1. Articles from Toru Naganuma

    1-22 of 22
    1. Acute stent malapposition: Harmful or harmless?

      Acute stent malapposition: Harmful or harmless?

      Acute Stent malapposition (ASM) is the post-procedure lack of contact of stent struts with vessel wall. Operators are naturally displeased when ASM is revealed by intravascular imaging modalities, such as optical coherence tomography (OCT), because previous studies have reported presence of ASMs in patients suffering from stent thrombosis [1–3]. Actually, ASMs are not that rare [4–6]. We should be aware of what we should do when we encounter the cases of ASM. Many of us may consider postdilation to correct a malapposition with a larger balloon or higher pressure, especially in cases with coexisting stent underexpansion.

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    2. Bioresorbable vascular scaffolds for a long diffuse coronary lesion: insights from optical coherence tomography at 25-month follow-up

      Bioresorbable vascular scaffolds for a long diffuse coronary lesion: insights from optical coherence tomography at 25-month follow-up

      A 57-year-old man with crescendo angina had a long segment of diffuse lesion in the left anterior descending artery (LAD) (Fig. 1A). Surgical revascularisation was precluded due to poor distal targets, so the patient underwent percutaneous coronary intervention. Overlapping drug eluting stents (DESs) would have resulted in a full metal jacket, which poses long-term risk of stent thrombosis and restenosis, which are often difficult to treat. Considering these issues, we used three overlapping bioresorbable vascular scaffolds (BVS) following adequate lesion preparation (Fig. 1B–D). At the LAD/first-diagonal (D1) bifurcation we used a short DES that overlapped the BVS to ...

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    3. Association of skin autofluorescence with plaque vulnerability evaluated by optical coherence tomography in patients with cardiovascular disease

      Association of skin autofluorescence with plaque vulnerability evaluated by optical coherence tomography in patients with cardiovascular disease

      Background and aims Accumulation of advanced glycation end products (AGEs) can be measured non-invasively by skin autofluorescence (SAF) whose values are elevated in patients with cardiovascular disease (CVD). Optical coherence tomography (OCT) is an intravascular imaging modality that could allow visualization of plaque composition. We aim to examine the relationship between SAF and plaque composition evaluated by frequency-domain OCT in patients with CVD. Methods We prospectively enrolled 108 patients with CVD who underwent OCT images during percutaneous coronary intervention (PCI). We divided the population into two groups: high SAF group (greater than or equal to 2.6) and low SAF ...

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    4. One-year follow-up optical coherence tomography after endovascular treatment with a new-generation zotarolimus-eluting stent for chronic mesenteric ischemia

      One-year follow-up optical coherence tomography after endovascular treatment with a new-generation zotarolimus-eluting stent for chronic mesenteric ischemia

      A 62-year-old man experienced lower abdominal pain triggered by a hypotensive episode during hemodialysis for end-stage renal failure. Computed tomography scan and subsequent angiography revealed a significant calcified stenosis at the proximal part of inferior mesenteric artery (IMA) ( Fig. 1 A-C). Abdominal angina was diagnosed and his symptoms were reproduced during intentional hypotension induced by intravenous administration of calcium channel blocker with drop in the Pd/Pa within the IMA lesion from 0.90 to 0.80. In addition, the balloon occlusion during endovascular treatment as described below also reproduced his symptoms. Pre-procedural optical coherence tomography (OCT) showed a lipid-rich ...

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      Mentions: Yusuke Fujino
    5. Difference in Vascular Response between Sirolimus-eluting- and Everolimus-eluting Stents in Ostial Left Circumflex Artery after Unprotected Left Main as Observed by

      Difference in Vascular Response between Sirolimus-eluting- and Everolimus-eluting Stents in Ostial Left Circumflex Artery after Unprotected Left Main as Observed by

      Background Kissing-balloon technique (KBT) is commonly performed during percutaneous coronary intervention of distal unprotected left main coronary artery (ULM) aiming at obtaining optimal opening of the side branch (left circumflex artery; LCX) ostium. Nonetheless, detailed evaluation of vascular response to stents in LCX ostium is lacking. We therefore evaluated the vascular response to different drug-eluting stents (DES) in ostial LCX after ULM by means of optical coherence tomography (OCT). Methods We prospectively enrolled 38 consecutive patients with ULM disease, whom were treated with single-stent procedure using DES, crossover the ULM-left anterior descending artery (LAD) following by KBT. Twelve patients were ...

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    6. Optical coherence tomography assessment of in-stent restenosis after percutaneous coronary intervention with two-stent technique in unprotected left main

      Optical coherence tomography assessment of in-stent restenosis after percutaneous coronary intervention with two-stent technique in unprotected left main

      Background Optical coherence tomography (OCT) has contributed to a better understanding of in-stent restenosis (ISR); however, studies evaluating ISR pattern after two-stent technique in unprotected left main (ULM) are lacking. We aim to evaluate the ISR pattern of proximal LAD and LCX after two-stent technique in ULM. Methods We performed OCT in 26 patients with isolated or combined ISR (identified by angiography as >50%) after two stent implantation in the proximal LCX and LAD. Finally, 13 LAD and 22 LCX ISR lesions underwent OCT assessments. OCT analyses were undertaken in the proximal segments of the LAD and LCX. In addition ...

