1. Articles in category: Cardiology

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    1. Optical coherence tomography for coronary imaging

      Optical coherence tomography for coronary imaging

      Optical coherence tomography (OCT) is a novel invasive imaging technique that produces high resolution intracoronary images. Its general principle of operation is similar to IVUS, however OCT uses infrared light, not ultrasound. In the last years, the need for more precise information regarding coronary artery disease to achieve optimal treatment has seen intravascular imaging becoming an area of primary importance in interventional cardiology. OCT in this area has grown and is spreading. It benefits both therapeutic and research purposes and is also proving able to fill gaps in conventional invasive coronary imaging.

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    2. Optical coherence tomography-based predictors for creatine kinase-myocardial band elevation after elective percutaneous coronary intervention for in-stent restenosis

      Optical coherence tomography-based predictors for creatine kinase-myocardial band elevation after elective percutaneous coronary intervention for in-stent restenosis

      Objectives We evaluated whether morphological characteristics of neointimal tissue of in-stent restenosis (ISR) lesions assessed by optical coherence tomography (OCT) affect periprocedural elevation of creatine kinase-myocardial band (CK-MB). Background The impact of neointimal characteristics of ISR lesions on periprocedural myocardial injury has not been sufficiently investigated. Methods A total of 125 patients with ISR lesions underwent elective percutaneous coronary intervention (PCI) and pre-PCI OCT examination. Measurements of CK-MB were performed upon hospitalization, before PCI, and every 8 hr for 24 hr after PCI. CK-MB elevation was defined as levels above the 99th percentile of the upper reference limit. Neoatherosclerosis was ...

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    3. Feature Of The Week 8/31/14: Fully Integrated High-speed Intravascular OCT/NIRF Structural/Molecular Imaging In Vivo using a Clinically-available NIRF Emitting Indocyanine Green to Detect Inflamed Lipid-rich Atheromata in Coronary-sized Vessels

      Feature Of The Week 8/31/14: Fully Integrated High-speed Intravascular OCT/NIRF Structural/Molecular Imaging In Vivo using a Clinically-available NIRF Emitting Indocyanine Green to Detect Inflamed Lipid-rich Atheromata in Coronary-sized Vessels

      In current study, we fully integrated near-infrared fluorescence (NIRF) molecular imaging into intravascular OCT structural imaging. The OCT/NIRF single catheter imaging clearly demonstrated the microstructure of atheromata and simultaneously identified ICG-enhancing macrophage abundant lipid-rich areas of the plaques. Ex vivo NIRF imaging evidently validated in vivo OCT-NIRF imaging. NIRF signals on ex vivo fluorescence reflectance imaging colocalized well with in vivo NIRF imaging. In vitro ICG cell uptake, correlative fluorescence microscopy, and histopathology corroborated the in vivo imaging findings. Herein, our research team have solved the issues critical for application of this OCT/NIRF imaging technology to clinical practice ...

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    4. Treatment of coronary bifurcation lesions with the Absorb bioresorbable vascular scaffold in combination with the Tryton dedicated coronary bifurcation stent

      Treatment of coronary bifurcation lesions with the Absorb bioresorbable vascular scaffold in combination with the Tryton dedicated coronary bifurcation stent

      Aims: The Tryton bifurcation stent has been developed to improve clinical outcomes after treatment of bifurcation lesions. Limited data are available on the use of the Absorb bioresorbable vascular scaffold (BVS) in bifurcation lesions with side branches >2 mm. We present here the acute procedural results and midterm clinical follow-up of the first-in-man combined use of the Tryton stent and the Absorb scaffold for the treatment of complex bifurcation lesions. Methods and results: Ten patients treated with the Tryton stent in combination with Absorb BVS were included in the current report. Offline two- and three-dimensional optical coherence tomography (OCT) analyses ...

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    5. Optical coherence tomography to guide below-the-knee endovascular interventions

      Optical coherence tomography to guide below-the-knee endovascular interventions

      Peripheral arterial disease remains a common cause of leg amputations causing significant morbidity and mortality. Data regarding below-the-knee endovascular interventions is scarce while long-term patency rates via different endovascular revascularization modalities remain limited. OCT offers excellent three dimension endothelial visualization; however its value to guide peripheral interventions has not been studied. We describe the use of OCT to guide endovascular below-the-knee interventions in order to achieve excellent OCT results.

