1. Articles in category: Cardiology

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    1. Optical coherence tomography features of angiographic complex and smooth lesions in acute coronary syndromes

      Optical coherence tomography features of angiographic complex and smooth lesions in acute coronary syndromes

      Plaque rupture (PR) and superimposed thrombosis have been shown as the most frequent underlying substrate in acute coronary syndromes (ACS). Coronary angiography is a luminogram not able to define in vivo features of the culprit plaques. The aim of the study was to use optical coherence tomography (OCT) to investigate the pathology underlying complex (CL) and non-complex angiographic lesions (NCL). We retrospectively enrolled 107 ACS patients admitted to our institution; 83 with non-ST elevation ACS (NSTE-ACS) and 24 with ST-elevation myocardial infarction. Coronary angiography was performed and culprit lesions were classified according to Ambrose criteria into NCL (n = 47) and ...

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    2. Simultaneous morphological and biochemical endogenous optical imaging of atherosclerosis

      Simultaneous morphological and biochemical endogenous optical imaging of atherosclerosis

      Aims The aim of this study was to validate novel imaging technology for simultaneous morphological and biochemical endogenous optical imaging of coronary atherosclerotic plaque. Methods and results Optical coherence tomography (OCT) generates high-resolution 3D images of plaque morphology and endogenous fluorescence lifetime imaging microscopy (FLIM) characterizes biochemical composition. Both imaging modalities rely on plaque's intrinsic optical characteristics, making contrast agents unnecessary. A multimodal OCT/FLIM system was utilized to generate luminal biochemical maps superimposed on high-resolution (7 µm axial and 13 µm lateral) structural volumetric images. Forty-seven fresh postmortem human coronary segments were imaged: pathological intimal thickening (PIT, n ...

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    3. Clinical and pathological characteristics of homogeneous and nonhomogeneous tissue of in-stent restenosis visualized by optical coherence tomography

      Clinical and pathological characteristics of homogeneous and nonhomogeneous tissue of in-stent restenosis visualized by optical coherence tomography

      Background: Although it is known that in-stent restenosis (ISR) patterns appear homogeneous or nonhomogeneous by optical coherence tomography (OCT), interpretations of the ISR inflammatory response, of the OCT image, and its pathological implications are unclear. The aim of this study was to use OCT to characterize ISR and its inflammatory index in patients after coronary stenting. Methods: OCT was performed at follow-up in 100 angiographic ISR lesions. ISR lesions were divided into two groups: (a) homogeneous (n=48) and (b) nonhomogeneous (n=52) image groups. We assessed the ISR images produced by OCT for tissue heterogeneity and neo-intimal hyperplasia using ...

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    4. Multidisciplinary approach in early stent thrombosis: Insights From Optical Coherence Tomography and Platelet Reactivity testing

      Multidisciplinary approach in early stent thrombosis: Insights From Optical Coherence Tomography and Platelet Reactivity testing

      Intracoronary diagnostic techniques, like optical coherence tomography (OCT), and the assessment of platelet reactivity are not approved for routinely use in acute percutaneous coronary interventions (PCI) complications. In this report we describe how a multidisciplinary approach with both techniques may be key in the etiopathogenic diagnosis in acute stent thrombosis (ST) and very useful to apply the correct treatment.

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    5. Plaque rupture and intact fibrous cap assessed by optical coherence tomography portend different outcomes in patients with acute coronary syndrome

      Plaque rupture and intact fibrous cap assessed by optical coherence tomography portend different outcomes in patients with acute coronary syndrome

      Aims Patients presenting with acute coronary syndrome (ACS) may have different plaque morphologies at the culprit lesion. In particular, plaque rupture (PR) has been shown as the more frequent culprit plaque morphology in ACS. However, its prognostic value is still unknown. In this study, we evaluated the prognostic value of PR, compared with intact fibrous cap (IFC), in patients with ACS. Methods and results We enrolled consecutive patients admitted to our Coronary Care Unit for ACS and undergoing coronary angiography followed by interpretable optical coherence tomography (OCT) imaging. Culprit lesion was classified as PR and IFC by OCT criteria. Prognosis ...

