1. Articles in category: Cardiology

    1-24 of 3052 1 2 3 4 ... 126 127 128 »
    1. Association of global and local low endothelial shear stress with high-risk plaque using intracoronary 3D optical coherence tomography: Introduction of ‘shear stress score’

      Association of global and local low endothelial shear stress with high-risk plaque using intracoronary 3D optical coherence tomography: Introduction of ‘shear stress score’

      Aims The association of low endothelial shear stress (ESS) with high-risk plaque (HRP) has not been thoroughly investigated in humans. We investigated the local ESS and lumen remodelling patterns in HRPs using optical coherence tomography (OCT), developed the shear stress score , and explored its association with the prevalence of HRPs and clinical outcomes. Methods and results A total of 35 coronary arteries from 30 patients with stable angina or acute coronary syndrome (ACS) were reconstructed with three dimensional (3D) OCT. ESS was calculated using computational fluid dynamics and classified into low, moderate, and high in 3-mm-long subsegments. In each subsegment ...

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    2. Brigham and Women's Hospital Receives a NIH Grant for Aortic Valve Microcalicifacation

      Brigham and Women's Hospital Receives a NIH Grant for Aortic Valve Microcalicifacation

      Brigham and Women's Hospital Receives a 2016 NIH Grant for $415,740 for Aortic Valve Microcalicifacation. The principal investigator is Elena Aikawa. The program began in 2012 and ends in 2017. Below is a summary of the proposed work. This research project will test the hypothesis that, in the diabetic milieu, S100A9 induces the calcification potential of valvular interstitial cell (VIC)-derived matrix vesicles, precursors of microcalcification, offering the novel mechanism of calcific aortic valve disease (CAVD). Our pilot studies showed that S100A9 - a recently identified biomarker of acute cardiovascular events - is expressed by VIC and a component of ...

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    3. Intravascular MRI for Plaque Characterization: Are We Close to Reality?

      Intravascular MRI for Plaque Characterization: Are We Close to Reality?

      Non-invasive external magnetic resonance imaging (MRI) of large vessel atherosclerosis is a robust and promising imaging modality that can be applied for the evaluation of the atherosclerotic process in large vessels. However, it requires expertise for setup and time for data acquisition and analysis. Intravascular MRI is a promising tool, but its use remains at the pre-clinical stage within selected research groups. In this review, the current status and future role of intravascular MRI for atherosclerotic plaque characterization are summarized, along with important challenges which will be necessary to overcome prior to the wide adoption of this technique.

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    4. Left main artery compression by haematoma following acute aortic root dissection: identification by optical coherence tomography

      Left main artery compression by haematoma following acute aortic root dissection: identification by optical coherence tomography

      A 42-year-old woman with no previous history of cardiovascular disease was referred to our institution for a type A aortic dissection (A1), compressing the left main artery (LMA) ostium (arrow/ A2) and causing anterior ST elevation myocardial infarction with cardiogenic shock. The patient underwent emergent cardiac surgery: the ascending aorta was replaced, and a haematoma was removed from LMA …

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      Mentions: Nicolas Foin
    5. Optical coherence tomography for hypertensive pulmonary vasculature

      Optical coherence tomography for hypertensive pulmonary vasculature

      Background Optical coherence tomography (OCT) is an intravascular imaging modality capable of providing in situ images of tissues at near histologic resolution. In this study we examine the utility of OCT in identifying vascular changes related to pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Methods and results OCT of four different distal pulmonary arteries was performed during right heart catheterization in 87 patients, 64 patients with PAH and 23 patients with CTEPH. The mean luminal diameter measured by OCT for all patients was 2.26 mm. Intimal thickening was significantly increased in all PAH patients (0.26 ...