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    6. New Insights on acute expansion and longitudinal elongation of bioresorbable vascular scaffolds In-Vivo and at bench test: A note of caution on reliance to compliance charts and nominal length

      New Insights on acute expansion and longitudinal elongation of bioresorbable vascular scaffolds In-Vivo and at bench test: A note of caution on reliance to compliance charts and nominal length

      Objectives : We performed systematic optical coherence tomography (OCT) analyses after BVS implantation in a “real world” setting aiming at evaluating scaffold expansion and longitudinal integrity. Background : A comprehensive elucidation of bioresorbable vascular scaffolds´ (BVS) acute performance in the “real-world” setting is lacking Methods : Acute BVS expansion compared with compliance chart information and longitudinal integrity were assessed in 29 patients (32 lesions) by OCT. In addition, bench experiments with 4 scaffolds were performed with different combinations of deployment pressures and tube stiffness. Results : Scaffold underexpansion, using compliance chart information as reference, was observed in 97% of OCT cross-sections in vivo; however ...

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    7. SJC Issues Decision Concerning Recovery Of Lost Profits Damages In Commercial Litigation

      SJC Issues Decision Concerning Recovery Of Lost Profits Damages In Commercial Litigation

      In a noteworthy recent decision addressing the parameters of damages in commercial litigation, the Massachusetts Supreme Judicial Court (SJC) affirmed an order excluding expert testimony concerning future lost profits damages relating to "yet-to-be conceived future products." In LightLab Imaging, Inc. v. Axsun Technologies, Inc., SJC-11374 (July 28, 2014), the SJC held that the trial court was well within its discretion to exclude an expert economist's testimony in support of a plaintiff's claim for future lost profits based on a "hypothetical new product" and extending more than twenty years beyond the term of the contract at issue. In so ...

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    8. Periprocedural Myocardial Injury and Right Bundle Branch Block during Coronary Optical Coherence Tomography in an Acute Coronary Syndrome Patient with Severe Coronary Ectasia

      Periprocedural Myocardial Injury and Right Bundle Branch Block during Coronary Optical Coherence Tomography in an Acute Coronary Syndrome Patient with Severe Coronary Ectasia

      A 66-year-old man was referred for emergent coronary angiography (CAG) due to unstable angina with typical chest pain without elevation of cardiac enzymes. He had several coronary risk factors including dyslipidemia, hypertension, and smoking. He had a history of endovascular aortic repair for abdominal aortic aneurysm 5 months ago. Emergent CAG showed no significant stenosis; however, there was a filling defect at the left anterior descending artery (LAD) with flow limitation even though the previous CAG revealed no flow limitation.

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    9. Fully automated side branch detection in intravascular optical coherence tomography pullback runs

      Fully automated side branch detection in intravascular optical coherence tomography pullback runs

      Side branches in the atherosclerotic lesion region are important as they highly influence the treatment strategy selection and optimization. Moreover, they are reliable landmarks for image registration. By providing high resolution delineation of coronary morphology, intravascular optical coherence tomography (IVOCT) has been increasingly used for side branch analysis. This paper presents a fully automated method to detect side branches in IVOCT images, which relies on precise segmentation of the imaging catheter, the protective sheath, the guide wire and the lumen. 25 in-vivo data sets were used for validation. The intraclass correlation coefficient between the algorithmic results and manual delineations for ...

