1. Articles from Giovanni Luigi De Maria

    1-15 of 15
    1. Coronary injury in mitral and aortic valve surgery: a case series using optical coherence tomography

      Coronary injury in mitral and aortic valve surgery: a case series using optical coherence tomography

      Coronary occlusion is a rare but well described complication of heart valve surgery. The left circumflex coronary artery, especially when it is dominant, is particularly at risk due to the proximity of the mitral valve annulus. We report on three cases of acute coronary complications of different valvular surgical procedures diagnosed and treated in the cardiac catheterization laboratory. Intracoronary optical coherence tomography was used to identify the cause of coronary flow impairment and provided important insights on the mechanism of intra-operative vascular damage.

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    2. Prospective Randomized Comparison of Fractional Flow Reserve Versus Optical Coherence Tomography to Guide Revascularization of Intermediate Coronary Stenoses: One-Month Results

      Prospective Randomized Comparison of Fractional Flow Reserve Versus Optical Coherence Tomography to Guide Revascularization of Intermediate Coronary Stenoses: One-Month Results

      Background-—Fractional flow reserve (FFR) and optical coherence tomography (OCT) may help both in assessment and in percutaneous coronary intervention optimization of angiographically intermediate coronary lesions. We designed a prospective trial comparing the clinical and economic outcomes associated with FFR or OCT in angiographically intermediate coronary lesions. Methods and Results-—Three hundred fifty patients with angiographically intermediate coronary lesions (n=446) were randomized to FFR or OCT guidance. In the FFR arm, percutaneous coronary intervention was performed if FFR was ≤0.80 aiming for a postprocedure FFR >0.90. In the OCT arm, percutaneous coronary intervention was performed if percentage ...

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      Mentions: Rocco Vergallo
    3. Dual quantitative coronary angiography accurately quantifies intracoronary thrombotic burden in patients with acute coronary syndrome: Comparison with optical coherence tomography imaging

      Dual quantitative coronary angiography accurately quantifies intracoronary thrombotic burden in patients with acute coronary syndrome: Comparison with optical coherence tomography imaging

      Background Dual quantitative coronary angiography (QCA) has been recently tested for assessment of intracoronary thrombus volume in experimental models. The present study aimed to validate dual QCA in vivo for the assessment of thrombus burden by exploring the correlations between dual QCA-thrombus volume and optical coherence tomography (OCT)-derived indices of thrombotic burden. Methods and results Fifty-one patients with ACS and angiographic evidence of thrombus undergoing OCT of the culprit lesion before stenting were included. Dual QCA-thrombus volume was calculated as difference between edge-detection and video-densitometry area functions along the target segment. Culprit lesion was categorized using the Ambrose's ...

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    4. Stent malapposition, strut coverage and atherothrombotic prolapse after percutaneous coronary interventions in ST-segment elevation myocardial infarction

      Stent malapposition, strut coverage and atherothrombotic prolapse after percutaneous coronary interventions in ST-segment elevation myocardial infarction

      Aims Stent implantation in ST-segment elevation myocardial infarction (STEMI) patients can be challenging and sometimes associated with immediate and long-term suboptimal results. Stent malapposition and strut uncoverage, predictors of stent thrombosis, are frequently detected in STEMI patients at medium/long-term follow-up. Nevertheless, data at a short follow-up are missing. We aimed to assess the extent of stent malapposition and struts coverage in the subacute phase of STEMI after stent implantation in primary or rescue percutaneous coronary intervention (PCI). Methods STEMI patients undergone primary or rescue PCI and scheduled for a second coronary angiography after 2–7 days were enrolled. During ...

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    5. Transverse partial stent ablation with rotational atherectomy for suboptimal culotte technique in left main stem bifurcation

      Transverse partial stent ablation with rotational atherectomy for suboptimal culotte technique in left main stem bifurcation

      Longitudinal rotational atherectomy of metal struts is well described as bail-out strategy to treat undilatable instent restenosis. Ablation of metal stent struts jailing the ostium of a major side branch in a coronary bifurcation is not described. In the current report, we describe a case of “transverse” rotational atherectomy to treat a failure of culotte stenting in a left main stem bifurcation. We document for the first time in vivo and in man the effect of this strategy using optical coherence tomography.

