1. Articles from Francesco Burzotta

    1-24 of 38 1 2 »
    1. Dual quantitative coronary angiography accurately quantifies intracoronary thrombotic burden in patients with acute coronary syndrome: Comparison with optical coherence tomography imaging

      Dual quantitative coronary angiography accurately quantifies intracoronary thrombotic burden in patients with acute coronary syndrome: Comparison with optical coherence tomography imaging

      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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    2. 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

      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

      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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    3. Stent malapposition, strut coverage and atherothrombotic prolapse after percutaneous coronary interventions in ST-segment elevation myocardial infarction

      Stent malapposition, strut coverage and atherothrombotic prolapse after percutaneous coronary interventions in ST-segment elevation myocardial infarction

      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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    4. Trends and outcomes of optical coherence tomography use: 877 patients single-center experience

      Trends and outcomes of optical coherence tomography use: 877 patients single-center experience

      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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    5. Correlation between CD4+CD28null T lymphocytes, regulatory T cells and plaque rupture: An Optical Coherence Tomography study in Acute Coronary Syndromes

      Correlation between CD4+CD28null T lymphocytes, regulatory T cells and plaque rupture: An Optical Coherence Tomography study in Acute Coronary Syndromes

      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
    6. A Patient-Specific Study Investigating the Relation between Coronary Hemodynamics and Neo-Intimal Thickening after Bifurcation Stenting with a Polymeric Bioresorbable Scaffold

      A Patient-Specific Study Investigating the Relation between Coronary Hemodynamics and Neo-Intimal Thickening after Bifurcation Stenting with a Polymeric Bioresorbable Scaffold

      We present an application of a validated reconstruction methodology for the comparison between patient-specific hemodynamics and neo-intimal thickening at nine months from the intervention. (1) Background: Coronary bifurcation stenting alters the vessel geometry, influencing the local hemodynamics. The evaluation of wall shear stress (WSS) relies on the application of computational fluid dynamics to model its distribution along the coronary tree. The endothelium actively responds to WSS, which triggers eventual cell proliferation to cover the stent struts. (2) Methods: Baseline optical coherence tomography and angiographic data were combined to reconstruct a patient-specific coronary bifurcation with an implanted bioresorbable scaffold and to ...

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    7. Rational and Design of the European Randomized Optical Coherence Tomography Optimized Bifurcation Event Reduction Trial (OCTOBER)

      Rational and Design of the European Randomized Optical Coherence Tomography Optimized Bifurcation Event Reduction Trial (OCTOBER)

      Background Percutaneous coronary intervention (PCI) in complex bifurcation lesions is prone to suboptimal implantation results and is associated with increased risk of subsequent clinical events. Angiographic ambiguity is high during bifurcation stenting but it is unknown if procedural guidance by intravascular optical coherence tomography (OCT) improves clinical outcome. Methods and design OCTOBER is a randomized, investigator initiated, multi-center trial aimed to show superiority of OCT guided stent implantation compared to standard angiographic guided implantation in bifurcation lesions. The primary outcome measure is a two-year composite endpoint of cardiac death, target lesion myocardial infarction, and ischemia driven target lesion revascularization. The ...

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    8. Role of optical coherence tomography in identifying sub-optimal stent positioning and predicting major adverse cardiac events in a comparative study with angiography: a CLIO-OPCI II sub-study

      Role of optical coherence tomography in identifying sub-optimal stent positioning and predicting major adverse cardiac events in a comparative study with angiography: a CLIO-OPCI II sub-study

      Background Quantitative coronary angiography (QCA) is the gold standard for evaluating correct stenting, despite its limitation in recognizing features indicative of suboptimal deployment. This subanalysis of the CLI-OPCI II registry addressed the role of optical coherence tomography (OCT) to verify whether suboptimal OCT deployment occurs in the presence of an optimal angiographic result. Patients and methods We retrospectively analyzed 125 lesions in the 105 patients with major adverse cardiac events of the CLI-OPCI II . Every lesion was evaluated with OCT and angiography , including visual and QCA assessment. Optimal angiographic result was defined as residual stenosis of less than 30% at ...

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    9. Long-term consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study

      Long-term consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study

      Aims: The role of intra-procedural Optical Coherence Tomography (OCT) on long-term clinical outcome of percutaneous coronary interventions (PCI) remains undefined. Methods and results: In the context of the multicenter Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) registry, we compared long-term PCI outcome of 1211 patients from 13 independent OCT-experienced centers according to end-procedural OCT findings. OCT assessment revealed suboptimal stent implantation in 30.9% of lesions, with increased prevalence in patients experiencing device-oriented cardiovascular events (DoCE) (52.8% vs. 28.0%, p<0.001). At median follow-up of 833 (quartiles 415-1447) days, in-stent minimum lumen ...

