1. Articles from Tsunenari Soeda

    1-24 of 69 1 2 3 »
    1. Optical coherence tomography in coronary atherosclerosis assessment and intervention

      Optical coherence tomography in coronary atherosclerosis assessment and intervention

      Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in the management of patients with acute coronary syndromes. Detection by OCT of healed coronary plaque has been important in our understanding of the mechanisms involved in plaque destabilization and healing ...

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    2. Detection of myocardial bridge by optical coherence tomography

      Detection of myocardial bridge by optical coherence tomography

      Myocardial bridge (MB) is less commonly documented by angiography than autopsy. Optical coherence tomography (OCT) may be useful to detect angiographically undetectable MB. To investigate OCT characteristics of MB, 86 LAD vessels were imaged by OCT. MB was defined as presence of intermediate optical intensity, “fine” layer surrounding coronary artery by OCT. Frequency and characteristics of the angio-detectable and angio-undetectable but OCT-detectable MB were investigated. In a subset of patients with angio-detectable MB, cyclic changes in coronary arterial dimensions were analyzed. OCT detected MB in 44 of 86 (51%). Arc of the MB was significantly larger (334.8 ± 58.5 ...

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    3. Incidence and characteristics of incomplete stent apposition in calcified lesions: An optical coherence tomography study

      Incidence and characteristics of incomplete stent apposition in calcified lesions: An optical coherence tomography study

      Background: Persistent or late acquired incomplete stent apposition (ISA) may be associated with late or very late stent thrombosis following drug-eluting stent implantation. Presence of calcium at the target lesion may increase the risk of ISA even after rotational atherectomy (RA) followed by stenting with high pressure balloon inflation. The aim of this study is to examine the incidence and characteristics of ISA in heavily calcified lesions. Methods: A total of 52 heavily calcified coronary artery lesions requiring RA plus stenting were selected and studied. After successful ablation followed by stent implantation, optical coherence tomography (OCT) was performed to assess ...

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    4. Clinical Course of Optical Coherence Tomography-Detected Lipid-Rich Coronary Plaque After Optimal Medical Therapy

      Clinical Course of Optical Coherence Tomography-Detected Lipid-Rich Coronary Plaque After Optimal Medical Therapy

      Background: The aim of this study was to evaluate optical coherence tomography (OCT)-detected lipid-rich coronary plaques (LRCPs) with coronary computed tomography angiography (CCTA) 10 months after optimal medical therapy (OMT). Methods and Results: Baseline OCT detected 28 LRCPs in non-culprit lesions. High-risk plaque features (HRPFs), such as positive remodeling, very low attenuation plaques, napkin-ring sign, and spotty calcification, were observed in 67.9%, 67.9%, 21.4%, and 64.3% of LRCPs, respectively, at the 10-month follow-up CCTA. Lesions with ≥3 HRPFs were defined as high-risk LRCPs (n=12); the remaining were defined as low-risk LRCPs (n=16). The ...

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    5. Layered Plaque Characteristics and Layer Burden in Acute Coronary Syndromes

      Layered Plaque Characteristics and Layer Burden in Acute Coronary Syndromes

      Recently, layered plaque, an optical coherence tomography equivalent of healed plaque, has been gaining attention. However, detailed layered plaque characteristics including the burden of plaque layer have not been investigated. Patients with acute coronary syndromes who underwent preintervention optical coherence tomography imaging of culprit lesion were included. Layer index, a product of the mean layer arc and layer length, was correlated with the pattern of layer and culprit pathology. In addition, layer index was compared between culprit and nonculprit plaques. Finally, predictors for greater layer index were identified using general linear modeling. In 349 patients, 99 culprit plaques had layered ...