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      Mentions: UCLA
    6. OCT Medical Imaging Inc. Receives a NIH Grant for Clinical Evaluation and Development of a Diagnostic Multi-modal Intravascular Imaging System

      OCT Medical Imaging Inc. Receives a NIH Grant for Clinical Evaluation and Development of a Diagnostic Multi-modal Intravascular Imaging System

      OCT Medical Imaging Inc. Receives a 2016 NIH Grant for $1,252,899 for Clinical Evaluation and Development of a Diagnostic Multi-modal Intravascular Imaging System. The principal investigator is Tirunelveli Ramalingam. The program began in 2015 and ends in 2018. Below is a summary of the proposed work. Understanding that not a single imaging technique can alone address needs of all vascular diagnosis, OCT medical imaging Inc. (OCTMI) propose to develop a clinical multimodal intravascular imaging system encompassing ultra-high resolution optical coherence tomography (OCT) and IVUS. This Combined multimodal vascular imaging system will permit cross-sectional visualization of vascular artery with ...

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    7. Impact of optical coherence tomography- and coronary angioscopy-assessed neointimal tissue characteristics on occurrence of periprocedural myonecrosis in patients with in-stent restenosis

      Impact of optical coherence tomography- and coronary angioscopy-assessed neointimal tissue characteristics on occurrence of periprocedural myonecrosis in patients with in-stent restenosis

      Several characteristics of neointimal tissues, including neoatherosclerotic progression, have been reported in lesions with in-stent restenosis (ISR). However, the effects of these characteristics on outcomes after percutaneous coronary intervention (PCI) for ISR lesions remain unclear. We assessed the relationships between neointimal tissue characteristics and the occurrence of periprocedural myonecrosis (PMN) after PCI in ISR lesions. We investigated 72 ISR lesions in 72 patients with stable angina pectoris (SAP) who underwent pre- and post-revascularization optical coherence tomography (OCT) and coronary angioscopy (CAS). All lesions were classified as with PMN, defined by an elevated peak high-sensitivity cardiac troponin-T level during the 24-h ...

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    8. Evaluation of Early Healing Profile and Neointimal Transformation Over 24 Months Using Longitudinal Sequential Optical Coherence Tomography Assessments and 3-Year Clinical Results of the New Dual-Therapy Endothelial Progenitor Cell Capturing Sirolimus-Elu

      Evaluation of Early Healing Profile and Neointimal Transformation Over 24 Months Using Longitudinal Sequential Optical Coherence Tomography Assessments and 3-Year Clinical Results of the New Dual-Therapy Endothelial Progenitor Cell Capturing Sirolimus-Elu

      Background— Current monotherapy drug-eluting stents are associated with impaired healing, neoatherosclerosis, and late stent thrombosis. The healing profile and neointimal transformation of the first dual-therapy endothelial progenitor cell–capturing sirolimus-eluting stent are unknown. Methods and Results— In this prospective, single-center study, 61 patients treated with the Combo stent had optical coherence tomography at baseline, early follow-up (4 monthly groups in a 1:2:2:1 ratio from 2 to 5 months), 9 months, and 24 months. Optical coherence tomography early strut coverage increased from 77.1% to 92.5% to 92.7% to 94.9% between 2 and 5 months ...

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    9. Quantitative Analysis of Retinal OCT

      Quantitative Analysis of Retinal OCT

      Clinical acceptance of 3-D OCT retinal imaging brought rapid development of quantitative 3-D analysis of retinal layers, vascu-lature, retinal lesions as well as facilitated new research in retinal diseases. One of the cornerstones of many such analyses is segmentation and thickness quantification of retinal layers and the choroid, with an inherently 3-D simultaneous multi-layer LO-GISMOS (Layered Optimal Graph Image Segmentation for Multiple Objects and Surfaces) segmentation approach being extremely well suited for the task. Once retinal layers are segmented, regional thickness, brightness, or texture-based indices of individual layers can be easily determined and thus contribute to our understanding of retinal ...

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    10. Diagnosis of Thin-Capped Fibroatheromas in Intravascular Optical Coherence Tomography Images Effects of Light Scattering

      Diagnosis of Thin-Capped Fibroatheromas in Intravascular Optical Coherence Tomography Images Effects of Light Scattering

      Background— Intravascular optical coherence tomography (IVOCT) images are recorded by detecting light backscattered within coronary arteries. We hypothesize that non–thin-capped fibroatheroma (TCFA) causes may scatter light to create the false appearance of IVOCT TCFA. Methods and Results— Ten human cadaver hearts were imaged with IVOCT (n=14 coronary arteries). IVOCT and histological TCFA images were coregistered and compared. Of 21 IVOCT TCFAs (fibrous cap <65 μm, lipid arc >1 quadrant), only 8 were true histological TCFA. Foam cell infiltration was responsible for 70% of false IVOCT TCFA and caused both thick-capped fibroatheromas to appear as TCFA, and the appearance ...