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      Mentions: Francesco Prati
    6. 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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    7. In Vivo Characterization of Carotid Neointimal Hyperplasia by use of Optical Coherence Tomography: Before and After Cutting Balloon Angioplasty

      In Vivo Characterization of Carotid Neointimal Hyperplasia by use of Optical Coherence Tomography: Before and After Cutting Balloon Angioplasty

      Optical coherence tomography (OCT) is a modern intravascular imaging modality that has the capability to provide detailed, in vivo characterization of the arterial wall and atherosclerotic plaque. The current understanding of the appearance of atherosclerotic plaque via OCT is largely based on coronary arterial studies where OCT information has been employed to guide therapeutic management and permits the immediate evaluation of percutaneous intervention. The clinical success of OCT in the coronary arteries has laid the foundation for investigation of the carotid artery and thus, stroke risk assessment. We report the novel use of OCT for tissue characterization of severe stenosis ...

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    8. Automated peroperative assessment of stents apposition from OCT pullbacks

      Automated peroperative assessment of stents apposition from OCT pullbacks

      This study׳s aim was to control the stents apposition by automatically analyzing endovascular optical coherence tomography (OCT) sequences. Lumen is detected using threshold, morphological and gradient operators to run a Dijkstra algorithm. Wrong detection tagged by the user and caused by bifurcation, struts’presence, thrombotic lesions or dissections can be corrected using a morphing algorithm. Struts are also segmented by computing symmetrical and morphological operators. Euclidian distance between detected struts and wall artery initializes a stent׳s complete distance map and missing data are interpolated with thin-plate spline functions. Rejection of detected outliers, regularization of parameters by generalized cross-validation ...

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    9. Lumen Segmentation in Intravascular Optical Coherence Tomography using Backscattering Tracked and Initialized Random Walks

      Lumen Segmentation in Intravascular Optical Coherence Tomography using Backscattering Tracked and Initialized Random Walks

      Intravascular imaging using ultrasound (IVUS) or optical coherence tomography (OCT) is predominantly used to adjunct clinical information in interventional cardiology. OCT provides high-resolution images for detailed investigation of atherosclerosis induced thickening of the lumen wall resulting in arterial blockage and triggering acute coronary events. However, the stochastic uncertainty of speckles limits effective visual investigation over large volume of pullback data and clinicians are challenged by their inability to investigate subtle variations in the lumen topology associated with plaque vulnerability and onset of necrosis. This paper presents a lumen segmentation method using OCT imaging physics based graph representation of signals and ...

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    10. Development and Receding of a Coronary Artery Aneurysm After Implantation of a Fully Bioresorbable Scaffold

      Development and Receding of a Coronary Artery Aneurysm After Implantation of a Fully Bioresorbable Scaffold

      A 83-year-old man included in the ABSORB cohort B trial underwent successful percutaneous coronary intervention of the middle left anterior descending artery with a 3.0×18-mm bioresorbable scaffold (Absorb, Abbott Vascular, CA) that was postdilated with a 3.0-mm noncompliant balloon at 24 atm (Figure 1A and 1B). The 2-dimensional and 3-dimensional (3D) optical coherence tomography (OCT) confirmed the absence of structural discontinuity after the procedure (Figure 2B and Figure 3A’). At 6 months, the planned angiography showed the absence of restenosis but an ectasia in the scaffolded segment (Figure 1C). Intravascular ultrasound revealed a focal vessel and lumen ...

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    11. Real-time OCT guidance of an ablation laser for advancement in the fight of atherosclerotic cardio-vascular disease

      Real-time OCT guidance of an ablation laser for advancement in the fight of atherosclerotic cardio-vascular disease

      Real-time OCT guidance of an ablation laser has now been developed for use in the treatment of atherosclerotic cardio-vascular disease. DWH Systems, Inc. of Seminole Florida working with ELAN Vascular Technologies has developed a system whereby three OCT imaging heads monitor a femtosecond ablation laser in real-time, to perform micro ablation on the outer surface of diseased arteries. OCT is used first to acquire a 3D, C-scan map of the diseased portion of an artery then develops an ablation map for the system to follow. As ablation is performed, OCT again monitors the lasers cutting process from multiple angles in ...