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    6. Optical Coherence Tomography of Plaque Vulnerability and Rupture: JACC Focus Seminar Part 1/3

      Optical Coherence Tomography of Plaque Vulnerability and Rupture: JACC Focus Seminar Part 1/3

      Plaque rupture is the most common cause of acute coronary syndromes and sudden cardiac death. Characteristics and pathobiology of vulnerable plaques prone to plaque rupture have been studied extensively over 2 decades in humans using optical coherence tomography (OCT), an intravascular imaging technique with micron scale resolution. OCT studies have identified key features of plaque vulnerability and described the in vivo characteristics and spatial distribution of thin cap fibroatheromas as major precursors to plaque rupture. In addition, OCT data supports the evolving understanding of coronary heart disease as a panvascular process associated with inflammation. In the setting of high atherosclerotic ...

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    7. Coronary plaque and clinical characteristics of South Asian (Indian) patients with acute coronary syndromes: An optical coherence tomography study

      Coronary plaque and clinical characteristics of South Asian (Indian) patients with acute coronary syndromes: An optical coherence tomography study

      Background South Asians, and Indians in particular, are known to have a higher incidence of premature atherosclerosis and acute coronary syndromes (ACS) with worse clinical outcomes, compared to populations with different ethnic backgrounds. However, the underlying pathobiology accounting for these differences has not been fully elucidated. Methods ACS patients who had culprit lesion optical coherence tomography (OCT) imaging were enrolled. Culprit plaque characteristics were evaluated using OCT. Results Among 1315 patients, 100 were South Asian, 1009 were East Asian, and 206 were White. South Asian patients were younger (South Asians vs. East Asians vs. Whites: 51.6 ± 13.4 vs ...

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    8. Clinical Impact of Irregular Protrusion Angle After Coronary Stenting at Culprit Lesions With ST-Elevation Myocardial Infarction - An Intravascular Optical Coherence Tomography Study

      Clinical Impact of Irregular Protrusion Angle After Coronary Stenting at Culprit Lesions With ST-Elevation Myocardial Infarction - An Intravascular Optical Coherence Tomography Study

      Background: A recent optical coherence tomography (OCT) registry showed that the presence of irregular protrusion (IP) after coronary stenting was a predictor of worse 1-year cardiovascular events. This study evaluated the clinical impact of OCT-detected IP after coronary stenting at ST-elevation myocardial infarction (STEMI) culprit lesions. Methods and Results: In all, 139 consecutive STEMI patients with OCT-detected IP after stenting were analyzed retrospectively. The maximum IP angles were measured and patients with IP were divided into 2 groups (large IP, maximum IP angle ≥180°; small IP, 0°<angle<180°). The primary endpoints were cardiac death, target vessel myocardial infarction, target ...

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    9. Prognostic Impact of Calcified Plaque Morphology After Drug Eluting Stent Implantation: An Optical Coherence Tomography Study

      Prognostic Impact of Calcified Plaque Morphology After Drug Eluting Stent Implantation: An Optical Coherence Tomography Study

      Background: Optical coherence tomography (OCT) has the potential to characterize the detailed morphology of calcified coronary plaques. This study examined the prognostic impact of calcified plaque morphology in patients with coronary artery calcification (CAC) who underwent newer-generation drug-eluting stent (DES) implantation.Methods and Results:In all, 251 patients with moderate to severe CAC who underwent OCT-guided DES implantation were reviewed retrospectively and divided into 3 groups according to OCT findings of the target lesion: 25 patients (10.0%) with calcified nodules (CN), 69 patients (27.5%) with calcified protrusion (CP) without CN, and 157 patients (62.5%) with superficial calcific ...

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    10. Post-Stent Optical Coherence Tomography Findings at Index Percutaneous Coronary Intervention - Characteristics Related to Subsequent Stent Thrombosis

      Post-Stent Optical Coherence Tomography Findings at Index Percutaneous Coronary Intervention - Characteristics Related to Subsequent Stent Thrombosis

      Background: The association between unfavorable post-stent optical coherence tomography (OCT) findings and subsequent stent thrombosis (ST) remains unclear. This study investigated the ST-related characteristics of post-stent OCT findings at index percutaneous coronary intervention (PCI).Methods and Results:Fifteen patients with ST onset after OCT-guided PCI (ST group) were retrospectively enrolled. Post-stent OCT findings in the ST group were compared with those in 70 consecutive patients (reference group) without acute coronary syndrome onset for at least 5 years after OCT-guided PCI. The incidence of acute myocardial infarction (AMI) was higher in the ST than reference group (60.0% vs. 17.1 ...

