1. Articles from Shengxian Tu

    1-23 of 23
    1. Comparison of Diagnostic Performance of Intracoronary Optical Coherence Tomography-based and Angiography-based Fractional Flow Reserve for Evaluation of Coronary Stenosis

      Comparison of Diagnostic Performance of Intracoronary Optical Coherence Tomography-based and Angiography-based Fractional Flow Reserve for Evaluation of Coronary Stenosis

      Aims: To evaluate the diagnostic performance of OCT-based optical flow ratio (OFR) in unselected patients and compare it with angiography-based quantitative flow ratio (QFR), using wire-based FFR as reference standard. Methods and results: All patients with OCT and FFR assessment prior to revascularization were analyzed. OFR and QFR were computed in blinded fashion and compared with FFR, all applying same cut-off value of ≤0.80 to define ischemia. Paired comparison between OFR and QFR was performed in 212 vessels from 181 patients. Average FFR was 0.82±0.10 and 40.1% vessels had FFR≤0.80. OFR showed significant ...

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    2. Fractional flow reserve in clinical practice: from wire-based invasive measurement to image-based computation

      Fractional flow reserve in clinical practice: from wire-based invasive measurement to image-based computation

      Fractional flow reserve (FFR) and instantaneous wave-free ratio are the present standard diagnostic methods for invasive assessment of the functional significance of epicardial coronary stenosis. Despite the overall trend towards more physiology-guided revascularization, there remains a gap between guideline recommendations and the clinical adoption of functional evaluation of stenosis severity. A number of image-based approaches have been proposed to compute FFR without the use of pressure wire and induced hyperaemia. In order to better understand these emerging technologies, we sought to highlight the principles, diagnostic performance, clinical applications, practical aspects, and current challenges of computational physiology in the catheterization laboratory ...

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    3. Diagnostic accuracy of intracoronary optical coherence tomography-derived fractional flow reserve for assessment of coronary stenosis severity

      Diagnostic accuracy of intracoronary optical coherence tomography-derived fractional flow reserve for assessment of coronary stenosis severity

      ims: A novel method for computation of fractional flow reserve (FFR) from optical coherence tomography (OCT) was developed recently. This study aimed to evaluate the diagnostic accuracy of a new OCT-based FFR (OFR) computational approach, using wire-based FFR as the reference standard. Methods and results: Patients who underwent both OCT and FFR prior to intervention were analysed. The lumen of the interrogated vessel and the ostia of the side branches were automatically delineated and used to compute OFR. Bifurcation fractal laws were applied to correct the change in reference lumen size due to the step-down phenomenon. OFR was compared with ...

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    4. In-stent fractional flow reserve variations and related optical coherence tomography findings: the FFR–OCT co-registration study

      In-stent fractional flow reserve variations and related optical coherence tomography findings: the FFR–OCT co-registration study

      We sought to assess in-stent variations in fractional flow reserve (FFR) in patients with previous percutaneous coronary intervention (PCI) and to associate any drop in FFR with findings by optical coherence tomography (OCT) imaging. Suboptimal post-PCI FFR values were previously associated with poor outcomes. It is not known to which extent in-stent pressure loss contributes to reduced FFR. In this single-arm observational study, 26 patients who previously underwent PCI with drug-eluting stent or scaffold implantation were enrolled. Motorized FFR pullback during continuous intravenous adenosine infusion and OCT assessments was performed. Post-PCI FFR < 0.94 was defined as suboptimal. At a ...

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    5. Anatomical and functional assessment of Tryton bifurcation stent before and after final kissing balloon dilatation: Evaluations by three-dimensional coronary angiography, optical coherence tomography imaging and fractional flow reserve

      Anatomical and functional assessment of Tryton bifurcation stent before and after final kissing balloon dilatation: Evaluations by three-dimensional coronary angiography, optical coherence tomography imaging and fractional flow reserve

      Objectives To assess the anatomical and functional impact of final kissing balloon inflation (FKBI) after implantation of a dedicated bifurcation stent system. Background Current evidence suggests clinical benefit of FKBI in patients undergoing bifurcation dilatation using the Tryton side branch stent (Tryton-SBS). We hypothesized that FKBI improves anatomical reconstruction and functional results of bifurcation treated by Tryton-SBS. Methods An unselected group of patients with complex bifurcation coronary lesions undergoing percutaneous coronary intervention (PCI) with Tryton-SBS underwent paired anatomical assessment with two- and three-dimensional quantitative coronary analysis (2D- and 3D-QCA), and optical coherence tomography (OCT), including 3D reconstruction before and after ...

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    6. Advances in three-dimensional coronary imaging and computational fluid dynamics: is virtual fractional flow reserve more than just a pretty picture?

