1. Articles from Maria D. Radu

    1-25 of 25
    1. Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Intervent

      Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Intervent

      This consensus document is the second of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near infrared spectroscopy (NIRS)-IVUS. Beyond guidance of stent selection and optimization of deployment, invasive imaging facilitates angiographic interpretation and may guide treatment in acute coronary syndrome. Intravascular imaging can provide additional important diagnostic information when confronted with angiographically ambiguous lesions and allows assessment of plaque morphology enabling identification of vulnerability characteristics. This second document focuses on useful ...

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    2. Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Intervent

      Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Intervent

      This consensus document is the second of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near infrared spectroscopy (NIRS)-IVUS. Beyond guidance of stent selection and optimization of deployment, invasive imaging facilitates angiographic interpretation and may guide treatment in acute coronary syndrome. Intravascular imaging can provide additional important diagnostic information when confronted with angiographically ambiguous lesions and allows assessment of plaque morphology enabling identification of vulnerability characteristics. This second document focuses on useful ...

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    3. Changes in Coronary Plaque Composition in Patients With Acute Myocardial Infarction Treated With High-Intensity Statin Therapy (IBIS-4): A Serial Optical Coherence Tomography Study

      Changes in Coronary Plaque Composition in Patients With Acute Myocardial Infarction Treated With High-Intensity Statin Therapy (IBIS-4): A Serial Optical Coherence Tomography Study

      Objectives This study assessed changes in optical coherence tomography (OCT)-defined plaque composition in patients with ST-elevation myocardial infarction (STEMI) receiving high-intensity statin treatment. Background OCT is a high-resolution modality capable of measuring plaque characteristics including fibrous cap thickness (FCT) and macrophage infiltration. There is limited in vivo evidence regarding the effects of statins on OCT-defined coronary atheroma composition and no evidence in the context of STEMI. Methods In the IBIS-4 (Integrated Biomarker Imaging Study-4), 103 patients underwent intravascular ultrasonography and OCT of 2 noninfarct-related coronary arteries in the acute phase of STEMI. Patients were treated with high-dose rosuvastatin for ...

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    4. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions

      Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions

      his Consensus Document is the first of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The first document appraises the role of intracoronary imaging to guide percutaneous coronary interventions (PCIs) in clinical practice. Current evidence regarding the impact of intracoronary imaging guidance on cardiovascular outcomes is summarized, and patients or lesions most likely to derive clinical benefit from an imaging-guided intervention are identified. The relevance of the use of IVUS or OCT prior ...

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    5. Serial Assessment of Tissue Precursors and Progression of Coronary Calcification Analyzed by Fusion of IVUS and OCT

      Serial Assessment of Tissue Precursors and Progression of Coronary Calcification Analyzed by Fusion of IVUS and OCT

      Objectives The aim of this study was to assess calcium growth with fused grayscale intravascular ultrasound (IVUS), IVUS–virtual histology, and optical coherence tomography (OCT) from baseline to 5-year follow-up in patients treated with bioresorbable vascular scaffolds. Background IVUS and OCT have individual strengths in assessing plaque composition and volume. Fusion of images obtained using these methods could potentially aid in coronary plaque assessment. Methods Anatomic landmarks and endoluminal radiopaque markers were used to fuse OCT and IVUS images and match baseline and follow-up. Results Seventy-two IVUS–virtual histology and OCT paired matched cross-sectional in- and out-scaffold segments were fused ...

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    6. Variability in the measurement of minimum fibrous cap thickness and reproducibility of fibroatheroma classification by optical coherence tomography using manual versus semi-automatic assessment

      Variability in the measurement of minimum fibrous cap thickness and reproducibility of fibroatheroma classification by optical coherence tomography using manual versus semi-automatic assessment

      Aims: The minimum fibrous cap thickness (FCT) is considered a major criterion of coronary plaque vulnerability according to autopsy studies. We aimed to assess the reproducibility in the measurement of the optical coherence tomography (OCT)-detected minimum FCT and the agreement in the classification of thin-cap fibroatheroma (TCFA), by a software-based semi-automatic method compared with the manual method. Methods and results: A total of 50 frames with fibroatheromas (FA) were randomly selected from the Integrated Biomarker Imaging Study-4 (IBIS-4). Two experienced OCT analysts independently measured the minimum FCT at two different time points, manually and by three different semi-automatic software-based ...

