1. Articles from Nicolas Meneveau

    1-16 of 16
    1. Optical coherence tomography in coronary atherosclerosis assessment and intervention

      Optical coherence tomography in coronary atherosclerosis assessment and intervention

      Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in the management of patients with acute coronary syndromes. Detection by OCT of healed coronary plaque has been important in our understanding of the mechanisms involved in plaque destabilization and healing ...

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    2. Optical Flow Ratio for Assessing Stenting Result and Physiological Significance of Residual Disease

      Optical Flow Ratio for Assessing Stenting Result and Physiological Significance of Residual Disease

      Background: Optical flow ratio (OFR) is a novel method for fast computation of fractional flow reserve (FFR) from optical coherence tomography (OCT) images. Aims: We aimed to evaluate the accuracy of OFR in predicting post-percutaneous coronary intervention (PCI) FFR and to evaluate the impact of stent expansion on within-stent OFR pressure drop (In-stent OFR). Methods: Post-PCI OFR was computed in patients with both OCT and FFR interrogation immediately after PCI. Calculation of post-PCI OFR (called simulated residual OFR) from pre-PCI OCT pullbacks after elimination of the stenotic segment by virtual stenting was performed in a subgroup of patients who had ...

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    3. Optical Coherence Tomography to Guide Percutaneous Coronary Intervention of the Left Main Coronary Artery: the LEMON study

      Optical Coherence Tomography to Guide Percutaneous Coronary Intervention of the Left Main Coronary Artery: the LEMON study

      Aims: IVUS is currently recommended by international guidelines to guide left main stem (LMS) PCI. Although OCT resolution outmatches IVUS, this tool is not yet recommended in LMS angioplasty due to the absence of data. This pilot study aimed to analyze the feasibility, safety and impact of OCT-guided LMS PCI. Methods and results: This prospective, multicenter trial investigated whether patients might benefit from OCT-guided PCI for mid/distal LMS according to a pre-specified protocol. The primary endpoint was procedural success defined as follows: residual angiographic stenosis <50% + TIMI 3 flow in all branches + adequate OCT stent expansion (LEMON criteria ...

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    4. How can optical coherence tomography be used to optimize percutaneous coronary intervention?

      How can optical coherence tomography be used to optimize percutaneous coronary intervention?

      Optical coherence tomography (OCT) imaging provides high resolution assessment of coronary parietal and endoluminal abnormalities. Clinical evidence and intuitive utilization make this tool relevant for use in daily practice in the catheterization laboratory. In the present review, we summarize the benefits of OCT for the optimization of percutaneous coronary intervention (PCI) in daily practice. First, we focus on the characterization of lesion type with a view to anticipating challenges during PCI. Then, we describe the utility of OCT to identify culprit lesions and ambiguous angiographic findings. Finally, we outline targets for optimization after PCI and the mechanisms underlying stent failure.

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    5. Automatic stent reconstruction in optical coherence tomography based on a deep convolutional model

      Automatic stent reconstruction in optical coherence tomography based on a deep convolutional model

      Intravascular optical coherence tomography (IVOCT) can accurately assess stent apposition and expansion, thus enabling the optimisation of a stenting procedure to minimize the risk of device failure. This paper presents a deep convolutional based model for automatic detection and segmentation of stent struts. The input of pseudo-3D images aggregated the information from adjacent frames to refine the probability of strut detection. In addition, multi-scale shortcut connections were implemented to minimize the loss of spatial resolution and refine the segmentation of strut contours. After training, the model was independently tested in 21,363 cross-sectional images from 170 IVOCT image pullbacks. The ...

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    6. Quantitative flow ratio virtual stenting and post stenting correlations to post stenting fractional flow reserve measurements from the DOCTORS (Does Optical Coherence Tomography Optimize Results of Stenting) study population

      Quantitative flow ratio virtual stenting and post stenting correlations to post stenting fractional flow reserve measurements from the DOCTORS (Does Optical Coherence Tomography Optimize Results of Stenting) study population

      Objective We sought to evaluate the correlations of pre‐PCI QFR analysis with virtual PCI called residual QFR and post‐PCI QFR compared to post‐PCI FFR. Background Quantitative flow ratio (QFR) is a computation of fractional flow reserve (FFR) based on angiography without use of a pressure wire. The ability to evaluate post‐PCI FFR using pre‐PCI QFR analysis with a virtual PCI and the correlation between post‐PCI QFR compared to post‐PCI FFR remains unknown. Methods From the DOCTORS (Does Optical Coherence Tomography Optimize Results of Stenting) study population, we blindly analyzed residual QFR and post ...

