All Articles from Filippo Crea -Optical Coherence Tomography News

Articles from Filippo Crea

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1. COMPARISON OF POST STENT OPTICAL COHERENCE TOMOGRAPHY FINDINGS AMONG THREE SUBTYPES OF CALCIFIED CULPRIT PLAQUES IN PATIENTS WITH ACUTE CORONARY SYNDROME
  
  Explore onlinejacc.org Mar 22 2020 Cardiology
  
  Background Recently, three subtypes of calcified plaques at the culprit lesion were reported in patients with acute coronary syndrome (ACS): eruptive calcified nodule, superficial calcific sheet, and calcified protrusion. Methods A total of 157 patients with ACS and calcified plaque at the culprit lesion were selected from our database. Optical coherence tomography (OCT) findings at index procedure and after stent implantation were compared among the three subgroups. Results In the final analysis, 92 cases were included. Pre-procedural OCT showed eruptive calcified nodules in 20 (21.7%) cases, superficial calcific sheets in 66 (71.7%), and calcified protrusion in 6 (6 ...
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  Mentions: Massachusetts General Hospital Ik-Kyung Jang Masamichi Takano
2. Comparison of post‐stent optical coherence tomography findings among three subtypes of calcified culprit plaques in patients with acute coronary syndrome
  
  Explore Wiley Online Library Mar 17 2020 Cardiology
  
  Objectives To compare the postprocedural optical coherence tomography (OCT) findings and in‐hospital outcomes among the three subtypes of calcified plaques: eruptive calcified nodules, superficial calcific sheet, and calcified protrusion. Background Recently, three subtypes of calcified culprit plaques were reported in patients with acute coronary syndrome (ACS). How these subtypes respond to stenting is unknown. Methods ACS patients with calcified plaque at the culprit lesion were selected from our database. OCT findings at baseline and after stent implantation were compared. Results In the final analysis, 87 cases were included. Preprocedural OCT showed eruptive calcified nodules in 19 (21.8%) cases ...
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  Mentions: Massachusetts General Hospital Ik-Kyung Jang Masamichi Takano
3. Reply: Value of Optical Coherence Tomography in Angiographically Intermediate Coronary Lesions
  
  Explore ScienceDirect Jan 25 2020 Cardiology
  
  Letter To the Editor
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  Mentions: Rocco Vergallo
4. The year in cardiology: acute coronary syndromes: The year in cardiology 2019
  
  Explore Journals Jan 6 2020 Cardiology
  
  The mechanisms and the pathologic substrate of plaque erosion and plaque fissure are different. Indeed, plaques complicated by erosion tend to be matrix-rich, lipid-poor, and usually lack prominent macrophage collections, unlike plaques that rupture, which characteristically have thin fibrous caps, large lipid pools, and abundant foam cells. 9 In a prospective study in 211 patients with STEMI who underwent pre-intervention optical coherence tomography (OCT) examination for the culprit lesion, Tan et al . 10 found that trimethylamine N-oxide (TMAO) levels, a gut microbiota-dependent metabolite derived from dietary phosphatidylcholine and choline, were significantly and independently higher in patients with plaque fissure than ...
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  Mentions: Imperial College London Boston Scientific European Society of Cardiology
5. The year in cardiology 2019: Acute Coronary Syndromes
  
  Explore Journals Jan 6 2020 Cardiology
  
  The management of acute coronary syndromes (ACS) has made enormous progress over the last five decades due to the introduction of defibrillation, beta blockers, thrombolytics, aspirin, primary percutaneous transluminal intervention (PCI), P 2 Y 12 inhibitors, statins, radial access, and eventually PCSK9 inhibitors, among others. 1 However, in spite of all these remedies, there is a remaining acute mortality risk, in particular, in those presenting in cardiogenic shock or after resuscitation and an accruing number of major cardiovascular events (MACE) over the following years. 2 Thus, there is an unmet need in the management of ACS. In 2019, there were ...
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  Mentions: Boston Scientific European Society of Cardiology Thomas F. Luscher
6. Characteristics of non-culprit plaques in acute coronary syndrome patients with layered culprit plaque
  
  Explore Journals Dec 21 2019 Cardiology
  
  Aims Layered plaques represent signs of previous plaque destabilization. A recent study showed that acute coronary syndrome (ACS) patients with layered culprit plaque have more vulnerability at the culprit lesion and systemic inflammation. We aimed to compare the characteristics of non-culprit plaques between patients with or without layered plaque at the culprit lesion. We also evaluated the characteristics of layered non-culprit plaques, irrespective of culprit plaque phenotype. Methods and results We studied ACS patients who had undergone pre-intervention optical coherence tomography (OCT) imaging. The number of non-culprit lesions was evaluated on coronary angiogram and morphological characteristics of plaques were studied ...
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  Mentions: Massachusetts General Hospital Ik-Kyung Jang Harvard University
7. Fractional Flow Reserve or Optical Coherence Tomography to Guide Management of Angiographically-Intermediate Coronary Stenosis: A Single-Center Trial
  
