1. Articles in category: Cardiology

    1-24 of 2862 1 2 3 4 ... 118 119 120 »
    1. A robust fully automatic lumen segmentation method for in vivo intracoronary optical coherence tomography

      A robust fully automatic lumen segmentation method for in vivo intracoronary optical coherence tomography

      Introduction: Intravascular optical coherence tomography (IVOCT) is an in-vivo imaging modality based on the introduction of a catheter in a blood vessel for viewing its inner wall using electromagnetic radiation. One of the most developed automatic applications for this modality is the lumen area segmentation, however on the evaluation of these methods, the slices inside bifurcation regions, or with the presence of complex atherosclerotic plaques and dissections are usually discarded. This paper describes a fully-automatic method for computing the lumen area in IVOCT images where the set of slices includes complex atherosclerotic plaques and dissections. Methods The proposed lumen segmentation ...

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    2. A Comparison of Intravascular Imaging Modalities for Detection of Stent Struts in Acute Coronary Syndrome

      A Comparison of Intravascular Imaging Modalities for Detection of Stent Struts in Acute Coronary Syndrome

      Background We used optical coherence tomography (OCT) and intravascular ultrasound (IVUS) to assess the struts of implanted stents in patients with acute coronary syndrome (ACS). Methods A totle of 10,756 stent struts were analyzed with OCT in 42 patients of ACS. Of them, both of IVUS and OCT imaging were performed in 33 patients. Appearance of stent struts was classified as well apposed, buried, malapposed, and nondetectable, and the number of stent struts were counted by OCT and IVUS was compared. Results Most of stent struts were well apposed (78.1%, 8,407/10,756). However, malapposed struts were ...

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    3. Impact of Culprit Plaque and Atherothrombotic Components on Incomplete Stent Apposition in Patients With ST-Elevation Myocardial Infarction Treated With Everolimus-Eluting Stents – An OCTAVIA Substudy –

      Impact of Culprit Plaque and Atherothrombotic Components on Incomplete Stent Apposition in Patients With ST-Elevation Myocardial Infarction Treated With Everolimus-Eluting Stents – An OCTAVIA Substudy –

      Background: The role of culprit plaque and related atherothrombotic components on incomplete stent apposition (ISA) occurrence after primary percutaneous coronary intervention (p-PCI) is unknown. Methods and Results: ST-segment elevation myocardial infarction (STEMI) patients undergoing p-PCI with an everolimus-eluting stent were prospectively investigated with optical coherence tomography (OCT) of the infarct-related artery before, after stenting and at 9 months. OCT data, aspirated thrombus and serum inflammatory biomarkers were analyzed. 114 patients with 114 lesions were evaluated. Acute ISA occurred in 82 lesions (71.9%), preferentially in larger vessels with a median area of 0.2 mm 2 . The presence of thrombus ...

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    4. Coronary optical coherence tomography: A practical overview of current clinical applications

      Coronary optical coherence tomography: A practical overview of current clinical applications

      Coronary optical coherence tomography has emerged as the most powerful in-vivo imaging modality to evaluate vessel structure in detail. It is a useful research tool that provides insights into the pathogenesis of coronary artery disease. This technology has an important clinical role that is still being developed. We review the evidence on the wide spectrum of potential clinical applications for coronary optical coherence tomography, which encompass the successive stages in coronary artery disease management: accurate lesion characterization and quantification of stenosis, guidance for the decision to perform percutaneous coronary intervention and subsequent planning, and evaluation of immediate and long-term results ...

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    5. St. Jude Medical Announces Launch of OPTIS Mobile System in Europe and Japan

      St. Jude Medical Announces Launch of OPTIS Mobile System in Europe and Japan

      St. Jude Medical, Inc. (NYSE:STJ), a global medical device company, today announced the launch of the company’s OPTIS™ Mobile System in Japan and Europe. The diagnostic system is designed to couple state-of-the-art optical coherence tomography (OCT) and angiography co-registration with fractional flow reserve (FFR) technology into one portable system for hospitals with multiple catheterization labs. OPTIS Mobile Integrated Lab (Photo: Business Wire) Driven by a global increase in vascular disease and enabled by advances in technology, the catheterization lab allows physicians to use minimally invasive percutaneous coronary intervention (PCI) procedures that give patients an alternative to open heart ...

