1. Articles in category: Cardiology

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    1. Multimodality imaging of attenuated plaque using grayscale and virtual histology intravascular ultrasound and optical coherent tomography

      Multimodality imaging of attenuated plaque using grayscale and virtual histology intravascular ultrasound and optical coherent tomography

      Background Although attenuated plaque is a marker for plaque vulnerability, the quantification and its implication have not been known. Methods Multimodality pre-procedural imaging using grayscale intravascular ultrasound (IVUS), virtual histology-IVUS (VH-IVUS) and optical coherence tomography (OCT) were performed in 115 coronary lesions with diameter stenosis (DS) >30% and plaque burden ≥50% and compared the diagnostic accuracies for detecting thin-cap fibroatheromas (TCFA). Results A maximal arc of attenuation (40MHz IVUS) ≥29.0° was the cut-off for predicting VH-TCFA (sensitivity 74%, specificity 66%); and OCT-TCFA (sensitivity 89%, specificity 64%), while a maximal arc attenuation≥29.0° (20MHz IVUS) showed a poor sensitivity ...

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    2. Philips to acquire Volcano to expand global leadership position in image-guided therapy market

      Philips to acquire Volcano to expand global leadership position in image-guided therapy market

      Royal Philips (NYSE: PHG; AEX: PHIA) and Volcano Corporation (NASDAQ:VOLC), a global leader in catheter-based imaging and measurement solutions for cardiovascular applications, today announced that they have entered into a definitive merger agreement. Pursuant to the agreement, Philips will commence a tender offer to acquire all of the issued and outstanding shares of Volcano for USD 18.00 per share, or a total equity purchase price of USD 1 billion (approx. EUR 800 million), to be paid in cash upon completion. The board of directors of Volcano has unanimously approved the transaction and recommends the offer to its shareholders ...

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    3. Optical Coherence Tomography Assessment of Late Intra-Scaffold Dissection - A New Challenge of Bioresorbable Scaffolds

      Optical Coherence Tomography Assessment of Late Intra-Scaffold Dissection - A New Challenge of Bioresorbable Scaffolds

      A 48-year-old man was admitted because of a non–ST-segment elevation myocardial infarction. Fifteen months previously, he had received a 3.0 × 28-mm bioresorbable vascular scaffold (BVS) (Absorb, Abbott Vascular, Santa Clara, California) in the mid-left anterior descending coronary artery for stable angina. Coronary angiography showed a focal in-scaffold restenosis (Figure 1 ). Optical coherence tomography (OCT) (Ilumien, St. Jude Medical, Saint Paul, Minnesota) revealed a heterogeneous pattern consisting of neointimal hyperplasia (Figure 1 ), mural white thrombus (Figure 1 ), and lipidic plaque with attenuation (Figure 1 ). OCT after pre-dilation with a 2.0 × 15-mm semicompliant balloon showed outer migration of scaffold ...

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    4. Infraredx Announces Research Collaboration with Massachusetts General Hospital to Explore New Generation of Cardiovascular Imaging Devices

      Infraredx Announces Research Collaboration with Massachusetts General Hospital to Explore New Generation of Cardiovascular Imaging Devices

      Infraredx, Inc., a cardiovascular imaging company pioneering the personalized diagnosis of coronary artery disease, today announced a collaboration with Massachusetts General Hospital (MGH) and leading coronary imaging researcher, Gary Tearney, M.D., Ph.D., professor of pathology at Harvard Medical School, Mike and Sue Hazard Family MGH Research Scholar, and founder of the Tearney Lab at the Wellman Center for Photomedicine at MGH. Dr. Tearney is best known for pioneering research efforts developing Optical Coherence Tomography (OCT), an imaging technology that uses light-scattering to image coronary arteries. Infraredx and Dr. Tearney first collaborated over a decade ago on the development ...

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    5. Feasibility of Optical Coronary Tomography in Quantitative Measurement of Coronary Arteries With Lipid-Rich Plaque

      Feasibility of Optical Coronary Tomography in Quantitative Measurement of Coronary Arteries With Lipid-Rich Plaque

      Background: The aim of the present study was to evaluate the feasibility of optical coherence tomography (OCT) for measurement of vessel area in coronary arteries with lipid-rich plaque as compared with intravascular ultrasound (IVUS). Methods and Results: We investigated 80 coronary artery segments with lipid-rich plaque on OCT and non-attenuated plaque on IVUS. According to the lipid arc on OCT, the plaques were classified into 4 groups: group 1, lipid arc ≤90°; group 2, 90°<lipid arc≤180°; group 3, 180°<lipid arc≤270°; group 4, lipid arc >270°. Vessel circular arcs that could not be identified due to OCT ...