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    10. Different Findings in a Calcified Nodule Between Histology and Intravascular Imaging Such as Intravascular Ultrasound, Optical Coherence Tomography, and Coronary Angioscopy

      Different Findings in a Calcified Nodule Between Histology and Intravascular Imaging Such as Intravascular Ultrasound, Optical Coherence Tomography, and Coronary Angioscopy

      An 89-year-old woman who suffered a stroke and congestive heart failure was admitted to our hospital. She died of heart failure and autopsy was performed. Coronary arteries were removed from the heart and used for ex vivo imaging of intravascular ultrasound ([IVUS]; Atlantis, Boston Scientific Corporation, Natick, Massachusetts), optical coherence tomography (LightLab imaging Inc., Westford, Massachusetts), and coronary angioscopy (FiberTech, Tokyo, Japan) within 6 h after death before fixation with 10% buffered formalin. IVUS illustrated a convex lesion with superficial hyperechoic signal accompanied by acoustic shadowing at the left anterior descending artery (Figure 1 , arrows). Optical coherence tomography demonstrated an ...

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    11. Optical coherence tomography (OCT) to reveal vascular lesions after renal nerve ablation using a novel water-cooled, open-irrigated helical catheter approach

      Optical coherence tomography (OCT) to reveal vascular lesions after renal nerve ablation using a novel water-cooled, open-irrigated helical catheter approach

      Catheter-based renal denervation (RDN) has been introduced for the treatment of resistant hypertension. During the RDN ablation procedure, transmural lesions are delivered along the walls of the renal arteries to disrupt the sympathetic nerve network located within the arterial adventitia [1]. In an animal model using swine which underwent RDN, no vascular lesions were found at 6-month follow-up despite diffuse injury of the vessel wall in the acute phase [2]. However, first studies in humans using optical coherence tomography (OCT) have demonstrated that diffuse renal artery constriction and local tissue damage may occur at the ablation site, with edema and ...

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    12. Optical coherence tomography study of healing characteristics of paclitaxel-eluting balloons vs. everolimus-eluting stents for in-stent restenosis: the SEDUCE (Safety and Efficacy of a Drug elUting balloon in Coronary artery rEstenosis) randomised clinica

      Optical coherence tomography study of healing characteristics of paclitaxel-eluting balloons vs. everolimus-eluting stents for in-stent restenosis: the SEDUCE (Safety and Efficacy of a Drug elUting balloon in Coronary artery rEstenosis) randomised clinica

      Aims: Little is known about the respective healing responses and clinical efficacy and safety of drug-eluting balloons (DEB) and the second generation of drug-eluting stents (DES) when used to treat in-stent restenosis (ISR). In this study, we set out to compare prospectively the healing characteristics, as assessed by optical coherence tomography (OCT), of DEB versus DES after treatment of ISR in bare metal stents (BMS). Methods and results: Fifty patients with BMS ISR were randomised to treatment with a paclitaxel-eluting balloon vs. an everolimus-eluting stent (EES). The primary endpoint was the percentage of uncovered struts, assessed with OCT at nine ...

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    13. UC Irvine Receives NIH Grant for Phased Resolved ARF Optical Coherence Elastography for Intravascular Imaging

      UC Irvine Receives NIH Grant for Phased Resolved ARF Optical Coherence Elastography for Intravascular Imaging

      University of California at Irvine Received a 2014 NIH Grant for $598,705 for Phased Resolved ARF Optical Coherence Elastography for Intravascular Imaging. The principal investigator is Zhongping Chen. The program began in 2014 and ends in 2018. Below is a summary of the proposed work. The broad, long term objective of the proposed grant is to develop an integrated multimodal intravascular imaging system that combines intravascular optical coherence tomography (OCT), ultrasound (US), and phase-resolved acoustic radiation force optical coherence elastography (ARF-OCE). The multimodal intravascular imaging system is unique in that it combines the advantages of the high spatial resolution ...

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    14. Fractional Flow Reserve and Optical Coherence Tomography

      Fractional Flow Reserve and Optical Coherence Tomography

      Angiography has long been considered the gold standard in guiding coronary interventional therapies. However, well-documented limitations of angiography necessitate the use of more advanced imaging and functional hemodynamic evaluation to arrive at optimal decisions regarding revascularization.1 Contemporary guideline-driven practice dictates revascularization only for ischemia-causing lesions and medical therapy for other lesions.2,3 For this reason, accurate assessment of the functional significance of a lesion (ischemic vs. nonischemic) using noninvasive or invasive techniques is very important.