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      Mentions: St. Jude Medical
    6. Association between Cholesterol Crystals and Culprit Lesion Vulnerability in Patients with Acute Coronary Syndrome: an Optical Coherence Tomography Study

      Association between Cholesterol Crystals and Culprit Lesion Vulnerability in Patients with Acute Coronary Syndrome: an Optical Coherence Tomography Study

      Background Cholesterol Crystals (ChCs) are recognized as a hallmark of advanced atherosclerotic lesions. Previous animal and histopathology studies have revealed that Cholesterol crystallization trigger a local inflammatory response and plaque rupture. We sought to investigate the in vivo relationship between ChCs and culprit lesion vulnerability in patients with acute coronary syndrome (ACS). Methods 206 culprit lesions from 206 patients with ACS who underwent optical coherence tomography (OCT) imaging were divided into 2 groups based on the presence or absence of ChCs. Culprit lesions characteristics were compared between ChCs and Non-ChCs groups. Results For overall ACS patients, culprit lesions with ChCs ...

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      Mentions: Jingbo Hou Bo Yu
    7. Are Microcalcification and Hemosiderin Really Limitations of OCT in Detection of TCFA?

      Are Microcalcification and Hemosiderin Really Limitations of OCT in Detection of TCFA?

      With great interest, we read the recent work by Fujii et al. (1) published in iJACC reporting the diagnostic accuracy of optical coherence tomography (OCT) and grayscale intravascular ultrasound for the detection of coronary thin cap fibroatheroma (TCFA) with histologic validation in human autopsy hearts. In this publication, Fujii et al. (1) documented a limited capability of OCT and intravascular ultrasound for TCFA identification when each imaging device was solely utilized. The authors attributed the low accuracy of OCT in TCFA detection to 4 reasons: presence of foam cell macrophage, microcalcification, hemosiderin accumulation, and organizing thrombus inclusive of fibrin. However ...

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    8. Enhanced Adventitial Vasa Vasorum Formation in Patients With Vasospastic Angina Assessment With OFDI

      Enhanced Adventitial Vasa Vasorum Formation in Patients With Vasospastic Angina Assessment With OFDI

      Coronary artery spasm plays important roles in the pathogenesis of a wide range of ischemic heart disease. Recent studies have demonstrated that coronary spasm is frequently noted in Caucasians as in Asians (1) . We previously demonstrated that vascular smooth muscle cell hypercontraction through Rho-kinase activation is the key mechanism of the spasm, for which adventitial inflammatory changes may be involved (1) . The adventitia has recently attracted much attention as a source of inflammation as it harbors nutrient blood vessels called vasa vasorum (VV). Indeed, VV plays an important role as a supply route of vascular inflammation in the progression of ...

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    9. Contribution of optical coherence tomography imaging in management of iatrogenic coronary dissection

      Contribution of optical coherence tomography imaging in management of iatrogenic coronary dissection

      Iatrogenic coronary dissection is a rare but potentially serious complication of coronary angiography and angioplasty. Treatment with angioplasty guided only by angiography is often difficult. Optical coherence tomography imaging seems to be an interesting technique to lead the management of iatrogenic coronary dissection. Diagnosis can be made by optical coherence tomography; it can also eliminate differential diagnosis. Furthermore, this technique can guide safely the endovascular treatment.

