1. Articles in category: Cardiology

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    1. Feasibility and Safety of the Novel Vivolight Frequency Domain Optical Coherence Tomography System: A Multicenter Study

      Feasibility and Safety of the Novel Vivolight Frequency Domain Optical Coherence Tomography System: A Multicenter Study

      Objective. The study sought to assess the effectiveness and safety of the novel P60 Vivolight frequency-domain optical coherence tomography (OCT) system (Shenzhen Vivolight Medical Device & Technology). Methods. A total of 90 patients were enrolled from 3 institutions. The pullbacks were performed with both the P60 Vivolight OCT system and the Ilumien Optis OCT system (Abbott Vascular). The primary endpoint was the clear stent length (CSL). Device safety was assessed by the record of serious procedure-related or postprocedure adverse events. The secondary endpoints were the average lumen area of stent, clear image length (CIL), system stability, and imaging catheter operability. Results ...

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      Mentions: Vivolight
    2. Physicians: The future of cardiac imaging is now

      Physicians: The future of cardiac imaging is now

      Use of dedicated imaging catheters as an adjunct to conventional angiography (x-ray imaging) can assist in the diagnosis and guide the treatment of narrowing coronary arteries during invasive procedures to treat angina. Optical coherence tomography (OCT) is a red light-based imaging technique that captures high-resolution images when the catheter is placed inside the patient’s heart arteries; the high-quality and granular data thus obtained allows physicians to assess anatomy and execute coronary interventions, such as stent placement, with unrivalled precision. Recent data have indicated that use of OCT can alter physician decision-making over conventional x-ray (angiographic) imaging alone in nearly ...

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    3. Learning With Fewer Images via Image Clustering: Application to Intravascular OCT Image Segmentation

      Learning With Fewer Images via Image Clustering: Application to Intravascular OCT Image Segmentation

      Deep learning based methods are routinely used to segment various structures of interest in varied medical imaging modalities. Acquiring annotations for a large number of images requires a skilled analyst, and the process is both time consuming and challenging. Our approach to reduce effort is to reduce the number of images needing detailed annotation. For intravascular optical coherence tomography (IVOCT) image pullbacks, we tested 10% to 100% of training images derived from two schemes: equally-spaced image subsampling and deep-learning- based image clustering. The first strategy involves selecting images at equally spaced intervals from the volume, accounting for the high spatial ...

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    4. Evaluation of coronary plaques and atherosclerosis using optical coherence tomography

      Evaluation of coronary plaques and atherosclerosis using optical coherence tomography

      Introduction: Coronary angiography (CAG) is the standard modality for assessing coronary stenosis; however, it has limitations in assessing coronary plaque morphology. Optical coherence tomography (OCT) is a high-resolution (10-20μm) light-based intravascular imaging technique that can identify more detailed coronary plaque morphology compared to other intravascular imaging modalities. OCT is remarkable for characterizing fibrous, fibrocalcific, and lipid-rich plaques. The capabilities of OCT are well suited for discriminating three types of unstable plaque morphologies underlying coronary thrombosis, such as plaque rupture, erosion, and calcified nodules. The high resolution of OCT makes it possible to identify important features of vulnerable plaques, such ...

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    5. Early coronary healing in ST segment elevation myocardial infarction: sirolimus-eluting stents vs. drug-coated balloons after bare-metal stents. The PEBSI-2 optical coherence tomography randomized study

      Early coronary healing in ST segment elevation myocardial infarction: sirolimus-eluting stents vs. drug-coated balloons after bare-metal stents. The PEBSI-2 optical coherence tomography randomized study

      Objectives: Drug-coated balloons (DCBs) have theoretical advantages over drug-eluting stents (DESs) to facilitate stent healing. We studied whether, in patients undergoing primary coronary interventions (pPCIs), a strategy of DCB after bare-metal stent improves early healing as determined by optical coherence tomography (OCT) compared with new-generation DES. Methods: pPCI patients were randomized (1:1) to treatment with new-generation sirolimus-eluting stents (DES group) or DCB-strategy. Vessel healing was assessed by OCT at 90 days. Results: Fifty-three patients were randomized (26 DES vs. 27 DCB). At 90 days, both strategies showed a low rate of uncovered struts (3.2 vs. 3.2%, P ...

