All Articles from Francesco Burzotta -Optical Coherence Tomography News

Articles from Francesco Burzotta

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1. Fractional Flow Reserve or Optical Coherence Tomography to Guide Management of Angiographically-Intermediate Coronary Stenosis: A Single-Center Trial
  
  Explore interventions.onlinejacc.org Oct 1 2019 Cardiology
  
  Background Fractional flow reserve (FFR) and optical coherence tomography (OCT) may help both in assessment of angiographically-intermediate coronary lesions (AICL) and in percutaneous coronary interventions (PCI) optimization. Objectives: To compare OCT-guidance and FFR-guidance in patients with AICL in a single-center, prospective, 1:1 randomized trial (acronym: FORZA, NCT01824030 ). Methods Patients with AICL were randomized to FFR or OCT. In the FFR arm, PCI was performed if FFR was ≤0.80. In the OCT arm, PCI was performed if area stenosis was ≥75% or 50%-75% with minimal lumen area <2.5 mm 2 or plaque rupture. Angina (evaluated by Seattle ...
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  Mentions: Rocco Vergallo
2. Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: the CLIMA study
  
  Explore Journals Aug 6 2019 Cardiology
  
  Aims The CLIMA study, on the relationship between c oronary p l aque morphology of the left anter i or descending artery and twelve m onths clinic a l outcome, was designed to explore the predictive value of multiple high-risk plaque features in the same coronary lesion [minimum lumen area (MLA), fibrous cap thickness (FCT), lipid arc circumferential extension, and presence of optical coherence tomography (OCT)-defined macrophages] as detected by OCT. Composite of cardiac death and target segment myocardial infarction was the primary clinical endpoint. Methods and results From January 2013 to December 2016, 1003 patients undergoing OCT evaluation ...
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  Mentions: Corrado Tamburino Fernando Alfonso Francesco Prati
3. Prospective Randomized Comparison of Fractional Flow Reserve Versus Optical Coherence Tomography to Guide Revascularization of Intermediate Coronary Stenoses: One-Month Results
  
  Explore Home | AHA/ASA Journals Jul 27 2019 Cardiology
  
  Background-—Fractional flow reserve (FFR) and optical coherence tomography (OCT) may help both in assessment and in percutaneous coronary intervention optimization of angiographically intermediate coronary lesions. We designed a prospective trial comparing the clinical and economic outcomes associated with FFR or OCT in angiographically intermediate coronary lesions. Methods and Results-—Three hundred fifty patients with angiographically intermediate coronary lesions (n=446) were randomized to FFR or OCT guidance. In the FFR arm, percutaneous coronary intervention was performed if FFR was ≤0.80 aiming for a postprocedure FFR >0.90. In the OCT arm, percutaneous coronary intervention was performed if percentage ...
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  Mentions: Rocco Vergallo
4. Dual quantitative coronary angiography accurately quantifies intracoronary thrombotic burden in patients with acute coronary syndrome: Comparison with optical coherence tomography imaging
  
  Explore International Journal of Cardiology Apr 22 2019 Cardiology
  
  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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5. 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
  
  Explore The JAMA Network Mar 19 2019 Cardiology
  
  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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  Mentions: Mount Sinai School of Medicine Massachusetts General Hospital Harvard University
6. Stent malapposition, strut coverage and atherothrombotic prolapse after percutaneous coronary interventions in ST-segment elevation myocardial infarction
  
  Explore LWW Online Feb 2 2019 Cardiology
  
  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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7. Trends and outcomes of optical coherence tomography use: 877 patients single-center experience
  
  Explore ScienceDirect Dec 26 2018 Cardiology
  
  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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8. Correlation between CD4+CD28null T lymphocytes, regulatory T cells and plaque rupture: An Optical Coherence Tomography study in Acute Coronary Syndromes
  
  Explore International Journal of Cardiology Sep 7 2018 Cardiology
  
  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
9. A Patient-Specific Study Investigating the Relation between Coronary Hemodynamics and Neo-Intimal Thickening after Bifurcation Stenting with a Polymeric Bioresorbable Scaffold
  
  Explore MDPI Open Access Journals Platform Sep 1 2018 Cardiology
  
  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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10. Rational and Design of the European Randomized Optical Coherence Tomography Optimized Bifurcation Event Reduction Trial (OCTOBER)
  
  Explore ScienceDirect Aug 21 2018 Cardiology
  
  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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  Mentions: Tampere University of Technology VU University Amsterdam John A. Ormiston
11. 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
  
  Explore LWW Online May 1 2018 Cardiology
  
  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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  Mentions: University of Catania Francesco Prati
12. 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
  
  Explore eurointervention.org Apr 17 2018 Cardiology
  
  $Long-term consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study$
  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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  Mentions: Cardiovascular Research Foundation Gary S. Mintz Corrado Tamburino
13. 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
  
  Explore eurointervention.org Apr 10 2018 Cardiology
  
  $Long-tem consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study$
  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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  Mentions: Cardiovascular Research Foundation Gary S. Mintz Corrado Tamburino
14. Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions
  
  Explore International Journal of Cardiology Jan 4 2018 Cardiology
  
  $Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions$
  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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15. Patient-Specific Modeling of Stented Coronary Arteries Reconstructed from Optical Coherence Tomography: Towards a Widespread Clinical Use of Fluid Dynamics Analyses
  
  Explore Home - Springer Jan 2 2018 Cardiology
  
  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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16. Data on optical coherence tomography guidance for the management of angiographically intermediate left main bifurcation lesions
  
  Explore ScienceDirect Sep 17 2017 Cardiology
  
  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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17. A framework for computational fluid dynamic analyses of patient-specific stented coronary arteries from optical coherence tomography images
  
  Explore ScienceDirect Jul 21 2017 Cardiology
  
  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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18. Coronary stents and vascular response to implantation: literature review
  
  Explore Medical Journals Publisher Jul 14 2017 Cardiology
  
  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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19. Optical coherence tomography guidance for the management of angiographically intermediate left main bifurcation lesions: Early clinical experience
  
  Explore International Journal of Cardiology Jul 5 2017 Cardiology
  
  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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20. Frequency-domain optical coherence tomography plaque morphology in stable coronary artery disease: sex differences
  
  Explore LWW Online Jun 23 2017 Cardiology
  
  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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21. Reconstruction of stented coronary arteries from optical coherence tomography images: Feasibility, validation, and repeatability of a segmentation method
  
  Explore Journals | PLOS Jun 2 2017 Cardiology
  
  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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22. Plaque erosion causing ST-segment elevation myocardial infarction: report of an optical coherence tomography-documented case and concise literature review
  
  Explore LWW Online Jan 10 2017 Cardiology
  
  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
23. Not all plaque ruptures are born equal: an optical coherence tomography study
  
  Explore ehjcimaging.oxfordjournals.org Dec 27 2016 Cardiology
  
  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
24. Angiographically intermediate left main bifurcation disease assessment by frequency domain optical coherence tomography (FD-OCT)
  
  Explore International Journal of Cardiology Jun 28 2016 Cardiology
  
  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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