1. Articles in category: Cardiology

    1-24 of 2649 1 2 3 4 ... 109 110 111 »
    1. Grading of Regional Apposition after Flow-Diverter Treatment (GRAFT): a comparative evaluation of VasoCT and intravascular OCT

      Grading of Regional Apposition after Flow-Diverter Treatment (GRAFT): a comparative evaluation of VasoCT and intravascular OCT

      Background Poor vessel wall apposition of flow diverter (FD) stents poses risks for stroke-related complications when treating intracranial aneurysms, necessitating long-term surveillance imaging. To facilitate quantitative evaluation of deployed devices, a novel algorithm is presented that generates intuitive two-dimensional representations of wall apposition from either high-resolution contrast-enhanced cone-beam CT (VasoCT) or intravascular optical coherence tomography (OCT) images. Methods VasoCT and OCT images were obtained after FD implant (n=8 aneurysms) in an experimental sidewall aneurysm model in canines. Surface models of the vessel wall and FD device were extracted, and the distance between them was presented on a two-dimensional flattened ...

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    2. Speckle And Motion Based Vascular Image Analysis for Optical Coherence Tomography (Thesis)

      Speckle And Motion Based Vascular Image Analysis for Optical Coherence Tomography (Thesis)

      Optical Coherence Tomography (OCT) is an emerging optical imaging modality that is capable of imaging biological tissues with micron resolution and millimeter penetration depth. In clinical diagnostic imaging and pathology, OCT has helped fill a gap in terms of both resolution and imaging depth, in between traditional fluoroescence based microscopes and non-invasive organ level imaging. In this domain, OCT can be used both as an ex vivo pathological examination tool or in vivo imaging modality.OCT has been successful in ophthalmology owing to its excellent in vivo optical sectioning ability and penetration depth. Over the years, OCT has seen substantial ...

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    3. Illuminating Culprit Plaque Histology by Optical Coherence Tomography : Shedding New Light on Old Insights

      Illuminating Culprit Plaque Histology by Optical Coherence Tomography : Shedding New Light on Old Insights

      Coronary atherosclerosis continues to be major cause of death in the developed world ( (1) ). Although we have known for at least a century that fissures and ruptures of coronary arteries are the cause of coronary thrombosis and, in the last 2 decades, that plaque erosion and calcified nodule are additional causes of thrombosis, our ability to use this knowledge in a real-time fashion to affect the treatment of patients with acute coronary syndromes (ACS) has been limited ( (2) ). Although angiography-guided percutaneous coronary intervention (PCI) has become the standard of care for treatment of ACS, it provides little understanding of culprit ...

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      Mentions: Emory University
    4. Tissue Characterization of In-Stent Neointima Using Optical Coherence Tomography in the Late Phase After Bare-Metal Stent Implantation – An Ex Vivo Validation Study –

      Tissue Characterization of In-Stent Neointima Using Optical Coherence Tomography in the Late Phase After Bare-Metal Stent Implantation – An Ex Vivo Validation Study –

      Background: We performed an ex vivo study to investigate optical coherence tomography (OCT) imaging for differentiating several types of neointimal tissue during the later phases after bare-metal stent (BMS) implantation as compared with histologic results. Methods and Results: OCT imaging was performed in 6 autopsy hearts for 10 BMS with implant duration >4 years. OCT qualitative neointimal tissue characterization was based on tissue structure and classified as homogeneous pattern, heterogeneous pattern with visible struts, or heterogeneous pattern with invisible struts. Corresponding histological analyses of each 2-mm cross-section of the entire BMS were performed. Of 81 cross-sections, histological analysis revealed that ...

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    5. Excimer Laser Angioplasty–Facilitated Fracturing of Napkin-Ring Peri-Stent Calcium in a Chronically Underexpanded Stent Documentation by Optical Coherence Tomography

      Excimer Laser Angioplasty–Facilitated Fracturing of Napkin-Ring Peri-Stent Calcium in a Chronically Underexpanded Stent Documentation by Optical Coherence Tomography

      A 79-year-old man underwent stent implantation into a severely calcified proximal left anterior descending coronary lesion ( Figure 1 ) in December 2012 followed by restenting in March 2014 to treat in-stent restenosis ( Figure 2 ), both without full balloon expansion. Optical coherence tomography (OCT) documented thick, peri-stent napkin-ring calcium. He was admitted for recurrent unstable angina in April 2014. After initial treatment with excimer laser coronary angioplasty (ELCA; 1.4 mm, Spectranetics Corporation, Colorado Springs, Colorado) using saline injection, fluence of 60 mJ/mm 2 , and frequency of 80 Hz, a balloon was fully expanded. OCT showed fracturing of peri-stent calcium and ...

