1. Articles from Ziad A. Ali

    1-24 of 29 1 2 »
    1. In-Stent Restenosis Lesion Morphology Related to Repeat Stenting Underexpansion as Evaluated by Optical Coherence Tomography

      In-Stent Restenosis Lesion Morphology Related to Repeat Stenting Underexpansion as Evaluated by Optical Coherence Tomography

      Aims: To use optical coherence tomography (OCT) to predict newly implanted stent expansion for treatment of in-stent restenosis (ISR). Methods and results: With OCT-guidance, 143 ISR lesions were treated with a new stent. Stent underexpansion was defined as minimum stent area (MSA) <4.5mm 2 and MSA/average of reference lumen area <70%. New stent underexpansion was found in 33 lesions (23%), had a smaller old stent MSA (4.13 [3.32-4.62] versus 5.18 [4.01-6.38] mm 2 , p=0.001), and had a higher prevalence of multiple old stent layers (51.5% versus 10.9%, p ...

      Read Full Article
    2. The “Oculo‐Appositional Reflex”: Should Optical Coherence Tomography–Detected Stent Malapposition Be Corrected?

      The “Oculo‐Appositional Reflex”: Should Optical Coherence Tomography–Detected Stent Malapposition Be Corrected?

      Stent malposition, recognized as an entity with the advent of intravascular imaging, refers to the lack of full contact between stent struts and the vessel wall after percutaneous coronary intervention ( Figure ). Malapposition may be present immediately after placement of stents (acute stent malapposition), or it may develop later (late stent malapposition), which can, in turn, be categorized as late persistent malapposition (ongoing since the time of implantation) or late acquired malapposition (developing de novo during follow‐up). 1

      Read Full Article
    3. Covering our tracks – optical coherence tomography to assess vascular healing

      Covering our tracks – optical coherence tomography to assess vascular healing

      Over the better part of two decades, lessons learned from stent failure have led to technical advances that have resulted in current-generation metallic drug-eluting stents (DES) with very low rates of target lesion failure (TLF) and stent thrombosis 1 . Continued efforts have been directed at achieving iterative improvements in the design of DES to enhance adaptive vascular healing following vascular injury. By promoting early strut coverage with minimal neointimal hyperplasia but a functioning endothelial layer, stent thrombosis may be minimised and, by reducing the inflammatory response to the foreign

      Read Full Article
    4. A prospective, single‐center, randomized study to assess whether automated coregistration of optical coherence tomography with angiography can reduce geographic miss

      A prospective, single‐center, randomized study to assess whether automated coregistration of optical coherence tomography with angiography can reduce geographic miss

      Objective We sought to evaluate whether automated coregistration of optical coherence tomography (OCT) with angiography reduces geographic miss (GM) during coronary stenting. Background Previous intravascular ultrasound or OCT studies have showed that residual disease at the stent edge or stent edge dissection was associated with stent thrombosis or edge restenosis. This has been termed GM. Methods Two hundred de novo coronary lesions were randomized in a 1:1 ratio to OCT‐guided percutaneous coronary intervention (PCI) with versus without automated coregistration of OCT with angiography. GM, the primary endpoint, was defined as angiographic ≥type B dissection or diameter stenosis >50 ...

      Read Full Article
    5. Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography

      Effect of orbital atherectomy in calcified coronary artery lesions as assessed by optical coherence tomography

      Objectives We sought to assess plaque modification and stent expansion following orbital atherectomy (OA) for calcified lesions using optical coherence tomography (OCT). Background The efficacy of OA for treating calcified lesions is not well studied, especially using intravascular imaging in vivo. Methods OCT was performed preprocedure, post‐OA, and post‐stent ( n  = 58). Calcium modification after OA was defined as a round, concave, polished calcium surface. Calcium fracture was complete discontinuity of calcium. Results Comparing pre‐ vs post‐OA OCT ( n  = 29), calcium area was significantly decreased post‐OA (from 3.4 mm 2 [2.4–4.7] to 2 ...

