1. Articles from Tom Adriaenssens

    1-24 of 34 1 2 »
    1. Neoatherosclerosis in Patients With Coronary Stent Thrombosis: Findings From Optical Coherence Tomography Imaging (A Report of the PRESTIGE Consortium)

      Neoatherosclerosis in Patients With Coronary Stent Thrombosis: Findings From Optical Coherence Tomography Imaging (A Report of the PRESTIGE Consortium)

      Objectives The purpose of this study was to assess neoatherosclerosis in a registry of prospectively enrolled patients presenting with stent thrombosis using optical coherence tomography . Background In-stent neoatherosclerosis was recently identified as a novel disease manifestation of atherosclerosis after coronary stent implantation. Methods Angiography and intravascular optical coherence tomography were used to investigate etiologic factors of neoatherosclerosis in patients presenting with stent thrombosis >1 year after implantation (very late stent thrombosis [VLST]). Clinical data were collected according to a standardized protocol. Optical coherence tomographic acquisitions were analyzed in a core laboratory. Cox regression analysis was performed to identify factors associated ...

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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. Optical Coherence Tomography Findings in Patients with Coronary Stent Thrombosis: A Report of the PREvention of Late Stent Thrombosis by an Interdisciplinary Global European Effort (PRESTIGE) Consortium

      Optical Coherence Tomography Findings in Patients with Coronary Stent Thrombosis: A Report of the PREvention of Late Stent Thrombosis by an Interdisciplinary Global European Effort (PRESTIGE) Consortium

      Background —Stent thrombosis (ST) is a serious complication following coronary stenting. Intravascular optical coherence tomography (OCT) may provide insights into mechanistic processes leading to ST. We performed a prospective, multicenter study to evaluate OCT findings in patients with ST. Methods —Consecutive patients presenting with ST were prospectively enrolled in a registry using a centralized telephone registration system. After angiographic confirmation of ST, OCT imaging of the culprit vessel was performed with frequency domain OCT. Clinical data were collected according to a standardized protocol. OCT acquisitions were analyzed at a core laboratory. Dominant and contributing findings were adjudicated by an imaging ...

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    4. Recent Advances in the Field of Optical Coherence Tomography

      Recent Advances in the Field of Optical Coherence Tomography

      Purpose of Review The scope of this text is to critically review the most important recent advances in the field of optical coherence tomography, both from a clinical, scientific, and technical point of view. Recent Findings In recent years, important steps forward have been put in the field of optimization of PCI (with a focus on optimal sizing of stents and optimization of stent expansion after implantation) and the differentiation and its possible applications of various underlying morphologic characteristics of acute coronary syndrome lesions. Several efforts have been made to elucidate underlying mechanical causes of stent thrombosis, based on optical ...

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    5. Optical coherence tomography findings: insights from the “randomised multicentre trial investigating angiographic outcomes of hybrid sirolimus-eluting stents with biodegradable polymer compared with everolimus-eluting stents with durable polymer in chroni

      Optical coherence tomography findings: insights from the “randomised multicentre trial investigating angiographic outcomes of hybrid sirolimus-eluting stents with biodegradable polymer compared with everolimus-eluting stents with durable polymer in chroni

      Aims: The PRISON IV trial investigated the next-generation sirolimus-eluting stent (SES) with ultra-thin struts and biodegradable polymer against the second-generation everolimus-eluting stent (EES) with thin struts and durable polymer in patients with successfully recanalised chronic total occlusions (CTO). In this study, we examined the secondary optical coherence tomography endpoints. Methods and results: The main PRISON IV trial randomised 330 patients to either SES or EES. At nine months, 281 (85%) patients underwent repeat angiography. Of these, 60 consecutive patients received optical coherence tomography divided over both stent groups. The mean number of struts analysed was 750±337 and 633±358 ...