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    6. Uncertain Detection of Nonuniform Scaffold Expansion Patterns Using Optical Coherence Tomography

      Uncertain Detection of Nonuniform Scaffold Expansion Patterns Using Optical Coherence Tomography

      We read with interest the paper by Ohno et al. ( (1) ) and found that their conclusions merit a few comments. Longitudinal nonuniform expansion patterns by the ABSORB bioresorbable scaffold (BVS) (Abbott Vascular, Irvine, California) may be of clinical importance, but the use of optical coherence tomography (OCT) to identify such patterns requires methods that take catheter motion artifacts into account. The variation in length measurements by OCT compared with nominal length has been reported in ABSORB BVS–treated patients with differences of as much as 5.2 mm ( (2) ) and as much as 10 mm in metal stent–treated patients ...

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    7. Clinical utility of quantitative bright spots analysis in patients with acute coronary syndrome: an optical coherence tomography study

      Clinical utility of quantitative bright spots analysis in patients with acute coronary syndrome: an optical coherence tomography study

      To investigate the clinical significance of bright spots in coronary plaque detected by optical coherence tomography (OCT) in patients with coronary artery disease. We identified 112 patients [acute coronary syndromes (ACS): n = 50, stable angina pectoris (SAP): n = 62] who underwent OCT imaging of the culprit lesion. A novel OCT algorithm was applied to detect bright spots representing the juxtaposition of a variety of plaque components including macrophages. The density of bright spots within the most superficial 250 μm of the vessel wall was measured at the site of culprit lesion. Bright spot density in the culprit lesion was significantly ...

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    8. Coronary Artery and Systemic Autoimmune Disease: Diagnostics and Treatment

      Coronary Artery and Systemic Autoimmune Disease: Diagnostics and Treatment

      This study evaluates in vivo intracoronary imaging using intravascular ultrasound and optical coherence tomography and safety and efficacy of new generation fully bioresorbable vascular scaffolds in four well defined systemic autoimmune (rheumatoid arthritis, mixed connective tissue disease, systemic sclerosis, systemic lupus erythematosus) and concomitant coronary disease patients.

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    9. Angiographic appearance of spontaneous coronary artery dissection with intramural hematoma proven on intracoronary imaging

      Angiographic appearance of spontaneous coronary artery dissection with intramural hematoma proven on intracoronary imaging

      Background The pathognomonic appearance of multiple radiolucent lumen on angiography is used to diagnose spontaneous coronary artery dissection (SCAD). However, this finding is absent in >70% of SCAD, in which case optical coherence tomography (OCT) or intravascular ultrasound (IVUS) is useful to assess arterial wall integrity. Methods We report the angiographic appearance of SCAD that were proven on intracoronary imaging with OCT or IVUS. Our angiographic classification and algorithm for SCAD diagnosis was previously reported. Patients with type 1 SCAD (multiple radiolucent lumen) do not require OCT/IVUS, whereas, it was recommended for those with suspected type 2 (diffuse stenosis ...

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    10. Serial optical coherence tomography imaging of ACS-causing culprit plaques

      Serial optical coherence tomography imaging of ACS-causing culprit plaques

      Aims: The aim of this study was to understand better the mechanisms of repair of plaque complications causing acute coronary syndrome. Methods and results: We used OCT in the acute phase and at follow-up (one to seven months) to investigate the plaque healing in 10 culprit plaques: five ruptured fibrous cap (RFC) and five intact fibrous cap (IFC) which were not treated with stent deployment and caused ST-segment elevation myocardial infarction (n=8) and non-STEMI (n=2). At follow-up OCT, the margins of the evacuated cavity in RFC plaques showed a smooth surface and a morphology similar to that of ...

