1. Articles from Ugo Limbruno

    1-11 of 11
    1. A comparison of intracoronary treatment strategies for thrombus burden removal during primary percutaneous coronary intervention: a COCTAIL II substudy

      A comparison of intracoronary treatment strategies for thrombus burden removal during primary percutaneous coronary intervention: a COCTAIL II substudy

      Background: Manual thrombus aspiration and local drug delivery of abciximab have been proposed as a strategy to reduce thrombus burden during percutaneous coronary intervention in patients with ST elevation myocardial infarction; however, the effectiveness of these approaches, is uncertain. In this COCTAIL II substudy, we compared the effect of these strategies on prestenting and poststenting thrombus burden assessed by optical coherence tomography. Patients and methods: COCTAIL II trial enrolled patients with ST elevation myocardial infarction randomized to intralesion (IL, by the ClearWay catheter) versus intracoronary (IC, by the guide catheter) abciximab bolus with or without aspiration thrombectomy (AT). The following ...

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      Mentions: Francesco Prati
    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. The role of residual intrastent thrombus during primary angioplasty: insights from the COCTAIL II study

      The role of residual intrastent thrombus during primary angioplasty: insights from the COCTAIL II study

      Aims: Recent frequency-domain optical coherence tomography studies showed that a complete removal of thrombotic materials is rarely achieved after percutaneous coronary interventions for ST segment elevation myocardial infarction. Residual intrastent thrombus can embolize distally leading to microcirculatory injury. The aim was to find a possible correlation between residual intrastent thrombus and angiographic indexes of myocardial reperfusion. Methods: The population consisted of 128 ST segment elevation myocardial infarction patients enrolled in the COCTAIL II trial. Intrastent thrombus at optical coherence tomography was defined as the maximum percentage value of thrombus area (thrombus area/stent area × 100 in the cross-section with largest ...

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      Mentions: Francesco Prati
    4. Clinical Impact of OCT Findings During PCI: The CLI-OPCI II Study

      Clinical Impact of OCT Findings During PCI: The CLI-OPCI II Study

      Objectives The goal of this study was to assess the clinical impact of optical coherence tomography (OCT) findings during percutaneous coronary intervention (PCI). Background OCT provides unprecedented high-definition visualization of plaque/stent structures during PCI; however, the impact of OCT findings on outcome remains undefined. Methods In the context of the multicenter CLI-OPCI (Centro per la Lotta contro l’Infarto–Optimisation of Percutaneous Coronary Intervention) registry, we retrospectively analyzed patients undergoing end-procedural OCT assessment and compared the findings with clinical outcomes. Results A total of 1,002 lesions (832 patients) were assessed. Appropriate OCT assessment was obtained in 98.2 ...

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    5. Optical coherence tomography appraisal of residual thrombus burden in patients with ST-segment elevation myocardial infarction undergoing intraprocedural versus post-stenting prolonged bivalirudin infusion. Rationale and design of the MATRIX (Minimizing A

      Optical coherence tomography appraisal of residual thrombus burden in patients with ST-segment elevation myocardial infarction undergoing intraprocedural versus post-stenting prolonged bivalirudin infusion. Rationale and design of the MATRIX (Minimizing A

      Aims: Residual thrombus accumulation around stent struts has been observed after the end of primary PCI and may represent a risk factor for acute stent thrombosis. The aim of this study is to test whether a strategy of prolonged bivalirudin infusion may reduce thrombosis of stent struts as compared to an intraprocedural only administration in subjects undergoing primary PCI. Methods and results: One hundred and sixty patients will be selected from the MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and angioX) study with all the following inclusion criteria: a) STEMI patients undergoing primary PCI with stent implantation, b ...

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    6. Comparison of Strut Coverage at Six Months by Optical Coherence Tomography with Everolimus Eluting Stent or Bare-Metal Stent Restenosis –vs- Stenosis of Non-Stented Atherosclerotic Narrowing (from the DESERT Study)

      Comparison of Strut Coverage at Six Months by Optical Coherence Tomography with Everolimus Eluting Stent or Bare-Metal Stent Restenosis –vs- Stenosis of Non-Stented Atherosclerotic Narrowing (from the DESERT Study)

      Incomplete struts coverage is a predictor of late stent thrombosis after drug eluting stent (DES) implantation in atherosclerotic lesions. The process of struts coverage in DES implanted for bare-metal stent (BMS) restenosis has never been described. Thirty-two patients with stable coronary artery disease were consecutively selected, 11 with BMS restenosis (group A) and 21 with de-novo atherosclerotic lesions (group B). All patients underwent everolimus eluting stent implantation; coronary angiography and optical coherence tomography (OCT) were performed at 6-month follow-up. Percentage difference in struts coverage between the two groups was the primary end-point. A total of 85773 struts (17891 in group ...