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    11. Understanding Why and When Optical Coherence Tomography Does Not Detect Vulnerable Plaques Is It Important?

      Understanding Why and When Optical Coherence Tomography Does Not Detect Vulnerable Plaques Is It Important?

      The goal of research into the in vivo detection of vulnerable plaques is to provide a clinician with a diagnostic tool that identifies vulnerable plaques prospectively to prevent acute events. This tool must have both a high positive predictive value and a high negative predictive value in the clinical setting (not just against histopathology) and cannot require specific expertise or core-laboratory analysis to determine whether a plaque should be treated pre-emptively—in other words, a yes/no, red light/green light, treat/don’t treat tool. Optical coherence tomography (OCT) has been proposed to be that tool. 1 OCT criteria ...

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    12. Optical coherence tomography imaging during endovascular treatment of a patient with Takayasu arteritis

      Optical coherence tomography imaging during endovascular treatment of a patient with Takayasu arteritis

      Takayasu disease (TA) is an inflammation of the large arteries arising from the aortic arch, and sometimes the abdominal aorta. The basis for the treatment of TA is systemic therapy together with symptomatic treatment involving operational or endovascular treatment. Indications are interpolated from recommendations on treatment of atherosclerosis. However, these recommendations should be approached with caution. Thus, the use of modern methods to diagnose and monitor treatment of these changes are of particular interest. Optical coherence tomography (OCT) allows detailed analysis of the inner layers of the wall and atherosclerotic plaque, and it has been performed safely for acute coronary ...

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    13. Development of Advanced Atherosclerotic Plaque by Injection of Inflammatory Proteins in a Rabbit Iliac Artery Model

      Development of Advanced Atherosclerotic Plaque by Injection of Inflammatory Proteins in a Rabbit Iliac Artery Model

      Purpose Appropriate animal models of atherosclerotic plaque are crucial to investigating the pathophysiology of atherosclerosis, as well as for the evaluation of the efficacy and safety of vascular devices. We aimed to develop a novel animal model that would be suitable for the study of advanced atherosclerotic lesions in vivo . Materials and Methods Atherosclerotic plaque was induced in 24 iliac arteries from 12 rabbits by combining a high cholesterol diet, endothelial denudation, and injection into the vessel wall with either saline (n=5), olive oil (n=6), or inflammatory proteins [n=13, high-mobility group protein B1 (HMGB1) n=8 and ...

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    14. Optical coherence tomography images of three different overlapping stents

      Optical coherence tomography images of three different overlapping stents

      A 49-year-old Caucasian woman with prior history of hypertension, diabetes and smoking presented with an inferior ST-elevation myocardial infarction in Killip class I. Ischemia time was four hours. Primary percutaneous coronary intervention (PCI) was performed with thrombus aspiration and direct stenting with a drug-eluting stent (DES). She subsequently underwent PCI with bioresorbable vascular scaffolds (BVS) in the circumflex artery (Cx). After deployment of the BVS a coronary perforation was seen at the distal edge of the device. A stent graft was implanted overlapping the edge of the BVS. The perforation was resolved, nevertheless the distal lesion on the CX artery ...

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    15. Spontaneous coronary artery dissection and healing documented by optical coherence tomography

      Spontaneous coronary artery dissection and healing documented by optical coherence tomography

      An otherwise healthy 57-year-old female patient with no risk factors for coronary artery disease presented to the emergency room with acute chest pain. The patient had been taking appetite suppressant (dimethylamylamine, Oxyelite Pro, (USP Labs) for the last 7 days. 1 , 2 Electrocardiography showed no abnormalities although both serum creatinine kinase-MB (3.59ng/mL) and troponin I (8,310pg/mL) were elevated. Coronary angiography revealed extensive and abrupt lumen narrowing in the obtuse marginal with a subtle intraluminal defect within the distal part of the vessel ( Figure 1 ). Optical coherence tomography (OCT), which is a novel near-infrared light based intravascular ...

