1. Articles from Guilherme F. Attizzani

    1-24 of 38 1 2 »
    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. Association of skin autofluorescence with plaque vulnerability evaluated by optical coherence tomography in patients with cardiovascular disease

      Association of skin autofluorescence with plaque vulnerability evaluated by optical coherence tomography in patients with cardiovascular disease

      Background and aims Accumulation of advanced glycation end products (AGEs) can be measured non-invasively by skin autofluorescence (SAF) whose values are elevated in patients with cardiovascular disease (CVD). Optical coherence tomography (OCT) is an intravascular imaging modality that could allow visualization of plaque composition. We aim to examine the relationship between SAF and plaque composition evaluated by frequency-domain OCT in patients with CVD. Methods We prospectively enrolled 108 patients with CVD who underwent OCT images during percutaneous coronary intervention (PCI). We divided the population into two groups: high SAF group (greater than or equal to 2.6) and low SAF ...

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    3. OCT guidance during stent implantation in primary Pci: A randomized multicenter study with nine months of optical coherence tomography follow-up

      OCT guidance during stent implantation in primary Pci: A randomized multicenter study with nine months of optical coherence tomography follow-up

      Aims To assess the possible merits of optical coherence tomography (OCT) guidance in primary percutaneous coronary intervention (pPCI). Methods and results 201 patients with ST-elevation myocardial infarction (STEMI) were enrolled in this study. Patients were randomized either to pPCI alone (angio-guided group, n = 96) or to pPCI with OCT guidance (OCT-guided group, n = 105) and also either to biolimus A9 or to everolimus-eluting stent implantation. All patients were scheduled for nine months of follow-up angiography and OCT study. OCT guidance led to post-pPCI optimization in 29% of cases (59% malapposition and 41% dissections). No complications were found related to the ...

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    4. OCT Made Easy (Textbook)

      OCT Made Easy (Textbook)

      This book, written by premier authors in the field of OCT intravascular imaging, covers the best practices for using OCT to provide high resolution cross-sectional viewing for atherosclerotic plaque assessment, stent strut coverage and apposition, assessment in stent restenosis evaluation, and PCI guide and optimization. Fully illustrated thorughout in a handy, cath-lab side handbook supplemented by online movie clips, OCT Made Easy includes case studies, angiography, CT correlations, and simple techniques for getting the best image.

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    5. Difference in Vascular Response between Sirolimus-eluting- and Everolimus-eluting Stents in Ostial Left Circumflex Artery after Unprotected Left Main as Observed by

      Difference in Vascular Response between Sirolimus-eluting- and Everolimus-eluting Stents in Ostial Left Circumflex Artery after Unprotected Left Main as Observed by

      Background Kissing-balloon technique (KBT) is commonly performed during percutaneous coronary intervention of distal unprotected left main coronary artery (ULM) aiming at obtaining optimal opening of the side branch (left circumflex artery; LCX) ostium. Nonetheless, detailed evaluation of vascular response to stents in LCX ostium is lacking. We therefore evaluated the vascular response to different drug-eluting stents (DES) in ostial LCX after ULM by means of optical coherence tomography (OCT). Methods We prospectively enrolled 38 consecutive patients with ULM disease, whom were treated with single-stent procedure using DES, crossover the ULM-left anterior descending artery (LAD) following by KBT. Twelve patients were ...

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    6. Failure Mechanisms and Neoatherosclerosis Patterns in Very Late Drug-Eluting and Bare-Metal Stent Thrombosis

      Failure Mechanisms and Neoatherosclerosis Patterns in Very Late Drug-Eluting and Bare-Metal Stent Thrombosis

      Background— There are few clinical studies on the pathophysiological mechanisms of very late stent thrombosis (VLST). We report optical coherence tomography findings in patients with VLST and compare the findings between bare-metal stents (BMS) and drug-eluting stents (DES). Methods and Results— We conducted a registry of stent thrombosis at 4 North American centers with optical coherence tomography imaging programs SAFE registry (The Study of Late Stent Failure Evaluated by OCT). Images were acquired in 61 patients (42 DES and 19 BMS) presenting with definite VLST. The median duration from implantation to VLST presentation was 51.4 months in the DES ...