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    6. First-In-Human Intracoronary OCT-FLIm In Patients Undergoing PCI

      First-In-Human Intracoronary OCT-FLIm In Patients Undergoing PCI

      Patients will undergo intracoronary imaging using combined optical coherence tomography- fluorescence lifetime imaging (OCT-FLIm) during percutaneous coronary intervention, and the obtained imaging data will be used to assess the efficacy of this dual-modal catheter imaging strategy in characterizing high-risk plaque.

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      Mentions: Korea University
    7. Optical Coherence Tomography of Plaque Erosion and Thrombus in Severe Vertebral Artery Stenosis

      Optical Coherence Tomography of Plaque Erosion and Thrombus in Severe Vertebral Artery Stenosis

      A 69-year-old male presented with medically refractory vertebrobasilar insufficiency and paroxysmal subjective dizziness for six months. Severe stenosis of a dominant left V2 vertebral artery segment was identified on digital subtraction angiography (DSA) with an irregular intraluminal filling defect immediately above the stenosis. Optical coherence tomography (OCT) demonstrated a normal lumen at the distal end, with red thrombus detected distal to the stenosis. Atherosclerotic plaque containing fibro-lipid was also identified and treated with a drug-eluting stent. Distal red thrombi were not covered by stenting, indicating embolization risk in the future. Clear posterior fossa symptoms occurred after intervention, and treatment with ...

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    8. Predicting plaque vulnerability change using intravascular ultrasound + optical coherence tomography image-based fluid–structure interaction models and machine learning methods with patient follow-up data: a feasibility study

      Predicting plaque vulnerability change using intravascular ultrasound + optical coherence tomography image-based fluid–structure interaction models and machine learning methods with patient follow-up data: a feasibility study

      Background Coronary plaque vulnerability prediction is difficult because plaque vulnerability is non-trivial to quantify, clinically available medical image modality is not enough to quantify thin cap thickness, prediction methods with high accuracies still need to be developed, and gold-standard data to validate vulnerability prediction are often not available. Patient follow-up intravascular ultrasound (IVUS), optical coherence tomography (OCT) and angiography data were acquired to construct 3D fluid–structure interaction (FSI) coronary models and four machine-learning methods were compared to identify optimal method to predict future plaque vulnerability. Methods Baseline and 10-month follow-up in vivo IVUS and OCT coronary plaque data were ...

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    9. Malapposed Struts with Cre8, Biomatrix, and Xience Stents Assessed with OCT Immediately after Implantation and at 6-Month Follow-Up: Can the Different Biomechanical Characteristics of the Three Stents Impact on Struts Malapposition?

      Malapposed Struts with Cre8, Biomatrix, and Xience Stents Assessed with OCT Immediately after Implantation and at 6-Month Follow-Up: Can the Different Biomechanical Characteristics of the Three Stents Impact on Struts Malapposition?

      Background . Although the clinical effects of stent malapposition remain controversial, several analyses of stent registries consistently have found that malapposed struts were frequently identified in patients who experienced stent thrombosis. In this study, which is a subanalysis of the previously published CREBX-OCT study, we compared optical coherence tomography (OCT) analysis at the index percutaneous coronary intervention (PCI) and at six-month follow-up in 37 patients randomly assigned to receive, by a single operator, three different second-generation drug-eluting stents (Cre8, Biomatrix, and Xience) aiming to clarify if the malapposition observed at six-month follow-up was persistent or late-acquired. Moreover, we investigated if there ...

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    10. Diagnosis of vascular catastrophe using optical coherence tomography

      Diagnosis of vascular catastrophe using optical coherence tomography

      A 73-year-old female presented with symptoms of left-sided arm pain, neck pain of acute onset, and the electrocardiogram (ECG) findings were suggestive of inferior ST-segment elevation myocardial infarction. She had a background history of temporal arteritis, on long-term oral steroid and hypertension. Urgent left coronary angiography via right radial access showed severe stenosis of the proximal right coronary artery (RCA) ( Panel A , arrow) that improved with intracoronary nitrate ( Panel B , arrow). Given the unusual appearance of the RCA lesion, an optical coherence tomography (OCT) was performed and revealed an extensive intramural haematoma extending from the proximal RCA into the aorto-ostial ...