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    16. Optical Imaging Measurement of Intravascular Solution Efficacy Trial (OPTIMISE)

      Optical Imaging Measurement of Intravascular Solution Efficacy Trial (OPTIMISE)

      Iodinated contrast is the current gold standard for infrainguinal angiography imaging in patients without renal insufficiency and has also been used with intravascular Optical Coherence Tomography (iOCT) to improve image quality in human coronary arteries as well as carotid arteries. The current debate in the literature for iOCT medium is between iodinated contrast and dextran and CO2 may offer a superior method of iOCT imaging during lower extremity occlusive disease interventions. The investigators hypothesize that the CO2 medium injection during iOCT data acquisition is feasible and will produce at least the same quality of imaging as that obtained with contrast ...

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    17. Dextran or Saline Can Replace Contrast for Intravascular Optical Coherence Tomography in Lower Extremity Arteries

      Dextran or Saline Can Replace Contrast for Intravascular Optical Coherence Tomography in Lower Extremity Arteries

      Purpose: To examine the hypothesis that alternative flush media could be used for lower extremity optical coherence tomography (OCT) imaging in long lesions that would normally require excessive use of contrast. Methods: The OPTical Imaging Measurement of Intravascular Solution Efficacy (OPTIMISE) trial was a single-center, prospective study ( ClinicalTrials.gov identifier NCT01743872 ) that enrolled 23 patients (mean age 68±11 years; 14 men) undergoing endovascular intervention involving the superficial femoral artery. Four flush media (heparinized saline, dextran, carbon dioxide, and contrast) were used in succession in random order for each image pullback. Quality was defined as ≥270° visualization of vessel wall ...

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    18. Quantitative Assessment of Anterior Segment Inflammation in a Rat Model of Uveitis Using Spectral-Domain Optical Coherence Tomography

      Quantitative Assessment of Anterior Segment Inflammation in a Rat Model of Uveitis Using Spectral-Domain Optical Coherence Tomography

      Purpose : To develop anterior segment spectral-domain optical coherence tomography (SD-OCT) and quantitative image analysis for use in experimental uveitis in rats. Methods : Acute anterior uveitis was generated in Lewis rats. A spectral domain anterior segment OCT system was used to image the anterior chamber (AC) and ciliary body at baseline and during peak inflammation 2 days later. Customized MatLab image analysis algorithms were developed to segment the AC, count AC cells, calculate central corneal thickness (CCT), segment the ciliary body and zonules, and quantify the level of ciliary body inflammation with the ciliary body index (CBI). Images obtained at baseline ...

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    19. Characterization of lipid-rich plaques using spectroscopic optical coherence tomography

      Characterization of lipid-rich plaques using spectroscopic optical coherence tomography

      Intravascular optical coherence tomography (IV-OCT) is a high-resolution imaging method used to visualize the internal structures of walls of coronary arteries in vivo . However, accurate characterization of atherosclerotic plaques with gray-scale IV-OCT images is often limited by various intrinsic artifacts. In this study, we present an algorithm for characterizing lipid-rich plaques with a spectroscopic OCT technique based on a Gaussian center of mass (GCOM) metric. The GCOM metric, which reflects the absorbance properties of lipids, was validated using a lipid phantom. In addition, the proposed characterization method was successfully demonstrated in vivo using an atherosclerotic rabbit model and was found ...

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    20. "VACUOLE" SIGN ADJACENT TO RETINAL PIGMENT EPITHELIAL DEFECTS ON SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY IN CENTRAL SEROUS CHORIORETINOPATHY ASSOCIATED WITH SUBRETINAL FIBRIN

      "VACUOLE" SIGN ADJACENT TO RETINAL PIGMENT EPITHELIAL DEFECTS ON SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY IN CENTRAL SEROUS CHORIORETINOPATHY ASSOCIATED WITH SUBRETINAL FIBRIN

      Purpose: To report spectral domain optical coherence tomography features in central serous chorioretinopathy associated with subretinal fibrin. Method: Retrospective observational case series of patients with central serous chorioretinopathy with subretinal fibrin imaged with spectral domain optical coherence tomography. Result: Twenty-three eyes of 23 patients (19 males and 4 females), with mean age of 39.09 +/- 5.8 years were included in the study. Subretinal fibrin clinically ranged from localized well-defined areas to extensive ill-defined areas. Along with the presence of subretinal hyperreflectivity (n = 23, 100%), corresponding to fibrin, spectral domain optical coherence tomography also revealed the presence of the retinal ...