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    7. Optical coherence tomography assessment of in-stent restenosis after percutaneous coronary intervention with two-stent technique in unprotected left main

      Optical coherence tomography assessment of in-stent restenosis after percutaneous coronary intervention with two-stent technique in unprotected left main

      Background Optical coherence tomography (OCT) has contributed to a better understanding of in-stent restenosis (ISR); however, studies evaluating ISR pattern after two-stent technique in unprotected left main (ULM) are lacking. We aim to evaluate the ISR pattern of proximal LAD and LCX after two-stent technique in ULM. Methods We performed OCT in 26 patients with isolated or combined ISR (identified by angiography as >50%) after two stent implantation in the proximal LCX and LAD. Finally, 13 LAD and 22 LCX ISR lesions underwent OCT assessments. OCT analyses were undertaken in the proximal segments of the LAD and LCX. In addition ...

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    8. A Honeycomb-Like Structure in Chronic Total Occlusion Demonstrated by Frequency-Domain Optical Coherence Tomography

      A Honeycomb-Like Structure in Chronic Total Occlusion Demonstrated by Frequency-Domain Optical Coherence Tomography

      A 68 year-old male with a history of hypertension and current smoking was admitted due to exertional chest pain. Coronary angiography (CAG) showed a chronic total occlusion (CTO) in the left circumflex artery with collateral supply from the right coronary artery (Fig. 1). PCI was performed in this lesion as patient has normal left ventricular function. After crossing the lesion with guide wire (Gaia 2nd) and micro catheter, frequency-domain optical coherence tomography (FD-OCT) (ILUMIEN™ OCT Imaging System, St Jude Medical, Inc, St Paul, Minnesota) was performed

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    9. Optical Coherence Tomography Assessment of Late Intra-Scaffold Dissection - A New Challenge of Bioresorbable Scaffolds

      Optical Coherence Tomography Assessment of Late Intra-Scaffold Dissection - A New Challenge of Bioresorbable Scaffolds

      A 48-year-old man was admitted because of a non–ST-segment elevation myocardial infarction. Fifteen months previously, he had received a 3.0 × 28-mm bioresorbable vascular scaffold (BVS) (Absorb, Abbott Vascular, Santa Clara, California) in the mid-left anterior descending coronary artery for stable angina. Coronary angiography showed a focal in-scaffold restenosis (Figure 1 ). Optical coherence tomography (OCT) (Ilumien, St. Jude Medical, Saint Paul, Minnesota) revealed a heterogeneous pattern consisting of neointimal hyperplasia (Figure 1 ), mural white thrombus (Figure 1 ), and lipidic plaque with attenuation (Figure 1 ). OCT after pre-dilation with a 2.0 × 15-mm semicompliant balloon showed outer migration of scaffold ...

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    10. Differences determined by optical coherence tomography volumetric analysis in non-culprit lesion morphology and inflammation in ST-segment elevation myocardial infarction and stable angina pectoris patients

      Differences determined by optical coherence tomography volumetric analysis in non-culprit lesion morphology and inflammation in ST-segment elevation myocardial infarction and stable angina pectoris patients

      Background: While the current methodology for determining fibrous cap (FC) thickness of lipid plaques is based on manual measurements of arbitrary points, which could lead to high variability and decreased accuracy, it ignores the three-dimensional (3-D) morphology of coronary artery disease. Objective: To compare, utilizing optical coherence tomography (OCT) assessments, volumetric quantification of FC and macrophage detection using both visual assessment and automated image processing algorithms in non-culprit lesions of STEMI and stable angina pectoris (SAP) patients. Methods: Lipid plaques were selected from 67 consecutive patients (1 artery/patient). FC was manually delineated by a computer-aided method and automatically classified ...