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    7. Mechanisms of Atherothrombosis and Vascular Response to Primary Percutaneous Coronary Intervention in Women Versus Men With Acute Myocardial Infarction : Results of the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angiop

      Mechanisms of Atherothrombosis and Vascular Response to Primary Percutaneous Coronary Intervention in Women Versus Men With Acute Myocardial Infarction : Results of the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angiop

      Objectives This study sought to assess in vivo sex differences in the pathophysiology of ST-segment elevation myocardial infarction (STEMI) and vascular response to primary percutaneous coronary intervention (PCI). Background There is no consensus on whether differences in the pathophysiology of STEMI and response to primary PCI between women and men reflect biological factors as opposed to differences in age. Methods In this prospective, multicenter study, 140 age-matched men and women with STEMI undergoing primary PCI with everolimus-eluting stent were investigated with intravascular optical coherence tomography, histopathology-immunohistochemistry of thrombus aspirates, and serum biomarkers. Primary endpoints were the percentages of culprit plaque ...

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    8. Predictors of Periprocedural (Type IVa) Myocardial Infarction, as Assessed by Frequency-Domain Optical Coherence Tomography

      Predictors of Periprocedural (Type IVa) Myocardial Infarction, as Assessed by Frequency-Domain Optical Coherence Tomography

      Background—Frequency-domain optical coherence tomography (FD-OCT) is easily able to define both pre- and post-stenting features of the atherosclerotic plaque that can potentially be related to periprocedural complications. We sought to examine which FD-OCT-defined characteristics, assessed both before and after stent deployment, predicted periprocedural (type IVa) myocardial infarction (MI). Methods and Results—FD-OCT was performed before and after coronary stenting in 50 patients undergoing percutaneous coronary intervention (PCI) for either non-ST segment elevation MI (NSTEMI) or stable angina. All patients underwent single-vessel stenting, and only drug-eluting stents were implanted. Troponin T was analyzed on admission, before PCI, and at 12 ...

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      Mentions: Rocco Vergallo
    9. Rationale and design of the randomized, multicenter EREMUS trial, a study that investigates how to achieve low restenosis and early reendothelialization after percutaneous coronary interventions

      Rationale and design of the randomized, multicenter EREMUS trial, a study that investigates how to achieve low restenosis and early reendothelialization after percutaneous coronary interventions
      Background: Drug eluting stent (DES) use has improved clinical outcome after percutaneous coronary interventions. However, DES-treated patients may have a higher risk of stent thrombosis, mainly due to uncorrect stent deployment or lack of reendothelialization. Thus, the availabilily of different approaches with comparable efficacy to DES, but higher safety, especially in bleeding-prone patients, have to be investigated. Study Design: The EREMUS is a multicenter open-label prospective randomized three-arm clinical trial that will investigate the efficacy of a paclitaxel coated balloon + an endothelial progenitor capture stent for the treatment of native coronary lesions, and compare it to a DES strategy, or ...
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    10. The traumatic effect of balloon dilatation on neointimal hyperplasia: what we did not see before optical coherence tomography

      The traumatic effect of balloon dilatation on neointimal hyperplasia: what we did not see before optical coherence tomography
      A 79-year-old patient was referred to our cardiac care unit for unstable angina. He had a history of diabetes and hypercholesterolaemia and 5 months earlier he had undergone percutaneous coronary intervention of the proximal left anterior descending with bare metal stent implantation because of unstable angina. One month after stent implantation clopidogrel was discontinued because of a cutaneous allergy. Coronary angiography showed a severe in-stent restenosis of the proximal left anterior descending (figure 1A); taking …
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    1-11 of 11
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    1. (4 articles) Francesco Prati
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    3. (2 articles) University of Catania
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    The traumatic effect of balloon dilatation on neointimal hyperplasia: what we did not see before optical coherence tomography Rationale and design of the randomized, multicenter EREMUS trial, a study that investigates how to achieve low restenosis and early reendothelialization after percutaneous coronary interventions Predictors of Periprocedural (Type IVa) Myocardial Infarction, as Assessed by Frequency-Domain Optical Coherence Tomography Mechanisms of Atherothrombosis and Vascular Response to Primary Percutaneous Coronary Intervention in Women Versus Men With Acute Myocardial Infarction : Results of the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angiop Comparison of Strut Coverage at Six Months by Optical Coherence Tomography with Everolimus Eluting Stent or Bare-Metal Stent Restenosis –vs- Stenosis of Non-Stented Atherosclerotic Narrowing (from the DESERT Study) Optical coherence tomography appraisal of residual thrombus burden in patients with ST-segment elevation myocardial infarction undergoing intraprocedural versus post-stenting prolonged bivalirudin infusion. Rationale and design of the MATRIX (Minimizing A Clinical Impact of OCT Findings During PCI: The CLI-OPCI II Study Fate of Nonculprit Plaques in Patients With STEMI Undergoing Primary PCI Followed by Statin Therapy : A Serial Optical Coherence Tomography Analysis From the OCTAVIA Study The role of residual intrastent thrombus during primary angioplasty: insights from the COCTAIL II study Optical coherence tomography compared with fractional flow reserve guided approach in acute coronary syndromes: A propensity matched analysis Intravitreal Ranibizumab Monotherapy or Combined with Laser for Diabetic Macular Edema (OCT guided study) Prospective evaluation of drug eluting self‐apposing stent for the treatment of unprotected left main coronary artery disease: 1‐year results of the TRUNC study