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    15. SEDUCEd by optical coherence tomography in drug-eluting balloon assessment

      SEDUCEd by optical coherence tomography in drug-eluting balloon assessment

      In everyday practice, percutaneous coronary intervention using a bare metal stent (BMS) is still frequently performed and the chance of incurring in-stent restenosis (ISR) is not negligible. Different treatment modalities for BMS ISR are still an important area of discussion. One of the most appealing is the drug-eluting balloon (DEB). This device has been proven angiographically and clinically superior to an uncoated balloon in BMS ISR1,2. Moreover, in the same type of lesion, DEBs have also shown angiographic and clinical results at least comparable to first-generation drug-eluting stents (DES), with a trend towards lower angiographic restenosis and lower ...

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    16. Long-term coronary arterial response to biodegradable polymer biolimus-eluting stents in comparison with durable polymer sirolimus-eluting stents and bare-metal stents: Five-year follow-up optical coherence tomography study

      Long-term coronary arterial response to biodegradable polymer biolimus-eluting stents in comparison with durable polymer sirolimus-eluting stents and bare-metal stents: Five-year follow-up optical coherence tomography study

      Objective The long-term coronary arterial response of biodegradable polymer biolimus-eluting stents (BES) remains unclear. We sought to evaluate the coronary arterial response of biodegradable polymer BES at 5 years after stent implantation using optical coherence tomography (OCT) as compared with that of durable polymer sirolimus-eluting stents (SES) and bare-metal stents (BMS). Methods Five-year follow-up OCT was performed in 30 patients with 33 stents (10 with 12 BES; 10 with 11 SES; 10 with 10 BMS). Quantitative parameters and qualitative characteristics of the neointima were evaluated. A total of 5178 struts (BES, n=2056; SES, n=1410; BMS, n=1712) were ...

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    17. Impact of Eicosapentaenoic Acid Treatment on the Fibrous Cap Thickness in Patients with Coronary Atherosclerotic Plaque: An Optical Coherence Tomography Study

      Impact of Eicosapentaenoic Acid Treatment on the Fibrous Cap Thickness in Patients with Coronary Atherosclerotic Plaque: An Optical Coherence Tomography Study

      Aim : Previous clinical trials have demonstrated the effectiveness of eicosapentaenoic acid (EPA) in preventing cardiovascular events. The aim of the present study was to investigate the effects of EPA treatment on the accumulation of coronary atherosclerotic plaque using optical coherence tomography (OCT). Methods : A total of 46 acute coronary syndrome (ACS) patients without dyslipidemia were divided into two groups: those who received 1,800 mg/day of EPA ( n =15) or the control group ( n =31). Serial OCT examinations were performed at baseline and after eight months of follow-up. The target for the OCT analysis was non-culprit plaque with a ...

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    18. Mechanisms of Atherothrombosis and Vascular Response to Primary Percutaneous Coronary Intervention in Women Versus Men With Acute Myocardial Infarction : Results of the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angiop

      Mechanisms of Atherothrombosis and Vascular Response to Primary Percutaneous Coronary Intervention in Women Versus Men With Acute Myocardial Infarction : Results of the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angiop

      Objectives This study sought to assess in vivo sex differences in the pathophysiology of ST-segment elevation myocardial infarction (STEMI) and vascular response to primary percutaneous coronary intervention (PCI). Background There is no consensus on whether differences in the pathophysiology of STEMI and response to primary PCI between women and men reflect biological factors as opposed to differences in age. Methods In this prospective, multicenter study, 140 age-matched men and women with STEMI undergoing primary PCI with everolimus-eluting stent were investigated with intravascular optical coherence tomography, histopathology-immunohistochemistry of thrombus aspirates, and serum biomarkers. Primary endpoints were the percentages of culprit plaque ...