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    6. Optical coherence tomography to guide percutaneous treatment of coronary bifurcation disease

      Optical coherence tomography to guide percutaneous treatment of coronary bifurcation disease

      Introduction : Cardiovascular disease remains the most common cause of death worldwide. Enormous progress in the technology and applicability of percutaneous techniques to treat obstructive coronary heart disease has been made, and the number of percutaneous coronary interventions (PCI) is increasing. Coronary bifurcations are involved in a substantial number of PCIs and despite recent advances, bifurcation PCI remains a challenge in terms of immediate success and long-term outcome. Angiography has a limited capacity for showing important features of the 3 dimensional coronary vessel anatomy, position of stent struts and exact wire positions and is therefore suboptimal for guiding bifurcation PCI. Intracoronary ...

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    7. Frequency domain optical coherence tomography to assess non-ostial left main coronary artery

      Frequency domain optical coherence tomography to assess non-ostial left main coronary artery

      Aims: The aim of this study was to assess the feasibility of unprotected non-ostial left main (LM) imaging by frequency domain optical coherence tomography (FD-OCT). Methods and results: We conducted a retrospective analysis of OCT studies performed to image lesions located in the non-ostial LM. OCT studies were analysed to detect the number of artefact frames in the different LM/bifurcation segments. OCT cross-sectional images were used to assess area measures. OCT longitudinal reconstructions were used to obtain the LM length. Standard quantitative coronary angiography (QCA) was used as the reference methodology. A total of 54 patients with non-ostial LM ...

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      Mentions: St. Jude Medical
    8. Dual role of circulating endothelial progenitor cells in stent struts endothelialisation and neointimal regrowth: a substudy of the IN-PACT Coro trial

      Dual role of circulating endothelial progenitor cells in stent struts endothelialisation and neointimal regrowth: a substudy of the IN-PACT Coro trial

      Background Endothelialisation is a crucial event after percutaneous coronary intervention (PCI). Endothelial progenitor cells (EPC) are bone marrow derived elements with reparative properties. We aimed to assess the relationship between circulating EPC levels and stent neointimal hyperplasia (NIH) using frequency domain optical coherence tomography (FD-OCT). Methods Patients undergoing elective PCI to native vessels and randomized to bare metal stent (BMS) alone versus BMS plus drug coated balloon (DCB) were included. At six months, angiographic follow-up and FD-OCT were performed to measure percentage neointimal hyperplasia volume obstruction (%NIHV), and percentage of uncovered stent struts (%US). Venous blood samples were obtained before ...

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      Mentions: Francesco Prati
    9. Highly calcific in-stent restenosis as a substrate for sirolimus-eluting stent very late stent thrombosis

      Highly calcific in-stent restenosis as a substrate for sirolimus-eluting stent very late stent thrombosis

      We describe a case of very late stent thrombosis with documentation of highly calcific restenosis at optical coherence tomography without clear signs of stent malapposition, neoatherosclerosis disruption, or vascular toxicity to stent polymer. To the best of our knowledge, this is one of the first reports dealing with highly calcific restenosis as a potential background to very late stent thrombosis.

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    10. Management and optical coherence tomography imaging of an acute coronary artery injury induced by radiofrequency catheter ablation

      Management and optical coherence tomography imaging of an acute coronary artery injury induced by radiofrequency catheter ablation

      Catheter ablation with radiofrequency (RF) is the treatment of choice for atrio-ventricular reentrant tachycardias. In case of posterior or postero-lateral accessory pathways, epicardial RF ablation from within the coronary sinus (CS) may be warranted, but since both the left circumflex (LCx) coronary artery and the CS lie on the epicardial surface of the atrioventricular groove, LCx injury with possible acute occlusion or sub-total occlusion can occur.

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    11. Fractional flow reserve or optical coherence tomography guidance to revascularize intermediate coronary stenosis using angioplasty (FORZA) trial: study protocol for a randomized controlled trial

      Fractional flow reserve or optical coherence tomography guidance to revascularize intermediate coronary stenosis using angioplasty (FORZA) trial: study protocol for a randomized controlled trial

      Background The management of patients with angiographically intermediate coronary lesions is a major clinical issue. Fractional flow reserve provides validated functional insights while optical coherence tomography provides high resolution anatomic imaging. Both techniques may be applied to guide management in case of angiographically intermediate coronary lesions. Moreover, these techniques may be used to optimize the result of percutaneous coronary intervention. We aim to compare the clinical and economic impact of fractional flow reserve versus optical coherence tomography guidance in patients with angiographically intermediate coronary lesions. Methods Patients with at least one angiographically intermediate coronary lesion will be randomized (ratio 1 ...

