1. Articles from Koji Kato

    1-24 of 27 1 2 »
    1. Serial observation of a calcified nodule by optical coherence tomography

      Serial observation of a calcified nodule by optical coherence tomography

      The three most common underlying mechanisms of acute coronary syndrome (ACS) are believed to be plaque rupture, plaque erosion and, least common, a calcified nodule. Although treatment of ACS mainly consists of catheter-based reperfusion using a coronary stent, it remains under discussion whether deployment of a coronary stent is necessary for a culprit calcified nodule, particularly when coronary flow is preserved. A 75-year-old man with ST-elevation myocardial infarction (STEMI) was referred to our hospital. He had a history of hypertension and dyslipidaemia. Emergency coronary angiography revealed a moderately stenotic lesion in the mid left anterior descending coronary artery (LAD) with ...

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      Mentions: Koji Kato
    2. Target lesion evaluation by multiple modalities in vivo: near-infrared spectroscopy (NIRS), virtual histology intravascular ultrasound, optical coherence tomography, and angioscopy

      Target lesion evaluation by multiple modalities in vivo: near-infrared spectroscopy (NIRS), virtual histology intravascular ultrasound, optical coherence tomography, and angioscopy

      A 60-year-old man presented with ischaemic heart failure. We conducted coronary angiography (CAG) after improvement of the heart failure. On CAG, there was a hazy stenosis in the proximal left anterior descending artery (Figure 1, Moving image 1) . The lesion was observed by four modalities: near-infrared spectroscopy (NIRS), virtual histology intravascular ultrasound (VH-IVUS), optical coherence tomography (OCT), and angioscopy. NIRS detected lipid core plaque with echolucency on greyscale IVUS. VH-IVUS showed necrotic core plaque (Figure 1, Moving image 1) . OCT showed lipid-rich plaque, and angioscopy showed yellow intima (Figure 1, Moving image 1) . All modalities could detect lipid content and ...

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    3. Identification of Intrastent Pathology Associated With Late Stent Thrombosis Using Optical Coherence Tomography

      Identification of Intrastent Pathology Associated With Late Stent Thrombosis Using Optical Coherence Tomography

      Objective To better characterize intrastent pathology using optical coherence tomography (OCT) in patients presenting with late and very late stent thrombosis (LST/VLST). Background The contribution of specific intrastent pathologies to the development of LST/VLST is not well understood. Methods In this single-center, retrospective, observational study of 796 consecutive patients treated for ST-segment elevation myocardial infarction (STEMI) with primary PCI we identified 57 patients (7.2%) in whom STEMI resulted from LST/VLST. Of the patients with LST/VLST, 21 patients (37%) had OCT performed at the discretion of the operator during PCI for LST/VLST. Independent reviewers performed ...

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    4. Comparison by Optical Coherence Tomography of the Frequency of Lipid Coronary Plaques in Current Smokers, Former Smokers, and Non-smokers

      Comparison by Optical Coherence Tomography of the Frequency of Lipid Coronary Plaques in Current Smokers, Former Smokers, and Non-smokers

      Smoking is associated with high incidence of cardiovascular events including acute coronary syndrome (ACS). We sought to characterize coronary plaques in patients with ongoing smoking using optical coherence tomography (OCT) compared to former smokers and nonsmokers. We identified 465 coronary plaques from 182 subjects who underwent OCT imaging for all three coronary arteries. Subjects were divided into 3 groups: current smokers (n=41), former smokers (n=67) and nonsmokers (n=74). OCT analysis included the presence of lipid rich plaque, thin-cap fibroatheroma (TCFA), calcification, maximum lipid arc, lipid core length, lipid index, and fibrous cap thickness (FCT). Lipid index was ...