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    12. Optical coherence tomography appraisal of residual thrombus burden in patients with ST-segment elevation myocardial infarction undergoing intraprocedural versus post-stenting prolonged bivalirudin infusion. Rationale and design of the MATRIX (Minimizing A

      Optical coherence tomography appraisal of residual thrombus burden in patients with ST-segment elevation myocardial infarction undergoing intraprocedural versus post-stenting prolonged bivalirudin infusion. Rationale and design of the MATRIX (Minimizing A

      Aims: Residual thrombus accumulation around stent struts has been observed after the end of primary PCI and may represent a risk factor for acute stent thrombosis. The aim of this study is to test whether a strategy of prolonged bivalirudin infusion may reduce thrombosis of stent struts as compared to an intraprocedural only administration in subjects undergoing primary PCI. Methods and results: One hundred and sixty patients will be selected from the MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and angioX) study with all the following inclusion criteria: a) STEMI patients undergoing primary PCI with stent implantation, b ...

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    13. Spontaneous coronary artery dissection associated with ascending aorta dystrophy : a tear for fear

      Spontaneous coronary artery dissection associated with ascending aorta dystrophy : a tear for fear

      A 36-year old man with a recent history of aortic valve surgery for ascending aorta aneurysm was admitted for a non-ST elevation myocardial infarction. Cardiac MRI depicted a limited necrotic lesion in the anterior wall. Coronary angiography showed no significant stenosis, but a mild distal dynamic tortuosity on left anterior descending artery. Optical coherence tomography analysis confirmed the absence of any significant atherosclerotic infiltration but revealed the presence of a localized short arterial dissection within the kinked zone. The patient was managed with a conservative medical approach. The subsequent evolution was uneventful.

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    14. Comparison of Strut Coverage at Six Months by Optical Coherence Tomography with Everolimus Eluting Stent or Bare-Metal Stent Restenosis –vs- Stenosis of Non-Stented Atherosclerotic Narrowing (from the DESERT Study)

      Comparison of Strut Coverage at Six Months by Optical Coherence Tomography with Everolimus Eluting Stent or Bare-Metal Stent Restenosis –vs- Stenosis of Non-Stented Atherosclerotic Narrowing (from the DESERT Study)

      Incomplete struts coverage is a predictor of late stent thrombosis after drug eluting stent (DES) implantation in atherosclerotic lesions. The process of struts coverage in DES implanted for bare-metal stent (BMS) restenosis has never been described. Thirty-two patients with stable coronary artery disease were consecutively selected, 11 with BMS restenosis (group A) and 21 with de-novo atherosclerotic lesions (group B). All patients underwent everolimus eluting stent implantation; coronary angiography and optical coherence tomography (OCT) were performed at 6-month follow-up. Percentage difference in struts coverage between the two groups was the primary end-point. A total of 85773 struts (17891 in group ...

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    15. Expansion of the Clinical Application of Optical Coherence Tomography to Percutaneous Coronary Intervention and Assessment of the Instability of Coronary Atherosclerosis

      Expansion of the Clinical Application of Optical Coherence Tomography to Percutaneous Coronary Intervention and Assessment of the Instability of Coronary Atherosclerosis

      Optical coherence tomography (OCT) is an innovative intravascular imaging tool that can be used to examine coronary atherosclerotic lesions at a resolution (10–15μm) that far exceeds that of existing methods such as intravascular ultrasonography (IVUS), by an order of magnitude. In the research field, on account of its superior resolution, OCT has been used for qualitative assessment of vulnerable plaque characterized by thin-cap fibroatheroma;1,2 such plaque is the precursor of the ruptured thrombotic plaque, plaque containing calcium nodules, and plaque erosion

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    16. Intravascular magnetomotive optical coherence tomography of targeted early-stage atherosclerotic changes in ex vivo hyperlipidemic rabbit aortas

      Intravascular magnetomotive optical coherence tomography of targeted early-stage atherosclerotic changes in ex vivo hyperlipidemic rabbit aortas

      Representative magnetomotive signal (green) using targeted and non-targeted magnetomotive microspheres in atherosclerotic diseased rabbit aortas. We report the development of an intravascular magnetomotive optical coherence tomography (IV-MM-OCT) system used with targeted protein microspheres to detect early-stage atherosclerotic fatty streaks/plaques. Magnetic microspheres (MSs) were injected in vivo in rabbits, and after 30 minutes of in vivo circulation, excised ex vivo rabbit aorta samples specimens were then imaged ex vivo with our prototype IV-MM-OCT system. The alternating magnetic field gradient was provided by a unique pair of external custom-built electromagnetic coils that modulated the targeted magnetic MSs. The results showed a ...

