1. Articles in category: Cardiology

    1-24 of 3104 1 2 3 4 ... 128 129 130 »
    1. Automatic classification of atherosclerotic plaques imaged with intravascular OCT

      Automatic classification of atherosclerotic plaques imaged with intravascular OCT

      Intravascular optical coherence tomography (IV-OCT) allows evaluation of atherosclerotic plaques; however, plaque characterization is performed by visual assessment and requires a trained expert for interpretation of the large data sets. Here, we present a novel computational method for automated IV-OCT plaque characterization. This method is based on the modeling of each A-line of an IV-OCT data set as a linear combination of a number of depth profiles. After estimating these depth profiles by means of an alternating least square optimization strategy, they are automatically classified to predefined tissue types based on their morphological characteristics. The performance of our proposed method ...

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    2. The OPTIS Integrated System: real-time, co-registration of angiography and optical coherence tomography

      The OPTIS Integrated System: real-time, co-registration of angiography and optical coherence tomography

      The efficacy of an IVUS-guided stent implantation strategy to improve acute results and clinical outcome has been described previously. OCT is another technique which allows high-resolution intracoronary imaging. However, the use of invasive imaging modalities to guide PCI has, as yet, played a limited role in current clinical practice. This may be partly explained by the expertise required for interpretation and clinical decision making. We present a novel technology which enables real-time co-registration of OCT images with angiography. This will simplify matching cross-sectional images to their geographic position on the angiogram, thereby facilitating imaging-guided PCI.

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    3. Letter by Garcia-Garcia and Brugaletta Regarding Article, “Optical Coherence Tomography–Guided Percutaneous Coronary Intervention in ST-Segment–Elevation Myocardial Infarction: A Prospective Propensity-Matched Cohort of the Thrombectomy Versus Percutaneou

      Letter by Garcia-Garcia and Brugaletta Regarding Article, “Optical Coherence Tomography–Guided Percutaneous Coronary Intervention in ST-Segment–Elevation Myocardial Infarction: A Prospective Propensity-Matched Cohort of the Thrombectomy Versus Percutaneou

      Sheth et al 1 compared optical coherence tomography (OCT)–guided versus angiography-guided primary percutaneous coronary intervention for ST-segment–elevation myocardial infarction among patients in the TOTAL trial (Thrombectomy Versus Percutaneous Coronary Intervention Alone). Patients (n=214) were imaged with OCT and were propensity-matched with 428 patients who had angio-guided percutaneous coronary intervention. There were clear OCT guidelines for stent optimization; however, operator compliance to follow those guidelines and whether optimal results were achieved are not reported. This makes us wonder whether the investigator’s good intentions were actually executed and were effective. Hence, it is uncertain whether the OCT group ...

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    4. Optical Coherence Tomography for Online Guidance of Complex Coronary Interventions

      Optical Coherence Tomography for Online Guidance of Complex Coronary Interventions

      Decision making on lesion preparation and stent/scaffold optimization are cornerstones of patient outcome. Intravascular imaging recently emerged as a critical modality to achieve better results of stent/scaffold implantation and superior clinical outcomes compared with coronary angiography alone. Optical coherence tomography (OCT), a light-based intravascular imaging modality with high frame rate in acquisition and very high speed pullback, can interrogate the target vessel in a couple of seconds, and immediately display a pristine longitudinal lumen contour with automatic detection of lesion severity, site and lumen/stent areas. Further, OCT provides pivotal information on sites of calcium, with accurate measurements ...

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    5. Early Restenose in a Polymer-Free Biolimus A9-coated Stent (BioFreedom): a Case Report based on Optical Coherence Tomography

      Early Restenose in a Polymer-Free Biolimus A9-coated Stent (BioFreedom): a Case Report based on Optical Coherence Tomography

      A 81 year old male patient with a severe de novo coronary artery stenosis in the proximal left anterior descending artery was treated with a BioFreedom stent (3.5 × 11 mm), three months later, the patient was re-admitted with chest pain and slightly increased troponin. The angiogram showed a significant in-stent restenosis in the recently treated lesion. Optical coherence tomography revealed a fully expanded stent without areas of incomplete stent apposition. Severe immature neointimal hyperplasia without formation of thrombosis was visualized, causing a severe in-stent restenosis. An underlying plaque rupture within the mid-proximal part of the in-stent restenosis was evident.

