1. Articles from Emanuele Barbato

    1-9 of 9
    1. New Volumetric Analysis Method for Stent Expansion and its Correlation With Final Fractional Flow Reserve and Clinical Outcome An ILUMIEN I Substudy

      New Volumetric Analysis Method for Stent Expansion and its Correlation With Final Fractional Flow Reserve and Clinical Outcome An ILUMIEN I Substudy

      Download figure Open in new tab Download powerpoint Abstract Objectives This study sought to compare conventional methodology (CM) with a newly described optical coherence tomography (OCT)-derived volumetric stent expansion analysis in terms of fractional flow reserve (FFR)-derived physiology and device-oriented composite endpoints (DoCE). Background The analysis of coronary stent expansion with intracoronary imaging has used CM that relies on the analysis of selected single cross-sections for several decades. The introduction of OCT with its ability to perform semiautomated volumetric analysis opens opportunities to redefine optimal stent expansion. Methods A total of 291 lesions treated with post-stent OCT and ...

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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 imaging during percutaneous coronary intervention impacts physician decision-making: ILUMIEN I Study

      Optical coherence tomography imaging during percutaneous coronary intervention impacts physician decision-making: ILUMIEN I Study

      Aims ILUMIEN I is the largest prospective, non-randomized, observational study of percutaneous coronary intervention (PCI) procedural practice in patients undergoing intra-procedural pre- and post-PCI fractional flow reserve (FFR) and optical coherence tomography (OCT). We report on the impact of OCT on physician decision-making and the association with post-PCI FFR values and early clinical events. Methods and results Optical coherence tomography and documentary FFR were performed pre- and post-PCI in 418 patients (with 467 stenoses) with stable or unstable angina or NSTEMI. Based on pre-PCI OCT, the procedure was altered in 55% of patients (57% of all stenoses) by selecting different ...

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    4. Acute coronary syndromes in patients with multivessel disease: the key role of optical coherence tomography

      Acute coronary syndromes in patients with multivessel disease: the key role of optical coherence tomography

      In this article, we provide very illustrative images obtained with optical coherence tomography (OCT) of a patient presenting with ST-elevation myocardial infarction and multivessel disease. These patients are referred to the catheterization laboratory without performing any prior noninvasive imaging. This leads very often to diagnostic dilemmas with difficult solutions. Coronary angiography is frequently insufficient or even misleading to guide the interventional cardiologist in the identification and revascularization of the culprit coronary lesion. What makes our case particularly paradigmatic is the fact that without OCT guidance, an erroneous clinical decision-making process would have taken place, leaving untreated the culprit lesion in ...

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    5. 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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    6. 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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    7. 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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    8. The reconciliation of pressure and light: a clinical case of complementary use of fractional flow reserve and optical coherence tomography

      The reconciliation of pressure and light: a clinical case of complementary use of fractional flow reserve and optical coherence tomography
      An interesting case of acute coronary syndrome occurring shortly after a cardiac catheterization is reported. Different tests and imaging modalities for coronary artery disease have been performed in this patient. The potential for integration of the information available is underscored in order to overcome their inherent limitations.
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    1-9 of 9
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    The reconciliation of pressure and light: a clinical case of complementary use of fractional flow reserve and 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 Optimization of Tryton Dedicated Coronary Bifurcation System With Coregistration of Optical Coherence Tomography and Fractional Flow Reserve Quantitative angiography and optical coherence tomography for the functional assessment of nonobstructive coronary stenoses: Comparison with fractional flow reserve 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 Acute coronary syndromes in patients with multivessel disease: the key role of optical coherence tomography Optical coherence tomography imaging during percutaneous coronary intervention impacts physician decision-making: ILUMIEN I Study In-stent fractional flow reserve variations and related optical coherence tomography findings: the FFR–OCT co-registration study New Volumetric Analysis Method for Stent Expansion and its Correlation With Final Fractional Flow Reserve and Clinical Outcome An ILUMIEN I Substudy Schlemm's canal measured by optical coherence tomography and correlation study in a healthy Caucasian child population Optical coherence tomography angiography and microvascular changes in diabetic retinopathy: a systematic review High-accuracy endoscopic microscopy using a thin, 1.5 mm diameter probe with optical coherence tomography