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    6. 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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    7. Optical coherence tomography-based assessment of bifurcation stenting using the Axxess™ Biolimus A9™-eluting stent system

      Optical coherence tomography-based assessment of bifurcation stenting using the Axxess™ Biolimus A9™-eluting stent system

      Bifurcation lesions are associated with increased procedural complications and worse long-term outcome. Multiple techniques are available, including the dedicated drug-eluting Axxess™ stent system (Biosensors International Ltd., Singapore, Singapore), providing complete bifurcation support without covering the carina. Low rates of restenosis in both main vessel (MV) and side branch (SB) have been demonstrated. High-resolution imaging techniques such as intravascular optical coherence tomography (IV-OCT) may help the positioning and implantation of the Axxess device, as angiographic guidance alone may be insufficient. A Medina 1,1,1 bifurcation lesion was treated using the Axxess device and BioMatrix™ stents (Biosensors International Ltd.) in the ...

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    8. COmplex coronary Bifurcation lesions: RAndomized comparison of a strategy using a dedicated self-expanding biolimus-eluting stent versus a culotte strategy using everolimus-eluting stents: primary results of the COBRA trial

      COmplex coronary Bifurcation lesions: RAndomized comparison of a strategy using a dedicated self-expanding biolimus-eluting stent versus a culotte strategy using everolimus-eluting stents: primary results of the COBRA trial

      Aims: We aimed to compare healing responses with optical coherence tomography, and clinical and angiographic outcome after treatment of coronary bifurcation lesions with a dedicated stent versus aconventional culotte technique. Methods and results: Forty patients with true and complex coronary bifurcation lesions were randomly assigned to treatment with the Axxess™ bifurcation stent in the proximal main vessel (MV) and additional BioMatrix™ stents in the branches (Biosensors Europe SA, Morges, Switzerland), versus a culotte technique using XIENCE™ stents (Abbott Vascular, Santa Clara, CA, USA). The primary endpoint of percentage of uncovered struts at nine months was similar with the dedicated strategy ...

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    9. OCT for bifurcation stenting: what have we learned?

      OCT for bifurcation stenting: what have we learned?

      Treatment of bifurcation lesions by percutaneous coronary intervention (PCI) shows major variation in complexity. Intravascular optical coherence tomography (OCT) provides high-resolution images of the pathoanatomy, thrombus, wires and stent positions during the procedure. This information may prove crucial in optimising PCI results and clinical outcomes after complex bifurcation treatment. Mounting evidence confirms the feasibility of OCT in bifurcations, and specific steps where OCT may be advantageous in guiding bifurcation PCI have been identified. Awaiting major clinical outcome trials, OCT has already entered the European guidelines for myocardial revascularisation. This paper aims to provide an overview of the potential clinical use ...

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    10. STACCATO (Assessment of Stent sTrut Apposition and Coverage in Coronary ArTeries with Optical coherence tomography in patients with STEMI, NSTEMI and stable/unstable angina undergoing everolimus vs. biolimus A9-eluting stent implantation): a randomised co

      STACCATO (Assessment of Stent sTrut Apposition and Coverage in Coronary ArTeries with Optical coherence tomography in patients with STEMI, NSTEMI and stable/unstable angina undergoing everolimus vs. biolimus A9-eluting stent implantation): a randomised co

      Aims: To compare tissue coverage in coronary lesions stented with durable fluoropolymer-coated everolimus-eluting stents (EES) vs. biodegradable polymer-coated biolimus A9-eluting stents (BES). Methods and results: Sixty-four patients (64 lesions) with de novo coronary artery lesions were randomised to percutaneous treatment with XIENCE® EES (Abbott Vascular, Santa Clara, CA, USA) vs. BioMatrix™ BES (Biosensors, Morges, Switzerland). The primary endpoint was the percentage of uncovered struts, as assessed with OCT, at nine months. The average percentage of uncovered struts was significantly lower with EES (4.3±4.8% vs. 8.7±7.8% with BES, p=0.019). There was no difference ...

