1. Articles in category: Cardiology

    1-24 of 2329 1 2 3 4 ... 95 96 97 »
    1. A novel method to assess coronary artery bifurcations by OCT: cut-plane analysis for side-branch ostial assessment from a main-vessel pullback

      A novel method to assess coronary artery bifurcations by OCT: cut-plane analysis for side-branch ostial assessment from a main-vessel pullback

      Aims In coronary bifurcations assessment, evaluation of side-branch (SB) ostia by an optical coherence tomography (OCT) pullback performed in the main branch (MB) could speed up lesion evaluation and minimize contrast volume. Dedicated software that reconstructs the cross-sections perpendicular to the SB centreline could improve this assessment. We aimed to validate a new method for assessing the SB ostium from an OCT pullback performed in the MB. Methods and results Thirty-one sets of frequency-domain OCT pullbacks from 28 patients, both from the MB and the SB of a coronary artery bifurcation were analysed. Measurements of the SB ostium from the ...

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    2. Latest Data Shows OrbusNeich's COMBO™ Dual Therapy Stent has Excellent

      Latest Data Shows OrbusNeich's COMBO™ Dual Therapy Stent has Excellent

      Prof. Stephen W.L. Lee presented two-year optical coherence tomography (OCT) findings and three-year clinical follow up from the EGO COMBO study, providing further evidence to support the healing benefits of the COMBO Dual Therapy Stent, the only drug eluting stent (DES) with active EPC capture technology. The findings were presented during the 26th Annual Transcatheter Cardiovascular Therapeutics (TCT) meeting, held in Washington, D.C. , September 13-17, 2014 . "This is the first study to assess the healing profile of a dual therapy stent by optical coherence tomography," said Prof. Stephen W.L. Lee , M.D., of the Queen Mary Hospital ...

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    3. New Study Assesses the Utility of Optical Coherence Tomography During Stent Implantation in Primary PCI

      New Study Assesses the Utility of Optical Coherence Tomography During Stent Implantation in Primary PCI

      The first randomized trial to examine serial optical coherence tomography (OCT) in primary percutaneous coronary intervention (PCI) was reported today at the 26 th annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. Sponsored by the Cardiovascular Research Foundation (CRF), TCT is the world’s premier educational meeting specializing in interventional cardiovascular medicine. OCT uses light emitted from an intravascular catheter to capture high-resolution cross sectional imaging from within coronary arteries. OCT STEMI is the first randomized multicenter study to examine routine use of OCT guidance during stent implantation in patients with ST-elevation myocardial infarction (STEMI, the most serious form of a ...

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    4. Causes of very late stent thrombosis investigated using optical coherence tomograph

      Causes of very late stent thrombosis investigated using optical coherence tomograph

      Objective Very late stent thrombosis (VLST) remains an unresolved problem, and recent reports have indicated that VLST onset can occur in patients treated with both drug-eluting stents (DES) and bare metal stents (BMS). We evaluated the causes of VLST using optical coherence tomography (OCT). Methods OCT was performed in 22 patients (12 DES-treated patients, 10 BMS-treated patients). Because two instances of VLST occurred simultaneously in one case in the DES group, the DES group comprised 13 lesions, while the BMS group comprised 10 lesions. All struts were counted in each frame, and the proportion of uncovered or malapposed struts was ...

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    5. St. Jude Medical Announces Launch of OPTIS Integrated System

      St. Jude Medical Announces Launch of OPTIS Integrated System

      The OPTIS™ Integrated System combines OCT imaging with angiography to provide more detailed, on-demand coronary assessment for more accurate PCI guidanc e St. Jude Medical, Inc. (NYSE:STJ), a global medical device company, today announced the company has secured CE Mark and FDA clearance for the new OPTIS Integrated System. The system is a departure from traditional, mobile cart-based diagnostic tools and advances percutaneous coronary intervention (PCI) optimization via direct installation into a hospital’s cardiac catheterization laboratory, fully integrating optical coherence tomography (OCT) and fractional flow reserve (FFR) into PCI workflow. The approval of the OPTIS Integrated system marks ...

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    6. OCT STEMI: Optical Coherence Tomography Guidance During Primary PCI in AMI

      OCT STEMI: Optical Coherence Tomography Guidance During Primary PCI in AMI

      The OCT STEMI trial presented Sept. 14 at TCT 2014 looked at optical coherence tomography (OCT) guidance during drug-eluting stent implantation in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), and was the first randomized trial to look at serial OCT in primary PCI, but ultimately showed that larger randomized trials are needed on this topic to assess potential benefit. Led by principal investigator Pavel Červinka, MD, PhD, First Department of Cardio-Angiology and Internal Medicine, Faculty Hospital Hradec Králové, Czech Republic, the trial enrolled 201 patients, who were pre-treated with aspirin, heparin and ...