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    6. Serial optical coherence tomography assessment of malapposed struts after everolimus-eluting stent implantation. A subanalysis from the HEAL-EES study

      Serial optical coherence tomography assessment of malapposed struts after everolimus-eluting stent implantation. A subanalysis from the HEAL-EES study

      Background Incomplete stent apposition (ISA) is related to stent thrombosis, which is a serious adverse event. We aim to assess the time-course of ISA after 2nd generation everolimus-eluting stent (EES) implantation. Methods In HEAL-EES study, we enrolled 36 patients who underwent percutaneous coronary intervention (PCI) with EES. OCT imaging was performed at baseline and follow-up. Patients were randomized 1:1:1 into 3 groups according to the time in which follow-up was performed: group A (6-month), group B (9-month), and group C (12-month). In this subanalysis, patients who had ISA segments at baseline and/or follow-up OCT were analyzed. Result ...

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    7. Two-year clinical, angiographic, and serial optical coherence tomographic follow-up after implantation of an everolimus-eluting bioresorbable scaffold and an everolimus-eluting metallic stent: insights from the randomised ABSORB Japan trial

      Two-year clinical, angiographic, and serial optical coherence tomographic follow-up after implantation of an everolimus-eluting bioresorbable scaffold and an everolimus-eluting metallic stent: insights from the randomised ABSORB Japan trial

      Aims: We sought to investigate two-year clinical and serial optical coherence tomography (OCT) outcomes after implantation of a fully bioresorbable vascular scaffold (BVS) or a cobalt-chromium everolimus-eluting stent (CoCr-EES). Methods and results: In the ABSORB Japan trial, 400 patients were randomised in a 2:1 ratio to BVS (N=266) or CoCr-EES (N=134). A pre-specified OCT subgroup (N=125, OCT-1 group) underwent angiography and OCT post procedure and at two years. Overall, the two-year TLF rates were 7.3% and 3.8% in the BVS and CoCr-EES arms (p=0.18), respectively. Very late scaffold thrombosis (VLST) beyond one ...

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    8. Coronary Plaque Characteristics Associated With Reduced TIMI (Thrombolysis in Myocardial Infarction) Flow Grade in Patients With ST-Segment–Elevation Myocardial Infarction A Combined Optical Coherence Tomography and Intravascular Ultrasound Study

      Coronary Plaque Characteristics Associated With Reduced TIMI (Thrombolysis in Myocardial Infarction) Flow Grade in Patients With ST-Segment–Elevation Myocardial Infarction A Combined Optical Coherence Tomography and Intravascular Ultrasound Study

      Background— Previous studies reported that reduced TIMI (Thrombolysis in Myocardial Infarction) flow grade before procedure was associated with worse clinical outcomes in patients with ST-segment–elevation myocardial infarction undergoing primary percutaneous coronary intervention. The aim of this study was to identify specific morphological characteristics of the culprit plaque associated with poor TIMI flow grade at baseline in patients with ST-segment–elevation myocardial infarction using both optical coherence tomography and intravascular ultrasound. Methods and Results— A total of 111 ST-segment–elevation myocardial infarction patients who underwent percutaneous coronary intervention within 24 hours of symptom onset were included. Both optical coherence tomography ...

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    9. Optical coherence tomography attenuation imaging for lipid core detection: an ex-vivo validation study

      Optical coherence tomography attenuation imaging for lipid core detection: an ex-vivo validation study

      Lipid-core atherosclerotic plaques are associated with disease progression, procedural complications, and cardiac events. Coronary plaque lipid can be quantified in optical coherence tomography (OCT) pullbacks by measurement of lipid arcs and lipid lengths; parameters frequently used in clinical research, but labor intensive and subjective to analyse. In this study, we investigated the ability of quantitative attenuation, derived from intravascular OCT, to detect plaque lipid. Lipid cores are associated with a high attenuation coefficient. We compared the index of plaque attenuation (IPA), a local quantitative measure of attenuation, to the manually measured lipid score (arc and length) on OCT images, and ...

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    10. Clinical Significance of Pre-interventional Optical Coherence Tomography in Bioresorbable Vascular Scaffold Implantation

      Clinical Significance of Pre-interventional Optical Coherence Tomography in Bioresorbable Vascular Scaffold Implantation

      Previous studies reported 20-30% of under-expansion or malapposition with BVS, which would increase the risk of adverse events including late stent thrombosis. OCT-guidance may improve more optimized scaffold placement and also better outcomes. However, there is still no sufficient evidence that OCT has an inevitable role in optimal implantation of BVS and it should be more evaluated in real practice. In the study, the investigators will evaluate an incidence of OCT-defined BVS sub-optimization requiring additional PCI+A1.