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    11. Optical coherence tomography study of healing characteristics of paclitaxel-eluting balloons vs. everolimus-eluting stents for in-stent restenosis: the SEDUCE (Safety and Efficacy of a Drug elUting balloon in Coronary artery rEstenosis) randomised clinica

      Optical coherence tomography study of healing characteristics of paclitaxel-eluting balloons vs. everolimus-eluting stents for in-stent restenosis: the SEDUCE (Safety and Efficacy of a Drug elUting balloon in Coronary artery rEstenosis) randomised clinica

      Aims: Little is known about the respective healing responses and clinical efficacy and safety of drug-eluting balloons (DEB) and the second generation of drug-eluting stents (DES) when used to treat in-stent restenosis (ISR). In this study, we set out to compare prospectively the healing characteristics, as assessed by optical coherence tomography (OCT), of DEB versus DES after treatment of ISR in bare metal stents (BMS). Methods and results: Fifty patients with BMS ISR were randomised to treatment with a paclitaxel-eluting balloon vs. an everolimus-eluting stent (EES). The primary endpoint was the percentage of uncovered struts, assessed with OCT at nine ...

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    12. Automated detection and quantification of clusters of malapposed and uncovered intracoronary stent struts assessed with optical coherence tomography

      Automated detection and quantification of clusters of malapposed and uncovered intracoronary stent struts assessed with optical coherence tomography

      To date, accurate quantification and localization of malapposed and uncovered struts needs manual and time consuming analysis of large datasets. To develop an algorithm for automated detection and quantification of clusters of malapposed and uncovered struts in optical coherence tomography (OCT) pullbacks, including comprehensive information about their three-dimensional spatial distribution. 64 lesions in 64 patients treated with drug-eluting stent underwent assessment with OCT immediately after implantation and at 9-month follow-up (55 patients). An automated algorithm was used to detect and quantify stent strut malapposition at baseline and coverage at follow-up on an individual strut level. We subsequently applied an algorithm ...

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    13. Healing course of acute vessel wall injury after drug-eluting stent implantation assessed by optical coherence tomography

      Healing course of acute vessel wall injury after drug-eluting stent implantation assessed by optical coherence tomography

      BACKGROUND: Vessel wall injury after drug-eluting stent (DES) implantation can be characterized in detail by optical coherence tomography (OCT). Little is known about the healing course of these phenomena. METHODS AND RESULTS: In 62 lesions (62 patients), the incidence of acute vessel trauma was assessed in the stented region and the edge segments immediately after DES implantation. The healing course of these injuries was assessed at 9-month OCT follow-up using a software algorithm allowing for reliable spatial comparison of baseline and follow-up cross-sectional images. Tissue prolapse (TP) and tissue protrusions were detected in 81 and 35% of lesions, respectively. A ...

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    14. Detailed in vivo visualization of stent fracture causing focal restenosis using 3D reconstruction software for high-resolution optical coherence tomography images

      Detailed in vivo visualization of stent fracture causing focal restenosis using 3D reconstruction software for high-resolution optical coherence tomography images

      A 55-year-old female underwent repeat coronary angiography for recurrent angina, 9 months after percutaneous coronary intervention (PCI) of a mid-right coronary artery (RCA) chronic total occlusion with implantation of two overlapping Orsiro™ sirolimus-eluting stents (3.0 × 30 mm at 20 atm; 2.5 × 30 mm at 16 atm) (see Supplementary data online, Video S1). The distal part of the stented segment showed a focal in-stent restenosis (ISR) with the abnormal motion pattern (see Supplementary data online, Video S2). Optical coherence tomography (OCT) with 3D reconstruction confirmed suspected stent

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    15. Automatic characterization of neointimal tissue by intravascular optical coherence tomography

      Automatic characterization of neointimal tissue by intravascular optical coherence tomography