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    12. Frequency-domain optical coherence tomography findings in patients with bifurcated lesions undergoing provisional stenting

      Frequency-domain optical coherence tomography findings in patients with bifurcated lesions undergoing provisional stenting

      Aims Bifurcations represent challenging lesions which may benefit from improved understanding of stent-related vessel complications. Since optical coherence tomography (OCT) allows us to detect post-stenting vessel injuries, we sought to assess the geographic pattern of stent-related complications occurring during provisional stenting of bifurcated lesions. Methods and results Fifty-one patients with bifurcated lesions treated by provisional stenting and undergoing intra-procedural OCT assessment were enrolled. OCT images were acquired with the aim of guiding the percutaneous coronary intervention but were re-analysed off-line for the present study. The stented bifurcation was divided into four segments [three in the main vessel (MV) and one ...

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    13. Frequency-domain optical coherence tomography assessment of kissing-balloon effects in bifurcated coronary artery lesions undergoing provisional stenting - Corrected Proof

      Frequency-domain optical coherence tomography assessment of kissing-balloon effects in bifurcated coronary artery lesions undergoing provisional stenting - Corrected Proof

      Stenoses located at bifurcations represent a challenging subset of coronary lesions which may benefit from invasive imaging and optical coherence tomography (OCT) has been recognized to have a promising role in this setting . Provisional-T-stenting with drug-eluting stents (DES) represents the gold standard for percutaneous treatment of bifurcated lesions but the usefulness of final kissing balloon inflation (FKI) is not established. Indeed, in a dedicated trial, FKI has not been found to improve clinical outcome even if it provides better SB ostium angiographic results .

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    14. Long-term Morphofunctional Remodeling of Internal Thoracic Artery Grafts: A Frequency-Domain Optical Coherence Tomography Study

      Long-term Morphofunctional Remodeling of Internal Thoracic Artery Grafts: A Frequency-Domain Optical Coherence Tomography Study

      Background— Internal thoracic arteries (ITAs) are frequently anastomosed to the coronary circulation for bypass grafting. The purpose of this research was to investigate in vivo the long-term morphofunctional changes of ITAs after their use as coronary artery bypass conduits, by comparing the morphological features and vasoreactivity of the grafted left ITA (LITA) with the native, nonharvested right ITA (RITA) in the same patient. Methods and Results— At least 10 years after surgery, in 10 patients, LITA graft and nonharvested RITA were assessed by quantitative angiography and frequency-domain optical tomography. Endothelium-dependent and independent vasodilation was tested by selective infusion of acetylcholine ...

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    1-15 of 15
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    1. (2 articles) Oxford University
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    Long-term Morphofunctional Remodeling of Internal Thoracic Artery Grafts: A Frequency-Domain Optical Coherence Tomography Study Frequency-domain optical coherence tomography assessment of kissing-balloon effects in bifurcated coronary artery lesions undergoing provisional stenting - Corrected Proof Frequency-domain optical coherence tomography findings in patients with bifurcated lesions undergoing provisional stenting Fractional flow reserve or optical coherence tomography guidance to revascularize intermediate coronary stenosis using angioplasty (FORZA) trial: study protocol for a randomized controlled trial Management and optical coherence tomography imaging of an acute coronary artery injury induced by radiofrequency catheter ablation Highly calcific in-stent restenosis as a substrate for sirolimus-eluting stent very late stent thrombosis Dual role of circulating endothelial progenitor cells in stent struts endothelialisation and neointimal regrowth: a substudy of the IN-PACT Coro trial Frequency domain optical coherence tomography to assess non-ostial left main coronary artery Optical coherence tomography to guide percutaneous treatment of coronary bifurcation disease Transverse partial stent ablation with rotational atherectomy for suboptimal culotte technique in left main stem bifurcation Postdoctoral Associate Position at Duke Vision and Image Processing Laborator Anterior segment optical coherence tomography angiography