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    10. Integrated intravascular ultrasound and optical coherence tomography technology: a promising tool to identify vulnerable plaques

      Integrated intravascular ultrasound and optical coherence tomography technology: a promising tool to identify vulnerable plaques

      Heart attack is mainly caused by the rupture of a vulnerable plaque. IVUS-OCT is a novel medical imaging modality that provides opportunities for accurate assessment of vulnerable plaques in vivo in patients. IVUS provides deep penetration to image the whole necrotic core while OCT enables accurate measurement of the fibrous cap of a plaque owing to its high resolution. In this paper, the authors describe the fundamentals, the technical designs and the applications of IVUS-OCT technology. Results from cadaver specimens are summarized, which indicated the complementary nature of OCT and IVUS for assessment of vulnerable plaques, plaque composition, and stent-tissue ...

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    11. Metabolic syndrome predicts plaque rupture in patients with acute myocardial infarction. An optical coherence study

      Metabolic syndrome predicts plaque rupture in patients with acute myocardial infarction. An optical coherence study

      The metabolic syndrome (MS) is conceptualized as a clustering of risk factors-including insulin resistance, dyslipidemia, central adiposity, and elevated blood pressure (BP)-that increase the risk for cardiovascular disease and type 2 diabetes mellitus (DM) [1]. Metabolic syndrome is known to be a low-grade systemic inflammatory condition with its origins in the perinatal period and childhood, while recent evidence suggests that markers of systemic inflammation may be included in the definition of the syndrome and play some role in its pathogenesis

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    12. Use of intravascular ultrasound vs. optical coherence tomography for mechanism and patterns of in-stent restenosis among bare metal stents and drug eluting stents

      Use of intravascular ultrasound vs. optical coherence tomography for mechanism and patterns of in-stent restenosis among bare metal stents and drug eluting stents

      This article is a perspective responses to the “Mechanisms and Patterns of Intravascular Ultrasound In-Stent Restenosis Among Bare Metal Stents and First- and Second-Generation Drug-Eluting Stents” by Goto et al ., The above mentioned article outlines the use of intravascular ultrasound (IVUS) in visualizing the patterns and mechanisms of in-stent restenosis (ISR) post percutaneous coronary intervention (PCI). Although IVUS is an appropriate method of choice for this scenario, IVUS has certain limitations which can be overcome by using optical coherent tomography (OCT). OCT is not only able to overcome IVUS’s limitations but is also able to provide additional information to ...

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    13. Optical Coherence Tomography in Very Late DES Thrombosis

      Optical Coherence Tomography in Very Late DES Thrombosis

      Study Questions: What are the mechanisms underlying very late stent thrombosis (VLST), as assessed by optical coherence tomography (OCT) in patients treated with early- and newer-generation drug-eluting stents (DES)? Methods: Between August 2010 and December 2014, 64 patients were investigated at the time-point of VLST as part of an international OCT registry. OCT pullbacks were performed after restoration of flow and analyzed at 0.4 mm. A total of 38 early- and 20 newer-generation DES were suitable for analysis. The investigators reported frame-level, segment-level, and stent-level analyses. Results: VLST occurred at a median time of 4.7 years (interquartile range ...

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    14. Association between inflammatory biomarkers and thin-cap fibroatheroma detected by optical coherence tomography in patients with coronary heart disease

      Association between inflammatory biomarkers and thin-cap fibroatheroma detected by optical coherence tomography in patients with coronary heart disease

      Introduction : The relationship between plaque morphology detected by optical coherence tomography (OCT) and inflammatory biomarkers is not well known. Material and methods : This study included 47 patients with ischemic heart disease (22 patients with acute coronary syndrome and 25 patients with effort angina pectoris) who underwent percutaneous coronary intervention (PCI). Before PCI, peripheral blood levels of the inflammatory biomarkers high-sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were measured. The OCT can detect thin-cap fibroatheroma (TCFA), a lesion with high potential for adverse cardiac events. We investigated the relationships between TCFAs in culprit lesions detected by OCT and the peripheral blood ...