      Read Full Article
      Mentions: Gary S. Mintz
    6. Algorithmic Approach for Optical Coherence Tomography–Guided Stent Implantation During Percutaneous Coronary Intervention

      Algorithmic Approach for Optical Coherence Tomography–Guided Stent Implantation During Percutaneous Coronary Intervention

      Intravascular imaging plays a key role in optimizing outcomes for percutaneous coronary intervention (PCI). Optical coherence tomography (OCT) utilizes a user-friendly interface and provides high-resolution images. OCT can be used as part of daily practice in all stages of a coronary intervention: baseline lesion assessment, stent selection, and stent optimization. Incorporating a standardized, algorithmic approach when using OCT allows for precision PCI.

      Read Full Article
    7. Bifurcation and Ostial Optical Coherence Tomography Mapping (BOOM) – Case Description of a Novel Bifurcation Stent Technique

      Bifurcation and Ostial Optical Coherence Tomography Mapping (BOOM) – Case Description of a Novel Bifurcation Stent Technique

      Stent placement guided by angiography alone is often inexact, but of increased importance with bifurcation percutaneous coronary intervention (PCI). We describe a novel technique using optical coherence tomography (OCT)-guided angiographic co-registration termed “Bifurcation and Ostial OCT Mapping” (BOOM). The technique is based on the precise identification and mapping of the side-branch ostium using co-registration to minimize protrusion of stent struts into the main branch while ensuring full coverage of the ostium in the side-branch.

      Read Full Article
    8. Utility of intracoronary imaging in the cardiac catheterization laboratory: comprehensive evaluation with intravascular ultrasound and optical coherence tomography

      Utility of intracoronary imaging in the cardiac catheterization laboratory: comprehensive evaluation with intravascular ultrasound and optical coherence tomography

      Background Intracoronary imaging is an important tool for guiding decision making in the cardiac catheterization laboratory. Sources of data We have reviewed the latest available evidence in the field to highlight the various potential benefits of intravascular imaging. Areas of agreement Coronary angiography has been considered the gold standard test to appropriately diagnose and manage patients with coronary artery disease, but it has the inherent limitation of being a 2-dimensional x-ray lumenogram of a complex 3-dimensional vascular structure. Areas of controversy There is well-established inter- and intra-observer variability in reporting coronary angiograms leading to potential variability in various management strategies ...

      Read Full Article
    9. IVUS-Guided Versus OCT-Guided Coronary Stent Implantation: A Critical Appraisal

      IVUS-Guided Versus OCT-Guided Coronary Stent Implantation: A Critical Appraisal

      Procedural guidance with intravascular ultrasound (IVUS) imaging improves the clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) by: 1) informing the necessity for lesion preparation; 2) directing appropriate stent sizing to maximize the final stent area and minimize geographic miss; 3) selecting the optimal stent length to cover residual disease adjacent to the lesion, thus minimizing geographic miss; 4) guiding optimal stent expansion; 5) identifying acute complications (edge dissection, stent malapposition, tissue protrusion); and 6) clarifying the mechanism of late stent failure (stent thrombosis, neointimal hyperplasia, stent underexpansion or fracture, or neoatherosclerosis). Optical coherence tomography (OCT) provides similar information ...

      Read Full Article
    10. Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions: First Description

      Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions: First Description

      Objectives This study sought to determine the mechanistic effects of a novel balloon-based lithoplasty system on heavily calcified coronary lesions and subsequent stent placement using optical coherence tomography (OCT). Background The Shockwave Coronary Rx Lithoplasty System (Shockwave Medical, Fremont, California) delivers localized, lithotripsy-enhanced disruption of calcium within the target lesion (i.e., lithoplasty) for vessel preparation before stent implantation. Methods We analyzed OCT findings in 31 patients in whom lithoplasty was used to treat severely calcified stenotic coronary lesions. Results After lithoplasty, intraplaque calcium fracture was identified in 43% of lesions, with circumferential multiple fractures noted in >25%. The frequency ...