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    7. 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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    8. Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients with Non–ST-Elevation Acute Coronary Syndrome

      Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients with Non–ST-Elevation Acute Coronary Syndrome

      Background: No randomized study has investigated the value of optical coherence tomography (OCT) in optimizing the results of percutaneous coronary intervention (PCI) for non–ST-segment elevation acute coronary syndromes. Methods: We conducted a multicenter, randomized study involving 240 patients with non–ST-segment elevation acute coronary syndromes to compare OCT-guided PCI (use of OCT pre- and post-PCI; OCT-guided group) to fluoroscopy-guided PCI (angiography-guided group). The primary end point was the functional result of PCI assessed by the measure of post PCI fractional flow reserve. Secondary end points included procedural complications and type 4a periprocedural myocardial infarction. Safety was assessed by the ...

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    9. RE: Response to Letter Regarding Article, “Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients With Non-ST-Elevation Acute Coronary Syndrome: Results of the Multicenter, Randomized DOCTORS Study"

      RE: Response to Letter Regarding Article, “Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients With Non-ST-Elevation Acute Coronary Syndrome: Results of the Multicenter, Randomized DOCTORS Study"

      We read with interest the letters by Vallurupalli and Uretsky and also Dr Nadir relating to the results of the DOCTORS study (Does Optical Coherence Tomography Optimize Results of Stenting). We thank the authors for their insightful remarks. Vallurupalli and Uretsky raise an interesting point when they underline that a prolonged inflation time is superior to a rapid inflation/deflation technique in terms of both stent expansion and apposition. We acknowledge that we did not take stent inflation time into account in the case report form of the DOCTORS study. The arguments put forward by Vallurupalli and Uretsky suggest that ...

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    10. Characteristics of stent thrombosis in bifurcation lesions analyzed by optical coherence tomography

      Characteristics of stent thrombosis in bifurcation lesions analyzed by optical coherence tomography

      Aims: This work aimed to investigate a cohort of patients presenting with stent thrombosis (ST) explored by optical coherence tomography (OCT) to identify the underlying mechanical abnormalities in case of bifurcation lesions. Methods and results: The PESTO study was a prospective national registry involving 29 French catheterization facilities. Patients with acute coronary syndromes were prospectively screened for presence of definite ST and analyzed by OCT after culprit lesion reopening.The cohort involved n=120 subjects, including n=21 patients (17.5% of the global PESTO group; median age: 62.6 y; 76% male) with bifurcation lesions. The clinical presentation was ...

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    11. Identification of coronary artery plaque rupture before stenting and stent edge dissection after stenting by optical coherence tomography and their management

      Identification of coronary artery plaque rupture before stenting and stent edge dissection after stenting by optical coherence tomography and their management

      Background: Optical coherence tomography (OCT) is a high-resolution imaging modality that can provide an accurate assessment of the coronary artery plaque rupture before stenting, or edge dissection after stenting, and may subsequently provide guidance for optimizing the stenting procedure. Methods: A total of 112 patients with coronary artery disease, who underwent OCT before and after percutaneous coronary intervention (PCI), were enrolled into the study. Interventional procedures were performed with the ameliorated deployment of stents according to OCT. Results: Before PCI, 101 coronary lesion sites were examined, in which 12 plaque ruptures involved in intima (11.9%) were detected by OCT ...

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    12. Response by Meneveau and Ecarnot to Letter Regarding Article, “Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients With Non-ST-Elevation Acute Coronary Syndrome: Results of the Multicenter, Randomized DOCTORS

      Response by Meneveau and Ecarnot to Letter Regarding Article, “Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients With Non-ST-Elevation Acute Coronary Syndrome: Results of the Multicenter, Randomized DOCTORS

      We read with interest the letters by Vallurupalli and Uretsky and also Dr Nadir relating to the results of the DOCTORS study (Does Optical Coherence Tomography Optimize Results of Stenting). 1 We thank the authors for their insightful remarks. Vallurupalli and Uretsky raise an interesting point when they underline that a prolonged inflation time is superior to a rapid inflation/deflation technique in terms of both stent expansion and apposition. We acknowledge that we did not take stent inflation time into account in the case report form of the DOCTORS study. The arguments put forward by Vallurupalli and Uretsky suggest ...