      Intravascular optical coherence tomography (IVOCT) is rapidly becoming the method of choice for assessing vessel healing after stent implantation due to its unique axial resolution < 20     μ m . The amount of neointimal coverage is an important parameter. In addition, the characterization of neointimal tissue maturity is also of importance for an accurate analysis, especially in the case of drug-eluting and bioresorbable stent devices. Previous studies indicated that well-organized mature neointimal tissue appears as a high-intensity, smooth, and homogeneous region in IVOCT images, while lower-intensity signal areas might correspond to immature tissue mainly composed of acellular material. A new method for automatic ...

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    16. Automatic assessment of stent neointimal coverage by intravascular optical coherence tomography

      Automatic assessment of stent neointimal coverage by intravascular optical coherence tomography

      Aims This study aimed to validate automatic intravascular optical coherence tomography (IVOCT) analysis for the evaluation of neointimal coverage in response to stent implantation. Methods and results Fourteen stented segments in common iliac arteries, acquired from a total of seven adult male New Zealand White rabbits, were interrogated in vivo by IVOCT. Durable polymer everolimus-eluting stents (EES; Xience V, Abbott Vascular, Santa Clara, CA, USA) were used exclusively. Comparison with histology was made in a total of 63 pairs of images, where neointimal thickness over corresponding individual stent struts was assessed. A high correlation coefficient ( R = 0.85, P < 0 ...

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    17. Automated tissue characterization of in vivo atherosclerotic plaques by intravascular optical coherence tomography images

      Automated tissue characterization of in vivo atherosclerotic plaques by intravascular optical coherence tomography images

      Intravascular optical coherence tomography (IVOCT) is rapidly becoming the method of choice for the in vivo investigation of coronary artery disease. While IVOCT visualizes atherosclerotic plaques with a resolution <20µm, image analysis in terms of tissue composition is currently performed by a time-consuming manual procedure based on the qualitative interpretation of image features. We illustrate an algorithm for the automated and systematic characterization of IVOCT atherosclerotic tissue. The proposed method consists in a supervised classification of image pixels according to textural features combined with the estimated value of the optical attenuation coefficient. IVOCT images of 64 plaques, from 49 ...

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    18. Provisional side branch stenting: presentation of an automated method allowing online 3D OCT guidance

      Provisional side branch stenting: presentation of an automated method allowing online 3D OCT guidance

      A 58-year-old man with unstable angina underwent percutaneous coronary intervention for a severe stenosis of the mid-left anterior descending artery (LAD), at a bifurcation point with a large diameter diagonal side branch (SB). After predilation with an Emerge 3.0 × 12 mm balloon (Boston Scientific, MA, USA), a 3.0 × 32 mm Promus Element (Boston Scientific) everolimus-eluting stent was implanted in the LAD. Subsequently, proximal post-dilation with a non-compliant (NC) Quantum 3.75 × 8 mm balloon (Boston Scientific) and post-dilation of the stent segment with an NC Quantum 3.0 × 12 mm balloon

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    19. Fully automatic three-dimensional visualization of intravascular optical coherence tomography images: methods and feasibility in vivo

      Fully automatic three-dimensional visualization of intravascular optical coherence tomography images: methods and feasibility in vivo

      Intravascular optical coherence tomography (IV-OCT) is an imaging modality that can be used for the assessment of intracoronary stents. Recent publications pointed to the fact that 3D visualizations have potential advantages compared to conventional 2D representations. However, 3D imaging still requires a time consuming manual procedure not suitable for on-line application during coronary interventions. We propose an algorithm for a rapid and fully automatic 3D visualization of IV-OCT pullbacks. IV-OCT images are first processed for the segmentation of the different structures. This also allows for automatic pullback calibration. Then, according to the segmentation results, different structures are depicted with different ...