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    5. Comprehensive overview of definitions for optical coherence tomography-based plaque and stent analyses

      Comprehensive overview of definitions for optical coherence tomography-based plaque and stent analyses

      Optical coherence tomography (OCT) is the current state-of-the-art intracoronary imaging modality that allows visualization of detailed morphological characteristics of both atherosclerotic plaque and stent. So far, three expert review documents have been released for standardization of OCT image analysis. In the real world, a variety of definitions are being used by different groups and by different core laboratories to analyze OCT findings because of different clinical/procedural contexts in which OCT research has been carried out. This comprehensive overview is aimed to summarize different applicable definitions used by different research groups in plaque and stent analysis using OCT. In addition ...

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    6. Pancoronary Plaque Vulnerability in Patients with Acute Coronary Syndrome and Ruptured Culprit Plaque: A Three-Vessel Optical Coherence Tomography Study

      Pancoronary Plaque Vulnerability in Patients with Acute Coronary Syndrome and Ruptured Culprit Plaque: A Three-Vessel Optical Coherence Tomography Study

      Background Recent studies described different clinical and underlying plaque characteristics between patients with and without plaque rupture presenting with acute coronary syndrome (ACS). In light of the systemic nature of atherosclerosis, we hypothesized that non-culprit plaques might also express different morphological features in these two groups of patients. Methods Thirty-eight patients with ACS who underwent 3-vessel optical coherence tomography (OCT) imaging were identified from the Massachusetts General Hospital OCT Registry. Based on culprit plaque morphology, the study population was divided into two groups: patients with plaque rupture at the culprit lesion (Group 1), and patients with non-ruptured plaque at the ...

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    7. Features of Coronary Plaque in Patients with Metabolic Syndrome and Diabetes Mellitus Assessed by 3-vessel Optical Coherence Tomography

      Features of Coronary Plaque in Patients with Metabolic Syndrome and Diabetes Mellitus Assessed by 3-vessel Optical Coherence Tomography

      Background —The pathophysiologic basis for the association between metabolic syndrome (MetS) and coronary artery disease is not well understood. We sought to characterize coronary plaques in patients with MetS using optical coherence tomography (OCT). Methods and Results —We identified 451 coronary plaques from 171 subjects who underwent OCT imaging in three coronary arteries. Subjects were divided into 3 groups: diabetes mellitus (DM, n=77), MetS (n=35), and a control group (C group, n=59) without DM or MetS. OCT analysis included the presence of lipid-rich plaque, maximum lipid arc, lipid-core length (LL), lipid index (LI), fibrous cap thickness (FCT ...

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    8. Feature Of The Week 8/4/13: MGH OCT Registry Reports on In Vivo OCT Studies of Plaque Erosion and Calcified Nodule In Acute Coronary Syndrome

      Feature Of The Week 8/4/13: MGH OCT Registry Reports on In Vivo OCT Studies of Plaque Erosion and Calcified Nodule In Acute Coronary Syndrome

      Pathology studies reported that three most common causes of acute coronary syndrome (ACS) or sudden cardiac death are plaque rupture, plaque erosion and calcified nodules. The morphological and clinical characteristics of the underlying pathology of ACS, especially plaque erosion and calcified nodule, have never been well studied in vivo. Using optical coherence tomography, we found that plaque erosions are the substrate for ACS in 31% of patients and calcified nodules in 8% of patients, which are consistent with pathological findings. Erosions are more likely to cause non-ST-segment elevation ACS than ST-segment elevation myocardial infarction. Compared to plaque rupture, plaque erosion ...

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    9. Correlation Between Degree of Neointimal Hyperplasia and Incidence and Characteristics of Neoatherosclerosis as Assessed by Optical Coherence Tomography

      Correlation Between Degree of Neointimal Hyperplasia and Incidence and Characteristics of Neoatherosclerosis as Assessed by Optical Coherence Tomography

      Emerging evidence suggests that neointimal degenerative changes with development of neoatherosclerosis (NA) may represent an important mechanism for late stent failure. The aim of the present study was to investigate the relation between degree of neointimal hyperplasia and incidence and characteristics of NA using optical coherence tomography. We identified a total of 252 stents with mean neointimal thickness (NIT) >100 μm in 212 patients: 100 bare metal stents (BMSs) and 152 drug-eluting stents (DESs). Based on the values of mean NIT, we divided stents into tertiles and compared neointimal characteristics among the 3 groups. NA was defined as the presence ...