      Read Full Article
    13. Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients with Non-ST-Elevation Acute Coronary Syndrome: Results of the Multicenter, Randomized DOCTORS (Does Optical Coherence Tomography Optimize Results of Stentin

      Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients with Non-ST-Elevation Acute Coronary Syndrome: Results of the Multicenter, Randomized DOCTORS (Does Optical Coherence Tomography Optimize Results of Stentin

      BACKGROUND: No randomized study has investigated the value of optical coherence tomography (OCT) in optimizing the results of percutaneous coronary intervention (PCI) for non-ST-segment elevation acute coronary syndromes. METHODS: We conducted a multicenter, randomized study involving 240 patients with non-ST-segment elevation acute coronary syndromes to compare OCT-guided PCI (use of OCT pre- and post-PCI; OCT-guided group) to fluoroscopy-guided PCI (angiography-guided group). The primary end point was the functional result of PCI assessed by the measure of post PCI fractional flow reserve. Secondary end points included procedural complications and type 4a periprocedural myocardial infarction. Safety was assessed by the rate of ...

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    14. Mechanisms of stent thrombosis analysed by optical coherence tomography: insights from the national PESTO French registr

      Mechanisms of stent thrombosis analysed by optical coherence tomography: insights from the national PESTO French registr

      Aims Angiography has limited value for identifying the causes of stent thrombosis (ST). We studied a large cohort of patients by optical coherence tomography (OCT) to explore ST characteristics and mechanisms. Methods and results A prospective multicentre registry was screened for patients with confirmed ST. Optical coherence tomography was performed after initial intervention to the culprit lesion (in 69% of cases in a deferred procedure). Stent thrombosis was classified as acute (AST), sub-acute (SAST), late (LST), and very late (VLST). Optical coherence tomography records were analysed in a central core lab. The analysis included 120 subjects aged 61.7 [51 ...

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    15. Prognostic impact of tissue protrusion after stenting in patients with acute coronary syndrome: an optical coherence tomography study

      Prognostic impact of tissue protrusion after stenting in patients with acute coronary syndrome: an optical coherence tomography study

      Aim The real clinical impact of Optical Coherence Tomography (OCT) – defined abnormalities remains unknown. We investigated prognostic impact of tissue protrusion between stent struts after stent implantation in patients with non-ST elevation acute coronary syndromes (NSTEACS). Methods Prospective study of consecutive NSTEACS pts (≤72 h) undergoing PCI for an infarct-related artery presenting a single lesion without diffuse disease on the culprit artery. Pts were treated at the operator’s discretion. OCT was performed after initial coronary angiogram and at end of angioplasty procedure. Prolapse was defined as projection of tissue (plaque/thrombus) into the lumen between stent struts after implantation ...

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    16. Does optical coherence tomography optimize results of stenting? Rationale and study design.

      Does optical coherence tomography optimize results of stenting? Rationale and study design.

      Background To date, no randomized study has investigated the value of optical coherence tomography (OCT) in optimizing the results of coronary angioplasty for non-ST elevation acute coronary syndromes (NSTE-ACS). Methods DOCTORS is a randomized, prospective, multicentre, open-label clinical trial to evaluate the utility of OCT to optimize results of angioplasty of a lesion responsible for NSTE-ACS. Patients (n = 250) will be randomized to undergo OCT-guided angioplasty (use of OCT to optimise procedural result, including change to strategy with the possibility of additional interventions); or angioplasty under fluoroscopy alone. The primary endpoint is the functional result of the angioplasty procedure as ...

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    1-16 of 16
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    Does optical coherence tomography optimize results of stenting? Rationale and study design. Prognostic impact of tissue protrusion after stenting in patients with acute coronary syndrome: an optical coherence tomography study Mechanisms of stent thrombosis analysed by optical coherence tomography: insights from the national PESTO French registr Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients with Non-ST-Elevation Acute Coronary Syndrome: Results of the Multicenter, Randomized DOCTORS (Does Optical Coherence Tomography Optimize Results of Stentin Response by Meneveau and Ecarnot to Letter Regarding Article, “Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients With Non-ST-Elevation Acute Coronary Syndrome: Results of the Multicenter, Randomized DOCTORS Identification of coronary artery plaque rupture before stenting and stent edge dissection after stenting by optical coherence tomography and their management Characteristics of stent thrombosis in bifurcation lesions analyzed by optical coherence tomography RE: Response to Letter Regarding Article, “Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients With Non-ST-Elevation Acute Coronary Syndrome: Results of the Multicenter, Randomized DOCTORS Study" Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention in Patients with Non–ST-Elevation Acute Coronary Syndrome 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 New insights from non-invasive imaging: from prospection of skin photodamages to training with mobile application Short-sighted woman assumes debilitating headaches mean she needs new glasses but discovers she has multiple sclerosis