giuseppe Biondi-Zoccai
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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 Examination of the In Vivo Mechanisms of Late Drug-Eluting Stent Thrombosis: Findings From Optical Coherence Tomography and Intravascular Ultrasound Imaging Serial Assessment of Coronary Artery Response to Paclitaxel-Eluting Stents Using Optical Coherence Tomography Early vessel healing of the Avantgarde cobalt-chromium coronary stent: the ON-GARDE OCT study Reproducibility of Coronary Optical Coherence Tomography for Lumen and Length Measurements in Humans (The CLI-VAR [Centro per la Lotta contro l'Infarto-VARiability] Study) Angiography alone versus angiography plus optical coherence tomography to guide decision-making during percutaneous coronary intervention: the Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) study Transcatheter renal sympathetic ablation for resistant hypertension: in vivo insights in humans from optical coherence tomography Association Between Proximal Stent Edge Positioning on Atherosclerotic Plaques Containing Lipid Pools and Postprocedural Myocardial Infarction (from the CLI-POOL Study) OCT-Based Diagnosis and Management of STEMI Associated With Intact Fibrous Cap Postdoctoral Research Fellowships (Optical Coherence Tomography) at Massachusetts General Hosptial Postdoctoral Research Fellowships (In Vivo Microscopy) At Massachusetts General Hospital