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    21. Ex Vivo Assessment of Neointimal Characteristics After Drug-eluting Stent Implantation: Optical Coherence Tomography and Histopathology Validation Study

      Ex Vivo Assessment of Neointimal Characteristics After Drug-eluting Stent Implantation: Optical Coherence Tomography and Histopathology Validation Study

      Background Optical coherence tomography (OCT) is one of the tools trying to distinguish neoatherosclerosis from other neointimal tissue but its role has to be still validated. This study evaluated the diagnostic accuracy of OCT for characterization of lipid-atherosclerotic neointima following drug-eluting stent (DES) implantation. Methods Twelve stented coronary arteries from the 7 autopsy hearts were imaged by OCT. These OCT images were compared with histology. By OCT, the morphological appearances of neointima were classified into three patterns: homogeneous pattern, heterogeneous pattern with visible strut, or heterogeneous pattern with invisible strut. Results Of 21 histological cross-sections, 6 were categorized as homogeneous ...

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    22. Alternative flush media can replace contrast for peripheral OCT

      Alternative flush media can replace contrast for peripheral OCT

      In the OPTIMISE trial, intravascular OCT was feasible in peripheral vessels of less than 5 mm in diameter, and dextran and saline flush media were effectively used as alternative strategies to replace contrast media Daniel E. Kendrick, MD, of Harrington Heart & Vascular Institute, University Hospitals Case Medical Center, Cleveland, and colleagues enrolled 23 patients undergoing elective diagnostic angiography for femoropopliteal occlusive disease in the single-center, prospective study. Twenty-two patients presented with critical limb ischemia or lifestyle-limiting claudication. The mean age of the patients was 68 years, 14 patients were men, mean Rutherford category was 3.5 and mean WIFI (wound ...

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      Mentions: St. Jude Medical
    23. Distribution characteristics of coronary calcification and its substantial impact on stent expansion: an optical coherence tomography study

      Distribution characteristics of coronary calcification and its substantial impact on stent expansion: an optical coherence tomography study

      According to previous studies, the presence of coronary calcification was associated with worse clinical outcomes due to plaque fracture after angioplasty and stent underexpansion. It remained the biggest issue even after the emergence of drug-eluting stents (DES). Intravascular ultrasound (IVUS) played an important role in the evaluation of coronary calcification during percutaneous coronary intervention (PCI). However, due to limited resolution and inevitable artefacts such as acoustic shadowing and side lobes, only the arc or the “approximate” degree of superficiality of coronary calcifications could be assessed. Currently, optical coherence tomography (OCT), another intravascular imaging technique with a higher spatial resolution, has ...

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    24. Fractional flow reserve-guided coronary angioplasty using paclitaxel-coated balloons without stent implantation: feasibility, safety and 6-month results by angiography and optical coherence tomography

      Fractional flow reserve-guided coronary angioplasty using paclitaxel-coated balloons without stent implantation: feasibility, safety and 6-month results by angiography and optical coherence tomography

      Background Percutaneous coronary interventions (PCI) with drug-coated balloons (DCB) might be a promising trade-off between balloon angioplasty and drug-eluting stents, since DCB inhibit neointimal proliferation and limit duration of dual antiplatelet therapy. We investigated the safety, feasibility, and 6-month results of fractional flow reserve (FFR)-guided use of the paclitaxel-coated SeQuent Please ® balloon without stenting for elective PCI of de novo lesions. Methods and results In 46 patients (54 lesions) with stable symptomatic coronary artery disease (CAD), a FFR-guided POBA (plain old balloon angioplasty) was performed. In case of a sufficient POBA result with residual stenosis < 40 %, FFR > 0.8 ...

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      Mentions: Sylvia Otto
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