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    11. Predictors for Rapid Progression of Coronary Calcification: An Optical Coherence Tomography Study

      Predictors for Rapid Progression of Coronary Calcification: An Optical Coherence Tomography Study

      Background The role of coronary calcification in cardiovascular events and plaque stabilization is still being debated, and factors involved in the progression of coronary calcification are not fully understood. This study aimed to identify the predictors for rapid progression of coronary calcification. Methods and Results Patients with serial optical coherence tomography imaging at baseline and at 6 months were selected. Changes in the calcification index and predictors for progression of calcification were studied. Calcification index was defined as the product of the mean calcification arc and calcification length. Rapid progression of calcification was defined as an increase in the calcification ...

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    12. Optical Coherence Tomography Predictors for a Favorable Vascular Response to Statin Therapy

      Optical Coherence Tomography Predictors for a Favorable Vascular Response to Statin Therapy

      Background Specific plaque phenotypes that predict a favorable response to statin therapy have not been systematically studied. This study aimed to identify optical coherence tomography predictors for a favorable vascular response to statin therapy. Methods and Results Patients who had serial optical coherence tomography imaging at baseline and at 6 months were included. Thin‐cap area (defined as an area with fibrous cap thickness <200 μm) was measured using a 3‐dimensional computer‐aided algorithm, and changes in the thin‐cap area at 6 months were calculated. A favorable vascular response was defined as the highest tertile in the degree ...

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    13. Predictors of Rapid Plaque Progression: An Optical Coherence Tomography Study

      Predictors of Rapid Plaque Progression: An Optical Coherence Tomography Study

      Objectives This study sought to identify morphological predictors of rapid plaque progression. Background Two patterns of plaque progression have been described: slow linear progression and rapid step-wise progression. The former pattern will cause stable angina when the narrowing reaches a critical threshold, whereas the latter pattern may lead to acute coronary syndromes or sudden cardiac death. Methods Patients who underwent optical coherence tomography (OCT) imaging during the index procedure and follow-up angiography with a minimum interval of 6 months were selected. Nonculprit lesions with a diameter stenosis of ≥30% on index angiography were assessed. Lesion progression was defined as a ...

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    14. Spatial Distribution of Vulnerable Plaques: Comprehensive In Vivo Coronary Plaque Mapping

      Spatial Distribution of Vulnerable Plaques: Comprehensive In Vivo Coronary Plaque Mapping

      Objectives The authors performed a comprehensive analysis on the distribution of coronary plaques with different phenotypes from our 3-vessel optical coherence tomography (OCT) database. Background Previous pathology studies demonstrated that thin-cap fibroatheroma (TCFA) is localized in specific segments of the epicardial coronary arteries. A detailed description of in vivo coronary plaques of various phenotypes has not been reported. Methods OCT images of all 3 coronary arteries in 131 patients were analyzed every 1 mm to assess plaque phenotype and features of vulnerability. In addition, plaques were divided into tertiles according to percent area stenosis (%AS). Results Among 534 plaques identified ...

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    15. Effects of Fatty Acid Therapy in Addition to Strong Statin on Coronary Plaques in Acute Coronary Syndrome: An Optical Coherence Tomography Study

      Effects of Fatty Acid Therapy in Addition to Strong Statin on Coronary Plaques in Acute Coronary Syndrome: An Optical Coherence Tomography Study

      ACKGROUND Vascular healing response associated with adjunctive n‐3 polyunsaturated fatty acid therapy therapy in patients receiving strong statin therapy remains unclear. The aim of this study was to evaluate the effect of polyunsaturated fatty acid therapy with eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) in addition to strong statin therapy on coronary atherosclerotic plaques using optical coherence tomography. METHODS AND RESULTS This prospective multicenter randomized controlled trial included 130 patients with acute coronary syndrome treated with strong statins. They were assigned to either statin only (control group, n=42), statin+high‐dose EPA (1800 mg/day) (EPA group, n ...