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    7. Automatic detection of bioresorbable vascular scaffold struts in intravascular optical coherence tomography pullback runs

      Automatic detection of bioresorbable vascular scaffold struts in intravascular optical coherence tomography pullback runs

      Bioresorbable vascular scaffolds (BVS) have gained significant interest in both the technical and clinical communities as a possible alternative to metallic stents. For accurate BVS analysis, intravascular optical coherence tomography (IVOCT) is currently the most suitable imaging technique due to its high resolution and the translucency of polymeric BVS struts for near infrared light. However, given the large number of struts in an IVOCT pullback run, quantitative analysis is only feasible when struts are detected automatically. In this paper, we present an automated method to detect and measure BVS struts based on their black cores in IVOCT images. Validated using ...

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    8. Nonangiographic assessment of coronary artery disease: a practical approach to optical coherence tomography and fractional flow reserve

      Nonangiographic assessment of coronary artery disease: a practical approach to optical coherence tomography and fractional flow reserve

      In an era of increased scrutiny of the appropriateness and safety of revascularization, interventional cardiologists must evolve by adding key tools to their armamentarium. This review highlights the utility of optical coherence tomography and fractional flow reserve in the catheterization lab and provides a practical guide for using these technologies during coronary intervention in various lesion subsets. We propose that fractional flow reserve informs the decision to intervene and optical coherence tomography guides the optimization of the outcome.

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    9. Endothelial Shear Stress and Coronary Plaque Characteristics in Humans: A Combined Frequency-Domain Optical Coherence Tomography and Computational Fluid Dynamics Study

      Endothelial Shear Stress and Coronary Plaque Characteristics in Humans: A Combined Frequency-Domain Optical Coherence Tomography and Computational Fluid Dynamics Study

      Background —Despite the exposure of the entire vasculature to the atherogenic effects of systemic risk factors, atherosclerotic plaques preferentially develop at sites with disturbed flow. This study aimed at exploring in vivo the relationship between local endothelial shear stress (ESS) and coronary plaque characteristics in humans, using computational fluid dynamics and frequency-domain optical coherence tomography (FD-OCT). Methods and Results —Three-dimensional coronary artery reconstruction was performed in 21 patients (24 arteries) presenting with acute coronary syndrome using FD-OCT and coronary angiography. Each coronary artery was divided into sequential 3-mm segments, and analyzed for the assessment of local ESS and plaque characteristics ...

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    10. Differences determined by optical coherence tomography volumetric analysis in non-culprit lesion morphology and inflammation in ST-segment elevation myocardial infarction and stable angina pectoris patients

      Differences determined by optical coherence tomography volumetric analysis in non-culprit lesion morphology and inflammation in ST-segment elevation myocardial infarction and stable angina pectoris patients

      Background: While the current methodology for determining fibrous cap (FC) thickness of lipid plaques is based on manual measurements of arbitrary points, which could lead to high variability and decreased accuracy, it ignores the three-dimensional (3-D) morphology of coronary artery disease. Objective: To compare, utilizing optical coherence tomography (OCT) assessments, volumetric quantification of FC and macrophage detection using both visual assessment and automated image processing algorithms in non-culprit lesions of STEMI and stable angina pectoris (SAP) patients. Methods: Lipid plaques were selected from 67 consecutive patients (1 artery/patient). FC was manually delineated by a computer-aided method and automatically classified ...

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    11. A score to quantify coronary plaque vulnerability in high-risk patients with type 2 diabetes: an optical coherence tomography study

      A score to quantify coronary plaque vulnerability in high-risk patients with type 2 diabetes: an optical coherence tomography study

      Background Patients with type 2 diabetes are at a high risk for acute cardiovascular events, which usually arise from the rupture of a vulnerable coronary lesion characterized by specific morphological plaque features. Thus, the identification of vulnerable plaques is of utmost clinical importance in patients with type 2 diabetes. However, there is currently no scoring system available to identify vulnerable lesions based on plaque characteristics. Thus, we aimed to characterize the diagnostic value of optical coherence tomography (OCT) - derived lesion characteristics to quantify plaque vulnerability both as individual parameters and when combined to a score in patients with type 2 ...

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    12. 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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    13. 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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    14. Chronic Total Occlusion Crossing Devices With Imaging

      Chronic Total Occlusion Crossing Devices With Imaging

      An imaging device includes a hollow flexible shaft having a central longitudinal axis and an imaging window therein. An optical fiber extends within the hollow flexible shaft substantially along the central axis. A distal tip of the optical fiber is attached to the hollow flexible shaft and aligned with the imaging window so as to transfer an optical coherence tomography signal through the imaging window.

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      Mentions: Avinger
    15. 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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    16. Treatment of coronary bifurcation lesions with the Absorb bioresorbable vascular scaffold in combination with the Tryton dedicated coronary bifurcation stent: evaluation using two- and three-dimensional optical coherence tomography

      Treatment of coronary bifurcation lesions with the Absorb bioresorbable vascular scaffold in combination with the Tryton dedicated coronary bifurcation stent: evaluation using two- and three-dimensional optical coherence tomography

      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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    17. 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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    18. 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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    19. 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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    20. 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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    21. 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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    22. 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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    23. 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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