      Read Full Article
    11. EuroIntervention Characteristics of early versus late in-stent restenosis in second-generation drug-eluting stents: an optical coherence tomography study

      EuroIntervention Characteristics of early versus late in-stent restenosis in second-generation drug-eluting stents: an optical coherence tomography study

      Aims: In-stent restenosis (ISR) is an important cause of drug-eluting stent (DES) failure and target vessel revascularisation. In this study we aimed to evaluate differences between early and late-presenting restenosis in second-generation DES using optical coherence tomography (OCT). Methods and results: Overall, 171 cases of second-generation DES ISR with a follow-up OCT minimum lumen area <3.0 mm 2 were included: 33.3% of patients (n=57) had early ISR, and 66.7% (n=114) had late ISR (duration from stent implantation >1 year). Minimum stent area (MSA) <4.0 mm 2 , neointimal thickness <100 µm, and heterogeneous neointimal hyperplasia ...

      Read Full Article
    12. Optical coherence tomography-guided PCI – Authors' reply

      Optical coherence tomography-guided PCI – Authors' reply

      We read with interest the Correspondence by Rahman Shah regarding our 2016 ILUMIEN III: OPTIMIZE PCI trial. 1 In nearly all previous studies of percutaneous coronary intervention (PCI) guided by intravascular ultrasound (IVUS) or optical coherence tomography (OCT), the most important predictor of follow-up events was the minimum stent area, followed by edge dissections and untreated disease. 2 , 3 Nine randomised trials 4 have compared IVUS guidance versus angiography guidance for PCI with drug-eluting stents (DES). IVUS guidance improved event-free survival by achieving larger acute stent dimensions than angiography guidance. 4 Therefore, before embarking on a definitive trial comparing OCT-guided ...

      Read Full Article
    13. Characteristics of Early Versus Late In-Stent Restenosis in Second- Generation Drug-Eluting Stents: An Optical Coherence Tomography Study

      Characteristics of Early Versus Late In-Stent Restenosis in Second- Generation Drug-Eluting Stents: An Optical Coherence Tomography Study

      Aims: In-stent restenosis (ISR) is an important cause of DES failure and target vessel revascularization. We evaluated differences between early and late-presenting restenosis in second-generation drug-eluting stents (DES) using optical coherence tomography (OCT). Methods and results: Overall, 171 cases of second-generation DES ISR with a follow-up OCT minimum lumen area <3.0mm2 were included; 33.3% of patients (n=57) had early ISR; and 67.7% (n=114) had late ISR (duration from stent implantation >1 year). Minimum stent area (MSA) <4.0mm2, neointimal thickness <100µm, and heterogeneous neointimal hyperplasia (NIH) were more prevalent in early ISR, whereas NIH ...

      Read Full Article
    14. Neoatherosclerosis assessed with optical coherence tomography in restenotic bare metal and first- and second-generation drug-eluting stents

      Neoatherosclerosis assessed with optical coherence tomography in restenotic bare metal and first- and second-generation drug-eluting stents

      Although reported in bare metal stents (BMS) and first-generation drug-eluting stents (DES), little is known about neoatherosclerosis in second-generation DES. We used optical coherence tomography to evaluate neoatherosclerosis among different stent generations. Overall, 274 in-stent restenosis (ISR) lesions (duration from implantation 56.9 ± 47.2 months) in 274 patients were assessed for the presence of neoatherosclerosis. Neoatherosclerosis was identified in 38.7% of lesions (106/274): 23.0% second-generation DES (38/165), 65.1% first-generation DES (54/83), and 53.8% BMS (14/26). In the neoatherosclerosis cohort (n = 106), more stent underexpansion or fracture/deformation was observed in second-generation ...

      Read Full Article
      Mentions: Gary S. Mintz
    15. Coronary Plaque Characteristics in Hemodialysis-Dependent Patients as Assessed by Optical Coherence Tomography

      Coronary Plaque Characteristics in Hemodialysis-Dependent Patients as Assessed by Optical Coherence Tomography

      Coronary arteries in patients with chronic kidney disease (CKD) have been shown to exhibit more extensive atherosclerosis and calcium. We aimed to assess characteristics of coronary plaque in hemodialysis (HD)-dependent patients using optical coherence tomography (OCT). This was a multicenter, retrospective study of 124 patients with stable angina who underwent OCT imaging. Sixty-two HD-dependent patients who underwent pre-intervention OCT for coronary artery disease (CAD) were compared 1:1 with a cohort of patients without CKD, matched for age, diabetes mellitus, sex, and culprit vessel. Baseline characteristics were comparable. Pre-intervention OCT imaging identified 62 paired culprit, 53 paired non-culprit, and ...