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    10. Optical Coherence Tomography – 15 Years in Cardiology –

      Optical Coherence Tomography – 15 Years in Cardiology –

      Since its invention in the late 1990s, intravascular optical coherence tomography (OCT) has been rapidly adopted in clinical research and, more recently, in clinical practice. Given its unprecedented resolution and high image contrast, OCT has been used to visualize plaque characteristics and to evaluate the vascular response to percutaneous coronary intervention. In particular, OCT is becoming the standard modality to evaluate in vivo plaque vulnerability, including the presence of lipid content, thin fibrous cap, or macrophage accumulation. Furthermore, OCT findings after stent implantation, such as strut apposition, neointimal hyperplasia, strut coverage, and neoatherosclerosis, are used as surrogate markers of the ...

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    11. In Vivo Diagnosis of Plaque Erosion and Calcified Nodule in Patients with Acute Coronary Syndrome by Intravascular Optical Coherence Tomography

      In Vivo Diagnosis of Plaque Erosion and Calcified Nodule in Patients with Acute Coronary Syndrome by Intravascular Optical Coherence Tomography

      Objectives To characterize the morphological features of plaque erosion and calcified nodule in patients with acute coronary syndrome (ACS) by optical coherence tomography (OCT). Background Plaque erosion and calcified nodule have not been systematically investigated in vivo . Methods One hundred and twenty-six patients with ACS who had undergone pre-intervention OCT imaging were included. The culprit lesions were classified as plaque rupture (PR), erosion (OCT-erosion), calcified nodule (OCT-CN), or others using a new set of diagnostic criteria for OCT. Results The incidences of PR, OCT-erosion, and OCT-CN were 43.7%, 31.0%, and 7.9%, respectively. Patients with OCT-erosion were the ...

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    12. Comparison of near-infrared spectroscopy and optical coherence tomography for detection of lipid

      Comparison of near-infrared spectroscopy and optical coherence tomography for detection of lipid

      Objectives: To compare intra-coronary near-infrared spectroscopy (NIRS) and optical coherence tomography (OCT) for the detection of lipid, also to identify NIRS signals to differentiate superficial lipid, and to characterize the plaque with yellow block chemograms on NIRS. Background: Intra-coronary NIRS has been developed to detect lipid core plaque (LCP). Methods: We investigated a total of 17 patients who underwent both OCT and NIRS. NIRS analysis included plaque lipid core burden index (LCBI), LCP length, and the presence of yellow block (YB) on the block chemogram. OCT analysis included maximum lipid arc (LA), the length of lipid (LL), lipid index, and ...

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    13. Comparison of zotarolimus-eluting stent and everolimus-eluting stent for vascular healing response: serial 3-month and 12-month optical coherence tomography study

      Comparison of zotarolimus-eluting stent and everolimus-eluting stent for vascular healing response: serial 3-month and 12-month optical coherence tomography study

      Background: Everolimus-eluting stents (EES) have shown favorable clinical outcomes. However, there have been no studies evaluating early vascular response after EES implantation. We designed a prospective study to compare the neointimal response between zotarolimus-eluting stents (ZES) and EES at 3 and 12 months using serial optical coherence tomography examinations. Methods and results: Sixty patients who underwent 3-month and 12-month follow-up optical coherence tomography (36 EES, 24 ZES) were included. Neointimal coverage and malapposition were evaluated using a strut-based analysis at both 3 and 12 months. Neointimal hyperplasia area and thrombus were assessed. ZES showed a higher incidence of covered struts ...