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    11. New Insights on acute expansion and longitudinal elongation of bioresorbable vascular scaffolds In-Vivo and at bench test: A note of caution on reliance to compliance charts and nominal length

      New Insights on acute expansion and longitudinal elongation of bioresorbable vascular scaffolds In-Vivo and at bench test: A note of caution on reliance to compliance charts and nominal length

      Objectives : We performed systematic optical coherence tomography (OCT) analyses after BVS implantation in a “real world” setting aiming at evaluating scaffold expansion and longitudinal integrity. Background : A comprehensive elucidation of bioresorbable vascular scaffolds´ (BVS) acute performance in the “real-world” setting is lacking Methods : Acute BVS expansion compared with compliance chart information and longitudinal integrity were assessed in 29 patients (32 lesions) by OCT. In addition, bench experiments with 4 scaffolds were performed with different combinations of deployment pressures and tube stiffness. Results : Scaffold underexpansion, using compliance chart information as reference, was observed in 97% of OCT cross-sections in vivo; however ...

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    12. Impact of Main-Branch Calcified Plaque on Side-Branch Stenosis in Bifurcation Stenting: An Optical Coherence Tomography Study

      Impact of Main-Branch Calcified Plaque on Side-Branch Stenosis in Bifurcation Stenting: An Optical Coherence Tomography Study

      Percutaneous coronary intervention (PCI) in bifurcations is routinely performed, however this procedure is associated with higher rates of adverse events compared non-bifurcation PCI [1,2]. While bifurcation PCI per se leads to progressively higher rates of periprocedural myocardial infarction as its complexity increases (i.e., 1- vs. 2-stent technique) [3], side-branch (SB) stenosis (SBS) after main-branch (MB) stenting may further contribute to myocardial ischemia and necrosis; in addition, it might require additional intervention and resource utilization.

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    13. Comparison of scanning electron microscopy and optical coherence tomography (OCT) for imaging of coronary bifurcation stents

      Comparison of scanning electron microscopy and optical coherence tomography (OCT) for imaging of coronary bifurcation stents

      Background: Optical coherence tomography (OCT) is a new intracoronary imaging modality that has excellent resolution and image quality and has been used to image neointimal coverage after stent implantation. OCT has been compared to histologic, intravascular ultrasound, and scanning electron microscopy (SEM) studies. However, OCT has not been compared with SEM for imaging stent coverage over side branches. Objective: The aim of this study was to compare OCT with scanning electron microscopy (SEM) in imaging neointimal coverage over stent struts bridging coronary side-branch ostia. Methods: Using a balloon-overstretch in-stent restenosis model, we deployed 38 everolimus-eluting stents across coronary bifurcations in ...

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    14. Intravascular Frequency-Domain Optical Coherence Tomography Assessment of Carotid Artery Disease in Symptomatic and Asymptomatic Patients

      Intravascular Frequency-Domain Optical Coherence Tomography Assessment of Carotid Artery Disease in Symptomatic and Asymptomatic Patients

      Objectives The goal of this study was to investigate carotid plaque characteristics in symptomatic versus asymptomatic patients with the use of nonocclusive optical coherence tomography (OCT). Background The identification of asymptomatic patients with carotid disease who are at risk of stroke remains a challenge. There is an increasing awareness that plaque characteristics may best risk-stratify this population. We hypothesized that OCT, a new high-resolution (∼10 μm) imaging modality, might be useful for the identification of low-risk versus high-risk carotid plaque features and help us to understand the relationship between carotid diameter stenosis and plaque morphology to ischemic stroke. Methods Fifty-three ...