      Read Full Article
    16. Intraluminal bioresorbable vascular scaffold dismantling with aneurysm formation leading to very late thrombosis

      Intraluminal bioresorbable vascular scaffold dismantling with aneurysm formation leading to very late thrombosis

      Coronary artery aneurysm formation has been described in patients after the placement of first-generation drug-eluting stents (DES), but is less common with newer generation metallic stents. In contrast, coronary artery aneurysm formation may be more common with the use of bioresorbable vascular scaffolds (BVS) due to the frequent formation of evaginations in the arterial wall seen with BVS. In this article, we describe a unique case of BVS dismantling and thrombus formation leading to an acute coronary syndrome thirty-two months after initial BVS placement. We also discuss existing literature and the pathophysiology of BVS degradation, in addition to the utility ...

      Read Full Article
      Mentions: Gregg W. Stone
    17. Guiding Light: Insights Into Atherectomy by Optical Coherence Tomography

      Guiding Light: Insights Into Atherectomy by Optical Coherence Tomography

      Coronary calcification presents multiple technical challenges in percutaneous coronary intervention (PCI) and is associated with suboptimal procedural results and an increase in subsequent adverse clinical events (1) . Currently, there is no standardized evidence-based strategy for PCI of calcified coronary lesions. Decisions for the use of adjunctive atheroablation—shown to increase the acute procedural success rates (2) —are based on visual estimation of calcification severity on angiography (with its inherent limitations [3] ) or when delivery of devices is impeded by calcified deposits in the vessel wall. Although the so-called “rota-regret” remains common following suboptimal acute procedural results in calcified plaques not ...

      Read Full Article
    18. Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial

      Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial

      Background Percutaneous coronary intervention (PCI) is most commonly guided by angiography alone. Intravascular ultrasound (IVUS) guidance has been shown to reduce major adverse cardiovascular events (MACE) after PCI, principally by resulting in a larger postprocedure lumen than with angiographic guidance. Optical coherence tomography (OCT) provides higher resolution imaging than does IVUS, although findings from some studies suggest that it might lead to smaller luminal diameters after stent implantation. We sought to establish whether or not a novel OCT-based stent sizing strategy would result in a minimum stent area similar to or better than that achieved with IVUS guidance and better ...

      Read Full Article
    19. Utility of near-infrared spectroscopy for detection of thin-cap neoatherosclerosis

      Utility of near-infrared spectroscopy for detection of thin-cap neoatherosclerosis

      Aims Near-infrared spectroscopy (NIRS) has been employed to assess the composition of the atherosclerotic plaques in native coronary arteries. However, little is known about the detection of neoatherosclerosis by NIRS in in-stent restenosis (ISR). The aim of the study was to assess the relationship between the distribution of lipid determined by NIRS and morphology of ISR on optical coherence tomography (OCT). Methods and results We performed both NIRS and OCT in 39 drug-eluting stents with ISR. Values of lipid-core burden index (LCBI) derived by NIRS were compared with the OCT-derived thickness of the fibrous cap covering neoatherosclerotic lesions. A total ...

      Read Full Article
    20. Optical Coherence Tomography of De Novo Lesions and In-Stent Restenosis in Coronary Saphenous Vein Grafts (OCTOPUS Study)

      Optical Coherence Tomography of De Novo Lesions and In-Stent Restenosis in Coronary Saphenous Vein Grafts (OCTOPUS Study)

      Background: The OCTOPUS registry prospectively evaluates the procedural and long-term outcomes of saphenous vein graft (SVG) PCI. The current study assessed the morphology of de novo lesions and in-stent restenosis (ISR) in patients undergoing PCI of SVG. Methods and Results: Optical coherence tomography (OCT) of SVG lesions in consecutive patients presenting with stable CAD and ACS was carried out. Thirty-nine patients (32 de novo and 10 ISR lesions) were included in the registry. ISR occurred in 5 BMS and 5 DES. There were no differences in the presence of plaque rupture and thrombus between de novo lesions and ISR. Lipid-rich ...