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    11. Avinger Signs Agreement with HealthTrust for Lumivascular Technology

      Avinger Signs Agreement with HealthTrust for Lumivascular Technology

      Avinger, Inc. (NASDAQ: AVGR ), a developer of innovative treatments for peripheral artery disease (PAD), today announced it has signed an agreement with HealthTrust. The agreement establishes terms under which members of the HealthTrust group purchasing organization may acquire Avinger’s portfolio of technologies designed to treat PAD, including Avinger’s Pantheris TM Optical Coherence Tomography (OCT) image-guided atherectomy system, which recently received 510(k) clearance from the United States Food & Drug Administration (FDA). The agreement becomes effective September 15, 2016. Pantheris is a minimally invasive treatment for peripheral artery disease in which a catheter-based device is used to remove plaque ...

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      Mentions: FDA Avinger
    12. Avinger Signs Agreement with U.S. Department of Veterans Affairs for Lumivascular Technology

      Avinger Signs Agreement with U.S. Department of Veterans Affairs for Lumivascular Technology

      Avinger, Inc a developer of innovative treatments for peripheral artery disease (PAD), today announced the company has received an FSS Contract Award from the U.S. Department of Veterans Affairs (VA) which establishes terms under which VA hospitals across the country may acquire Avinger’s portfolio of Optical Coherence Tomography (OCT) image-guided catheters for their veterans hospitals. VA operates the nation's largest integrated health care system, with more than 1,700 hospitals, clinics, community living centers, domiciliaries, readjustment counseling centers, and other facilities. “We’re thrilled that our Lumivascular technologies will now be available to the men and women ...

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    13. Tail artifact removal in OCT angiography images of rodent cortex

      Tail artifact removal in OCT angiography images of rodent cortex

      Optical coherence tomography angiography (OCTA) is a surging non-invasive, label-free, in vivo volumetric imaging method, currently being translated to clinical ophthalmology and becoming popular in neuroscience. Despite its attractiveness, there is an inherent issue of using OCT angiograms for quantitative cerebrovascular studies: The dynamic scattering of moving erythrocytes within pial vasculature creates tail-like artifacts that shadow the capillary vessels in the deeper layers of cortex. This false flow effect is relatively benign for qualitative visualization purposes, but it might have a significant impact on quantitative interpretation of angiographic results. In this work, we propose a simple image processing method to ...

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    14. Effective anti-thrombotic therapy without stenting: intravascular optical coherence tomography-based management in plaque erosion (the EROSION study)

      Effective anti-thrombotic therapy without stenting: intravascular optical coherence tomography-based management in plaque erosion (the EROSION study)

      Aims Plaque erosion, compared with plaque rupture, has distinctly different underlying pathology and therefore may merit tailored therapy. In this study, we aimed to assess whether patients with acute coronary syndrome (ACS) caused by plaque erosion might be stabilized by anti-thrombotic therapy without stent implantation. Methods and results This was a single-centre, uncontrolled, prospective, proof-of concept study. Patients with ACS including ST-segment elevation myocardial infarction were prospectively enrolled. If needed, aspiration thrombectomy was performed. Patients diagnosed with plaque erosion by optical coherence tomography (OCT) and residual diameter stenosis <70% on coronary angiogram were treated with anti-thrombotic therapy without stenting. OCT ...

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    15. 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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    16. Patterns of coronary plaque progression: phasic versus gradual. A combined optical coherence tomography and intravascular ultrasound study

      Patterns of coronary plaque progression: phasic versus gradual. A combined optical coherence tomography and intravascular ultrasound study

      Objective: Some plaques grow slowly in a linear manner, whereas others undergo a rapid phasic progression. However, the detailed in-vivo relationship between plaque characteristics and plaque progression pattern has not been reported. The current study aimed to investigate the plaque progression patterns with serial intravascular ultrasound (IVUS) examinations, and to correlate baseline plaque characteristics assessed by optical coherence tomography and IVUS with plaque progression patterns. Methods: A total of 248 coronary lesions from 157 patients were identified and imaged by both optical coherence tomography and IVUS at baseline. IVUS examination was repeated at 6 and 12 months. Plaque progression was ...