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    6. Contemporary invasive imaging modalities that identify and risk-stratify coronary plaques at risk of rupture

      Contemporary invasive imaging modalities that identify and risk-stratify coronary plaques at risk of rupture

      Atherosclerotic plaque rupture is responsible for the majority of myocardial infarctions, with ruptured plaques exhibiting specific morphological features, including large lipid cores, thinner overlying fibrous caps and micro-calcifications. Contemporary imaging modalities are increasingly able to characterize plaques, potentially leading to the identification of precursor lesions that are at high risk of rupture. Observational studies using invasive imaging consistently find that plaques responsible for an acute coronary event display these high-risk morphological features, and recent prospective imaging studies have now established links between baseline plaque characteristics and future cardiovascular events. Despite these promising advances, subsequent overall event rates remain too low ...

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    7. Current OCT Approaches Do Not Reliably Identify TCFAs

      Current OCT Approaches Do Not Reliably Identify TCFAs

      It is now clearly established that Thin-Capped Fibroatheromas (TCFAs) lead to most Acute Coronary Syndromes (ACSs). The ability to selectively intervene on TCFAs predisposed to rupture and ACSs would dramatically alter the practice of cardiology. While the ability of OCT to identify thin walled plaques at micron scale resolutions has represented a major advance, it is a misconception that it can reliably identify TCFAs. One major reason is that the ‘diffuse border’ criteria currently used to determine ‘lipid plaque’ is almost undoubtedly from high scattering in the intima and not because of core composition (necrotic core). A second reason is ...

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    8. Randomized Comparison of Stent Strut Coverage Following Angiography- or Optical Coherence Tomography-guided Percutaneous Coronary Intervention

      Randomized Comparison of Stent Strut Coverage Following Angiography- or Optical Coherence Tomography-guided Percutaneous Coronary Intervention

      Abstract Introduction and objectives The clinical benefits of optical coherence tomography-guided percutaneous coronary intervention are unclear. Therefore, in this study we sought to evaluate the impact of optical coherence tomography guidance on stent strut coverage following drug-eluting stent implantation. Methods A total of 101 patients in 105 lesions were randomly assigned to receive percutaneous coronary intervention under either optical coherence tomography guidance (n = 51 lesions of 50 patients) or angiography guidance (n = 54 lesions of 51 patients), and underwent a follow-up optical coherence tomography examination 6 months after zotarolimus-eluting stent implantation. The primary and secondary end points were the percentage ...

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    9. Infraredx Announces Publication of Prospective Study Demonstrating thatNear-Infrared Spectroscopy May Assist in Predicting the Risk of Future Cardiovascular Events, Including Heart Attack and Stroke

      Infraredx Announces Publication of Prospective Study Demonstrating thatNear-Infrared Spectroscopy May Assist in Predicting the Risk of Future Cardiovascular Events, Including Heart Attack and Stroke

      Infraredx, Inc., a cardiovascular imaging company pioneering the personalized diagnosis of coronary artery disease, today announced results from an independent, prospective outcomes study published in the Journal of the American College of Cardiology (JACC). The study evaluated the ability of intravascular near-infrared spectroscopy (NIRS) to identify lipid core-containing plaques, which are believed to be implicated in most heart attacks, as a means to predict the risk of future major adverse cardiac and cerebrovascular events (MACCE). In the study, patients who presented with symptoms associated with limited blood supply to the heart also underwent NIRS imaging to evaluate the Lipid Core ...

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    10. In Search of the Vulnerable Plaque Is There Any Light at the End of the Catheter?

      In Search of the Vulnerable Plaque Is There Any Light at the End of the Catheter?

      Plaque destabilization with consequent rupture (or erosion) and superimposed thrombosis is the proximate cause of acute coronary syndromes (ACS). Although ACS treatment has advanced considerably in the past decade, the ability to detect, predict, and prevent plaque vulnerability remains elusive. Several imaging tools have been developed to characterize morphological determinants of plaque vulnerability 1 . Among these, intravascular ultrasound (IVUS) is useful for characterizing stenosis severity, plaque burden (PB), remodeling, and calcification but has low resolution and limited ability to detect plaque erosion, rupture, and thrombus. Optical coherence tomography (OCT) can characterize plaques but possesses poor penetration, thereby limiting assessment of ...

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      Mentions: Jagat Narula
    11. Two-Year Follow-Up OCT Images of 2 Bifurcation Lesions Treated With Bioresorbable Vascular Scaffolds

      Two-Year Follow-Up OCT Images of 2 Bifurcation Lesions Treated With Bioresorbable Vascular Scaffolds

      Letter to the editor. Diagnostic angiogram of a 66-year-old man presenting with stable angina revealed significant lesions in the left main coronary artery (LMCA) trifurcation and the left anterior descending artery (LAD) diagonal bifurcation (Figure 1 ). In the latter, after deployment of a 2.5 × 16.0 mm Promus element (Boston Scientific, Natick, Massachusetts) with mini-crush technique in the diagonal with initial kissing balloon inflation (KBI), a 3.0 × 18.0 mm ABSORB bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) was implanted in the proximal LAD without final KBI. In the LMCA trifurcation lesion, a 3.5 × 18 ...

