1. Articles from Thomas W. Johnson

    1-11 of 11
    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 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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    3. The role of optical coherence tomography in the setting of acute myocardial infarction

      The role of optical coherence tomography in the setting of acute myocardial infarction

      In recent years, intravascular imaging-guided percutaneous coronary intervention (PCI) has been increasing in patients with acute myocardial infarction (AMI). However, the role of optical coherence tomography (OCT) has not been established in the setting of AMI despite OCT providing superior resolution (10 μm axial resolution) and facilitating assessment of baseline lesion characteristics and post-intervention evaluation of the acute result of stent implantation, including visualization of procedural dissections, malapposition, tissue prolapse, and thrombus. We provide an overview of the potential benefits of OCT-guidance in various situations of AMI

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    4. A new technique for lipid core plaque detection by optical coherence tomography for prevention of peri-procedural myocardial infarction: A case report

      A new technique for lipid core plaque detection by optical coherence tomography for prevention of peri-procedural myocardial infarction: A case report

      Rationale: Percutaneous coronary intervention (PCI) provides effective revascularization of atherosclerotic coronary arteries but the invasive nature of treatment can result in complications. Patient concerns: A 53-year old man underwent coronary angiography due to chest pain with minimal ST-segment elevation in the inferior leads of the electrocardiogram. Diagnosis: We proceeded directly to coronary angiography and delineated a moderate stenosis with haziness in the mid right coronary artery (RCA). Interventions: Expert analysis of the pre-intervention OCT imaging demonstrated a large lipid core plaque (LCP), upstream of the culprit site, with minimal thrombus burden. Subsequent implantation of a bioresorbable vascular scaffold, protected with ...

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    5. The role of optical coherence tomography in decision making during the acute phase of spontaneous coronary artery dissection

      The role of optical coherence tomography in decision making during the acute phase of spontaneous coronary artery dissection

      A 69-year-old woman with a history of treated hypertension, presented with sudden onset chest pain, at rest, and evidence of ST-segment elevation in the inferior leads of a 12-lead electrocardiogram. Urgent coronary angiography demonstrated an abrupt lumen calibre reduction extending from segment 2 of the right coronary artery (RCA) into the posterior descending artery, with preserved Thrombolysis In Myocardial Infarction (TIMI) 3 flow ( Fig. 1 A ). The postero-lateral branch of the RCA was sub-totally occluded. Having confirmed patency of the infarct-related artery and complete resolution of the patient's symptoms, we proceeded to evaluate the RCA with OCT. We demonstrated ...

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    6. Optical coherence tomography attenuation imaging for lipid core detection: an ex-vivo validation study

      Optical coherence tomography attenuation imaging for lipid core detection: an ex-vivo validation study

      Lipid-core atherosclerotic plaques are associated with disease progression, procedural complications, and cardiac events. Coronary plaque lipid can be quantified in optical coherence tomography (OCT) pullbacks by measurement of lipid arcs and lipid lengths; parameters frequently used in clinical research, but labor intensive and subjective to analyse. In this study, we investigated the ability of quantitative attenuation, derived from intravascular OCT, to detect plaque lipid. Lipid cores are associated with a high attenuation coefficient. We compared the index of plaque attenuation (IPA), a local quantitative measure of attenuation, to the manually measured lipid score (arc and length) on OCT images, and ...

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    7. Development of Tissue Characterization Using Optical Coherence Tomography for Defining Coronary Plaque Morphology and the Vascular Responses After Coronary Stent Implantation

      Development of Tissue Characterization Using Optical Coherence Tomography for Defining Coronary Plaque Morphology and the Vascular Responses After Coronary Stent Implantation

      Cardiovascular disease is associated with a high burden of mortality secondary to acute coronary events. Assessment for vulnerable plaque and an understanding of the etiology of stent failure by intravascular imaging may facilitate a greater understanding of the underlying processes responsible for adverse clinical outcomes and guide future therapy. This review focuses on the role of optical coherence tomography in tissue characterization and highlights future advances within the field providing potential enhancement of image interpretation.