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    17. Coronary Plaque Characteristics Associated With Reduced TIMI (Thrombolysis in Myocardial Infarction) Flow Grade in Patients With ST-Segment–Elevation Myocardial Infarction A Combined Optical Coherence Tomography and Intravascular Ultrasound Study

      Coronary Plaque Characteristics Associated With Reduced TIMI (Thrombolysis in Myocardial Infarction) Flow Grade in Patients With ST-Segment–Elevation Myocardial Infarction A Combined Optical Coherence Tomography and Intravascular Ultrasound Study

      Background— Previous studies reported that reduced TIMI (Thrombolysis in Myocardial Infarction) flow grade before procedure was associated with worse clinical outcomes in patients with ST-segment–elevation myocardial infarction undergoing primary percutaneous coronary intervention. The aim of this study was to identify specific morphological characteristics of the culprit plaque associated with poor TIMI flow grade at baseline in patients with ST-segment–elevation myocardial infarction using both optical coherence tomography and intravascular ultrasound. Methods and Results— A total of 111 ST-segment–elevation myocardial infarction patients who underwent percutaneous coronary intervention within 24 hours of symptom onset were included. Both optical coherence tomography ...

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    18. Failure Mechanisms and Neoatherosclerosis Patterns in Very Late Drug-Eluting and Bare-Metal Stent Thrombosis

      Failure Mechanisms and Neoatherosclerosis Patterns in Very Late Drug-Eluting and Bare-Metal Stent Thrombosis

      Background— There are few clinical studies on the pathophysiological mechanisms of very late stent thrombosis (VLST). We report optical coherence tomography findings in patients with VLST and compare the findings between bare-metal stents (BMS) and drug-eluting stents (DES). Methods and Results— We conducted a registry of stent thrombosis at 4 North American centers with optical coherence tomography imaging programs SAFE registry (The Study of Late Stent Failure Evaluated by OCT). Images were acquired in 61 patients (42 DES and 19 BMS) presenting with definite VLST. The median duration from implantation to VLST presentation was 51.4 months in the DES ...

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    19. Thrombotic medications could replace stents in some patients, intravascular imaging shows

      Thrombotic medications could replace stents in some patients, intravascular imaging shows

      Stents have long been the preferred treatment for reopening blocked arteries in patients who’ve suffered a heart attack or other heart conditions. But new research suggests that physicians may be able to forgo stent procedures and instead give patients anti-thrombotic medications. The new study, titled EROSION (Effective Anti-thrombotic Therapy without Stenting: Intravascular OCT-based Management in Plaque Erosion), analyzes the effects of anti-thrombotic therapy, a drug that can increase blood flow through arteries and veins, and how it can help patients with acute coronary syndromes (ACS). The study, published in European Heart Journal, was led by Ik-Kyung Jang, MD, PhD ...

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    20. Intravascular imaging identifies some heart attack patients who can forgo stenting

      Intravascular imaging identifies some heart attack patients who can forgo stenting

      Rome, Italy 30 August 2016: More than one quarter of heart attack patients who are normally treated with stents to re-open their blocked arteries might be able to forgo this procedure and receive anti-thrombotic medications only, according to results of a pilot study. Results of the EROSION (Effective Anti-thrombotic Therapy without Stenting: Intravascular OCT-based Management in Plaque Erosion) study, presented in a Hot Line session at ESC Congress 2016, and published simultaneously in the European Heart Journal , suggest "a potentially major change in the treatment of a significant number of patients with acute coronary syndromes (ACS)," said lead investigator Ik-Kyung ...

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    21. Invasive imaging sheds more light on percutaneous coronary intervention

      Invasive imaging sheds more light on percutaneous coronary intervention

      An invasive imaging technique called optical coherence tomography (OCT) can visualize the coronary arteries in patients undergoing percutaneous coronary intervention (PCI) and lead to better outcomes compared to standard angiography-guided PCI, according to new findings reported here. Results of the DOCTORS (Does Optical Coherence Tomography Optimize Results of Stenting) study were presented in a Hot Line session at ESC Congress 2016, with simultaneous publication in Circulation . In patients with non–ST-segment elevation acute coronary syndromes (NSTE-ACS), OCT "provided useful additional information beyond that obtained by angiography alone, and impacted directly on physician decision-making," reported the study's lead investigator Nicolas ...

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