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    11. Calcified plaque ablated by rotational atherectomy visualised by optical coherence tomography

      Calcified plaque ablated by rotational atherectomy visualised by optical coherence tomography

      This paper also includes accompanying supplementary data published online at: http://www.pcronline.com/eurointervention/86th_issue/62 Calcification is visualised by optical coherence tomography (OCT) as a well-delineated, signal-poor region with sharp borders. A 63-year-old female patient with stable angina underwent percutaneous coronary intervention. OCT (C7 Dragonfly™, ILUMIEN™ OCT system; St. Jude Medical, St. Paul, MN, USA) showed lumen narrowing with heavily calcified plaque (Figure 1A) . Rotational atherectomy (RA) was performed using a 2 mm burr (Rotablator™ Rotational Atherectomy System; Boston Scientific, Marlborough, MA, USA). After RA, OCT clearly visualised the calcified segment ablated by the 2 mm burr as

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    12. Case Western Reserve University Receives NIH Grant for Cardiac Radiofrequency Ablation Catheter with Integrated OCT Imaging

      Case Western Reserve University Receives NIH Grant for Cardiac Radiofrequency Ablation Catheter with Integrated OCT Imaging

      Case Western Reserve University Receives a 2015 NIH grant for $198,125 for Cardiac Radiofrequency Ablation Catheter with Integrated OCT Imaging. The principal investigator is Andrew Rollins. The program began in 2015 and ends in 2017. Below is a summary of the proposed work. The long-term goal of this research program is to develop catheter-based optical coherence tomography (OCT) imaging tools that will improve the care of patients suffering from cardiac arrhythmias. This project aims to improve radiofrequency ablation (RFA) therapy, which is the standard of care for many arrhythmias, by providing microscopic image guidance at the tip of the ...

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    13. Utility of Optical Coherence Tomography Imaging with Angiographic Co-registration for the Guidance of Percutaneous Coronary Intervention

      Utility of Optical Coherence Tomography Imaging with Angiographic Co-registration for the Guidance of Percutaneous Coronary Intervention

      Intracoronary optical coherence tomography (OCT) is a light-based imaging modality able to visualise with high resolution (~10 μm) the vascular morphology and the acute and chronic effects of intervention with intracoronary devices. 1,2 OCT could therefore find application in the guidance of percutaneous coronary intervention (PCI), allowing a thorough preprocedural lesion assessment, which enables accurate device sizing, selection of the vessel segment requiring treatment, and, thus, efficient planning of the implantation strategy (see Table 1 ). 3 Moreover, it can be used for the assessment of the acute procedural result, allowing the estimation of stent expansion and vessel injury. Consequently ...

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    14. A Case of On-line Software-based Co-registration of Optical Coherence Tomography and Angiography Guided Percutaneous Coronary Intervention for a Patient With Angina Pectoris

      A Case of On-line Software-based Co-registration of Optical Coherence Tomography and Angiography Guided Percutaneous Coronary Intervention for a Patient With Angina Pectoris

      Recently developed imaging modalities provide precise and accurate evaluation of lesions within the coronary arteries. Among them, optical coherence tomography (OCT) provides higher resolution cross-sectional imaging than intravascular ultrasound [1]. Recently, software-based on-line co-registration of OCT and angiography has become available as a new tool in percutaneous coronary intervention. Here, we describe a case where this new modality was critical for successful percutaneous coronary intervention.

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    15. Error propagation in the characterization of atheromatic plaque types based on imaging

      Error propagation in the characterization of atheromatic plaque types based on imaging

      Imaging systems transmit and acquire signals and are subject to errors including: error sources, signal variations or possible calibration errors. These errors are included in all imaging systems for atherosclerosis and are propagated to methodologies implemented for the segmentation and characterization of atherosclerotic plaque. In this paper, we present a study for the propagation of imaging errors and image segmentation errors in plaque characterization methods applied to 2D vascular images. More specifically, the maximum error that can be propagated to the plaque characterization results is estimated, assuming worst-case scenarios. The proposed error propagation methodology is validated using methods applied to ...

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    16. Assessment of Cardiac Allograft Vasculopathy by Optical Coherence Tomography

      Assessment of Cardiac Allograft Vasculopathy by Optical Coherence Tomography

      Cardiac allograft vasculopathy (CAV) is characterized by marked intimal proliferation and concentric vascular thickening and fibrosis. CAV remains the leading cause of late morbidity and mortality in heart transplant recipients. Optical coherence tomography (OCT) is a new generation catheter-based modality that acquires images at a spatial resolution of 10-20 μm which is 10-fold greater than that of intravascular ultrasound (IVUS). OCT is currently the most sensitive imaging technique for early CAV detection. Recent studies proved that circulating human leukocyte antigen (HLA) directed donor-specific antibodies correlate with increased mortality and CAV. Contradiction of scientific results has been reported regarding increased resting ...