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    7. Mechanisms of Very Late Drug-Eluting Stent Thrombosis Assessed by Optical Coherence Tomography

      Mechanisms of Very Late Drug-Eluting Stent Thrombosis Assessed by Optical Coherence Tomography

      Background —The pathomechanisms underlying very late stent thrombosis (VLST) after implantation of drug-eluting stents (DES) are incompletely understood. Using optical coherence tomography (OCT), we investigated potential causes of this adverse event. Methods and Results —Between August 2010 and December 2014, 64 patients were investigated at the time-point of VLST as part of an international OCT registry. OCT pullbacks were performed after restoration of flow and analyzed at 0.4mm. A total of 38 early- and 20 newer-generation DES were suitable for analysis. VLST occurred at a median time of 4.7 years (IQR 3.1 to 7.5). An underlying ...

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    8. Casting light on coronary evaginations: different mechanisms in different coronary devices?

      Casting light on coronary evaginations: different mechanisms in different coronary devices?

      This editorial refers to ‘Coronary evaginations and peri-scaffold aneurysms following implantation of bioresorbable scaffolds: incidence, outcome, and optical coherence tomography analysis of possible mechanisms’, by T. Gori et al ., on page doi:10.1093/eurheartj/ehv581. Stent thrombosis (ST) remains a major concern due to high morbidity and mortality in both the short and long term. 1 Although the rates of this complication have been reduced with newer generation drug-eluting stents (DES), the risk of ST continues to persist for all DES and was recently also reported in bioresorbable vascular scaffolds (BVS). 2 – 4 Among the suggested causes of ST ...

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      Mentions: Maria D. Radu
    9. Comparative analysis method of permanent metallic stents (XIENCE) and bioresorbable poly-L-lactic (PLLA) scaffolds (Absorb) on optical coherence tomography at baseline and follow-up

      Comparative analysis method of permanent metallic stents (XIENCE) and bioresorbable poly-L-lactic (PLLA) scaffolds (Absorb) on optical coherence tomography at baseline and follow-up

      Aims: Fully bioresorbable Absorb poly-L-lactic-acid (PLLA) scaffolds (Abbott Vascular, Santa Clara, CA, USA) are a novel approach for the treatment of coronary narrowing. Due to the translucency of the material (PLLA), the optical coherence tomography (OCT) measurement methods used in the ABSORB trials were unique but not applicable for permanent metallic stents. When the Absorb scaffold and metallic stents are compared in the context of randomised trials, it is challenging to compare the two devices using the conventional methods. The primary purpose of this report is to explain the biases in conventional methodologies applied for metallic stents and for PLLA ...

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    10. Intracoronary Optical Coherence Tomography: Insights from Clinical Research—What Do We Need to Learn?

      Intracoronary Optical Coherence Tomography: Insights from Clinical Research—What Do We Need to Learn?

      Optical coherence tomography (OCT) is a high-resolution technology for imaging of biological tissues that has shown tremendous potential for intracoronary use. Based on near-infrared light rather than ultrasound, catheter-based OCT provides cross-sectional images of the vessel wall and related devices in a histology-like manner. At present, OCT is primarily being used in research to better characterize and understand the pathophysiology of vulnerable plaques and to study the acute and long-term effects of coronary stent implantation. The present review provides the interventional cardiologist with a summary of the clinical research involving OCT, with an emphasis on specific challenges and how these ...