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    19. Clinical Utilisation of Optical Coherence Tomography in Acute Coronary Syndromes

      Clinical Utilisation of Optical Coherence Tomography in Acute Coronary Syndromes

      In recent years, the development and widespread clinical utilisation of optical coherence tomography (OCT) has redefined the standard of intracoronary imaging. OCT is a unique, high-resolution, light-based imaging modality for application in the coronary circulation. OCT offers visualisation of coronary arteries at a resolution up to 10 times higher than that of intravascular ultrasound. 1 As a result, OCT is useful for assessing atherosclerotic plaque, stent apposition, stent thrombosis and stent bifurcations. The high resolution of OCT enables visualisation of various atherosclerotic plaque rupture (see Figure 1 ), including thin-cap fibroatheroma (TCFA), fibrous cap thickness and thrombus formation (see Figure 2 ).

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    20. Coronary Slow-Flow Phenomenon After Paclitaxel-Coated Balloon Angioplasty for Neointimal Plaque Confirmed by Optical Coherence Tomography

      Coronary Slow-Flow Phenomenon After Paclitaxel-Coated Balloon Angioplasty for Neointimal Plaque Confirmed by Optical Coherence Tomography

      The paclitaxel drug-coated balloon (PCB) is an emerging device in percutaneous coronary intervention, [1–3] and has been proven to be effective in preclinical trials and in clinical practice for the treatment of in-stent restenosis (ISR) [4,5]. Coronary slow-flow phenomenon is not an infrequent angiographic finding for ISR [6,7]. We report a very rare case of coronary slow-flow phenomenon after PCB angioplasty for an ISR lesion.

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    21. Correlation between optical coherence tomography-derived intraluminal parameters and fractional flow reserve measurements in intermediate grade coronary lesions

      Correlation between optical coherence tomography-derived intraluminal parameters and fractional flow reserve measurements in intermediate grade coronary lesions

      Background Fractional flow reserve (FFR) measurements accurately assess functional relevance in intermediate grade coronary lesions. A significant relationship between hemodynamic stenosis severity and optical coherence tomography (OCT)-derived intraluminal dimensions has recently been demonstrated. However, morphologic thresholds to identify significant stenoses are variable and exploration of this correlation in patients with diabetes mellitus (DM) remains currently incomplete. This study aimed at comparing the diagnostic value of intraluminal parameters as determined by OCT to predict FFR ≤0.8 in lesions of patients with versus without DM. Methods In 100 patients (DM = 56, non-DM = 44) with 142 coronary de novo lesions (DM ...

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    22. Bivalirudin versus unfractionated heparin for residual thrombus burden: A frequency-domain optical coherence tomography study

      Bivalirudin versus unfractionated heparin for residual thrombus burden: A frequency-domain optical coherence tomography study

      Objectives: This study aimed to compare the effect of bivalirudin and unfractionated heparin (UFH) on residual thrombus burden assessed by frequency-domain optical coherence tomography (FD-OCT), and on angiographic indices of microvascular obstruction (MVO). Background: The efficacy of bivalirudin to inhibit thrombus formation inside the stent during percutaneous coronary interventions (PCI) as compared to UFH is unknown. Methods: Sixty patients with coronary artery disease who underwent post-PCI FD-OCT were studied, including 20 patients treated with bivalirudin and 40 control patients treated with UFH, matched by clinical presentation, stent characteristics, and periprocedural medications. In-stent thrombus volume, thrombus score (number of quadrants with ...

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    23. Prevalence and Characteristics of TCFA and Degree of Coronary Artery Stenosis An OCT, IVUS, and Angiographic Study

      Prevalence and Characteristics of TCFA and Degree of Coronary Artery Stenosis An OCT, IVUS, and Angiographic Study

      Background The relationship between features of vulnerable plaque and angiographic coronary stenosis is unknown. Objectives The purpose of this study was to systematically investigate the absolute number, relative prevalence, and characteristics of thin-cap fibroatheroma (TCFA) at different degrees of stenosis using optical coherence tomography (OCT), intravascular ultrasound, and coronary angiography. Methods We identified 643 plaques from 255 subjects who underwent OCT imaging in all 3 coronary arteries. They were divided into 3 groups on the basis of angiographic diameter stenosis: Group A (30% to 49%, n = 325), Group B (50% to 69%, n = 227), and Group C (>70%, n = 91 ...

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    1-24 of 2316 1 2 3 4 ... 95 96 97 »
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