      Advances in three-dimensional coronary imaging and computational fluid dynamics: is virtual fractional flow reserve more than just a pretty picture?

      Percutaneous coronary intervention (PCI) has shown a high success rate in the treatment of coronary artery disease. The decision to perform PCI often relies on the cardiologist’s visual interpretation of coronary lesions during angiography. This has inherent limitations, particularly due to the low resolution and two-dimensional nature of angiography. State-of-the-art modalities such as three-dimensional quantitative coronary angiography, optical coherence tomography and invasive fractional flow reserve (FFR) may improve clinicians’ understanding of both the anatomical and physiological importance of coronary lesions. While invasive FFR is the gold standard technique for assessment of the haemodynamic significance of coronary lesions, recent studies ...

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    7. Impact of Side Branch Modeling on Computation of Endothelial Shear Stress in Coronary Artery Disease Coronary Tree Reconstruction by Fusion of 3D Angiography and OCT

      Impact of Side Branch Modeling on Computation of Endothelial Shear Stress in Coronary Artery Disease Coronary Tree Reconstruction by Fusion of 3D Angiography and OCT

      Background Computational fluid dynamics allow virtual evaluation of coronary physiology and shear stress (SS). Most studies hitherto assumed the vessel as a single conduit without accounting for the flow through side branches. Objectives This study sought to develop a new approach to reconstruct coronary geometry that also computes outgoing flow through side branches in hemodynamic and biomechanical calculations, using fusion of optical coherence tomography (OCT) and 3-dimensional (3D) angiography. Methods Twenty-one patients enrolled in the DOCTOR (Does Optical Coherence Tomography Optimize Revascularization) fusion study underwent OCT and 3D-angiography of the target vessel (9 left anterior descending, 2 left circumflex, 10 ...

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    8. Co-registration of Optical Coherence Tomography and X-ray Angiography in Percutaneous Coronary Intervention. The Does Optical Coherence Tomography Optimize Revascularization (DOCTOR) Fusion Study

      Co-registration of Optical Coherence Tomography and X-ray Angiography in Percutaneous Coronary Intervention. The Does Optical Coherence Tomography Optimize Revascularization (DOCTOR) Fusion Study

      Background Intracoronary imaging provides accurate lesion delineation and precise measurements for sizing and positioning of coronary stents. During percutaneous coronary intervention (PCI), it may be challenging to identify corresponding segments between intracoronary imaging and angiography. Computer based online co-registration may aid the target segment identification. Methods The DOCTOR Fusion study was a prospective, single arm, observational study including patients admitted for elective PCI. Optical coherence tomography (OCT) was acquired pre-stent implantation for sizing of stents. The operator subsequently indicated on the angiogram the target area as identified by OCT. Computer based co-registration was performed on-line immediately after pre-stent acquisition to ...

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    9. OCT Assessment of the Long-Term Vascular Healing Response 5 Years After Everolimus-Eluting Bioresorbable Vascular Scaffold

      OCT Assessment of the Long-Term Vascular Healing Response 5 Years After Everolimus-Eluting Bioresorbable Vascular Scaffold

      Background Although recent observations suggest a favorable initial healing process of the everolimus-eluting bioresorbable vascular scaffold (BVS), little is known regarding long-term healing response. Objectives This study assessed the in vivo vascular healing response using optical coherence tomography (OCT) 5 years after elective first-in-man BVS implantation. Methods Of the 14 living patients enrolled in the Thoraxcenter Rotterdam cohort of the ABSORB A study, 8 patients underwent invasive follow-up, including OCT, 5 years after implantation. Advanced OCT image analysis included luminal morphometry, assessment of the adluminal signal-rich layer separating the lumen from other plaque components, visual and quantitative tissue characterization, and ...

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    10. Is it safe to implant bioresorbable scaffolds in ostial side-branch lesions? Impact of ‘neo-carina’ formation on main-branch flow pattern. Longitudinal clinical observations

      Is it safe to implant bioresorbable scaffolds in ostial side-branch lesions? Impact of ‘neo-carina’ formation on main-branch flow pattern. Longitudinal clinical observations

      Formation of a ‘neo-carina’ has been reported after bioresorbable vascular scaffolds (BVS) implantation over side-branches. However, as this ‘neo-carina’ could protrude into the main-branch, its hemodynamic impact remains unknown. We present two cases of BVS implantation for ostial side-branch lesions, and investigate the flow patterns at follow-up and their potential impact. Computational fluid dynamics analysis was performed, using a 3D mesh created by fusion of 3-dimensional angiogram with optical coherence tomography images. In our first case, mild disturbances were seen when ‘neo-carina’ did not protrude perpendicularly into the main branch. In the second case, extensive flow re-distribution was observed due ...