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    11. Association of the age shock index with coronary plaque characteristics in ST‐segment elevation myocardial infarction: A 3‐vessel optical coherence tomography study

      Association of the age shock index with coronary plaque characteristics in ST‐segment elevation myocardial infarction: A 3‐vessel optical coherence tomography study

      Objectives We investigated whether the age shock index (SI) was associated with coronary plaque characteristics in patients with ST‐segment elevation myocardial infarction (STEMI) using optical coherence tomography (OCT). Background The age SI is a simple clinical parameter that effectively predicts poor clinical outcomes among patients with STEMI. Methods This retrospective study evaluated 408 STEMI patients who underwent 3‐vessel OCT during emergency percutaneous coronary interventions at a single center between January 2017 and October 2018. Patients were divided into groups with low or high age SI values (<41 vs. ≥41). Plaque characteristics were compared between the two groups for ...

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    12. Zero contrast optical coherence tomography‐guided percutaneous coronary intervention in patients with non‐ST segment elevation myocardial infarction and chronic kidney disease

      Zero contrast optical coherence tomography‐guided percutaneous coronary intervention in patients with non‐ST segment elevation myocardial infarction and chronic kidney disease

      Objectives To investigate a strategy for ultra‐low volume contrast percutaneous coronary intervention (PCI) with the aims of preserving renal function and observing the 90‐day clinical endpoint in patients with non‐ST‐elevated myocardial infarction (non‐STEMI) and chronic kidney disease (CKD). Background The feasibility, safety, and clinical utility of PCI with ultra‐low radio‐contrast medium in patients with non‐STEMI and CKD are unknown. Methods A total of 29 patients with non‐STEMI and CKD (estimated glomerular filtration rate [eGFR] of ≤60 ml/min/1.73 m 2 ) were included. Ultra‐low volume contrast PCI was performed ...

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    13. Optical coherence tomography-guided excimer laser coronary angioplasty in overlapping stents with severe under-expansion and underlying calcification

      Optical coherence tomography-guided excimer laser coronary angioplasty in overlapping stents with severe under-expansion and underlying calcification

      Coronary artery calcification remains an important reason of insufficient stent expansion. Dealing with under-expanded stents remains a technical challenge, as cutting and high-pressure balloons are ineffective and harmful in many cases. [ 4 ] In 2014, the Ellement Registry study demonstrated the effectiveness and reproducibility of ELCA combining with contrast injection in modifying plaques and improving stent expansion in under-expanded lesions. [ 5 ] At present, ELCA is still the only anti-atherosclerosis technique that can be used without damaging the structure of the stent. It modifies the plaque beneath stent struts, weakening the overall resistance, and thus allowing the subsequent full stent expansion. [ 6 ]

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    14. Occlusion-crossing devices

      Occlusion-crossing devices

      A catheter device for crossing occlusions includes an elongate catheter shaft, a rotatable tip configured to rotate relative to the elongate catheter shaft, a drive shaft, and an OCT imaging sensor. The rotatable tip includes a housing coupled with the elongate catheter shaft and cutting wedges extendable from the housing. The drive shaft has a central lumen extending therethrough and extends within the elongate catheter shaft. The drive shaft is coupled with the wedges and is configured to rotate the rotatable tip. The OCT sensor includes an optical fiber coupled with the rotatable tip and configured to rotate therewith. The ...

