1. Articles from Antonio Colombo

    1-21 of 21
    1. Twelve-month clinical and imaging outcomes of the uncaging DynamX Bioadaptor System

      Aims- We assessed the safety and efficacy of the DynamX™ Novolimus-Eluting Coronary Bioadaptor System, a novel device that initially acts as a second-generation drug-eluting stent, but after six months frees the vessel through uncaging elements. Methods and results- This multi-center study enrolled 50 patients with single de novo lesions. In-device acute lumen gain was 1.61±0.34 mm, and device and procedure success was 100%. Through 12 months, two target lesion failures occurred, both were cardiac deaths (day 255 and 267 post-procedure). No definite or probable device thrombosis was observed. Mean late lumen loss was 0.12±0.18 ...

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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. Procedural and follow-up insights from optical coherence tomography-guided management of intracoronary stent loss and crushing

      Procedural and follow-up insights from optical coherence tomography-guided management of intracoronary stent loss and crushing

      A 55-year-old man underwent left anterior descending (LAD) chronic total occlusion intervention (Fig. 1A, B). The occlusion was crossed antegradely and predilated (Fig. 1C). During delivery of a 3.0 × × 33-mm stent, the operator encountered significant resistance, and soon noticed stent dislodgment from the delivery system. Since the stent appeared deformed and was located in front of the circumflex and first diagonal (D1) ostia (Fig. 1D), the operator chose to crush it (Fig. 1E). A 3.5 × × 33-mm stent (Fig. 1F) was then implanted and post-dilated with a 4.5-mm non-compliant balloon. Optical coherence tomography revealed that stent crushing also ...

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    4. Zero-contrast percutaneous coronary intervention guided by dextran-based optical coherence tomography

      Zero-contrast percutaneous coronary intervention guided by dextran-based optical coherence tomography

      Subjects with advanced chronic kidney disease (CKD) and coronary artery disease are often denied percutaneous coronary intervention (PCI) due to the aversion to the risk of contrast-induced nephropathy. We present the case of a 76-year-old man with stage 4 CKD requiring coronary revascularization. Zero-contrast PCI was successfully performed using dextran-based optical coherence tomography (OCT) guidance. Our report suggests the feasibility of dextran-based OCT-guided zero-contrast PCI in patients with advanced CKD. Further studies should evaluate the safety and efficacy of this novel approach.

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    5. OCT Images of Longitudinal Deformation Following BVS Implantation in the Right Coronary Ostium

      OCT Images of Longitudinal Deformation Following BVS Implantation in the Right Coronary Ostium

      A 62-year-old man presenting with stable angina underwent coronary angiography demonstrating critical diffuse disease of the right coronary artery. Four sequential Absorb bioresorbable scaffolds (BRS) (Abbott Vascular, Santa Clara, California) were implanted from distal to proximal lesions in the right coronary artery following pre-dilation. This was followed by post-dilation with a 3.5-mm noncompliant balloon (20 atm) proximally and a 3.0-mm noncompliant balloon (18 atm) distally. Although angiography following post-dilation demonstrated an acceptable result, optical coherence tomography (Ilumien Optis, St. Jude Medical, St. Paul, Minnesota) clearly revealed longitudinal deformation and strut disruption of the BRS at the ostium of ...

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      Mentions: Abbot
    6. Accuracy of intravascular ultrasound and optical coherence tomography in identifying functionally significant coronary stenosis according to vessel diameter: A meta-analysis of 2,581 patients and 2,807 lesions

      Accuracy of intravascular ultrasound and optical coherence tomography in identifying functionally significant coronary stenosis according to vessel diameter: A meta-analysis of 2,581 patients and 2,807 lesions

      Introduction Accuracy of intracoronary imaging to discriminate functionally significant coronary stenosis according to vessel diameter remains to be defined. Methods PubMed, Scopus, and Google Scholar were systematically searched for studies assessing diagnostic accuracy (area under the receiver operating characteristic curve [AUC], the primary end point) and sensitivity and specificity (the secondary end points) of minimal luminal area (MLA) or of minimal luminal diameter (MLD) derived from intravascular ultrasound (IVUS) or optical coherence tomography (OCT) to detect functionally significant stenosis as determined with fractional flow reserve (FFR). Results Fifteen studies were included, 2 with 110 patients analyzing only left main (LM ...

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    7. One-Year Follow-Up Optical Coherence Tomography of a “Hybrid” Neocarina After T-Stenting With Small Protrusion Technique Using a Bioresorbable Vascular Scaffold and a Metallic Stent

      One-Year Follow-Up Optical Coherence Tomography of a “Hybrid” Neocarina After T-Stenting With Small Protrusion Technique Using a Bioresorbable Vascular Scaffold and a Metallic Stent

      A 75-year-old man with stable angina underwent coronary angiography demonstrating significant stenosis at the bifurcation of the left anterior descending coronary artery (LAD) with a diagonal branch (Figure 1 ). Following pre-dilation, a 3.5 × 28-mm bioresorbable vascular scaffold (BVS) (Absorb, Abbott Vascular, Santa Clara, California) was implanted in the LAD. This was followed by post-dilation with a 3.5-mm noncompliant balloon and subsequent “T kissing” inflation. Because of an extensive dissection in the proximal segment of the diagonal (Figure 1 ), a 2.5 × 28-mm everolimus-eluting stent (EES) was implanted using the T-stenting with small protrusion (TAP) technique followed by “T ...