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      Mentions: Maria D. Radu
    11. Flow disturbances in stent-related coronary evaginations: a computational fluid-dynamic simulation study

      Flow disturbances in stent-related coronary evaginations: a computational fluid-dynamic simulation study

      Aims: Angiographic ectasias and aneurysms in stented segments have been associated with late stent thrombosis. Using optical coherence tomography (OCT), some stented segments show coronary evaginations reminiscent of ectasias. The purpose of this study was to explore, using computational fluid-dynamic (CFD) simulations, whether OCT-detected coronary evaginations can induce local changes in blood flow. Methods and results: OCT-detected evaginations are defined as outward bulges in the luminal vessel contour between struts, with the depth of the bulge exceeding the actual strut thickness. Evaginations can be characterised cross ectionally by depth and along the stented segment by total length. Assuming an ellipsoid ...

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    12. Coronary evaginations are associated with positive vessel remodelling and are nearly absent following implantation of newer-generation drug-eluting stents: an optical coherence tomography and intravascular ultrasound study

      Coronary evaginations are associated with positive vessel remodelling and are nearly absent following implantation of newer-generation drug-eluting stents: an optical coherence tomography and intravascular ultrasound study

      Objectives The purpose of this study was to assess the occurrence, predictors, and mechanisms of optical coherence tomography (OCT)-detected coronary evaginations following drug-eluting stent (DES) implantation. Background Angiographic ectasias and aneurysms in stented segments have been associated with a risk of late stent thrombosis. Using OCT, some stented segments show coronary evaginations reminiscent of ectasias. Methods Evaginations were defined as outward bulges in the luminal contour between struts. They were considered major evaginations (MEs) when extending ≥3 mm along the vessel length, with a depth ≥10% of the stent diameter. A total of 228 patients who had sirolimus (SES ...

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    13. Natural history of optical coherence tomography-detected non-flow-limiting edge dissections following drug-eluting stent implantation

      Natural history of optical coherence tomography-detected non-flow-limiting edge dissections following drug-eluting stent implantation

      Aims: Angiographic evidence of edge dissections has been associated with a risk of early stent thrombosis. Optical coherence tomography (OCT) is a high-resolution technology detecting a greater number of edge dissections -particularly non-flow-limiting- compared to angiography. Their natural history and clinical implications remain unclear. The objectives of the present study were to assess the morphology, healing response, and clinical outcomes of OCT-detected edge dissections using serial OCT imaging at baseline and at one year following drug-eluting stent (DES) implantation. Methods and results: Edge dissections were defined as disruptions of the luminal surface in the 5 mm segments proximal and distal ...

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    14. Intracoronary Optical Coherence Tomography and Histology of Overlapping Everolimus-Eluting Bioresorbable Vascular Scaffolds in a Porcine Coronary Artery Model : The Potential Implications for Clinical Practice

      Intracoronary Optical Coherence Tomography and Histology of Overlapping Everolimus-Eluting Bioresorbable Vascular Scaffolds in a Porcine Coronary Artery Model : The Potential Implications for Clinical Practice

      Objectives This study sought to assess the vascular response of overlapping Absorb stents compared with overlapping newer-generation everolimus-eluting metallic platform stents (Xience V [XV]) in a porcine coronary artery model. Background The everolimus-eluting bioresorbable vascular scaffold (Absorb) is a novel approach to treating coronary lesions. A persistent inflammatory response, fibrin deposition, and delayed endothelialization have been reported with overlapping first-generation drug-eluting stents. Methods Forty-one overlapping Absorb and overlapping Xience V (XV) devices (3.0 × 12 mm) were implanted in the main coronary arteries of 17 nonatherosclerotic pigs with 10% overstretch. Implanted coronary arteries were evaluated by optical coherence tomography (OCT ...

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    15. Optimising cardiovascular outcomes using optical coherence tomography-guided percutaneous coronary interventions

      Optimising cardiovascular outcomes using optical coherence tomography-guided percutaneous coronary interventions

      Cardiovascular outcomes following percutaneous coronary intervention (PCI) steadily improve due to progress of coronary stent technology1,2, antithrombotic therapy3,4, and the use of novel diagnostic approaches5. As angiography provides only limited information, it is tempting to employ intracoronary imaging to assess the post-procedural results with the intention to further optimise outcomes. Although intravascular ultrasound (IVUS) provides more detailed information than angiography alone, its uptake has been modest to guide PCI6,7. Meanwhile, a new and more promising technology – optical coherence tomography (OCT) – has become available. By utilising light instead of sound, it provides histologylike images of stents and the ...

