1. Articles from Alessio Mattesini

    1-19 of 19
    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 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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    3. OCT-Guided Percutaneous Coronary Intervention In Bifurcation Lesions

      OCT-Guided Percutaneous Coronary Intervention In Bifurcation Lesions

      Coronary artery bifurcation lesions remain challenging despite significant advancements in stent technology and development of specific bifurcation stenting approaches. Optical coherence tomography (OCT) is the intracoronary imaging technique with the highest resolution and can generate automatically contoured lumen areas across the variable geometry of bifurcation lesions. Knowledge of plaque severity and composition facilitates planning of the best strategy for percutaneous coronary intervention (PCI) and stenting. In particular, the provisional stent strategy preferred in this context can be modified when there is high risk of side-branch compromise at the ostium after main vessel stenting. OCT is unique because it allows the ...

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      Mentions: Carlo Di Mario
    4. Will Optical Coherence Tomography Become the Standard Imaging Tool for Percutaneous Coronary Intervention Guidance?

      Will Optical Coherence Tomography Become the Standard Imaging Tool for Percutaneous Coronary Intervention Guidance?

      Editorial Comment: In the last 3 decades, intravascular ultrasound (IVUS) and, more recently, optical coherence tomography (OCT) have been increasingly used to guide percutaneous coronary intervention (PCI). Although there are randomized trials, registries, and meta-analyses suggesting better outcomes using IVUS to guide PCI (1–3), data on the clinical impact of OCT are still missing. In the United Kingdom, consecutive data of all PCI procedures must be prospectively entered in the registry organized by the British Cardiovascular Interventional Society, endorsed by the United Kingdom Department of Health, with tracking of events based on the complete and unquestionable national statistics. One ...

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      Mentions: Carlo Di Mario
    5. Impact of strut thickness on acute mechanical performance: a comparison study using optical coherence tomography between DESolve 150 and DESolve 100

      Impact of strut thickness on acute mechanical performance: a comparison study using optical coherence tomography between DESolve 150 and DESolve 100

      Objective To evaluate the acute performance of a novolimus-eluting bioresorbable scaffold (BRS) with different strut thickness (DESolve system 150 and 100) using optical coherence tomography (OCT) in terms of appropriate scaffold deployment. Background Outcome after BRS implantation seen in registries and meta-analyses continue to show a higher rate of scaffold thrombosis than those reported with DES. Thus, second scaffold generations with lower strut thickness might have potential advantages in terms of flow disturbance. However, whether mechanical properties are comparable has to be evaluated. Methods and results Fifty-seven patients undergoing OCT-guided scaffold implantation were enrolled consecutively in this retrospective study. The ...

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    6. Post-dilatation after implantation of bioresorbable everolimus- and novolimus-eluting scaffolds: an observational optical coherence tomography study of acute mechanical effects

      Post-dilatation after implantation of bioresorbable everolimus- and novolimus-eluting scaffolds: an observational optical coherence tomography study of acute mechanical effects

      bjectives The objective was to investigate the acute mechanical effects of post-dilatation on bioresorbable scaffolds (BRS) as determined by optical coherence tomography (OCT). Background Post-dilatation with high-pressure balloons is regarded as a key component of BRS implantation for treatment of coronary artery stenoses. However, the impact of post-dilatation on BRS in vivo has not been thoroughly investigated. Methods OCT was performed after the implantation procedure of 51 everolimus-eluting or novolimus-eluting polylactic acid-based BRS with ( n = 27) or without non-compliant balloon post-dilatation ( n = 24). The number of malapposed struts, strut fractures, edge dissections, residual in-scaffold area stenosis, and incomplete scaffold apposition ...

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    7. Absorb vs. DESolve: an optical coherence tomography comparison of acute mechanical performances

      Absorb vs. DESolve: an optical coherence tomography comparison of acute mechanical performances

      Aims: The aim of the study was to compare retrospectively the acute mechanical performance of the Absorb vs. DESolve scaffolds in terms of appropriate deployment with OCT. Methods and results: Final post-deployment OCT pullbacks of consecutive patients treated with either Absorb or DESolve were reviewed. The following parameters were calculated and compared: mean and minimal lumen area (MLA), residual in-scaffold area stenosis (RAS), incomplete strut apposition (ISA), tissue prolapse area, eccentricity index, asymmetry index, strut fracture and edge dissection. A total of 72 patients were included. The Absorb group consisted of 35 patients treated with 63 Absorb scaffolds and was ...

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    8. Optical coherence tomography guidance for percutaneous coronary intervention with bioresorbable scaffolds

      Optical coherence tomography guidance for percutaneous coronary intervention with bioresorbable scaffolds

      Background The effect of optical coherence tomography (OCT) guidance on the implantation strategy during all phases of percutaneous coronary intervention (PCI) with bioresorbable vascular scaffolds (BVSs) in a real-world scenario has been poorly investigated. Methods Consecutive patients undergoing BVS implantation at our institution were included in this registry. Frequency-domain OCT pullbacks were performed at the operator's discretion during all phases of BVS implantation procedures to optimize preparation of lesions, confirm BVS size, and optimize expansion and apposition of scaffolds. Results Between September 2012 and July 2015, 203 BVSs were implanted in 101 consecutive patients at our institution (2.01 ...