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      Mentions: Avinger
    15. Stepwise regression of non-culprit lipid-rich plaque observed using serial near-infrared spectroscopy–intravascular ultrasound and optical coherence tomographic measurements after aggressive cholesterol-lowering treatment: a case report

      Stepwise regression of non-culprit lipid-rich plaque observed using serial near-infrared spectroscopy–intravascular ultrasound and optical coherence tomographic measurements after aggressive cholesterol-lowering treatment: a case report

      Background Lipid-rich plaques (LRP) in the non-culprit lesions (NCL) in patients with the acute coronary syndrome may trigger lesion-related, adverse cardiovascular events. Aggressive lipid-lowering therapy may stabilize LRP; however, the times of stabilization remain undefined. Case summary A 60-year-old man presented with unstable angina. Coronary angiography revealed a severely stenotic lesion (culprit lesion) in the left descending artery, and another non-obstructive lesion in the distal left main trunk artery. Near-infrared spectroscopy (NIRS) imaging showed LRP with a maximum lipid core burden index (LCBI) 4mm of 422. Optical coherence tomographic (OCT) imaging showed the vulnerable plaque as a thin cap fibroatheroma ...

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    16. Adaptation to Exercise Training in Conduit Arteries and Cutaneous Microvessels in Humans: An Optical Coherence Tomography Study

      Adaptation to Exercise Training in Conduit Arteries and Cutaneous Microvessels in Humans: An Optical Coherence Tomography Study

      Introduction: Exercise training has anti-atherogenic impacts on conduit and resistance artery function and structure in humans and induces angiogenic changes in skeletal muscle. However, training-induced adaptation in cutaneous microvessels is poorly understood, partly due to technological limitations. Optical coherence tomography (OCT) is a novel high resolution imaging technique capable of visualising cutaneous microvasculature at a resolution of ~30μm. We utilised OCT to visualise the impacts of training on cutaneous microvessels, alongside assessment of conduit artery flow mediated dilation (FMD). Methods: We assessed brachial FMD and cutaneous microcirculatory responses at rest and in response to local heating and reactive hyperaemia ...

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    17. Safety and outcomes of combined carbon dioxide angiography and OCT-guided femoro-popliteal chronic total occlusion crossing and directional atherectomy in patients with chronic kidney disease

      Safety and outcomes of combined carbon dioxide angiography and OCT-guided femoro-popliteal chronic total occlusion crossing and directional atherectomy in patients with chronic kidney disease

      Background: Carbon dioxide angiography with addition of optical coherence tomography imaging may improve procedural success and clinical outcomes in patients with peripheral artery disease and chronic kidney disease. Methods: Single-center, retrospective analysis of patients with chronic kidney disease who underwent carbon dioxide angiography and optical coherence tomography-guided chronic total occlusion crossing and/or optical coherence tomography-guided directional atherectomy was performed. Patient and procedure-related characteristics, along with peri- and one-year post-procedural major adverse events, were analyzed. Results: A total of 18 vessels in 11 patients, with mean age 70 years were treated. All had co-morbidities such as hypertension, hyperlipidemia, had history ...

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    18. Prognostic Links Between OCT-Delineated Coronary Morphologies and Coronary Functional Abnormalities in Patients With INOCA

      Prognostic Links Between OCT-Delineated Coronary Morphologies and Coronary Functional Abnormalities in Patients With INOCA

      Objectives: Whether there are prognostic links between coronary morphologies and coronary functional abnormalities was examined in ischemia and nonobstructive coronary artery disease (INOCA) patients. Background: Although INOCA has attracted much attention, little is known about the prognostic impact of coronary morphologies in this disorder. Methods: A total of 329 consecutive INOCA patients were enrolled and underwent spasm provocation testing combined with lactate sampling for diagnosis of epicardial and microvascular spasm (MVS). On the basis of the functional tests, the patients were classified into 4 groups: a control group without epicardial spasm or MVS (n = 32), MVS alone (n = 51), diffuse ...