  Explore interventions.onlinejacc.org Oct 1 2019 Cardiology
  
  Background Fractional flow reserve (FFR) and optical coherence tomography (OCT) may help both in assessment of angiographically-intermediate coronary lesions (AICL) and in percutaneous coronary interventions (PCI) optimization. Objectives: To compare OCT-guidance and FFR-guidance in patients with AICL in a single-center, prospective, 1:1 randomized trial (acronym: FORZA, NCT01824030 ). Methods Patients with AICL were randomized to FFR or OCT. In the FFR arm, PCI was performed if FFR was ≤0.80. In the OCT arm, PCI was performed if area stenosis was ≥75% or 50%-75% with minimal lumen area <2.5 mm 2 or plaque rupture. Angina (evaluated by Seattle ...
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  Mentions: Rocco Vergallo
8. Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: the CLIMA study
  
  Explore Journals Aug 6 2019 Cardiology
  
  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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  Mentions: Massachusetts General Hospital Abbot Corrado Tamburino
9. Prospective Randomized Comparison of Fractional Flow Reserve Versus Optical Coherence Tomography to Guide Revascularization of Intermediate Coronary Stenoses: One-Month Results
  
  Explore Home | AHA/ASA Journals Jul 27 2019 Cardiology
  
  Background-—Fractional flow reserve (FFR) and optical coherence tomography (OCT) may help both in assessment and in percutaneous coronary intervention optimization of angiographically intermediate coronary lesions. We designed a prospective trial comparing the clinical and economic outcomes associated with FFR or OCT in angiographically intermediate coronary lesions. Methods and Results-—Three hundred fifty patients with angiographically intermediate coronary lesions (n=446) were randomized to FFR or OCT guidance. In the FFR arm, percutaneous coronary intervention was performed if FFR was ≤0.80 aiming for a postprocedure FFR >0.90. In the OCT arm, percutaneous coronary intervention was performed if percentage ...
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  Mentions: Rocco Vergallo
10. Healed Culprit Plaques in Patients With Acute Coronary Syndrome
  
  Explore onlinejacc.org May 9 2019 Cardiology
  
  ackground Healed plaques, morphologically characterized by a layered phenotype, are frequently found in subjects with sudden cardiac death. However, in vivo data are lacking. Objectives The purpose of this study was to determine the prevalence, morphological characteristics, and clinical significance of healed culprit plaques in patients with acute coronary syndromes (ACS) using optical coherence tomography (OCT). Methods A total of 376 ACS patients (252 ST-segment elevation myocardial infarction [MI] and 124 non–ST-segment elevation acute coronary syndrome) who had undergone pre-intervention OCT imaging of the culprit lesion were enrolled. Patients were stratified according to the presence of layered phenotype, defined ...
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  Mentions: Massachusetts Institute of Technology James G. Fujimoto Mount Sinai School of Medicine
11. Dual quantitative coronary angiography accurately quantifies intracoronary thrombotic burden in patients with acute coronary syndrome: Comparison with optical coherence tomography imaging
  
  Explore International Journal of Cardiology Apr 22 2019 Cardiology
  
  Background Dual quantitative coronary angiography (QCA) has been recently tested for assessment of intracoronary thrombus volume in experimental models. The present study aimed to validate dual QCA in vivo for the assessment of thrombus burden by exploring the correlations between dual QCA-thrombus volume and optical coherence tomography (OCT)-derived indices of thrombotic burden. Methods and results Fifty-one patients with ACS and angiographic evidence of thrombus undergoing OCT of the culprit lesion before stenting were included. Dual QCA-thrombus volume was calculated as difference between edge-detection and video-densitometry area functions along the target segment. Culprit lesion was categorized using the Ambrose's ...
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12. Activation of Nrf2/HO-1 Pathway and Human Atherosclerotic Plaque Vulnerability:an In Vitro and In Vivo Study
  
  Explore MDPI Open Access Journals Platform Apr 16 2019 Cardiology
  
  Reactive oxygen species (ROS) induce nuclear factor erythroid 2–related factor 2 (Nrf2) activation as an adaptive defense mechanism, determining the synthesis of antioxidant molecules, including heme-oxygenase-1 (HO-1). HO-1 protects cells against oxidative injury, degrading free heme and inhibiting ROS production. HO-1 is highly expressed in macrophages during plaque growth. Macrophages are morpho-functionally heterogeneous, and the prevalence of a specific phenotype may influence the plaque fate. This heterogeneity has also been observed in monocyte-derived macrophages (MDMs), a model of macrophages infiltrating tissue. The study aims to assess oxidative stress status and Nrf2/HO-1 axis in MDM morphotypes obtained from healthy ...
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13. Coronary Atherosclerotic Phenotype and Plaque Healing in Patients With Recurrent Acute Coronary Syndromes Compared With Patients With Long-term Clinical Stability An In Vivo Optical Coherence Tomography Study
  