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    10. Long-tem consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study

      Long-tem consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study

      Aims: The role of intra-procedural Optical Coherence Tomography (OCT) on long-term clinical outcome of percutaneous coronary interventions (PCI) remains undefined. Methods and results: In the context of the multicenter Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) registry, we compared long-term PCI outcome of 1211 patients from 13 independent OCT-experienced centers according to end-procedural OCT findings. OCT assessment revealed suboptimal stent implantation in 30.9% of lesions, with increased prevalence in patients experiencing device-oriented cardiovascular events (DoCE) (52.8% vs. 28.0%, p<0.001). At median follow-up of 833 (quartiles 415-1447) days, in-stent minimum lumen ...

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    11. Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions

      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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    12. Patient-Specific Modeling of Stented Coronary Arteries Reconstructed from Optical Coherence Tomography: Towards a Widespread Clinical Use of Fluid Dynamics Analyses

      Patient-Specific Modeling of Stented Coronary Arteries Reconstructed from Optical Coherence Tomography: Towards a Widespread Clinical Use of Fluid Dynamics Analyses

      The recent widespread application of optical coherence tomography (OCT) in interventional cardiology has improved patient-specific modeling of stented coronary arteries for the investigation of local hemodynamics. In this review, the workflow for the creation of fluid dynamics models of stented coronary arteries from OCT images is presented. The algorithms for lumen contours and stent strut detection from OCT as well as the reconstruction methods of stented geometries are discussed. Furthermore, the state of the art of studies that investigate the hemodynamics of OCT-based stented coronary artery geometries is reported. Although those studies analyzed few patient-specific cases, the application of the ...

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    13. Data on optical coherence tomography guidance for the management of angiographically intermediate left main bifurcation lesions

      Data on optical coherence tomography guidance for the management of angiographically intermediate left main bifurcation lesions

      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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    14. A framework for computational fluid dynamic analyses of patient-specific stented coronary arteries from optical coherence tomography images

      A framework for computational fluid dynamic analyses of patient-specific stented coronary arteries from optical coherence tomography images

      The clinical challenge of percutaneous coronary interventions (PCI) is highly dependent on the recognition of the coronary anatomy of each individual. The classic imaging modality used for PCI is angiography, but advanced imaging techniques that are routinely performed during PCI, like optical coherence tomography (OCT), may provide detailed knowledge of the pre-intervention vessel anatomy as well as the post-procedural assessment of the specific stent-to-vessel interactions. Computational fluid dynamics (CFD) is an emerging investigational tool in the setting of optimization of PCI results. In this study, an OCT-based reconstruction method was developed for the execution of CFD simulations of patient-specific coronary ...

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    15. Coronary stents and vascular response to implantation: literature review

      Coronary stents and vascular response to implantation: literature review

      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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    16. Optical coherence tomography guidance for the management of angiographically intermediate left main bifurcation lesions: Early clinical experience

      Optical coherence tomography guidance for the management of angiographically intermediate left main bifurcation lesions: Early clinical experience

      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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    17. Frequency-domain optical coherence tomography plaque morphology in stable coronary artery disease: sex differences

      Frequency-domain optical coherence tomography plaque morphology in stable coronary artery disease: sex differences

      Background: The cause for discrepancy in the clinical presentation and outcome of coronary artery disease (CAD) between men and women is not established. Different prevalences of risk factors or specific sex-related atherosclerotic aspects have been advocated as possible explanations. We investigated coronary plaque morphology looking at possible differences in plaque vulnerability between men and women with stable CAD.

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    18. Reconstruction of stented coronary arteries from optical coherence tomography images: Feasibility, validation, and repeatability of a segmentation method

      Reconstruction of stented coronary arteries from optical coherence tomography images: Feasibility, validation, and repeatability of a segmentation method

      Optical coherence tomography (OCT) is an established catheter-based imaging modality for the assessment of coronary artery disease and the guidance of stent placement during percutaneous coronary intervention. Manual analysis of large OCT datasets for vessel contours or stent struts detection is time-consuming and unsuitable for real-time applications. In this study, a fully automatic method was developed for detection of both vessel contours and stent struts. The method was applied to in vitro OCT scans of eight stented silicone bifurcation phantoms for validation purposes. The proposed algorithm comprised four main steps, namely pre-processing, lumen border detection, stent strut detection, and three-dimensional ...

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    19. Plaque erosion causing ST-segment elevation myocardial infarction: report of an optical coherence tomography-documented case and concise literature review

      Plaque erosion causing ST-segment elevation myocardial infarction: report of an optical coherence tomography-documented case and concise literature review

      A 61-year-old man presented to the Emergency Room of a referring hospital with anterior ST-segment elevation myocardial infarction (STEMI) and was immediately treated by antiplatelet therapy and transferred to our hospital to perform a primary percutaneous coronary intervention (PCI)...