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    16. Circadian variations in pathogenesis of ST-segment elevation myocardial infarction: an optical coherence tomography study

      Circadian variations in pathogenesis of ST-segment elevation myocardial infarction: an optical coherence tomography study

      Previous studies have reported a circadian variation in the onset of ST-segment elevation myocardial infarction (STEMI). However, underlying mechanisms for the circadian variation have not been fully elucidated. We investigated the relationship between onset of STEMI and the underlying pathology using optical coherence tomography (OCT). Patients with a diagnosis of STEMI were selected from a multicenter OCT registry. Patients were divided into 4 groups based on the estimated time of onset (00:00–05:59, 06:00–11:59, 12:00–17:59, or 18:00–23:59). Underlying pathologies of MI (plaque rupture, plaque erosion, and calcified plaque) were ...

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    17. Degree of luminal narrowing and composition of thrombus in plaque erosion

      Degree of luminal narrowing and composition of thrombus in plaque erosion

      As the degree of luminal narrowing increases, shear stress increases, and high shear stress is known to activate platelets. However, the relationship between the degree of luminal narrowing and the composition of thrombus in patients with plaque erosion has not been studied. A total of 148 patients with plaque erosion and thrombus detected by optical coherence tomography were divided into tertiles based on the minimum lumen area (MLA) at the culprit lesion. Thrombus was categorized as platelet-rich or fibrin-rich. Among 148 patients, 50 (34%) were in the mild stenosis group, 49 (33%) were in the moderate stenosis group, and 49 ...

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    18. Predictors for layered coronary plaques: an optical coherence tomography study

      Predictors for layered coronary plaques: an optical coherence tomography study

      Healed coronary plaques, morphologically characterized by a layered pattern, are signatures of previous plaque disruption and healing. Recent optical coherence tomography (OCT) studies showed that layered plaque is associated with vascular vulnerability. However, factors associated with layered plaques have not been studied. The aim of this study was to investigate predictors for layered plaque at the culprit plaques and at non-culprit plaques. Patients with coronary artery disease who underwent pre-intervention OCT imaging of the culprit lesion were included. Layered plaques were defined as plaques with one or more layers of different optical density and a clear demarcation from underlying components ...

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    19. COMPARISON OF POST STENT OPTICAL COHERENCE TOMOGRAPHY FINDINGS AMONG THREE SUBTYPES OF CALCIFIED CULPRIT PLAQUES IN PATIENTS WITH ACUTE CORONARY SYNDROME

      COMPARISON OF POST STENT OPTICAL COHERENCE TOMOGRAPHY FINDINGS AMONG THREE SUBTYPES OF CALCIFIED CULPRIT PLAQUES IN PATIENTS WITH ACUTE CORONARY SYNDROME

      Background Recently, three subtypes of calcified plaques at the culprit lesion were reported in patients with acute coronary syndrome (ACS): eruptive calcified nodule, superficial calcific sheet, and calcified protrusion. Methods A total of 157 patients with ACS and calcified plaque at the culprit lesion were selected from our database. Optical coherence tomography (OCT) findings at index procedure and after stent implantation were compared among the three subgroups. Results In the final analysis, 92 cases were included. Pre-procedural OCT showed eruptive calcified nodules in 20 (21.7%) cases, superficial calcific sheets in 66 (71.7%), and calcified protrusion in 6 (6 ...

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    20. Comprehensive In Vivo Coronary Plaque Mapping: A 3-Vessel Optical Coherence Tomography Study

      Comprehensive In Vivo Coronary Plaque Mapping: A 3-Vessel Optical Coherence Tomography Study

      Background Previous pathology studies demonstrated that thin-cap fibroatheroma (TCFA) is localized in specific segments of the epicardial coronary arteries. A detailed description of in vivo coronary plaques of various phenotypes has not been reported. Objectives We performed a comprehensive analysis on the distribution of coronary plaques with different phenotypes from our 3-vessel optical coherence tomography (OCT) database. Methods OCT images of all 3 coronary arteries in 131 patients were analyzed every 1 mm to assess plaque phenotype and features of vulnerability. In addition, plaques were divided into tertiles according to percent area stenosis (%AS). Results Among 534 plaques identified in ...

