1. Articles from Johan H. C. Reiber

    1-22 of 22
    1. 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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    2. 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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    3. Invasive assessment of coronary artery disease

      Invasive assessment of coronary artery disease

      oronary artery disease is associated to high mortality and morbidity rates and an accurate diagnostic assessment during heart catheterization has a fundamental role in prognostic stratification and treatment choices. Coronary angiography has been integrated by intravascular imaging modalities, namely intravascular ultrasound and optical coherence tomography, which allow the precise quantification of the atherosclerotic burden of coronary arteries. The hemodynamic relevance of a given coronary stenosis can be assessed using stress or resting indexes: fractional flow reserve and instantaneous wave-free ratio are both coronary flow surrogates, used to guide percutaneous coronary interventions. This review summarizes the current state-of-the-art of invasive diagnostic ...

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    4. 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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    5. 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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    6. 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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    7. 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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    8. 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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    9. Automatic detection of bioresorbable vascular scaffold struts in intravascular optical coherence tomography pullback runs

      Automatic detection of bioresorbable vascular scaffold struts in intravascular optical coherence tomography pullback runs

      Bioresorbable vascular scaffolds (BVS) have gained significant interest in both the technical and clinical communities as a possible alternative to metallic stents. For accurate BVS analysis, intravascular optical coherence tomography (IVOCT) is currently the most suitable imaging technique due to its high resolution and the translucency of polymeric BVS struts for near infrared light. However, given the large number of struts in an IVOCT pullback run, quantitative analysis is only feasible when struts are detected automatically. In this paper, we present an automated method to detect and measure BVS struts based on their black cores in IVOCT images. Validated using ...

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    10. Fully automated side branch detection in intravascular optical coherence tomography pullback runs

      Fully automated side branch detection in intravascular optical coherence tomography pullback runs

      Side branches in the atherosclerotic lesion region are important as they highly influence the treatment strategy selection and optimization. Moreover, they are reliable landmarks for image registration. By providing high resolution delineation of coronary morphology, intravascular optical coherence tomography (IVOCT) has been increasingly used for side branch analysis. This paper presents a fully automated method to detect side branches in IVOCT images, which relies on precise segmentation of the imaging catheter, the protective sheath, the guide wire and the lumen. 25 in-vivo data sets were used for validation. The intraclass correlation coefficient between the algorithmic results and manual delineations for ...

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    11. 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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    12. Feature Of The Week 11/3/13: 3D Assessment of Stent Cell Size and Side Branch Access in Intravascular OCT

      Feature Of The Week 11/3/13: 3D Assessment of Stent Cell Size and Side Branch Access in Intravascular OCT

      We present a semi-automatic approach to assess the maximum circular unsupported surface area (MCUSA) of selected stent cells and the side branch access through stent cells in intravascular optical coherence tomography (IVOCT) pullback runs. Such 3D information may influence coronary interventions, stent design, blood flow analysis or prognostic evaluation. First, the stent struts are detected automatically and stent cells are reconstructed with users’ assistance. Using cylinder fitting, a 2D approximation of the stent cell is generated for MCUSA detection and measurement. Next, a stent surface is reconstructed and stent-covered side branches are detected. Both the stent cell contours and side ...

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    13. 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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    14. 3D assessment of stent cell size and side branch access in intravascular optical coherence tomographic pullback runs

      3D assessment of stent cell size and side branch access in intravascular optical coherence tomographic pullback runs

      We present a semi-automatic approach to assess the maximum circular unsupported surface area (MCUSA) of selected stent cells and the side branch access through stent cells in intravascular optical coherence tomography (IVOCT) pullback runs. Such 3D information may influence coronary interventions, stent design, blood flow analysis or prognostic evaluation. First, the stent struts are detected automatically and stent cells are reconstructed with users’ assistance. Using cylinder fitting, a 2D approximation of the stent cell is generated for MCUSA detection and measurement. Next, a stent surface is reconstructed and stent-covered side branches are detected. Both the stent cell contours and side ...

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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. Feature Of The Week 11/11/12: Characterization of Coronary Bifurcations using Optical Coherence Tomography

      Feature Of The Week 11/11/12: Characterization of Coronary Bifurcations using Optical Coherence Tomography

      Correct characterization of coronary bifurcations by optical coherence tomography (OCT) is critical in the evaluation of lesions, dedicated bifurcation stents and stent techniques. Assessment is limited by the need for acquiring images in both the main branch (MB) and the dissection prone side branch (SB). Analysis poses the significant risk of OCT cross sections not being perpendicular to the true vessel centerline due to imaging wires being non-parallel to the centerline. Correct measurements in tortuous vessels and ostia are particularly sensitive to the non-parallel wire problem and to the actual measurement plane, independent of whether a MB or a SB ...

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    17. 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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    18. Automatic stent strut detection in intravascular optical coherence tomographic pullback runs

      Automatic stent strut detection in intravascular optical coherence tomographic pullback runs

      We developed and evaluated an automatic stent strut detection method in intravascular optical coherence tomography (IVOCT) pullback runs. Providing very high resolution images, IVOCT has been rapidly accepted as a coronary imaging modality for the optimization of the stenting procedure and its follow-up evaluation based on stent strut analysis. However, given the large number of struts visible in a pullback run, quantitative three-dimensional analysis is only feasible when the strut detection is performed automatically. The presented method first detects the candidate pixels using both a global intensity histogram and the intensity profile of each A-line. Gaussian smoothing is applied followed ...

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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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    1-22 of 22
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    1. (21 articles) Johan H. C. Reiber
    2. (19 articles) Leiden University
    3. (16 articles) Shengxian Tu
    4. (7 articles) Abbot
    5. (6 articles) Erasmus University
    6. (5 articles) Ancong Wang
    7. (5 articles) Jeroen Eggermont
    8. (5 articles) Jouke Dijkstra
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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 Automatic stent strut detection in intravascular optical coherence tomographic pullback runs Carina shift as a mechanism for side-branch compromise following main vessel intervention: Insights from three-dimensional optical coherence tomography First Presentation of 3-Dimensional Reconstruction and Centerline-Guided Assessment of Coronary Bifurcation by Fusion of X-Ray Angiography and Optical Coherence Tomography Feature Of The Week 11/11/12: Characterization of Coronary Bifurcations using 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 3D assessment of stent cell size and side branch access in intravascular optical coherence tomographic pullback runs Quantitative angiography and optical coherence tomography for the functional assessment of nonobstructive coronary stenoses: Comparison with fractional flow reserve Feature Of The Week 11/3/13: 3D Assessment of Stent Cell Size and Side Branch Access in Intravascular OCT Both speckle reduction and contrast enhancement for optical coherence tomography via sequential optimization in the logarithmic domain based on a refined Retinex model OCT parameters of the optic nerve head and the retina as surrogate markers of brain volume in a normal population, a pilot study