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    11. A novel method to assess coronary artery bifurcations by OCT: cut-plane analysis for side-branch ostial assessment from a main-vessel pullback

      A novel method to assess coronary artery bifurcations by OCT: cut-plane analysis for side-branch ostial assessment from a main-vessel pullback

      Aims In coronary bifurcations assessment, evaluation of side-branch (SB) ostia by an optical coherence tomography (OCT) pullback performed in the main branch (MB) could speed up lesion evaluation and minimize contrast volume. Dedicated software that reconstructs the cross-sections perpendicular to the SB centreline could improve this assessment. We aimed to validate a new method for assessing the SB ostium from an OCT pullback performed in the MB. Methods and results Thirty-one sets of frequency-domain OCT pullbacks from 28 patients, both from the MB and the SB of a coronary artery bifurcation were analysed. Measurements of the SB ostium from the ...

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    12. Optical Coherence Tomography-guided Bifurcation Stenting of a Coronary Artery Dissection

      Optical Coherence Tomography-guided Bifurcation Stenting of a Coronary Artery Dissection

      Periprocedural guide-wire induced coronary artery dissection is a rare but potentially serious complication of PCI. Immediate stenting of the entry point is one of the therapeutic options but engaging the guide-wire in the true lumen may be challenging. We report a case of a 55-year-old woman with a guide-wire induced coronary dissection that occurred during treatment of a bifurcation lesion. Optical coherence tomography was instrumental to distinguish true form false lumen and thereby guide correct positioning of the guide-wire to successfully treat the lesion using a dedicated bifurcation stent.

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    13. Co-registration of fractional flow reserve and optical coherence tomography with the use of a three-dimensional angiographic roadmap: an opportunity for optimisation of complex percutaneous coronary interventions

      Co-registration of fractional flow reserve and optical coherence tomography with the use of a three-dimensional angiographic roadmap: an opportunity for optimisation of complex percutaneous coronary interventions

      Angiography of a 63-year-old male patient with unstable angina revealed a tight stenosis in the mid right coronary artery, proximal to a formerly implanted drug-eluting stent (DES). A motorised pullback of the pressure wire at 1 mm/sec during IV adenosine (140 μg/kg/min) permitted co-registration of the pressure-derived fractional flow reserve (FFR) signal along the angiographic roadmap, and the precise length (12 mm) of the segment where the pressure “jump” was derived. Additional OCT co-registration was performed revealing extensive spiral dissection at the proximal edge of the - See more at: http://www.pcronline.com/eurointervention/66th_issue/146/#sthash ...

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    14. Quantitative angiography and optical coherence tomography for the functional assessment of nonobstructive coronary stenoses: Comparison with fractional flow reserve

      Quantitative angiography and optical coherence tomography for the functional assessment of nonobstructive coronary stenoses: Comparison with fractional flow reserve

      Background The purpose was to compare 3-dimensional quantitative coronary angiography (3D-QCA) with optical coherence tomography (OCT) for the functional assessment of nonobstructive coronary stenoses, as evaluated by fractional flow reserve (FFR). Methods Fifty-five nonobstructive coronary stenoses (30%-50% diameter stenosis by visual estimation) were assessed in 36 patients using FFR, 2-dimensional QCA (2D-QCA), 3D-QCA, and OCT. Results Angiographic stenosis severity by 2D-QCA was 34% ± 13% diameter stenosis, and minimal lumen diameter (MLD) was 1.77 ± 0.58 mm. Fractional flow reserve values were 0.85 ± 0.10. Correlation coefficients between FFR and MLD or minimal lumen area (MLA) were highly ...

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    15. In Vivo Flow Simulation at Coronary Bifurcation Reconstructed by Fusion of 3-Dimensional X-ray Angiography and Optical Coherence Tomography [Images and Case Reports in Interventional Cardiology

      In Vivo Flow Simulation at Coronary Bifurcation Reconstructed by Fusion of 3-Dimensional X-ray Angiography and Optical Coherence Tomography [Images and Case Reports in Interventional Cardiology

      High-quality reconstruction of coronary bifurcations is crucial in the evaluation of lesions, dedicated bifurcation stents, and stent techniques. Although 3-dimensional (3D) X-ray angiography restores natural bending of vascular structures, optical coherence tomography (OCT) provides an ultra–high resolution of the vessel wall morphology and stents at baseline and follow-up. We present a new method for 3D fusion of the 2 imaging modalities combined with flow simulation at the target bifurcation. A 63-year-old woman was admitted for percutaneous coronary intervention attributable to severe stenosis (Figure 1A) in the left anterior descending artery (LAD) at the bifurcation of the first diagonal branch ...