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    7. Extremely Late Catch-Up Phenomenon After First-Generation Sirolimus-Eluting Stent in the Left Main Stem : Insights From Optical Coherence Tomography

      Extremely Late Catch-Up Phenomenon After First-Generation Sirolimus-Eluting Stent in the Left Main Stem : Insights From Optical Coherence Tomography

      A72-year-old man had undergone angioplasty of the left main stem (LMS) with an implantation of a first-generation drug-eluting stent (DES) (3.5 18-mm Cypher stent, Cordis, Johnson & Johnson, Bridgewater, New Jersey) (Figure 1A). Post-procedural intravascular ultrasound (IVUS) had shown a well-expanded stent (Figures 1A0 and 1Aa–c). Four years later, both angiography and IVUS exhibited no significant in-stent restenosis (ISR) or stent recoil (Figures 1B, 1B0 , and 1Ba0 –c0 ). At 7 years, he presented with acute coronary syndrome (ACS) while still on long-term dual antiplatelet therapy. A subsequently obtained coronary angiogram exhibited severe ISR at the midshaft of LMS (Figure ...

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    8. Extremely Late Catch-Up Phenomenon After First-Generation Sirolimus-Eluting Stent in the Left Main Stem

      Extremely Late Catch-Up Phenomenon After First-Generation Sirolimus-Eluting Stent in the Left Main Stem

      A 72-year-old man had undergone angioplasty of the left main stem (LMS) with an implantation of a first-generation drug-eluting stent (DES) (3.5 × 18-mm Cypher stent, Cordis, Johnson & Johnson, Bridgewater, New Jersey) ( Figure 1A ). Post-procedural intravascular ultrasound (IVUS) had shown a well-expanded stent ( Figures 1A′ and 1Aa–c ). Four years later, both angiography and IVUS exhibited no significant in-stent restenosis (ISR) or stent recoil ( Figures 1B, 1B′, and 1Ba′–c′ ). At 7 years, he presented with acute coronary syndrome (ACS) while still on long-term dual antiplatelet therapy. A subsequently obtained coronary angiogram exhibited severe ISR at the midshaft of LMS ...

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    9. Potential advantages of the GuideLiner® catheter: insights from optical coherence tomography

      Potential advantages of the GuideLiner® catheter: insights from optical coherence tomography

      Optical coherence tomography (OCT) has been reported as promising not only for the evaluation of lesion morphology, but also for better clinical outcomes; however, in some cases with severe vessel tortuosity or angulated bifurcation, it is difficult to advance an intravascular imaging catheter. We report a case in which a GuideLiner ® catheter facilitated obtaining better angiographic and OCT images with the sub-selective injection of minimal contrast medium, even in a case with a tortuous vessel or angulated bifurcation. Furthermore, OCT assessment of a vessel through the catheter may be other potential advantage of this device.

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    10. 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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    11. 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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    12. A Honeycomb-Like Structure in Chronic Total Occlusion Demonstrated by Frequency-Domain Optical Coherence Tomography

      A Honeycomb-Like Structure in Chronic Total Occlusion Demonstrated by Frequency-Domain Optical Coherence Tomography

      A 68 year-old male with a history of hypertension and current smoking was admitted due to exertional chest pain. Coronary angiography (CAG) showed a chronic total occlusion (CTO) in the left circumflex artery with collateral supply from the right coronary artery (Fig. 1). PCI was performed in this lesion as patient has normal left ventricular function. After crossing the lesion with guide wire (Gaia 2nd) and micro catheter, frequency-domain optical coherence tomography (FD-OCT) (ILUMIEN™ OCT Imaging System, St Jude Medical, Inc, St Paul, Minnesota) was performed

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    13. 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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    14. 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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    15. Impact of Main-Branch Calcified Plaque on Side-Branch Stenosis in Bifurcation Stenting: An Optical Coherence Tomography Study

      Impact of Main-Branch Calcified Plaque on Side-Branch Stenosis in Bifurcation Stenting: An Optical Coherence Tomography Study

      Percutaneous coronary intervention (PCI) in bifurcations is routinely performed, however this procedure is associated with higher rates of adverse events compared non-bifurcation PCI [1,2]. While bifurcation PCI per se leads to progressively higher rates of periprocedural myocardial infarction as its complexity increases (i.e., 1- vs. 2-stent technique) [3], side-branch (SB) stenosis (SBS) after main-branch (MB) stenting may further contribute to myocardial ischemia and necrosis; in addition, it might require additional intervention and resource utilization.

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    16. 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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    17. 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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    18. 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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    19. 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
    20. 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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    1-22 of 22
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    Optical Coherence Tomography of a Bifurcation Lesion Treated With Bioresorbable Vascular Scaffolds With the “Mini-Crush” Technique Bioresorbable vascular scaffold strut disruption after crossing with an optical coherence tomography imaging catheter 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 Impact of Main-Branch Calcified Plaque on Side-Branch Stenosis in Bifurcation Stenting: An Optical Coherence Tomography Study One-Year Follow-Up Optical Coherence Tomography After Implantation of Bioresorbable Vascular Scaffolds for a Chronic Coronary Total Occlusion A Honeycomb-Like Structure in Chronic Total Occlusion Demonstrated by Frequency-Domain Optical Coherence Tomography 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 Potential advantages of the GuideLiner® catheter: insights from optical coherence tomography Spectral Domain Optical Coherence Tomography Imaging Performance Improvement Based on Field Curvature Aberration-Corrected Spectrometer Pentosan polysulfate maculopathy versus inherited macular dystrophies: comparative assessment with multimodal imaging