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    20. A randomized multicenter comparison of hybrid sirolimus-eluting stents with bioresorbable polymer versus everolimus-eluting stents with durable polymer in total coronary occlusion: rationale and design of the Primary Stenting of Occluded Native Coronary A

      A randomized multicenter comparison of hybrid sirolimus-eluting stents with bioresorbable polymer versus everolimus-eluting stents with durable polymer in total coronary occlusion: rationale and design of the Primary Stenting of Occluded Native Coronary A

      Background Percutaneous recanalization of total coronary occlusion (TCO) was historically hampered by high rates of restenosis and reocclusions. The PRISON II trial demonstrated a significant restenosis reduction in patients treated with sirolimus-eluting stents compared with bare metal stents for TCO. Similar reductions in restenosis were observed with the second-generation zotarolimus-eluting stent and everolimus-eluting stent. Despite favorable anti-restenotic efficacy, safety concerns evolved after identifying an increased rate of very late stent thrombosis (VLST) with drug-eluting stents (DES) for the treatment of TCO. Late malapposition caused by hypersensitivity reactions and chronic inflammation was suggested as a probable cause of these VLST. New ...

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      Mentions: Tom Adriaenssens
    21. Optical Coherence Tomography Assessment of Coverage of Side Branch Ostium After Implantation of Xience SBA Dedicated Coronary Bifurcation System

      Optical Coherence Tomography Assessment of Coverage of Side Branch Ostium After Implantation of Xience SBA Dedicated Coronary Bifurcation System

      OCT Imaging of the Xience SBA Coronary Bifurcation Stent (A) A cross-section at the entry of the side branch (SB) shows proper strut apposition and optimal scaffolding of the ostium. (B) At the level of the carina, fully apposed stent struts properly span the width of the bifurcation core. From 4 to 8 o'clock, a calcified plaque is visible. (C) In the proximal main vessel (MV), all struts are well-apposed. (D) Three-dimensional optical coherence tomography (OCT)–based reconstruction of the stent. There is optimal scaffolding of the SB ostium with no free floating struts. (E) Simultaneous double balloon inflation ...

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    22. Expert review document part 2: methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures

      Expert review document part 2: methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures

      Introduction This document is complementary to an Expert Review Document on Optical Coherence Tomography (OCT) for the study of coronary arteries and atherosclerosis.1 The goal of this companion manuscript is to provide a practical guide framework for the appropriate use and reporting of the novel frequency domain (FD) OCT imaging to guide interventional procedures, with a particular interest on the comparison with intravascular ultrasound (IVUS).1–4 Technique for optical coherence tomography imaging In the OCT Expert Review Document on Atherosclerosis, a comprehensive description of the physical principles for OCT imaging and time domain (TD) catheters (St Jude Medical ...

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    Automated stent strut coverage and apposition analysis of in-vivo intra coronary optical coherence tomography images Automated volumetric stent analysis of in-vivo intracoronary optical coherence tomography three-dimensional datasets Optical coherence tomography (OCT) in PCI for in-stent restenosis (ISR): rationale and design of the SEDUCE (Safety and Efficacy of a Drug elUting balloon in Coronary artery rEstenosis) study Intracoronary Optical Coherence Tomography Images Analysis Optical Coherence Tomography Assessment of the Effect of High-pressure Non-compliant Balloon Postdilation on Underexpansion and Malapposition in Drug-eluting Stents Congratulations to Giovanni Ughi from K. U. Leuven a Winner of a 2012 Student Travel Grant Award Automatic three-dimensional registration of intra-vascular optical coherence tomography images for the clinical evaluation of stent implantation over time Automatic three-dimensional registration of intravascular optical coherence tomography images Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies: A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation Expert review document part 2: methodology, terminology and clinical applications of optical coherence tomography for the assessment of interventional procedures Optical coherence tomography angiography of foveal neovascularisation in proliferative diabetic retinopathy Treating port wine stain birthmarks using dynamic optical coherence tomography-guided setting