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    16. In vivo comparison of arterial lumen dimensions assessed by co-registered three-dimensional (3D) quantitative coronary angiography, intravascular ultrasound and optical coherence tomography

      In vivo comparison of arterial lumen dimensions assessed by co-registered three-dimensional (3D) quantitative coronary angiography, intravascular ultrasound and optical coherence tomography

      This study sought to compare lumen dimensions as assessed by 3D quantitative coronary angiography (QCA) and by intravascular ultrasound (IVUS) or optical coherence tomography (OCT), and to assess the association of the discrepancy with vessel curvature. Coronary lumen dimensions often show discrepancies when assessed by X-ray angiography and by IVUS or OCT. One source of error concerns a possible mismatch in the selection of corresponding regions for the comparison. Therefore, we developed a novel, real-time co-registration approach to guarantee the point-to-point correspondence between the X-ray, IVUS and OCT images. A total of 74 patients with indication for cardiac catheterization were ...

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    17. Online Three-Dimensional Rendering of Optical Coherence Tomography Images for the Assessment of Bifurcation Intervention

      Online Three-Dimensional Rendering of Optical Coherence Tomography Images for the Assessment of Bifurcation Intervention

      Three-dimensional optical coherence tomography rendering has been suggested as a method providing additive information for the assessment of the result of percutaneous coronary intervention. However, rendering of such models is very time-consuming and cannot be performed online during the intervention. We present a case in which a new method for 3-dimensional rendering of optical coherence tomography images helped visualize the stent–vessel wall interaction, providing useful information that discouraged further intervention.

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    18. Carina shift as a mechanism for side-branch compromise following main vessel intervention: Insights from three-dimensional optical coherence tomography

      Carina shift as a mechanism for side-branch compromise following main vessel intervention: Insights from three-dimensional optical coherence tomography

      Three-dimensional rendering of optical coherence tomography (OCT) images is a method that can be used for providing additive information for assessing the result of percutaneous coronary intervention (PCI), especially in complex lesions such as in bifurcations (1). While plaque shift has been considered the main underlying mechanism for side-branch compromise after stenting (2), new theories challenge the role of plaque shift and suggest carina shift to be a major contributor (3-6). We present a case were on-line three-dimensional OCT was used to demonstrate the role of carina shift in side-branch pinching, following main vessel intervention. A 53-year old female underwent ...

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    19. Fusion of 3D QCA and IVUS/OCT

      Fusion of 3D QCA and IVUS/OCT

      Abstract  The combination/fusion of quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS)/optical coherence tomography (OCT) depends to a great extend on the co-registration of X-ray angiography (XA) and IVUS/OCT. In this work a new and robust three-dimensional (3D) segmentation and registration approach is presented and validated. The approach starts with standard QCA of the vessel of interest in the two angiographic views (either biplane or two monoplane views). Next, the vessel of interest is reconstructed in 3D and registered with the corresponding IVUS/OCT pullback series by a distance mapping algorithm. The accuracy of the registration was ...

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    1-23 of 23
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    1. (23 articles) Shengxian Tu
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    Fusion of 3D QCA and IVUS/OCT Use of three-dimensional optical coherence tomography to verify correct wire position in a jailed side branch after main vessel stent implantation Carina shift as a mechanism for side-branch compromise following main vessel intervention: Insights from three-dimensional optical coherence tomography Online Three-Dimensional Rendering of Optical Coherence Tomography Images for the Assessment of Bifurcation Intervention First Presentation of 3-Dimensional Reconstruction and Centerline-Guided Assessment of Coronary Bifurcation by Fusion of X-Ray Angiography and Optical Coherence Tomography In vivo comparison of arterial lumen dimensions assessed by co-registered three-dimensional (3D) quantitative coronary angiography, intravascular ultrasound and optical coherence tomography In Vivo Flow Simulation at Coronary Bifurcation Reconstructed by Fusion of 3-Dimensional X-ray Angiography and Optical Coherence Tomography [Images and Case Reports in Interventional Cardiology Quantitative angiography and optical coherence tomography for the functional assessment of nonobstructive coronary stenoses: Comparison with fractional flow reserve Co-registration of fractional flow reserve and optical coherence tomography with the use of a three-dimensional angiographic roadmap: an opportunity for optimisation of complex percutaneous coronary interventions Impact of Side Branch Modeling on Computation of Endothelial Shear Stress in Coronary Artery Disease Coronary Tree Reconstruction by Fusion of 3D Angiography and OCT MULTIMODAL IMAGING CORRELATION OF THE CONCENTRIC MACULAR RINGS SIGN IN FOVEAL HYPOPLASIA Temporal dynamics of muscle optical properties during degeneration and regeneration in a canine muscle xenograft model