  Explore The JAMA Network Mar 19 2019 Cardiology
  
  Importance At one end of the coronary artery disease (CAD) spectrum, there are patients with multiple recurrent acute coronary syndromes (rACS), and at the other end there are those with long-standing clinical stability. Predicting the natural history of these patients is challenging because unstable plaques often heal without resulting in ACS. Objective To assess in vivo the coronary atherosclerotic phenotype as well as the prevalence and characteristics of healed coronary plaques by optical coherence tomography (OCT) imaging in patients at the extremes of the CAD spectrum. Design, Setting, and Participants This is an observational, single-center cohort study with prospective clinical ...
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  Mentions: Mount Sinai School of Medicine Massachusetts General Hospital Harvard University
14. Stent malapposition, strut coverage and atherothrombotic prolapse after percutaneous coronary interventions in ST-segment elevation myocardial infarction
  
  Explore LWW Online Feb 2 2019 Cardiology
  
  Aims Stent implantation in ST-segment elevation myocardial infarction (STEMI) patients can be challenging and sometimes associated with immediate and long-term suboptimal results. Stent malapposition and strut uncoverage, predictors of stent thrombosis, are frequently detected in STEMI patients at medium/long-term follow-up. Nevertheless, data at a short follow-up are missing. We aimed to assess the extent of stent malapposition and struts coverage in the subacute phase of STEMI after stent implantation in primary or rescue percutaneous coronary intervention (PCI). Methods STEMI patients undergone primary or rescue PCI and scheduled for a second coronary angiography after 2–7 days were enrolled. During ...
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15. Optical coherence tomography and C-reactive protein in risk stratification of acute coronary syndromes
  
  Explore International Journal of Cardiology Jan 17 2019 Cardiology
  
  Background Patients with acute coronary syndrome (ACS) associated to high C-reactive protein (CRP) levels exhibit a higher risk of future acute ischemic events. Yet, the positive predictive value of CRP is too low to guide a specific treatment. Our study aims to identify a high-risk patient subset who might mostly benefit from anti-inflammatory treatment on the basis of the combination of optical coherence tomography (OCT) assessment of the culprit vessel and CRP serum levels. Methods Patients admitted for ACS and undergoing pre-interventional OCT assessment of the culprit vessel were selected from “Agostino Gemelli” Hospital OCT Registry. The primary end-point was ...
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16. Coronary plaque erosion developing in an area of high endothelial shear stress: insights from serial optical coherence tomography imaging
  
  Explore LWW Online Jan 1 2019 Cardiology
  
  A 55-year-old man with type H Diabetes, hypertension, dyslipidemia, and smoking was admitted...
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  Mentions: Rocco Vergallo
17. Trends and outcomes of optical coherence tomography use: 877 patients single-center experience
  
  Explore ScienceDirect Dec 26 2018 Cardiology
  
  Background Optical-coherence-tomography (OCT) is an emerging invasive coronary imaging with still undefined clinical value. Recent data have underlined daily impact of such technique in several clinical settings such as acute coronary syndromes (ACS) and percutaneous coronary intervention (PCI) guidance. We aimed at assessing the trends and outcomes of OCT use in a high-volume percutaneous coronary interventions (PCI)-center. Methods Over 6 years, 1025 coronary artery segments in 877 patients underwent OCT evaluation. Clinical and procedural characteristics were prospectively collected. Clinical setting for OCT were: “ Diagnostic OCT” (OCT for lesion evaluation after coronary angiography without further PCI); “ PCI-guidance OCT” (OCT as ...
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18. Coronary plaque erosion developing in an area of high endothelial shear stress insights from serial optical coherence tomography imaging
  
  Explore LWW Online Nov 9 2018 Cardiology
  
  Images in CAD.
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  Mentions: Rocco Vergallo
19. Alterations of Hyaluronan Metabolism in Acute Coronary Syndrome: Implications for Plaque Erosion
  
