1. Articles from Walter Desmet

    1-23 of 23
    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. EuOptical 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 chro

      EuOptical 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 chro

      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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    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. 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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    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. 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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    7. 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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    8. 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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    9. 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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    10. 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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    11. 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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    12. 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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    13. 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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    14. 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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    15. 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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    16. Automatic three-dimensional registration of intravascular optical coherence tomography images

      Automatic three-dimensional registration of intravascular optical coherence tomography images

      Intravascular optical coherence tomography (IV-OCT) is a catheter-based high-resolution imaging technique able to visualize the inner wall of the coronary arteries and implanted devices in vivo with an axial resolution below 20 μm. IV-OCT is being used in several clinical trials aiming to quantify the vessel response to stent implantation over time. However, stent analysis is currently performed manually and corresponding images taken at different time points are matched through a very labor-intensive and subjective procedure. We present an automated method for the spatial registration of IV-OCT datasets. Stent struts are segmented through consecutive images and three-dimensional models of the ...

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    17. 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 intra-vascular optical coherence tomography images for the clinical evaluation of stent implantation over time

      In the last decade a large number of new intracoronary devices (i.e. drug-eluting stents, DES) have been developed to reduce the risks related to bare metal stent (BMS) implantation. The use of this new generation of DES has been shown to substantially reduce, compared with BMS, the occurrence of restenosis and recurrent ischemia that would necessitate a second revascularization procedure. Nevertheless, safety issues on the use of DES persist and full understanding of mechanisms of adverse clinical events is still a matter of concern and debate. Intravascular Optical Coherence Tomography (IV-OCT) is an imaging technique able to visualize the ...

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    18. Congratulations to Giovanni Ughi from K. U. Leuven a Winner of a 2012 Student Travel Grant Award

      Congratulations to Giovanni Ughi from K. U. Leuven a Winner of a 2012 Student Travel Grant Award

      Giovanni Ughi from the Catholic University Leuven is one of four winners of the OCT News 2012 student travel grant awards (see prior announcement Here). Below is a summary of his work. Topic covered by the project is software development for quantitative computer aided automated analysis of intra-vascular OCT images. Automated segmentation of stent struts and lumen, stent apposition, stent coverage and registration of IV-OCT datasets at different instants of times are part of the software research and development. Moreover, tissue characterization to automatically assess atherosclerotic plaques components and morphology are other issues at which the project address. The optical ...

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    19. Optical Coherence Tomography Assessment of the Effect of High-pressure Non-compliant Balloon Postdilation on Underexpansion and Malapposition in Drug-eluting Stents

      Optical Coherence Tomography Assessment of the Effect of High-pressure Non-compliant Balloon Postdilation on Underexpansion and Malapposition in Drug-eluting Stents
      Concerns of an increased risk of thrombosis in drug-eluting stents (DES) and the association, in human pathology studies of stent thrombosis, of delayed healing with malapposition of stent struts has fostered a renewed interest in stent implantation optimisation techniques. We investigated the rationale of the use of optical coherence tomography (OCT), an intravascular imaging technique with 10-fold better resolution than intravascular ultrasound (IVUS), in the guidance of percutaneous coronary intervention (PCI) with respect to the correction of stent underexpansion and malapposition in DES. In 12 patients with OCT characteristics of frank malapposition immediately after DES implantation, high-pressure postdilation with a ...
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    20. 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

      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
      The optimal treatment of bare metal stent restenosis is still not defined. The most employed contemporary option is the implantation of a drug-eluding stent (DES). However, this procedure implies the addition of a second metal layer in the vessel wall, which is linked to delayed healing.
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    21. Automated volumetric stent analysis of in-vivo intracoronary optical coherence tomography three-dimensional datasets

      Automated volumetric stent analysis of in-vivo intracoronary optical coherence tomography three-dimensional datasets
      Intra-vascular Optical Coherence Tomography (IV-OCT) is an appropriate imaging modality for the evaluation of stent struts apposition and coverage in the coronary arteries. Most often, image analysis is performed by a time-consuming manual contour tracing process. Recently, we proposed an algorithm for fully automated lumen morphology and individual stent struts apposition/coverage quantification. In this manuscript further developments allowing for automatic segmentation of the stent contour are presented. As such, quantification of in-stent area, malapposition cross-sectional area (i.e. the area representing the space from the stent surface to the vessel wall) and coverage cross-sectional area (i.e. the area ...
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    22. Automated stent strut coverage and apposition analysis of in-vivo intra coronary optical coherence tomography images

      Automated stent strut coverage and apposition analysis of in-vivo intra coronary optical coherence tomography images
      Several studies have proven that intra-vascular OCT is an appropriate imaging modality able to evaluate stent strut apposition and coverage in coronary arteries. Currently image processing is performed manually resulting in a very time consuming and labor intensive procedure. We propose an algorithm for fully automatic individual stent strut apposition and coverage analysis in coronary arteries. The vessel lumen and stent strut are automatically detected and segmented through analysis of the intensity profiles of the A-scan lines. From these data, apposition and coverage can then be estimated automatically. The algorithm was validated using manual measurement (performed by two trained cardiologists ...
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    1-23 of 23
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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 Fully automatic three-dimensional visualization of intravascular optical coherence tomography images: methods and feasibility in vivo 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 ORCA study: real-world versus reading centre assessment of disease activity of neovascular age-related macular degeneration (nAMD) Role of visual evoked potentials and optical coherence tomography in the screening for optic pathway gliomas in patients with neurofibromatosis type I