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    16. Offline fusion of co-registered intravascular ultrasound and frequency domain optical coherence tomography images for the analysis of human atherosclerotic plaques

      Offline fusion of co-registered intravascular ultrasound and frequency domain optical coherence tomography images for the analysis of human atherosclerotic plaques

      Aims: To demonstrate the feasibility and potential usefulness of an offline fusion of matched optical coherence tomography (OCT) and intravascular ultrasound (IVUS)/virtual histology (IVUS-VH) images.

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    17. The Clinical Atlas of Intravascular Optical Coherence Tomography iPad Application (Book)

      The Clinical Atlas of Intravascular Optical Coherence Tomography iPad Application (Book)

      Developed specifically for the iPad, The Clinical Atlas of OCT offers a rapid and interactive guidance to a systematic and scientifically critical interpretation of OCT images for interventional cardiologists, pathologists, and other physicians, technicians, trainees and research staff.  See screenshots by clicking HERE. Led by Professor Patrick W. Serruys, Dr. Maria Radu, Dr. Lorenz Räber and Dr. Hector Garcia-Garcia, the team behind this publication includes several international well-renowned experts and key opinion leaders within the field of intracoronary imaging and pathology. The Clinical Atlas of Intravascular OCT comprises eight separate chapters offering the following contents: 1. Principles of OCT 2 ...

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    18. Reproducibility of qualitative assessment of stent struts coverage by optical coherence tomography

      Reproducibility of qualitative assessment of stent struts coverage by optical coherence tomography

      Abstract  Assessment of stent strut coverage by optical coherence tomography (OCT) is not standardized. The methodology most commonly used is based on a visual binary qualitative assessment (strut covered or not). However, the influence of magnification (zoom setting) to the inter- and intra-observer agreements has not yet been evaluated. Aim of our study was therefore to evaluate the agreements of this approach, taking into account various zoom settings. 126 struts from 10 selected frames were independently evaluated by four observers using a stepwise approach increasing the zoom setting as following: (1) full view of the lumen (FV), (2) half view ...

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    19. 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

      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

      Objectives: The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease.Background: Intravascular optical coherence tomography (IVOCT) is a catheter-based modality that acquires images at a resolution of 10 μm, enabling visualization of blood vessel wall microstructure in vivo at an unprecedented level of detail. IVOCT devices are now commercially available worldwide, there is an active user base, and ...

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    20. Circumferential evaluation of the neointima by optical coherence tomography after ABSORB bioresorbable vascular scaffold implantation: Can the scaffold cap the plaque?

      Circumferential evaluation of the neointima by optical coherence tomography after ABSORB bioresorbable vascular scaffold implantation: Can the scaffold cap the plaque?

      Objective To quantify the circumferential healing process at 6 and 12 months following scaffold implantation. Background The healing process following stent implantation consists of tissue growing on the top of and in the space between each strut. With the ABSORB bioresorbable vascular scaffold (BVS), the outer circumference of the scaffold is detectable by optical coherence tomography (OCT), allowing a more accurate and complete evaluation of the intra-scaffold neointima. Methods A total of 58 patients (59 lesions), who received an ABSORB BVS 1.1 implantation and a subsequent OCT investigation at 6 (n = 28 patients/lesions) or 12 (n = 30 patients ...

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    21. Head to head comparison of optical coherence tomography, intravascular ultrasound echogenicity and virtual histology for the detection of changes in polymeric struts over time: insights from the ABSORB trial

      Head to head comparison of optical coherence tomography, intravascular ultrasound echogenicity and virtual histology for the detection of changes in polymeric struts over time: insights from the ABSORB trial

      Aims: To analyse and to compare the changes in the various optical coherence tomography (OCT), echo-genicity intravascular ultrasound virtual histology (VH) of the everolimus-eluting bioresorbable scaffold (ABSORB) degradation parameters during the first 12 months after ASOERB implantation.