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      Mentions: Rocco Vergallo
    20. Not all plaque ruptures are born equal: an optical coherence tomography study

      Not all plaque ruptures are born equal: an optical coherence tomography study

      Aims Plaque rupture (PR) represents the most common substrate of coronary thrombosis, in at least 50% of cases. Chronic low grade inflammation is a common background for atherosclerosis development; however, increased plaque inflammation may predispose by itself to PR. In the last decade, studies performed by optical coherence tomography (OCT) have allowed to establish the severity of plaque inflammation by assessing macrophage infiltration (MØI). Our retrospective study aimed at assessing the role of plaque inflammation in PR among patients with acute coronary syndrome (ACS) using OCT. Methods and results We enrolled 56 patients with ACS exhibiting PR at the ...

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      Mentions: Rocco Vergallo
    21. Angiographically intermediate left main bifurcation disease assessment by frequency domain optical coherence tomography (FD-OCT)

      Angiographically intermediate left main bifurcation disease assessment by frequency domain optical coherence tomography (FD-OCT)

      High-risk atherosclerotic plaques as thin cap fibroatheroma (TCFA) are frequently located in coronary regions with low shear stress [1,2], as coronary bifurcation and in particular left main (LM) bifurcation [3]. Previous invasive imaging studies on LM plaque characterization by intravascular ultrasound (IVUS) reported that LM carina is usually spared and that the disease is generally extended from LM into the distal branches [4]. Frequency domain-optical coherence tomography (FD-OCT) is a high resolution imaging modality that allows high-quality visualization of inner vessel wall structure and accurate measurement of vascular microstructures such as the fibrous cap [5].

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    22. Impact of Culprit Plaque and Atherothrombotic Components on Incomplete Stent Apposition in Patients With ST-Elevation Myocardial Infarction Treated With Everolimus-Eluting Stents – An OCTAVIA Substudy –

      Impact of Culprit Plaque and Atherothrombotic Components on Incomplete Stent Apposition in Patients With ST-Elevation Myocardial Infarction Treated With Everolimus-Eluting Stents – An OCTAVIA Substudy –

      Background: The role of culprit plaque and related atherothrombotic components on incomplete stent apposition (ISA) occurrence after primary percutaneous coronary intervention (p-PCI) is unknown. Methods and Results: ST-segment elevation myocardial infarction (STEMI) patients undergoing p-PCI with an everolimus-eluting stent were prospectively investigated with optical coherence tomography (OCT) of the infarct-related artery before, after stenting and at 9 months. OCT data, aspirated thrombus and serum inflammatory biomarkers were analyzed. 114 patients with 114 lesions were evaluated. Acute ISA occurred in 82 lesions (71.9%), preferentially in larger vessels with a median area of 0.2 mm 2 . The presence of thrombus ...

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    23. Clinical Impact of OCT Findings During PCI: The CLI-OPCI II Study

      Clinical Impact of OCT Findings During PCI: The CLI-OPCI II Study

      Objectives The goal of this study was to assess the clinical impact of optical coherence tomography (OCT) findings during percutaneous coronary intervention (PCI). Background OCT provides unprecedented high-definition visualization of plaque/stent structures during PCI; however, the impact of OCT findings on outcome remains undefined. Methods In the context of the multicenter CLI-OPCI (Centro per la Lotta contro l’Infarto–Optimisation of Percutaneous Coronary Intervention) registry, we retrospectively analyzed patients undergoing end-procedural OCT assessment and compared the findings with clinical outcomes. Results A total of 1,002 lesions (832 patients) were assessed. Appropriate OCT assessment was obtained in 98.2 ...

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    1-24 of 38 1 2 »
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    Superficial calcified nodules and post-stenting micro-dissections imaged through 3-dimensional optical coherence tomography Predictors of Periprocedural (Type IVa) Myocardial Infarction, as Assessed by Frequency-Domain Optical Coherence Tomography INtimal hyPerplasia evAluated by oCT in de novo COROnary lesions treated by drug-eluting balloon and bare-metal stent (IN-PACT CORO): study protocol for a randomized controlled trial Angiography alone versus angiography plus optical coherence tomography to guide decision-making during percutaneous coronary intervention: the Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) study Frequency-domain optical coherence tomography assessment of kissing-balloon effects in bifurcated coronary artery lesions undergoing provisional stenting - Corrected Proof Radial artery complications occurring after transradial coronary procedures using long hydrophilic-coated introducer sheath: a frequency domain-optical coherence tomography study Frequency-domain optical coherence tomography findings in patients with bifurcated lesions undergoing provisional stenting Association between inflammatory biomarkers and in-stent restenosis tissue features: an Optical Coherence Tomography Study Fractional flow reserve or optical coherence tomography guidance to revascularize intermediate coronary stenosis using angioplasty (FORZA) trial: study protocol for a randomized controlled trial Clinical Impact of OCT Findings During PCI: The CLI-OPCI II Study Image contrast correction method in full-field optical coherence tomography Evaluation of posterior vitreous detachment using ultrasonography and optical coherence tomography