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    17. A Micromotor Catheter for Intravascular Optical Coherence Tomography

      A Micromotor Catheter for Intravascular Optical Coherence Tomography

      We have developed a new form of intravascular optical coherence tomography (IV-OCT) that allows the extremely fast acquisition of high-resolution images of the coronary arteries. This process leads to much better image quality by eliminating cardiac motion artefacts and undersampling. It relies on a catheter that incorporates a synchronous micromotor with a diameter of 1.0 mm and a rotational speed of up to 5600 revolutions per second, enabling an IV-OCT frame rate of 5.6 kHz. This speed is matched by a wavelength-swept laser that generates up to 2.8 million image lines per second. With this setup, our ...

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    18. Critical analysis of the correlation between optical coherence tomography versus intravascular ultrasound and fractional flow reserve in the management of intermediate coronary artery lesion

      Critical analysis of the correlation between optical coherence tomography versus intravascular ultrasound and fractional flow reserve in the management of intermediate coronary artery lesion

      The appropriate assessment of intermediate coronary artery stenosis continues to be a challenge for cardiologists. Several studies have shown that anatomic parameters obtained by intravascular ultrasound (IVUS) and optical coherence tomography (OCT) showed a correlation with fractional flow reserve (FFR) values in identifying hemodynamically severe coronary stenoses. However, the efficacy of IVUS/OCT versus FFR integration in intermediate coronary lesions is still debated. This review will allow for an independent analysis of research data and outlines the diagnostic efficiency of IVUS and OCT derived-anatomical parameters in identifying the hemodynamic significance of an angiographically intermediate stenosis as determined by FFR.

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    19. In Vivo Demonstration of Frail Neointimal Tissue Embolization After Angioplasty With a Drug-Coated Balloon Confirmed by Optical Coherence Tomography and Histology

      In Vivo Demonstration of Frail Neointimal Tissue Embolization After Angioplasty With a Drug-Coated Balloon Confirmed by Optical Coherence Tomography and Histology

      A 60-year-old woman experienced exertional chest pain. She underwent percutaneous coronary intervention with a drug-eluting stent (Nobori, Terumo Corporation, Tokyo) at the midportion of the left anterior descending artery. In the 3-month follow-up angiography, there was an in-stent restenosis at the midportion of the left anterior descending artery, which was also the site of a previous stent implantation (arrow, Figure 1A). In optical coherence tomography, neointimal hyperplasia proliferation with a heterogeneous pattern was observed with a minimal lumen area of 1.7 mm 2 (asterisk, Figure 1A). Angioplasty with a drug-coated balloon (Sequent please; B. Braun, Melsungen, Germany) was performed ...

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    20. The Role of Multiple Imaging Modalities to Disclose the Mechanism of ACS Angioscopy in Comparison to Other Imaging Modalities Including OCT, IVUS and CTA (Book Chapter)

      The Role of Multiple Imaging Modalities to Disclose the Mechanism of ACS Angioscopy in Comparison to Other Imaging Modalities Including OCT, IVUS and CTA (Book Chapter)

      This book presents a thorough review of coronary angioscopy, ranging from instructions on its use to the latest advances. Starting with the structure and fundamental principles of angioscopy, it shows readers how to apply the image to comprehensive care of coronary-artery patients. Plentiful color photos and illustrations will enable readers to investigate and classify plaques and thrombi and to evaluate coronary stent- and drug-based therapies. The authors are leading researchers on angioscopy. This book offers the perfect guide not only for new clinicians but also for cardiologists who have already adopted this technique for medical examination and treatment. Angioscopy is ...

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    21. Excellent very early neointimal coverage of bioactive stents by optical coherence tomography

      Excellent very early neointimal coverage of bioactive stents by optical coherence tomography

      Objectives: In a prospective study, we explored the extent of neointimal coverage of stent struts by optical coherence tomography 14 days following the implantation of bioactive stents in an unselected cohort. Design: We enrolled 15 consecutive patients who underwent bioactive stent implantation. Optical coherence tomography images were obtained at 14-day follow-up. Morphometric analysis, strut coverage , strut apposition, neointimal hyperplasia and possible thrombosis were evaluated at 1-mm intervals. Binary stent strut coverage was defined as the percentage of covered struts of all analyzed struts. Results: Patients underwent optical coherence tomography examination at an average of 14.5 ± 2.3 days following ...

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