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    8. Late-acquired scaffold malapposition and discontinuity that may be attributable to pathological coronary ectasia: Insights from optical coherence tomography

      Late-acquired scaffold malapposition and discontinuity that may be attributable to pathological coronary ectasia: Insights from optical coherence tomography

      A 69-year-old man presenting with exertional angina, underwent successful percutaneous coronary intervention to the proximal mid-segment of the left circumflex coronary artery with implantation of two Absorb bioresorbable scaffolds (BRS; Abbott vascular, Santa Clara, CA) (Fig. 1A). He returned 16-months later with recurrent symptoms. Coronary angiography revealed focal ectasia and significant in-scaffold restenosis (Fig. 1B). Optical coherence tomography imaging of the ectatic lesion demonstrated a large scaffold lumen diameter (3.74 × 5.04 mm), which was above the upper dilatation limit of the 3.0 mm diameter scaffold and greater than the reference vessel diameter on intravascular ultrasound at the ...

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    9. Side Branch Occlusion After Bioresorbable Vascular Scaffold Implantation Lessons From Optimal Coherence Tomography

      Side Branch Occlusion After Bioresorbable Vascular Scaffold Implantation Lessons From Optimal Coherence Tomography

      There are limited data regarding the side branch occlusion (SBO) after Absorb bioresorbable everolimus-eluting vascular scaffolds (BVS) 1.1 (Abbott Vascular, Santa Clara, California). Even though the second-generation BVS 1.1 has improved on the design of BVS 1.0, the increased strut thickness and width remain and potentially more frequently compromise small SB as compared to the new-generation drug-eluting stents with thin strut. A previous study 1 demonstrated that BVS had a higher incidence (10.5%) of post-procedural SBO compared with the everolimus-eluting metallic stent for SB with a reference vessel diameter ≤0.5 mm. Regarding SB with a ...

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    10. Two-Year Follow-Up OCT Images of 2 Bifurcation Lesions Treated With Bioresorbable Vascular Scaffolds

      Two-Year Follow-Up OCT Images of 2 Bifurcation Lesions Treated With Bioresorbable Vascular Scaffolds

      Letter to the editor. Diagnostic angiogram of a 66-year-old man presenting with stable angina revealed significant lesions in the left main coronary artery (LMCA) trifurcation and the left anterior descending artery (LAD) diagonal bifurcation (Figure 1 ). In the latter, after deployment of a 2.5 × 16.0 mm Promus element (Boston Scientific, Natick, Massachusetts) with mini-crush technique in the diagonal with initial kissing balloon inflation (KBI), a 3.0 × 18.0 mm ABSORB bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) was implanted in the proximal LAD without final KBI. In the LMCA trifurcation lesion, a 3.5 × 18 ...

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    11. One-Year Follow-Up Optical Coherence Tomography After Implantation of Bioresorbable Vascular Scaffolds for a Chronic Coronary Total Occlusion

      One-Year Follow-Up Optical Coherence Tomography After Implantation of Bioresorbable Vascular Scaffolds for a Chronic Coronary Total Occlusion

      A 70-year-old male underwent coronary angiography because of worsening angina, which demonstrated proximal left anterior descending coronary artery (LAD) chronic total occlusion (CTO) collateralized by septal branches from the right coronary and antegrade bridge (Figure 1A).

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    12. 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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    13. Optimal duration of dual antiplatelet therapy after implantation of bioresorbable vascular scaffolds; lessons from optimal coherence tomography

      Optimal duration of dual antiplatelet therapy after implantation of bioresorbable vascular scaffolds; lessons from optimal coherence tomography

      The current case report demonstrates the interesting finding of incomplete bioresorbable vascular scaffold strut coverage at 18 months post implantation for a chronic total occlusion of the left anterior descending coronary artery. In this case, local differences in shear stress could explain the simultaneous presence of well covered and uncovered BVS strut segments in the same optical coherence tomography frame. Even though current standard practice suggests dual antiplatelet therapy (DAPT) for 12 months after BVS implantation, further studies are required to establish optimal duration of DAPT, particularly when tackling complex lesions.