  Explore onlinejacc.org Sep 20 2018 Cardiology
  
  Background Superficial erosion currently causes at least one-third of acute coronary syndromes (ACS), and its incidence is increasing. Yet, the underlying mechanisms in humans are still largely unknown. Objectives The authors sought to assess the role of hyaluronan (HA) metabolism in ACS. Methods Peripheral blood mononuclear cells were collected from ACS (n = 66), stable angina (SA) (n = 55), and control (CTRL) patients (n = 45). The authors evaluated: 1) gene expression of hyaluronidase 2 (HYAL2) (enzyme degrading high-molecular-weight HA to its proinflammatory 20-kDa isoform) and of CD44v1, CD44v4, and CD44v6 splicing variants of HA receptor; and 2) HYAL2 and CD44 protein ...
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  Mentions: Rocco Vergallo
20. Correlation between CD4+CD28null T lymphocytes, regulatory T cells and plaque rupture: An Optical Coherence Tomography study in Acute Coronary Syndromes
  
  Explore International Journal of Cardiology Sep 7 2018 Cardiology
  
  Background A sizeable proportion of patients with Acute Coronary Syndromes (ACS) shows a unique adaptive immune system profile, associated to a worse outcome, characterized by higher CD4 + CD28 null T-cells, lower regulatory T-cells (Treg) and increased CD4 + CD28 null /Treg ratio. We sought to investigate the correlation between CD4 + CD28 null T-cells, Treg, CD4 + CD28 null /Treg ratio and plaque phenotype as assessed by Optical Coherence Tomography (OCT). Methods Peripheral blood mononuclear cells (PBMC) were collected from 30 Non-ST Elevation Myocardial Infarction (NSTEMI) patients, sub-grouped according to OCT analysis of culprit lesions into two cohorts: Ruptured Fibrous Cap (NSTEMI-RFC, n ...
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  Mentions: Rocco Vergallo
21. Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions
  
  Explore International Journal of Cardiology Jan 4 2018 Cardiology
  
  $Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions$
  Background The decision-making process of patients with angiographically-intermediate coronary lesions (ICL) is clinically challenging and may benefit from adjunctive invasive techniques. Fractional-flow-reserve (FFR) represents the gold standard to evaluate ICL but frequency-domain optical-coherence-tomography (OCT) is a novel, promising, high resolution coronary imaging technique, which allows physiopathologic assessment of coronary plaque. We investigated the possible relation between OCT and FFR in selected ICL patients. Methods Stable or unstable patients with ICL who underwent both FFR and OCT assessment at two large tertiary centers were retrospectively enrolled. FFR was performed according to standard methodology. OCT images were (on blind to clinical and ...
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22. Data on optical coherence tomography guidance for the management of angiographically intermediate left main bifurcation lesions
  
  Explore ScienceDirect Sep 17 2017 Cardiology
  
  The data presented in this article are related to the research article entitled “Optical coherence tomography guidance for the management of angiographically intermediate left main bifurcation lesions: early clinical experience” [1] . In this article we reports details about our clinical experience with frequency domain-optical coherence tomography (FD-OCT) guidance for the management of patients with left main (LM) bifurcation lesions of intermediate angiographic severity. LM patients were assessed by FD-OCT and, on the bases of the findings, managed by myocardial revascularization or conservative treatment (revascularization deferral). The observed outcomes support the feasibility of FD-OCT guidance for LM bifurcated lesions and call ...
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23. Coronary stents and vascular response to implantation: literature review
  
  Explore Medical Journals Publisher Jul 14 2017 Cardiology
  
  Drug-eluting stents (DESs) have minimized the limitations of bare-metal stents (BMSs) after percutaneous coronary interventions. Nevertheless, serious concerns remain about possible late complications of stenting, such as stent thrombosis (ST) and in-stent restenosis (ISR), although the introduction of second-generation DESs seems to have softened the phenomenon, compared to the first-generation ones. ST is a potentially catastrophic event, which has been markedly reduced by optimization of stent implantation, novel stent designs, and dual antiplatelet therapy. The exact mechanism to explain its occurrence is under investigation, and, realistically, multiple factors are responsible. ISR of BMSs has been previously considered as a stable ...
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24. Optical coherence tomography guidance for the management of angiographically intermediate left main bifurcation lesions: Early clinical experience
  
  Explore International Journal of Cardiology Jul 5 2017 Cardiology
  
  Background Left main (LM) atherosclerotic lesions affect clinical outcomes. Frequency domain-optical coherence tomography (FD-OCT) allows detailed characterization of non-ostial coronary atherosclerotic lesions. The clinical impact of FD-OCT assessment of LM bifurcation disease on the revascularization decision is unknown. Methods Patients who underwent FD-OCT assessment to guide management of angiographically intermediate distal LM stenosis were retrospectively selected. The FD-OCT LM criteria for percutaneous or surgical revascularization were: - LM area stenosis (AS) ≥75% - LM AS >50% < 75% with minimum lumen area < 4 mm 2 or plaque ulceration critical FD-OCT ostial stenosis on the left anterior descending or circumflex arteries. Clinical follow-up was ...
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