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    14. Nonculprit Coronary Plaque Characteristics of Chronic Kidney Disease

      Nonculprit Coronary Plaque Characteristics of Chronic Kidney Disease

      Background— Chronic kidney disease (CKD) promotes the development of atherosclerosis and increases the risk of cardiovascular disease. The aim of the present study was to compare the coronary plaque characteristics of patients with and without CKD using optical coherence tomography. Methods and Results— We identified 463 nonculprit plaques from 287 patients from the Massachusetts General Hospital (MGH) optical coherence tomography registry. CKD was defined as estimated glomerular filtration rate <60 mL/min per 1.73 m 2 . A total of 402 plaques (250 patients) were in the non-CKD group and 61 plaques (37 patients) were in the CKD group. Compared ...

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    15. Non-Culprit Coronary Plaque Characteristics of Chronic Kidney Disease

      Non-Culprit Coronary Plaque Characteristics of Chronic Kidney Disease

      Background —Chronic kidney disease (CKD) promotes the development of atherosclerosis and increases the risk of cardiovascular disease. The aim of the present study was to compare the coronary plaque characteristics of patients with and without CKD using optical coherence tomography (OCT). Methods and Results —We identified 463 non-culprit plaques from 287 patients from the MGH OCT Registry. CKD was defined as estimated glomerular filtration rate (eGFR) < 60ml/min/1.73m 2 . 402 plaques (250 patients) were in the non-CKD group and 61 plaques (37 patients) were in the CKD group. Compared to non-CKD plaques, plaques with CKD had a larger ...

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    16. Evaluation of culprit lesions by optical coherence tomography in patients with ST-elevation myocardial infarction

      Evaluation of culprit lesions by optical coherence tomography in patients with ST-elevation myocardial infarction

      Optical coherence tomography (OCT) is a high-resolution imaging modality using a light source with a near-infrared spectrum that allows the characterization of atherosclerotic plaques in vivo . OCT is not able to image coronary arteries in the presence of blood, due to scattering and attenuation of light by red blood cells. While this problem is easily overcome by displacing blood with contrast or Dextran, the presence of erythrocyte-rich thrombus still remains an obstacle for the visualization of underlying plaque. This limitation is particularly relevant in patients with ST-elevation myocardial infarction (STEMI), usually presenting with high thrombotic burden at the site of ...

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    17. Lipid rich plaque, female gender and proximal coronary stent edge dissections

      Lipid rich plaque, female gender and proximal coronary stent edge dissections

      We hypothesized that women are more prone to develop coronary dissections during PCI due to potential balloon-oversizing or gender specific plaque and vascular characteristics. To date, a gender related difference in edge dissection has not been systematically studied. The Massachusetts General Hospital Optical Coherence Tomography (MGH OCT) Registry is an international registry of patients undergoing OCT procedures. We identified 206 consecutive patients (159 men, 47 women) with stable or unstable coronary syndromes demonstrating adequate OCT images for gender specific comparison in areas of non-overlapping stents. Presence of proximal edge dissection, its characteristics, plaque composition at stent borders and luminal diameters ...

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    18. In vivo comparison of lumen dimensions measured by time domain-, and frequency domain-optical coherence tomography, and intravascular ultrasound

      In vivo comparison of lumen dimensions measured by time domain-, and frequency domain-optical coherence tomography, and intravascular ultrasound

      Lumen dimensions measured by time-domain optical coherence tomography (TD-OCT) may be influenced by the hemodynamic effect of proximal balloon occlusion. Frequency-domain OCT (FD-OCT) does not require the interruption of blood flow. Therefore, we compared the coronary lumen dimensions measured by TD-OCT, FD-OCT, and intravascular ultrasound (IVUS) in both stented and non-stented segments. Twenty patients who underwent both IVUS and OCT imaging (10 for TD- and 10 for FD-OCT) after stent implantation were included. The maximum, minimum, and mean diameters and areas were measured at the proximal and distal stent edges, as well as 3 mm inside and 5 mm outside ...