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    19. In-vivo mechanical characterization of coronary atherosclerotic plaques in living swine using intravascular laser speckle imaging

      In-vivo mechanical characterization of coronary atherosclerotic plaques in living swine using intravascular laser speckle imaging

      The ability to evaluate the viscoelastic properties of coronary arteries is crucial for identifying mechanically unstable atherosclerotic plaques. Here, we demonstrate for the first time in living swine, the capability of intravascular laser speckle imaging (ILSI) to measure an index of coronary plaque viscoelasticity, τ, using a human coronary to swine xenograft model. Cardiac motion effects are evaluated by comparing the EKG-non-gated

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    20. Complex Bifurcation Lesions: RAndomized Comparison of Modified-T Stenting vs Reconstruction With Self-Expanding Stent and Bioresorbable Scaffold: COBRA II

      Complex Bifurcation Lesions: RAndomized Comparison of Modified-T Stenting vs Reconstruction With Self-Expanding Stent and Bioresorbable Scaffold: COBRA II

      Objectives. To evaluate the role of a double bioresorbable vascular scaffold (BVS) strategy in coronary bifurcations, alone or in combination with a dedicated bifurcation device. Methods. COBRA II is a prospective, single-center, randomized controlled trial. Patients were randomized to treatment with biolimus-eluting Axxess bifurcation device (Biosensors) in combination with Absorb BVS (Abbott Vascular) or a modified-T strategy using Absorb BVS. Optical coherence tomography (OCT) was performed post procedure and at 30 months. The primary endpoint was change in minimal luminal area (MLA) on OCT from baseline to 30-month follow-up. Clinical endpoints included major adverse cardiac event (MACE) rate. Results. From ...

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    21. Association of Trimethylamine N-Oxide Levels and Calcification in Culprit Lesion Segments in Patients With ST-Segment–Elevation Myocardial Infarction Evaluated by Optical Coherence Tomography

      Association of Trimethylamine N-Oxide Levels and Calcification in Culprit Lesion Segments in Patients With ST-Segment–Elevation Myocardial Infarction Evaluated by Optical Coherence Tomography

      The presence of calcified plaques is one of the pathological phenotypes of acute coronary syndrome (ACS) and can be frequently found in culprit lesion segments. Trimethylamine N-oxide (TMAO) is reported to be involved in vascular calcification and plaque instability. This study investigated the relationship between plasma TMAO levels and calcified lesions in culprit lesion segments in STEMI patients. A prospective series of 179 patients with STEMI were enrolled, and calcified lesions from 127 patients were analyzed by OCT. The plasma TMAO levels were measured by using stable isotope dilution liquid chromatography tandem mass spectrometry. Patients were divided into two groups ...

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    22. Method for parametric imaging of attenuation by intravascular optical coherence tomography

      Method for parametric imaging of attenuation by intravascular optical coherence tomography

      Catheter-based intravascular optical coherence tomography (IVOCT) is a powerful imaging modality for visualization of atherosclerosis with high resolution. Quantitative characterization of various tissue types by attenuation coefficient (AC) extraction has been proven to be a potentially significant application of OCT attenuation imaging. However, existing methods for AC extraction from OCT suffer from the challenge of variability in complex tissue types in IVOCT pullback data such as healthy vessel wall, mixed atherosclerotic plaques, plaques with a single component and stent struts, etc. This challenge leads to the ineffectiveness in the tissue differentiation by AC representation based on single scattering model of ...

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    23. Multi-spectral intravascular photoacoustic/ultrasound/optical coherence tomography tri-modality system with a fully-integrated 0.9-mm full field-of-view catheter for plaque vulnerability imaging

      Multi-spectral intravascular photoacoustic/ultrasound/optical coherence tomography tri-modality system with a fully-integrated 0.9-mm full field-of-view catheter for plaque vulnerability imaging

      Myocardial infarctions are most often caused by the so-called vulnerable plaques, usually featured as non-obstructive lesions with a lipid-rich necrotic core, thin-cap fibroatheroma, and large plaque size. The identification and quantification of these characteristics are the keys to evaluate plaque vulnerability. However, single modality intravascular methods, such as intravascular ultrasound, optical coherence tomography and photoacoustic, can hardly achieve all the comprehensive information to satisfy clinical needs. In this paper, for the first time, we developed a novel multi-spectral intravascular tri-modality (MS-IVTM) imaging system, which can perform 360° continuous rotation and pull-backing with a 0.9-mm miniature catheter and achieve simultaneous ...

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