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    21. Comparison of post‐stent optical coherence tomography findings among three subtypes of calcified culprit plaques in patients with acute coronary syndrome

      Comparison of post‐stent optical coherence tomography findings among three subtypes of calcified culprit plaques in patients with acute coronary syndrome

      Objectives To compare the postprocedural optical coherence tomography (OCT) findings and in‐hospital outcomes among the three subtypes of calcified plaques: eruptive calcified nodules, superficial calcific sheet, and calcified protrusion. Background Recently, three subtypes of calcified culprit plaques were reported in patients with acute coronary syndrome (ACS). How these subtypes respond to stenting is unknown. Methods ACS patients with calcified plaque at the culprit lesion were selected from our database. OCT findings at baseline and after stent implantation were compared. Results In the final analysis, 87 cases were included. Preprocedural OCT showed eruptive calcified nodules in 19 (21.8%) cases ...

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    22. Characteristics of non-culprit plaques in acute coronary syndrome patients with layered culprit plaque

      Characteristics of non-culprit plaques in acute coronary syndrome patients with layered culprit plaque

      Aims  Layered plaques represent signs of previous plaque destabilization. A recent study showed that acute coronary syndrome (ACS) patients with layered culprit plaque have more vulnerability at the culprit lesion and systemic inflammation. We aimed to compare the characteristics of non-culprit plaques between patients with or without layered plaque at the culprit lesion. We also evaluated the characteristics of layered non-culprit plaques, irrespective of culprit plaque phenotype. Methods and results We studied ACS patients who had undergone pre-intervention optical coherence tomography (OCT) imaging. The number of non-culprit lesions was evaluated on coronary angiogram and morphological characteristics of plaques were studied ...

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    23. Usefulness of longitudinal reconstructed optical coherence tomography images for predicting the need for the reverse wire technique during coronary bifurcation interventions

      Usefulness of longitudinal reconstructed optical coherence tomography images for predicting the need for the reverse wire technique during coronary bifurcation interventions

      Objectives The aim is to investigate the usefulness of longitudinal reconstructed optical coherence tomography (OCT) images in selecting the reverse wire (RW) technique for inserting a guidewire into a side branch (SB). Background It is sometimes necessary to protect the SB with a guidewire to prevent SB complications in PCI for bifurcation lesions. The RW is a novel method for guidewire insertion into an extremely angulated SB when the standard antegrade wire (AW) approach is difficult. Methods This retrospective study included 46 consecutive patients who underwent OCT‐guided PCI in bifurcation lesions with significant SB stenosis. Patients were divided into ...

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    24. Plaque modification of severely calcified coronary lesions by scoring balloon angioplasty using Lacrosse non-slip element: insights from an optical coherence tomography evaluation

      Plaque modification of severely calcified coronary lesions by scoring balloon angioplasty using Lacrosse non-slip element: insights from an optical coherence tomography evaluation

      Percutaneous coronary intervention (PCI) for heavily calcified lesions is challenging because these lesions are resistant to balloon dilatation and stenting. Lacrosse non-slip element (NSE) may have the potential to dilate heavily calcified lesions. We aimed to investigate predictors of successful lesion modification using Lacrosse NSE angioplasty via optical coherence tomography (OCT)-guided PCI. We investigated 32 patients with severe target lesion calcification treated with OCT-guided PCI. Successful lesion modification was defined as the complete fracture of calcification after Lacrosse NSE angioplasty. Before PCI, 172 segments with calcification were identified. After pre-dilatation using Lacrosse NSE, successful lesion modification was achieved in ...

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    1-24 of 69 1 2 3 »
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