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    14. Drug-eluting stent implantation in patients with acute coronary syndrome - the Activity of Platelets after Inhibition and Cardiovascular Events: Optical Coherence Tomography (APICE OCT) study

      Drug-eluting stent implantation in patients with acute coronary syndrome - the Activity of Platelets after Inhibition and Cardiovascular Events: Optical Coherence Tomography (APICE OCT) study

      Aims: To our knowledge, no randomised study has compared rates of uncovered stent struts in everolimus (EES) vs. new-generation zotarolimus-eluting (ZES-R) stents in acute coronary syndrome (ACS). The aim of our study was to evaluate the completeness of neointimal coverage with optical coherence tomography (OCT) in ACS patients treated with drug-eluting stents (DES) comparing EES versus new-generation ZES-R. Methods and results: All eligible ACS patients admitted to four Italian centres with a clinical indication for culprit lesion intervention were randomised 1:1 to EES or ZES-R. The primary study endpoint was the percentage of uncovered stent struts evaluated by optical ...

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    15. The role of integrated backscatter intravascular ultrasound in characterizing bare metal and drug-eluting stent restenotic neointima as compared to optical coherence tomography

      The role of integrated backscatter intravascular ultrasound in characterizing bare metal and drug-eluting stent restenotic neointima as compared to optical coherence tomography

      Background To evaluate the role of integrated backscatter intravascular ultrasound (IB-IVUS) in assessing the morphology of neointima in bare-metal stent (BMS) and drug-eluting stent (DES) restenosis as compared to the gold-standard, optical coherence tomography (OCT). Methods A total of 120 cross-sections were evaluated by IB-IVUS and OCT at five cross-sections from 24 patients (24 lesions): at the minimal lumen area (MLA) and at 1 and 2 mm proximal and distal to the MLA site in 24 lesions (9 treated with DES and 15 treated with BMS). IB-IVUS and OCT findings were analyzed according to the time at which restenosis was ...

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    16. Strategy for optimal side-branch positioning of bioresorbable vascular scaffolds in dedicated 2-stent techniques: Insights from optical coherence tomography

      Strategy for optimal side-branch positioning of bioresorbable vascular scaffolds in dedicated 2-stent techniques: Insights from optical coherence tomography

      We present a case of a left anterior descending artery/diagonal branch bifurcation successfully treated with a dedicated 2-stent technique utilizing bioresorbable vascular scaffolds, where the bifurcation angle did not strictly allow a T-stenting approach. We also propose a strategy to avoid or reduce scaffold overlap in the main branch, especially important in view of the bulkier size of these novel devices.

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      Mentions: Abbot
    17. Optical Coherence Tomography of a Bifurcation Lesion Treated With Bioresorbable Vascular Scaffolds With the “Mini-Crush” Technique

      Optical Coherence Tomography of a Bifurcation Lesion Treated With Bioresorbable Vascular Scaffolds With the “Mini-Crush” Technique

      A 51-year-old man was referred for coronary angiography following a positive scintigraphy test for anterior and anterolateral ischemia. Angiography showed a chronic total occlusion of the mid-left anterior descending coronary artery (LAD) and stenosis of the ostial first diagonal branch (Figure 1 ). The total occlusion of the LAD was crossed, and rotablation was performed. A 2.5 × 28-mm Absorb bioresorbable vascular scaffold (BVS) stent (Abbott Vascular, Santa Clara, California) was implanted in the LAD just distal to the first diagonal. A second 2.5 × 18-mm Absorb was implanted in the first diagonal branch. Optical coherence tomography (OCT) imaging demonstrated that ...

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    1-21 of 21
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    Optical Coherence Tomography of a Bifurcation Lesion Treated With Bioresorbable Vascular Scaffolds With the “Mini-Crush” Technique Strategy for optimal side-branch positioning of bioresorbable vascular scaffolds in dedicated 2-stent techniques: Insights from optical coherence tomography Bioresorbable vascular scaffold strut disruption after crossing with an optical coherence tomography imaging catheter Drug-eluting stent implantation in patients with acute coronary syndrome - the Activity of Platelets after Inhibition and Cardiovascular Events: Optical Coherence Tomography (APICE OCT) study Optimal duration of dual antiplatelet therapy after implantation of bioresorbable vascular scaffolds; lessons from optimal coherence tomography ABSORB Biodegradable Stents Versus Second-Generation Metal Stents : A Comparison Study of 100 Complex Lesions Treated Under OCT Guidance One-Year Follow-Up Optical Coherence Tomography After Implantation of Bioresorbable Vascular Scaffolds for a Chronic Coronary Total Occlusion Two-Year Follow-Up OCT Images of 2 Bifurcation Lesions Treated With Bioresorbable Vascular Scaffolds One-Year Follow-Up Optical Coherence Tomography of a “Hybrid” Neocarina After T-Stenting With Small Protrusion Technique Using a Bioresorbable Vascular Scaffold and a Metallic Stent Accuracy of intravascular ultrasound and optical coherence tomography in identifying functionally significant coronary stenosis according to vessel diameter: A meta-analysis of 2,581 patients and 2,807 lesions Retinal Vascular Features in Ocular Blunt Trauma by Optical Coherence Tomography Angiography Non-invasive imaging of a choroidal macrovessel