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    22. Three-dimensional optical frequency domain imaging in conventional percutaneous coronary intervention: the potential for clinical application

      Three-dimensional optical frequency domain imaging in conventional percutaneous coronary intervention: the potential for clinical application

      Two-dimensional (2D) frequency domain optical coherence tomography (FD-OCT) has enhanced our understanding of coronary atherosclerotic disease and is increasingly being used in conventional percutaneous coronary intervention (PCI) to elucidate mechanisms of disease and improve our understanding of complex coronary anatomy. Since the first report of three-dimensional (3D) OCT applied in human coronary vessels,1 the technology has rapidly progressed.2–10 Currently, the main limitation of this technology is the need for off-line creation of 3D reconstructions—prototypes of current generation ‘real time’ (i.e. available peri-procedurally at the ‘push-of-a-button’) remain experimental, work in progress, and are limited by relatively ...

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    23. Spatial Distribution and Temporal Evolution of Scattering Centers by Optical Coherence Tomography in the Poly(L-Lactide) Backbone of a Bioresorbable Vascular Scaffold

      Spatial Distribution and Temporal Evolution of Scattering Centers by Optical Coherence Tomography in the Poly(L-Lactide) Backbone of a Bioresorbable Vascular Scaffold

      Scattering centers (SC) are often observed with optical coherence tomography (OCT) in some struts of bioresorbable vascular scaffolds (BVS). These SC might be caused by crazes in the polymer during crimp-deployment (more frequent at inflection points) or by other processes, such as physiological loading or hydrolysis (eventually increasing with time). The spatial distribution and temporal evolution of SC in BVS might help to understand their meaning. Methods and Results: Three patients were randomly selected from 12 imaged with Fourier-domain OCT at both baseline and 6 months in the ABSORB cohort B study (NCT00856856). Frame-by-frame analysis of the SC distribution was ...

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    24. In vivo visualisation by three-dimensional optical coherence tomography of stress crazing of a bioresorbable vascular scaffold implanted for treatment of human coronary stenosis

      In vivo visualisation by three-dimensional optical coherence tomography of stress crazing of a bioresorbable vascular scaffold implanted for treatment of human coronary stenosis
      The concept of using bioresorbable intracoronary scaffolds in percutaneous coronary intervention has attracted interest since their inception, because the devices can overcome potential disadvantages of permanent metallic stents.
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    1-25 of 25
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    1. (24 articles) Maria D. Radu
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    In vivo visualisation by three-dimensional optical coherence tomography of stress crazing of a bioresorbable vascular scaffold implanted for treatment of human coronary stenosis Spatial Distribution and Temporal Evolution of Scattering Centers by Optical Coherence Tomography in the Poly(L-Lactide) Backbone of a Bioresorbable Vascular Scaffold Three-dimensional optical frequency domain imaging in conventional percutaneous coronary intervention: the potential for clinical application Head to head comparison of optical coherence tomography, intravascular ultrasound echogenicity and virtual histology for the detection of changes in polymeric struts over time: insights from the ABSORB trial Circumferential evaluation of the neointima by optical coherence tomography after ABSORB bioresorbable vascular scaffold implantation: Can the scaffold cap the plaque? 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 Reproducibility of qualitative assessment of stent struts coverage by optical coherence tomography The Clinical Atlas of Intravascular Optical Coherence Tomography iPad Application (Book) Offline fusion of co-registered intravascular ultrasound and frequency domain optical coherence tomography images for the analysis of human atherosclerotic plaques Natural history of optical coherence tomography-detected non-flow-limiting edge dissections following drug-eluting stent implantation Measurement of the Shrinkage of Natural and Simulated Lesions on Root Surfaces using CP-OCT Optic-Net: A Novel Convolutional Neural Network for Diagnosis of Retinal Diseases from Optical Tomography Images