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    12. STACCATO (Assessment of Stent sTrut Apposition and Coverage in Coronary ArTeries with Optical coherence tomography in patients with STEMI, NSTEMI and stable/unstable angina undergoing everolimus vs. biolimus A9-eluting stent implantation): a randomised co

      STACCATO (Assessment of Stent sTrut Apposition and Coverage in Coronary ArTeries with Optical coherence tomography in patients with STEMI, NSTEMI and stable/unstable angina undergoing everolimus vs. biolimus A9-eluting stent implantation): a randomised co

      Aims: To compare tissue coverage in coronary lesions stented with durable fluoropolymer-coated everolimus-eluting stents (EES) vs. biodegradable polymer-coated biolimus A9-eluting stents (BES). Methods and results: Sixty-four patients (64 lesions) with de novo coronary artery lesions were randomised to percutaneous treatment with XIENCE® EES (Abbott Vascular, Santa Clara, CA, USA) vs. BioMatrix™ BES (Biosensors, Morges, Switzerland). The primary endpoint was the percentage of uncovered struts, as assessed with OCT, at nine months. The average percentage of uncovered struts was significantly lower with EES (4.3±4.8% vs. 8.7±7.8% with BES, p=0.019). There was no difference ...

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    13. Optical Coherence Tomography in Thromboembolic Pulmonary Hypertension

      Optical Coherence Tomography in Thromboembolic Pulmonary Hypertension

      Thromboembolic pulmonary hypertension is caused by thrombotic obstruction of the pulmonary artery tree after a thromboembolic event. Ifthe thrombotic event does not resolve, fibrotic changes associated with vascular remodeling occur, leading to increased pulmonary resistance. An 80-year-old man was diagnosed with severe hypertension by echocardiography after signs and symptoms of acute pulmonary thromboembolism 2 years earlier. Cardiac catheterization found a pulmonary pressure of 80/30 mmHg (mean, 47 mmHg), with a resistance of 9 UW. Pulmonary angiography showed partial filling defects in both main pulmonary arteries. Optical coherence tomography is an imaging technique that allows the arterial wall to be ...

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    14. Proximal optimization technique and kissing balloon inflations with the bioresorbable vascular scaffold for coronary bifurcation percutaneous coronary intervention

      Proximal optimization technique and kissing balloon inflations with the bioresorbable vascular scaffold for coronary bifurcation percutaneous coronary intervention

      Proximal optimization technique and final kissing balloon inflations with noncompliant balloons facilitate success with coronary bifurcation intervention. The use of bioresorbable vascular scaffolds has been postulated to reduce the risk of in-stent restenosis, a particular problem with bifurcation intervention. We present a case of bifurcation intervention in a 49-year-old woman, using for the first time, proximal optimization and kissing balloon inflation within bioresorbable vascular scaffolds, using optical coherence tomography guidance.

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    15. OCT Assessment of the Long-Term Vascular Healing Response 5 Years After Everolimus-Eluting Bioresorbable Vascular Scaffold

      OCT Assessment of the Long-Term Vascular Healing Response 5 Years After Everolimus-Eluting Bioresorbable Vascular Scaffold

      Background Although recent observations suggest a favorable initial healing process of the everolimus-eluting bioresorbable vascular scaffold (BVS), little is known regarding long-term healing response. Objectives This study assessed the in vivo vascular healing response using optical coherence tomography (OCT) 5 years after elective first-in-man BVS implantation. Methods Of the 14 living patients enrolled in the Thoraxcenter Rotterdam cohort of the ABSORB A study, 8 patients underwent invasive follow-up, including OCT, 5 years after implantation. Advanced OCT image analysis included luminal morphometry, assessment of the adluminal signal-rich layer separating the lumen from other plaque components, visual and quantitative tissue characterization, and ...