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    9. A new novolimus-eluting bioresorbable scaffold for large coronary arteries: an OCT study of acute mechanical performance

      A new novolimus-eluting bioresorbable scaffold for large coronary arteries: an OCT study of acute mechanical performance

      Aims To evaluate the acute performance of a novolimus-eluting bioresorbable scaffold (BRS) with a nominal diameter of 4.0 mm (DESolve® XL) using optical coherence tomography (OCT) in terms of appropriate scaffold deployment. Methods and results Ten patients (55.6% male, mean age 60.0 y) undergoing OCT-guided scaffold implantation were enrolled consecutively in this retrospective study. Using data from the final pullback, the following indexes were calculated: mean and minimum area, residual area stenosis, incomplete strut apposition, tissue prolapse, eccentricity and symmetry indexes, strut fracture, and edge dissection. The clinical indication for the procedure was acute coronary syndrome in ...

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    10. Time-related changes in neointimal tissue coverage of a novel Sirolimus eluting stent: Serial observations with optical coherence tomography

      Time-related changes in neointimal tissue coverage of a novel Sirolimus eluting stent: Serial observations with optical coherence tomography

      Background DES has reduced rates of restenosis compared with BMS but it has been associated with delayed healing and increase of stent thrombosis. The aim of our study was to evaluate the vascular time-related changes following implantation of a new SES coated with an amorphous silicon carbide that allows faster re-endothelisation (Orsiro-Biotronik). Methods This prospective registry enrolled STEMI-patients with multi-vessel disease, thus candidates for a two-step procedure. PCI of the culprit lesion was performed with at least one Orsiro stent that was OCT-analysed during the second-step procedure (deferred to 30,90 and 180-days). Results 16 of the 95 patients with ...

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      Mentions: Carlo Di Mario
    11. Inducing Persistent Flow Disturbances Accelerates Atherogenesis and Promotes Thin Cap Fibroatheroma Development in D374Y-PCSK9 Hypercholesterolemic Minipigs

      Inducing Persistent Flow Disturbances Accelerates Atherogenesis and Promotes Thin Cap Fibroatheroma Development in D374Y-PCSK9 Hypercholesterolemic Minipigs

      Background— Although disturbed flow is thought to play a central role in the development of advanced coronary atherosclerotic plaques, no causal relationship has been established. We evaluated whether inducing disturbed flow would cause the development of advanced coronary plaques, including thin cap fibroatheroma. Methods and Results— D374Y -PCSK9 hypercholesterolemic minipigs (n=5) were instrumented with an intracoronary shear-modifying stent (SMS). Frequency-domain optical coherence tomography was obtained at baseline, immediately poststent, 19 weeks, and 34 weeks, and used to compute shear stress metrics of disturbed flow. At 34 weeks, plaque type was assessed within serially collected histological sections and coregistered to ...

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    12. Optical Coherence Tomography Assessment and Quantification of Intracoronary Thrombus: Status and Perspectives

      Optical Coherence Tomography Assessment and Quantification of Intracoronary Thrombus: Status and Perspectives

      Coronary angiography is the “golden standard” imaging technique in interventional cardiology and it is still widely used to guide interventions. A major drawback of this technique, however, is that it is inaccurate in the evaluation and quantification of intracoronary thrombus burden, a critical prognosticator and predictor of intraprocedural complications in acute coronary syndromes. The introduction of optical coherence tomography (OCT) holds the promise of overcoming this important limitation, as near-infrared light is uniquely sensitive to hemoglobin, the pigment of red blood cells trapped in the thrombus. This narrative review will focus on the use of OCT for the assessment, evaluation ...

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      Mentions: Francesco Prati
    13. ABSORB Biodegradable Stents Versus Second-Generation Metal Stents : A Comparison Study of 100 Complex Lesions Treated Under OCT Guidance

      ABSORB Biodegradable Stents Versus Second-Generation Metal Stents : A Comparison Study of 100 Complex Lesions Treated Under OCT Guidance

      Objectives The aim of this study was to compare the acute performance of the PLLA ABSORB bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) with second-generation metal drug-eluting stents (DES) in complex coronary artery lesions. Background Thick polymer-based BVS have different mechanical properties than thin second-generation DES. Data on the acute performance of BVS are limited to simple coronary lesions treated in trials with strict inclusion criteria. Methods Fifty complex coronary lesions (all type American College of Cardiology/American Heart Association B2-C) treated with a BVS undergoing a final optical coherence tomography (OCT) examination were compared with an equal ...

