1. Articles from Thomas F. Lüscher

    1-19 of 19
    1. Refining the management of acute coronary and aortic syndromes

      Refining the management of acute coronary and aortic syndromes

      Stents have revolutionized the treatment of acute coronary syndromes (ACS) 1 . Although drug-coated devices and in particular biolimus-eluting stents with biodegradable polymer are increasingly used in this patient population, their long-term outcomes as compared with bare metal stents in patients with ST-segment elevation myocardial infarction (STEMI) remains unknown. 2 In their article entitled ‘ Five-year clinical outcomes and intracoronary imaging findings of the COMFORTABLE AMI trial: randomized comparison of biodegradable polymer-based biolimus-eluting stents with bare-metal stents in patients with acute ST-segment elevation myocardial infarction ’, 3 Lorenz Räber and colleagues from the Bern University Hospital in Switzerland report the 5-year follow-up ...

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    2. Changes in Coronary Plaque Composition in Patients With Acute Myocardial Infarction Treated With High-Intensity Statin Therapy (IBIS-4): A Serial Optical Coherence Tomography Study

      Changes in Coronary Plaque Composition in Patients With Acute Myocardial Infarction Treated With High-Intensity Statin Therapy (IBIS-4): A Serial Optical Coherence Tomography Study

      Objectives This study assessed changes in optical coherence tomography (OCT)-defined plaque composition in patients with ST-elevation myocardial infarction (STEMI) receiving high-intensity statin treatment. Background OCT is a high-resolution modality capable of measuring plaque characteristics including fibrous cap thickness (FCT) and macrophage infiltration. There is limited in vivo evidence regarding the effects of statins on OCT-defined coronary atheroma composition and no evidence in the context of STEMI. Methods In the IBIS-4 (Integrated Biomarker Imaging Study-4), 103 patients underwent intravascular ultrasonography and OCT of 2 noninfarct-related coronary arteries in the acute phase of STEMI. Patients were treated with high-dose rosuvastatin for ...

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    3. Assessing coronary plaques: non-invasive and intracoronary imaging and haemodynamic measurements

      Assessing coronary plaques: non-invasive and intracoronary imaging and haemodynamic measurements

      Atherosclerotic plaque is the hidden culprit of angina and infarction. Commonly, we assume that a coronary plaque that causes ischaemia and/or angina is clinically relevant, although we have learned that even non-obstructive plaques can cause acute coronary syndromes. 1–3 The assessment of haemodynamically relevant plaques is challenging. The so-called gold standard, i.e. coronary angiography, only provides an estimate of the significance of luminal narrowing as it provides only a two-dimensional pictures of the lumen and, unless it is analysed quantitatively, also involves a lot of subjectivity. Intracoronary imaging with intravascular ultrasound (IVUS) and optical coherence tomography (OCT ...

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    4. Performance of modern stents in stable and acute coronary disease

      Performance of modern stents in stable and acute coronary disease

      Since Grüntzig’s seminal first procedure in 1977, 1 percutaneous coronary intervention or PCI has made impressive progress. Most importantly, the introduction of stents has markedly improved the acute and long-term results. 2–4 The first stent implantations were performed in patients with dissection and acute occlusions, 5 but their long-term follow-up also showed that restenosis rates were lower in those receiving a stent. A major breakthrough was the introduction of drug-eluting stents 6–9 which over time brought restenosis and stent thrombosis to an all-time low. With drug-eluting stents, delayed healing and endothelial dysfunction may occur, which favours ...

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    5. Frontiers in cardiac imaging: diagnostic and prognostic validity and safety

      Frontiers in cardiac imaging: diagnostic and prognostic validity and safety

      The heart is a hidden organ and was not accessible for clinicians until the discovery of the stethoscope by René Laennec in 1821.1 Thereafter, there was little progress until the discovery of radiation by Wilhelm Röntgen in 18982 and its application for chest X-rays and later angiography. In the 1970s, echocardiography was developed followed by magnetic resonance imaging or MRI3,4 and computed tomography or CT.5 These imaging tools have revolutionized the diagnosis of cardiac conditions, and without them most cardiac procedures and interventions such as, for instance, TAVI (transcatheter aortic valve implantation) most recently ...