      Read Full Article
    21. Update on Intracoronary Optical Coherence Tomography: a Review of Current Concepts

      Update on Intracoronary Optical Coherence Tomography: a Review of Current Concepts

      Purpose of review The advent of intracoronary optical coherence tomography (OCT) has been a significant leap forward in the ability to visualize coronary structures with unprecedented resolution. However, the clinical application of this imaging modality has lagged behind rapid technological advances. One of the main reasons for the lack of wider clinical uptake has been the paucity of appropriately designed prospective randomized studies to demonstrate the impact of OCT on outcome measures after percutaneous coronary intervention (PCI). Recent findings Over the last couple of years, studies from large registries have shown the impact of OCT in decision-making in PCI, with ...

      Read Full Article
    22. Comparison Between Cardiac Allograft Vasculopathy and Native Coronary Atherosclerosis by Optical Coherence Tomography

      Comparison Between Cardiac Allograft Vasculopathy and Native Coronary Atherosclerosis by Optical Coherence Tomography

      We sought to explore differences in distribution and morphology of coronary lesions comparing cardiac allograft vasculopathy (CAV) and native coronary atherosclerosis (NCA) using intravascular imaging with optical coherence tomography (OCT). At the time of routine surveillance angiography, 17 heart transplant (HT) recipients with a history of high-grade cellular rejection (HGR) and 43 HT recipients with none/mild (low)-grade rejection (LGR) underwent OCT imaging of the left anterior descending (LAD) and were compared to 60 non-HT patients with NCA. Compared with NCA patients, HGR patients had similar intima areas, but smaller external elastic lamina (EEL) areas [7.9 mm 2 ...

      Read Full Article
      Mentions: Gary S. Mintz
    1-24 of 29 1 2 »
  1. Categories

    1. Applications:

      Art, Cardiology, Dentistry, Dermatology, Developmental Biology, Gastroenterology, Gynecology, Microscopy, NDE/NDT, Neurology, Oncology, Ophthalmology, Other Non-Medical, Otolaryngology, Pulmonology, Urology
    2. Business News:

      Acquisition, Clinical Trials, Funding, Other Business News, Partnership, Patents
    3. Technology:

      Broadband Sources, Probes, Tunable Sources
    4. Miscellaneous:

      Jobs & Studentships, Student Theses, Textbooks
  2. Topics in the News

    1. (23 articles) Gary S. Mintz
    2. (12 articles) Cardiovascular Research Foundation
    3. (10 articles) Columbia University
    4. (10 articles) Gregg W. Stone
    5. (3 articles) Tetsumin Lee
    6. (2 articles) University of Sydney
    7. (2 articles) National Institutes of Health
    8. (2 articles) Renu Virmani
    9. (2 articles) Martin B. Leon
    10. (2 articles) St. Jude Medical
  3. Popular Articles

  4. Picture Gallery

    On OCT and Finding the Uncovered Tracks… Increased Thin-Cap Neoatheroma and Periprocedural Myocardial Infarction in Drug-Eluting Stent Restenosis  Multimodality Intravascular Imaging of Drug-Eluting and Bare-Metal Stents Imaging Comparison of a Bioresorbable Vascular Scaffold by High-Frequency Intravascular Ultrasound and Optical Coherence Tomography Optical coherence tomography-guided percutaneous coronary intervention in pre-terminal chronic kidney disease with no radio-contrast administration Optical Coherence Tomography of De Novo Lesions and In-Stent Restenosis in Coronary Saphenous Vein Grafts (OCTOPUS Study) Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial Intraluminal bioresorbable vascular scaffold dismantling with aneurysm formation leading to very late thrombosis IVUS-Guided Versus OCT-Guided Coronary Stent Implantation: A Critical Appraisal Bifurcation and Ostial Optical Coherence Tomography Mapping (BOOM) – Case Description of a Novel Bifurcation Stent Technique Algorithmic Approach for Optical Coherence Tomography–Guided Stent Implantation During Percutaneous Coronary Intervention Changes in the OCT angiographic appearance of type 1 and type 2 CNV in exudative AMD during anti-VEGF treatment Optical coherence angiography for pre-treatment assessment and treatment monitoring following photodynamic therapy: a basal cell carcinoma patient study