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    15. Mechanisms, Pathophysiology, and Clinical Aspects of Incomplete Stent Apposition

      Mechanisms, Pathophysiology, and Clinical Aspects of Incomplete Stent Apposition

      Incomplete stent apposition (ISA) is characterized by the lack of contact of at least 1 stent strut with the vessel wall in a segment not overlying a side branch; it is more commonly found in drug-eluting stents than bare-metal stents. The accurate diagnosis of ISA, initially only possible with intravascular ultrasound, can currently be performed with higher accuracy by optical coherence tomography, which also enables strut-level assessment due to its higher axial resolution. Different circumstances related both to the index procedure and to vascular healing might influence ISA occurrence. Although several histopathology and clinical studies linked ISA to stent thrombosis ...

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    16. Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque

      Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque

      Patients with Kawasaki disease (KD) not treated with immunoglobulin therapy have a 25% risk of developing coronary aneurysms, which lead to adverse cardiovascular events such as myocardial infarction and death . In addition, these individuals frequently present significant calcium deposits in regions of previous inflammation in the coronaries . OCT assessment of stent-vessel interactions seems to be more accurate than IVUS' in patients with highly calcified plaques .

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    17. Frequency-Domain Optical Coherence Tomography Assessment of Unfavorable Kissing-Balloon Result in Unprotected Left Main Intervention

      Frequency-Domain Optical Coherence Tomography Assessment of Unfavorable Kissing-Balloon Result in Unprotected Left Main Intervention

      A 67-year-old man with a history of hypertension and dyslipidemia was admitted because of angina symptoms. Coronary angiography (CAG) showed an eccentric lesion of the distal unprotected left main coronary artery (ULMCA) involving the ostium of the left anterior descending coronary artery (LAD) (Figure 1 A). ULMCA/LAD crossover stent implantation was conducted with a 3.5 × 18-mm everolimus-eluting stent (EES) (XIENCE PRIME, Abbott Vascular, Santa Clara, California) at 12 atm, followed by the kissing-balloon technique (KBT). Despite a favorable CAG result (Figure 2 A), frequency-domain optical coherence tomography (FD-OCT) revealed stent strut deformation towards the LAD, leading to a ...

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    18. Initial experience of percutaneous coronary intervention in bifurcations with bioresorbable vascular scaffolds using different techniques — Insights from optical coherence tomography

      Initial experience of percutaneous coronary intervention in bifurcations with bioresorbable vascular scaffolds using different techniques — Insights from optical coherence tomography

      Percutaneous coronary intervention (PCI) of coronary artery bifurcations (CABs) is associated with increased risk of drug-eluting stent (DES) failure when compared with non-CAB PCI . Although still a controversial topic, the risk of adverse events seems particularly increased when two – rather than one – DESs are implanted . Indeed, the preferred strategy recommended by the current guidelines, when feasible, is one stent technique .

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    19. Serial assessment of vessel interactions after drug-eluting stent implantation in unprotected distal left main coronary artery disease using frequency-domain optical coherence tomography

      Serial assessment of vessel interactions after drug-eluting stent implantation in unprotected distal left main coronary artery disease using frequency-domain optical coherence tomography

      Objectives This study sought to assess stent-vessel interactions after drug-eluting stent (DES) implantation in unprotected left main coronary artery (ULM) by frequency-domain optical coherence tomography (FD-OCT). Background Percutaneous coronary intervention using DES in ULM has been increasingly performed in routine practice. Recently, FD-OCT assessments of DES-vessel interactions have been used as surrogates for DES safety; however, there are no FD-OCT studies in ULM. Methods We prospectively enrolled 33 consecutive patients with ULM disease treated with sirolimus- (n = 11) and everolimus-eluting stents (n = 22). FD-OCT assessments were performed post-percutaneous coronary intervention and at 9-month follow-up. Three different segments of ULM were ...

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    1-24 of 38 1 2 »
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    1. (37 articles) Guilherme F. Attizzani
    2. (30 articles) Hiram G. Bezerra
    3. (29 articles) Case Western Reserve University
    4. (21 articles) Marco A. Costa
    5. (18 articles) Yusuke Fujino
    6. (15 articles) Wei Wang
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