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    6. The REMEDEE-OCT Study : An Evaluation of the Bioengineered COMBO Dual-Therapy CD34 Antibody–Covered Sirolimus-Eluting Coronary Stent Compared With a Cobalt-Chromium Everolimus-Eluting Stent in Patients With Acute Coronary Syndromes: Insights From Optical

      The REMEDEE-OCT Study : An Evaluation of the Bioengineered COMBO Dual-Therapy CD34 Antibody–Covered Sirolimus-Eluting Coronary Stent Compared With a Cobalt-Chromium Everolimus-Eluting Stent in Patients With Acute Coronary Syndromes: Insights From Optical

      Objectives The aim of the present study was to evaluate vascular healing of the bioengineered COMBO Dual Therapy Stent compared with a cobalt-chromium (CoCr) everolimus-eluting stent (EES) as assessed by optical coherence tomography in patients with acute coronary syndromes. Background CD34+ cells promote endothelial repair after vascular injury. The bioengineered COMBO Dual Therapy Stent combines CD34+ cell–capturing technology with abluminal sirolimus release, but more data from clinical studies evaluating the vascular response are needed. Methods In a prospective randomized multicenter clinical trial, 60 patients with acute coronary syndromes were randomized 1:1 to COMBO or CoCr EES implantation. The ...

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    7. 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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    8. 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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    9. 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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    10. Impact of local vascular lesions assessed with optical coherence tomography and ablation points on blood pressure reduction after renal denervation

      Impact of local vascular lesions assessed with optical coherence tomography and ablation points on blood pressure reduction after renal denervation

      Local vascular injury is detectable with optical coherence tomography (OCT) after catheter-based renal denervation (RDN). However, it is unclear whether the number and type of vascular lesions or the number of ablation points could affect blood pressure (BP) reduction. The aim of the study was to assess the impact of vascular injury induced by RDN detected with OCT and the number of ablation points on BP response after 1, 3 and 6 months. METHODS: RDN was either performed with a Simplicity ® catheter or an EnligHTN TM multielectrode basket followed by OCT. BP was recorded prospectively as office measurement and 24-hour ...

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    11. The bumpy road to evidence: why many research findings are lost in translation

      The bumpy road to evidence: why many research findings are lost in translation

      We have come a long way When, more than 2500 years ago, Thales of Milet (624–547 BC) claimed that nature was ruled by laws and not by gods, he changed the world. 1 Such a concept allowed for the discovery and mathematical proof of impersonal causation of what, until then, had been a mystery ruled by unpredictable gods. Indeed, ever since then the understanding of nature—today we would call it the natural sciences—has become a major activity of mankind. With this strategy, we have come a long way. Initially, it allowed us to use the position of ...

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    12. View point: what should the future design of clinical imaging studies be?

      View point: what should the future design of clinical imaging studies be?

      Coronary artery disease (CAD) is primarily a structural disease characterized by the build-up of atherosclerotic plaques in the coronary arteries. With progressive impingement on coronary blood flow, a given coronary stenosis will elicit functional consequences that are described by the ‘ischaemic cascade’ and emerge progressively as inducible changes of perfusion, wall motion, and electrocardiogram, and finally manifest as chest pain ( Figure 1 ). Thus, definitions for clinically significant CAD may vary considerably based on whether rather anatomical vs. functional criteria are used ( Table 1 ).

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    13. Optical coherence tomography to reveal vascular lesions after catheter-based renal nerve ablation with a novel multi-electrode EnligHTNTM system

      Optical coherence tomography to reveal vascular lesions after catheter-based renal nerve ablation with a novel multi-electrode EnligHTNTM system

      A 72-year-old female with a history of sleep apnoea syndrome was referred to the Andreas Gruentzig Catheterisation Laboratories for catheter-based renal nerve ablation (RNA) due to drug-resistant, uncontrolled hypertension. After intravenously loading with aspirin, the RNA was obtained using the first generation multi-electrode EnligHTNTM system (St. Jude Medical, Westford, MA, USA) delivering 8 ablation runs on both the left and the right renal artery. Before and after the RNA procedure, optical coherence tomography (OCT) was performed using the C7-XR imaging system (LightLab Imaging, Inc., Westford, MA, USA) with a non-occlusive technique and a single-mode optical fibre catheter (frequency domain-OCT-catheter, DragonFlyTM ...

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    14. Geometrically correct three-dimensional optical coherence tomography: first self-expanding bifurcation stent evaluation

      Geometrically correct three-dimensional optical coherence tomography: first self-expanding bifurcation stent evaluation

      A 78-year-old female was referred to the Andreas Gruentzig Catheterization Laboratories suffering from angina pain CCS II. Coronary angiography demonstrated a bifurcation lesion in the middle left anterior descending and the first diagonal branch ( Panel A ). Based on these findings, percutaneous coronary intervention (PCI) was performed with implantation of a

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    15. Vascular lesions induced by renal nerve ablation as assessed by optical coherence tomography: pre- and post-procedural comparison with the Simplicity® catheter system and the EnligHTN™ multi-electrode renal denervation catheter

      Vascular lesions induced by renal nerve ablation as assessed by optical coherence tomography: pre- and post-procedural comparison with the Simplicity® catheter system and the EnligHTN™ multi-electrode renal denervation catheter

      Aims Catheter-based renal nerve ablation (RNA) using radiofrequency energy is a novel treatment for drug-resistant essential hypertension. However, the local endothelial and vascular injury induced by RNA has not been characterized, although this importantly determines the long-term safety of the procedure. Optical coherence tomography (OCT) enables in vivo visualization of morphologic features with a high resolution of 10–15 µm. The objective of this study was to assess the morphological features of the endothelial and vascular injury induced by RNA using OCT. Methods and results In a prospective observational study, 32 renal arteries of patients with treatment-resistant hypertension underwent OCT ...