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    19. Comparison of Nonculprit Coronary Plaque Characteristics Between Patients With and Without Diabetes : A 3-Vessel Optical Coherence Tomography Study

      Comparison of Nonculprit Coronary Plaque Characteristics Between Patients With and Without Diabetes : A 3-Vessel Optical Coherence Tomography Study

      Objectives The aim of the present study was to compare the characteristics of nonculprit coronary plaques between diabetes mellitus (DM) and non-DM patients using 3-vessel optical coherence tomography (OCT) imaging. Background DM patients have a higher recurrent cardiovascular event rate. Methods Patients who had undergone 3-vessel OCT imaging were identified from the Massachusetts General Hospital OCT Registry. Characteristics of nonculprit plaques were compared between DM and non-DM patients. Results A total of 230 nonculprit plaques were identified in 98 patients. Compared with non-DM patients, DM patients had a larger lipid index (LI) (averaged lipid arc × lipid length; 778.6 ± 596 ...

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    20. Reproducibility of In Vivo Measurements for Fibrous Cap Thickness and Lipid Arc by OCT

      Reproducibility of In Vivo Measurements for Fibrous Cap Thickness and Lipid Arc by OCT

      Thin fibrous cap and lipid pool are thought to be major determinants of plaque instability. However, current imaging modalities such as angiography, intravascular ultrasound, and angioscopy do not have sufficient resolution to accurately measure them. It is widely accepted that optical coherence tomography (OCT) is the in vivo “gold standard” imaging modality for the measurement of fibrous cap thickness. However, its reproducibility has never been systematically studied. Therefore, we attempted a systematic investigation of interobserver agreement and intraobserver reproducibility of fibrous cap thickness and lipid arc measurements. Fifty frames and 25 pullback runs of OCT were randomly selected for frame ...

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    21. Significance of intraplaque neovascularisation for vulnerability: optical coherence tomography study

      Significance of intraplaque neovascularisation for vulnerability: optical coherence tomography study

      Objectives This study aimed to investigate the role of intraplaque neovascularisation (NV) in culprit lesions and non-culprit lesions of unstable angina pectoris (UAP) and in lesions of stable angina pectoris (SAP) using optical coherence tomography (OCT). Design This study was a retrospective study. Setting The significance of NV for culprit and non-culprit plaques remains unclear. Participants A total of 356 plaques from 92 UAP patients and 25 SAP patients who underwent OCT imaging were divided into three groups: culprit lesions in UAP (92), non-culprit lesions in UAP (203) and lesions of SAP (61). Main outcome measures NV and plaque characteristics ...

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    22. Predictors for Neoatherosclerosis: A Retrospective Observational Study from the Optical Coherence Tomography Registry

      Predictors for Neoatherosclerosis: A Retrospective Observational Study from the Optical Coherence Tomography Registry

      Background—Recent studies have reported development of neoatherosclerosis (NA) inside the stents several years after stent implantation. The aim of this study was to determine the predictors for NA using optical coherence tomography (OCT). Methods and Results—From a total of 1080 patients who underwent OCT, we identified 179 stents in 151 patients in which the mean neointimal thickness was >100 μm. The presence of lipid-laden neointima or calcification inside the stents was defined as NA in the present study. Patient characteristics, stent type, and time since stent implantation (stent age) were compared between stents with or without NA. Univariable ...

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    23. Comparison of Incidence and Time Course of Neoatherosclerosis Between Bare Metal Stents and Drug-Eluting Stents Using Optical Coherence Tomography

      Comparison of Incidence and Time Course of Neoatherosclerosis Between Bare Metal Stents and Drug-Eluting Stents Using Optical Coherence Tomography

      Recent studies have reported the development of neoatherosclerosis inside stents and subsequent acute coronary syndrome secondary to disruption of neointimal hyperplasia. The aim of the study was to compare the characteristics of neointimal hyperplasia and its time course between bare metal stents (BMSs) and drug-eluting stents (DESs) using optical coherence tomography. A total of 138 stents were divided into 3 groups according to the follow-up period: early phase, <9 months (25 BMSs and 27 DESs); intermediate phase, ≥9 and <48 months (18 BMSs and 43 DESs); and delayed phase, ≥48 months (13 BMSs and 12 DESs). Optical coherence tomographic analysis ...

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    1-24 of 27 1 2 »
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