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    8. Effect of temperature and fixation on the optical properties of atherosclerotic tissue: a validation study of an ex-vivo whole heart cadaveric model

      Effect of temperature and fixation on the optical properties of atherosclerotic tissue: a validation study of an ex-vivo whole heart cadaveric model

      Atherosclerotic plaque composition can be imaged using the optical attenuation coefficient derived from intravascular optical coherence tomography (OCT) data. The relation between optical properties and tissue type has been established on autopsy tissues. In this study, we validate an ex-vivo model for the effect of temperature and tissue fixation on optical parameters. We studied the optical attenuation of human coronary arteries at three temperatures, before and after formalin fixation. We developed an en-face longitudinal display of attenuation data of the OCT pullbacks. Using the unfixed, body-temperature condition image as a standard, and after extensive registration with other condition images, we ...

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    9. Dynamic separation of coronary artery medial and adventitial layers with vasospasm: New insights using OCT

      Dynamic separation of coronary artery medial and adventitial layers with vasospasm: New insights using OCT

      A 46year-old lady with raised body mass index but no other risk factors for coronary artery disease, presented with sudden onset of chest pain at rest and evidence of ST segment elevation in the inferior leads. Immediate angiography with intracoronary administration of nitrates demonstrated a long segment of tubular stenosis extending from the mid right coronary artery (RCA) into the posterior descending artery with preservation of Thrombolysis In Myocardial Infarction (TIMI) 3 flow. Confirmation of TIMI-3 flow with settling of the patient's symptoms led to a decision to treat conservatively, with interval angiography and intravascular imaging. The index presentation ...

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    10. Spontaneous Multivessel Coronary Intramural Hematoma: An Insight With OCT

      Spontaneous Multivessel Coronary Intramural Hematoma: An Insight With OCT

      Spontaneous coronary arterial intramural hematoma is a rarely diagnosed cause of acute myocardial infarction. The underlying pathophysiology is poorly understood. A historical series of intramedial dissecting hematomas, published in 1965 ( 1 ), postulated that rupture of the vasa vasorum or cystic medial necrosis, as described in the aorta by Erdheim ( 2 ), could be the precipitant. The appearance of angiographic luminal obstruction, without intravascular imaging to investigate its etiology, is likely to have contributed to an under-reporting of this phenomenon. A small number of case reports document intramural hematoma by intravascular ultrasound; however, the limited resolution of intravascular ultrasound may preclude accurate ...

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    11. Catheter-induced coronary dissection during optical coherence tomography investigation

      Catheter-induced coronary dissection during optical coherence tomography investigation
      A 58-year-old lady presented with atypical chest pain, anterior ECG changes and troponin elevation. Coronary angiography, via the radial artery, delineated unobstructed righ and circumflex coronaries but ectasia and delayed contrast clearance within the mid-LAD, suggestive of spontaneous coronary dissection. An OCT study was undertaken to confirm diagnosis.
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    1-11 of 11
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    Catheter-induced coronary dissection during optical coherence tomography investigation Spontaneous Multivessel Coronary Intramural Hematoma: An Insight With OCT Dynamic separation of coronary artery medial and adventitial layers with vasospasm: New insights using OCT Effect of temperature and fixation on the optical properties of atherosclerotic tissue: a validation study of an ex-vivo whole heart cadaveric model Development of Tissue Characterization Using Optical Coherence Tomography for Defining Coronary Plaque Morphology and the Vascular Responses After Coronary Stent Implantation Optical coherence tomography attenuation imaging for lipid core detection: an ex-vivo validation study The role of optical coherence tomography in decision making during the acute phase of spontaneous coronary artery dissection A new technique for lipid core plaque detection by optical coherence tomography for prevention of peri-procedural myocardial infarction: A case report The role of optical coherence tomography in the setting of acute myocardial infarction 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 Postdoctoral Associate Position at Duke Vision and Image Processing Laborator Anterior segment optical coherence tomography angiography