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    16. Optical coherence tomography to reveal strut malapposition due to thrombus resolution 3 weeks after acute coronary syndrome

      Optical coherence tomography to reveal strut malapposition due to thrombus resolution 3 weeks after acute coronary syndrome

      A 37-year-old male was admitted with a non-ST-elevation myocardial infarction. Coronary angiography and optical coherence tomography (OCT) revealed a 70% stenosis of the ostial left artery descending (LAD) with little thrombotic material but without obvious signs for rupture/dissection ( Panels A and B , Supplementary material online, Video S1 ). After direct stenting with a biolimus-eluting stent (BES, 3.5 × 18 mm, 10 atmospheres), OCT revealed suboptimal strut apposition with

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    17. Allograft vasculopathy vs. coronary artery disease: comparison by optical coherence tomography

      Allograft vasculopathy vs. coronary artery disease: comparison by optical coherence tomography

      Optical coherence tomography (OCT) is a novel high-resolution intravascular imaging technique allowing characterization of coronary artery plaques and evaluation of stent strut coverage. As a new application, OCT can be also used in allograft vasculopathy as demonstrated by the following images. Comparison of OCT and coronary angiography...

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    18. Dizziness and Pre-Syncope: An Unusual Clinical Presentation of a Spontaneous Coronary Artery Dissection as Revealed by Optical Coherence Tomography

      Dizziness and Pre-Syncope: An Unusual Clinical Presentation of a Spontaneous Coronary Artery Dissection as Revealed by Optical Coherence Tomography

      A 52-year-old woman was admitted to our hospital with a 2-day history of nausea and dizziness and a subsequent pre-syncope. Because of a known bipolar disorder, an emergency psychiatric evaluation was performed and an attempted suicide as suggested by relatives was considered unlikely. Subsequently, an increased troponin T level was observed (0.101 µg/l) and coronary angiography was performed. Coronary angiography revealed a highly variable degree of stenosis of the middle right coronary artery (A and B, arrows) that was unresponsive to intracoronary nitrate administration. Notably, when there was a high degree of stenosis cardiac arrhythmias, in particular sinus ...

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    19. Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy

      Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy
      Aims Coronary late stent thrombosis, a rare but devastating complication, remains an important concern in particular with the increasing use of drug-eluting stents. Notably, pathological studies have indicated that the proportion of uncovered coronary stent struts represents the best morphometric predictor of late stent thrombosis. Intracoronary optical frequency domain imaging (OFDI), a novel second-generation optical coherence tomography (OCT)-derived imaging method, may allow rapid imaging for the detection of coronary stent strut coverage with a markedly higher precision when compared with intravascular ultrasound, due to a microscopic resolution (axial ∼10–20 µm), and at a substantially increased speed of image ...
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    1-19 of 19
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    1. (19 articles) Thomas F. Luscher
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    Coronary optical frequency domain imaging (OFDI) for in vivo evaluation of stent healing: comparison with light and electron microscopy Dizziness and Pre-Syncope: An Unusual Clinical Presentation of a Spontaneous Coronary Artery Dissection as Revealed by Optical Coherence Tomography Allograft vasculopathy vs. coronary artery disease: comparison by optical coherence tomography Optical coherence tomography to reveal strut malapposition due to thrombus resolution 3 weeks after acute coronary syndrome Vascular lesions induced by renal nerve ablation as assessed by optical coherence tomography: pre- and post-procedural comparison with the Simplicity® catheter system and the EnligHTN™ multi-electrode renal denervation catheter Geometrically correct three-dimensional optical coherence tomography: first self-expanding bifurcation stent evaluation Optical coherence tomography to reveal vascular lesions after catheter-based renal nerve ablation with a novel multi-electrode EnligHTNTM system View point: what should the future design of clinical imaging studies be? Optical coherence tomography evaluation of intermediate-term healing of different stent types: systemic review and meta-analysis 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 AI-Assisted In Situ Detection of Human Glioma Infiltration Using a Novel Computational Method for Optical Coherence Tomography Motorized capsule for shadow-free OCT imaging and synchronous beam control