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    14. Prospectively electrocardiogram-triggered high-pitch spiral acquisition coronary computed tomography angiography for assessment of biodegradable vascular scaffold expansion: Comparison with optical coherence tomography

      Prospectively electrocardiogram-triggered high-pitch spiral acquisition coronary computed tomography angiography for assessment of biodegradable vascular scaffold expansion: Comparison with optical coherence tomography

      BVS polymeric struts are transparent to the light so that the vessel wall contour can be easily visualized using optical coherence tomography (OCT). Therefore OCT represents a unique tool for both the evaluation of the resorption process and for the assessment of acute BVS mechanical failure. Similarly, the metal-free struts allow unrestricted coronary computed tomography angiography (CCTA), thus this non invasive method might become the gold standard for a non invasive assessment of BVS. In this case we show the ability of CCTA, performed with a low X-Ray dose, to provide a good evaluation of scaffold expansion. The quantitative measurements ...

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    15. Optical coherence tomography characteristics of in-stent restenosis are different between first and second generation drug eluting stents ☆

      Optical coherence tomography characteristics of in-stent restenosis are different between first and second generation drug eluting stents ☆

      Aims Characterization of neointimal tissue is essential to understand the pathophysiology of in-stent restenosis (ISR) after drug eluting stent (DES) implantation. Using optical coherence tomography (OCT), we compared the morphologic characteristics of ISR between first and second generation DES. Methods and Results OCT was performed in 66 DES-ISR, defined as > 50% angiographic diameter stenosis within the stented segment. Patients with ISR of first generation sirolimus-eluting stents (SES), paclitaxel eluting stents (PES) and second generation zotarolimus-eluting stents (ZES), everolimus-eluting stents (EES) and biolimus-eluting stents (BES) were enrolled. Quantitative and qualitative ISR tissue analysis was performed at 1-mm intervals along the entire ...

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    16. Coronary artery aneurysm following stent implantation: insights from serial multiple intravascular imaging modalities

      Coronary artery aneurysm following stent implantation: insights from serial multiple intravascular imaging modalities

      Coronary artery aneurysms after coronary intervention are rare and most ‘aneurysms’ are, in fact, pseudoaneurysms rather than true aneurysms. A correct diagnosis is mandatory for optimal management of this rare coronary complication. Intravascular ultrasound (IVUS) has become the gold standard for providing crucial information on the anatomical composition of the vessel wall, necessary to achieve the diagnosis. On the other hand, optical coherence tomography (OCT) is the most accurate diagnostic tool for providing luminal coronary measurement,

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    17. Intracoronary Optical Coherence Tomography: Experience and Indications for Clinical Use

      Intracoronary Optical Coherence Tomography: Experience and Indications for Clinical Use

      Optical coherence tomography (OCT) is a light based technology that provides very high spatial resolution images. OCT has been initially employed as a research tool to investigate plaque morphology and stent strut coverage. The introduction of frequency domain OCT, allowing fast image acquisition during a prolonged contrast injection via the guiding catheter, has made OCT applicable for guidance of coronary interventions. In this manuscript the various applications of OCT are reviewed, from assessment of plaque vulnerability and severity to characteristics of unstable lesions and thrombus burden to stent optimization and evaluation of late results

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    18. Bioabsorbable scaffold optimization in provisional stenting: insight from optical coherence tomography

      Bioabsorbable scaffold optimization in provisional stenting: insight from optical coherence tomography

      Since the emergence of biabsorbable vascular scaffolds (BVS), treatment of bifurcation lesions with these devices has remained a source of question. Although SB dilatation has been previously performed with BVS, it is not yet clear how dilatation across BVS strut may impact scaffold structure. A 74-year-old lady with hypercholesterolaemia and …

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    1-19 of 19
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    Bioabsorbable scaffold optimization in provisional stenting: insight from optical coherence tomography Intracoronary Optical Coherence Tomography: Experience and Indications for Clinical Use Early coverage of Bioabsorbable Scaffold after STEMI analysed by 2D and 3D optical coherence tomography Coronary artery aneurysm following stent implantation: insights from serial multiple intravascular imaging modalities Optical coherence tomography characteristics of in-stent restenosis are different between first and second generation drug eluting stents ☆ Prospectively electrocardiogram-triggered high-pitch spiral acquisition coronary computed tomography angiography for assessment of biodegradable vascular scaffold expansion: Comparison with optical coherence tomography ABSORB Biodegradable Stents Versus Second-Generation Metal Stents : A Comparison Study of 100 Complex Lesions Treated Under OCT Guidance Optical Coherence Tomography Assessment and Quantification of Intracoronary Thrombus: Status and Perspectives Inducing Persistent Flow Disturbances Accelerates Atherogenesis and Promotes Thin Cap Fibroatheroma Development in D374Y-PCSK9 Hypercholesterolemic Minipigs Will Optical Coherence Tomography Become the Standard Imaging Tool for Percutaneous Coronary Intervention Guidance? Diurnal Stability Of Peripapillary Vessel Density And Nerve Fiber Layer Thickness On Optical Coherence Tomography Angiography In Healthy, Ocular Hypertension And Glaucoma Eyes The impact of artificial intelligence in the diagnosis and management of glaucoma