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    16. Determinants of Neointimal Proliferation and Stent Coverage After Intracoronary Therapy With Drug-Eluting Devices in Stable Coronary Artery Disease: Role of Endothelial Progenitor Cells and Interleukin-1 Family Cytokines

      Determinants of Neointimal Proliferation and Stent Coverage After Intracoronary Therapy With Drug-Eluting Devices in Stable Coronary Artery Disease: Role of Endothelial Progenitor Cells and Interleukin-1 Family Cytokines

      Background. Endothelial progenitor cells (EPCs) and cytokines seem to play a pivotal role in arterial healing after stent implantation. Using optical coherence tomography (OCT) as a high-resolution imaging technique, we aimed to assess the influence of circulating EPCs and levels of Il-1 cytokines on stent coverage and in-stent proliferation. Methods. Eighty-nine patients were randomly treated with either Xience V drug-eluting stent (DES; n = 48) or bare-metal stent (BMS) postdilated with the SeQuent Please drug-eluting balloon (DEB; n = 41). EPC populations (CD34+/CD133+ and CD34+/CD133+/KDR+EPC) and cytokines (Il-1ra, Il-18, and Il-1α) were measured before percutaneous coronary intervention using ...

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      Mentions: St. Jude Medical
    17. Spotty calcification and plaque vulnerability in vivo: frequency domain optical coherence tomography analysis

      Spotty calcification and plaque vulnerability in vivo: frequency domain optical coherence tomography analysis

      Background: Spotty calcification is a morphological characteristic of a vulnerable plaque phenotype. While this calcium pattern is considered an active process, promoted by inflammation, it is unknown whether spotty calcification associates with development of microstructures observed in vulnerable plaques. As frequencydomain optical coherence tomography (FD-OCT) enables visualization of microstructures associated with plaque vulnerability, we investigated the association between spotty calcification and plaque microstructures by using FD-OCT. Methods: A total of 300 patients with stable coronary artery disease (CAD), having clinical indication for percutaneous coronary intervention (PCI), were analyzed. Totally 280 non-culprit lipid plaques within the target vessel requiring PCI were ...

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    18. Optical coherence tomography evaluating unstable coronary plaques: A case report

      Optical coherence tomography evaluating unstable coronary plaques: A case report

      Unstable plaque is the main cause of ACS. However, it is difficult to find in some cases. We report a case in which conventional angiography and IVUS were unable to identify the ruptured plaque that caused the condition in a 72-year-old man. He has been suffered from accelerated angina at rest. Angiography and IVUS did not find culprit lesion. However, a ruptured thin-cap fibroatheroma plaque was found in right coronary using OCT. The symptom was disappeared after one stent coving the lesion. The case indicates that OCT is a new intravascular imaging modality that allows clear visualization of vulnerable plaques.

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    19. Optical Coherence Tomography for Quantitative Diagnosis in Cardiovascular Disease (Book Chapter)

      Optical Coherence Tomography for Quantitative Diagnosis in Cardiovascular Disease (Book Chapter)

      In recent years, biomedical imaging technology has made rapid advances that enable the visualization, quantification, and monitoring of morphology and function. There are several tomography modalities which are currently used in clinics, such as computed tomography (CT), positron emission tomography (PET), magnetic resonance imaging (MRI), ultrasound (US), etc. These modalities have been developed for in vivo structural and functional imaging in humans, but frequently require large, expensive and complex systems. The penetration depth of these tomographic techniques is long, but the spatial resolution is typically on the order of several millimeters or hundred of micrometers.

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    20. Clinical application of optical coherence tomography in combination with functional diagnostics: advantages and limitations for diagnosis and assessment of therapy outcome in central serous chorioretinopathy

      Clinical application of optical coherence tomography in combination with functional diagnostics: advantages and limitations for diagnosis and assessment of therapy outcome in central serous chorioretinopathy

      Purpose: While identifying functional and structural parameters of the retina in central serous chorioretinopathy (CSCR) patients, this study investigated how an optical coherence tomography (OCT)-based diagnosis can be significantly supplemented with functional diagnostic tools and to what degree the determination of disease severity and therapy outcome can benefit from diagnostics complementary to OCT. Methods: CSCR patients were evaluated prospectively with microperimetry (MP) and spectral domain optical coherence tomography (SD-OCT) to determine retinal sensitivity function and retinal thickness as outcome measures along with measures of visual acuity (VA). Patients received clinical care that involved focal laser photocoagulation or pharmacotherapy targeting ...

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    21. Left Main Coronary Artery Lesions and Optical Coherence Tomography

      Left Main Coronary Artery Lesions and Optical Coherence Tomography

      Optimal treatment of left main coronary artery (LMCA) lesions requires a highly tailored approach that incorporates patient comorbidities, clinical presentation, the extent of coronary artery disease (CAD), lesion characteristics and local expertise. 1,2 Coronary artery bypass grafting (CABG) is the treatment for LMCA lesions that has the highest evidence level in guideline recommendations. 2,3 However, the evidence for percutaneous coronary intervention (PCI) has increased in recent years and is now class IIa for ostial and trunk LMCA lesions and IIb for distal LMCA bifurcation treatment in stable patients suited for PCI. 2,3 However, these lesion-specific recommendations cannot ...

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      Mentions: St. Jude Medical
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