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    17. How to Detect and Treat Coronary Fibroatheromas The Synergy Between IVUS and NIRS

      How to Detect and Treat Coronary Fibroatheromas The Synergy Between IVUS and NIRS

      Coronary fibroatheromas can cause a wide spectrum of adverse events, such as sudden death, acute coronary syndromes, and procedural complications during percutaneous coronary interventions (PCI) ( 2 ). Accurate fibroatheroma detection could significantly enhance our ability to treat these lesions and prevent complications.

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    18. Machine Learning Based Analysis of Coronary Stent Images in Intravascular Optical Coherence Tomography Pullbacks (Thesis)

      Machine Learning Based Analysis of Coronary Stent Images in Intravascular Optical Coherence Tomography Pullbacks (Thesis)

      Coronary artery disease (CAD) is the most common heart disease and the leading cause of death worldwide. Stent implantation via percutaneous coronary intervention is a popular procedure for treating CAD. Drug eluting stents (DESs) were shown to reduce restenosis compared to bare metal stents. However, DESs were related to a higher risk of late stent thrombosis, a catastrophic clinical event caused by delayed arterial healing. Therefore, it’s important to evaluate the treatment efficacy and safety of new stent designs via pre-clinical and clinical trials. Stent strut coverage and apposition assessed by intravascular optical coherence tomography (IVOCT) have become important ...

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    19. 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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    20. OCT for the Identification of Vulnerable Plaque in Acute Coronary Syndrome

      OCT for the Identification of Vulnerable Plaque in Acute Coronary Syndrome

      After 2 decades of development and use in interventional cardiology research, optical coherence tomography (OCT) has now become a core intravascular imaging modality in clinical practice. Its unprecedented spatial resolution allows visualization of the key components of the atherosclerotic plaque that appear to confer “vulnerability” to rupture—namely the thickness of the fibrous cap, size of the necrotic core, and the presence of macrophages. The utility of OCT in the evaluation of plaque composition can provide insights into the pathophysiology of acute coronary syndrome and the healing that occurs thereafter. A brief summary of the principles of OCT technology and ...

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    21. Single-centre, Registry Trial, the Patients Presented With Stable Coronary Artery Disease

      Single-centre, Registry Trial, the Patients Presented With Stable Coronary Artery Disease

      This is a prospective study to analyze the outcome of provisional main vessel stenting on side branch by utilizing Two-Dimensional (2D) and Three-Dimensional (3D) frequency domain optical coherence tomography (FD-OCT). To analyze the fate of side-branch after provisional main vessel stenting based on morphology defined prior to PCI by OCT. Offline analysis of side branch impingement of the ostium of SB leading to acute loss in SB diameter area, carina shift and plaque shift will be also be performed.

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    22. Optical Coherence Tomography to Optimize Stent Deployment: Seeing is Believing

      Optical Coherence Tomography to Optimize Stent Deployment: Seeing is Believing

      Optimal coherence tomography (OCT) is a new light-based intracoronary imaging modality with unprecedented spatial resolution.1,2 Currently, its axial resolution is only 15 mm, that is, 10 times higher than that of more classical techniques such as intravascular ultrasound (IVUS) based on ultrasounds (150 mm). Optimal coherence tomography therefore provides extremely high-quality images of the coronary wall, especially of the structures closest to the vessel lumen.1,2 Moreover, numerous studies with histological validation have confirmed its ability to adequately differentiate the distinct types of atheromatous plaque, including fibrous plaques (homogeneous, signal-rich regions), lipid plaque (progressively signal-poor regions) and ...

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      Mentions: Fernando Alfonso
    23. Impact of local vascular lesions assessed with optical coherence tomography and ablation points on blood pressure reduction after renal denervation

      Impact of local vascular lesions assessed with optical coherence tomography and ablation points on blood pressure reduction after renal denervation

      Local vascular injury is detectable with optical coherence tomography (OCT) after catheter-based renal denervation (RDN). However, it is unclear whether the number and type of vascular lesions or the number of ablation points could affect blood pressure (BP) reduction. The aim of the study was to assess the impact of vascular injury induced by RDN detected with OCT and the number of ablation points on BP response after 1, 3 and 6 months. METHODS: RDN was either performed with a Simplicity ® catheter or an EnligHTN TM multielectrode basket followed by OCT. BP was recorded prospectively as office measurement and 24-hour ...

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    1-24 of 2504 1 2 3 4 ... 103 104 105 »
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