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    15. Progression of calcification after implantation of a fully bioresorbable scaffold: A serial and combined IVUS-OCT follow-up of 5 years

      Progression of calcification after implantation of a fully bioresorbable scaffold: A serial and combined IVUS-OCT follow-up of 5 years

      A 72-year-old female enrolled in the ABSORB Cohort B2 trial underwent successful percutaneous coronary intervention of the proximal left anterior descending artery with a 3 × 18 mm Absorb everolimus-eluting Bioresorbable scaffold (Absorb BVS, Abbott Vascular, CA). Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) images after the procedure showed optimal scaffold expansion without any mechanical complication (Fig. 1: Post-A, C). As protocol mandated, follow-up invasive coronary imagings (angiography, OCT, IVUS) were scheduled at 1-, 3- and 5-year, respectively.

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    16. Comparison Between Cardiac Allograft Vasculopathy and Native Coronary Atherosclerosis by Optical Coherence Tomography

      Comparison Between Cardiac Allograft Vasculopathy and Native Coronary Atherosclerosis by Optical Coherence Tomography

      We sought to explore differences in distribution and morphology of coronary lesions comparing cardiac allograft vasculopathy (CAV) and native coronary atherosclerosis (NCA) using intravascular imaging with optical coherence tomography (OCT). At the time of routine surveillance angiography, 17 heart transplant (HT) recipients with a history of high-grade cellular rejection (HGR) and 43 HT recipients with none/mild (low)-grade rejection (LGR) underwent OCT imaging of the left anterior descending (LAD) and were compared to 60 non-HT patients with NCA. Compared with NCA patients, HGR patients had similar intima areas, but smaller external elastic lamina (EEL) areas [7.9 mm 2 ...

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      Mentions: Gary S. Mintz
    17. Intravascular optical coherence tomography for the evaluation of arterial bifurcations covered by flow diverters

      Intravascular optical coherence tomography for the evaluation of arterial bifurcations covered by flow diverters

      Background and objective Due to its high spatial resolution, intravascular optical coherence tomography (OCT) has been used as a valid method for in vivo evaluation of several types of coronary stents at straight lumen and bifurcation sites. We sought to evaluate its effectiveness for flow diverting stents deployed in arterial bifurcation sites involving jailing of a side branch. Methods Four large white swine were stented with flow diverting stents covering the right common carotid artery–ascending pharyngeal artery bifurcation. After 12 weeks of follow-up the animals were evaluated by digital subtraction angiography and intravascular OCT and subsequently sacrificed. Neointimal thickness ...

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    18. Molecular multimodality imaging: has a long-standing dream come true?

      Molecular multimodality imaging: has a long-standing dream come true?

      Intravascular imaging has incrementally gained in clinical relevance in recent years. First triggered by the introduction of intravascular ultrasound >25 years ago, 1 interest has recently been augmented by the widespread implementation of optical coherence tomography (OCT) in cardiac catheterization laboratories. OCT, because of its outstanding spatial resolution in the range of 10–20 μm relative to comparative invasive and non-invasive imaging modalities, has been charged with great expectations regarding its potential to advance our capabilities in detecting and characterizing vascular pathologies. In particular for patients undergoing stent implantation, OCT has been put forward as a promising tool to assess ...

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    19. Endothelial erosion of plaques as a substrate for coronary thrombosis

      Endothelial erosion of plaques as a substrate for coronary thrombosis

      Myocardial infarction is a prevalent, life-threatening consequence of athero-thrombosis. Post-mortem histology and intravascular imaging in live patients have shown that approximately one third of myocardial infarctions are caused by a thrombus overlying an intact, non-ruptured atherosclerotic plaque. Histology identifies erosion of luminal endothelial cells from smooth muscle and proteoglycan-rich, thick fibrous cap atheromas as the underlying pathology. Unlike plaque ruptures, endothelial erosions tend to occur on thick-capped atherosclerotic plaques and may or may not be associated with inflammation. Smoking and female gender are strong risk factors for erosion. Multiple mechanisms may contribute to endothelial erosion, including endothelial dysfunction, TLR signalling ...

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    20. Optical Coherence Tomography Plaque Characterization in a Patient with ST Segment Elevation Myocardial Infarction After Cocaine Intake

      Optical Coherence Tomography Plaque Characterization in a Patient with ST Segment Elevation Myocardial Infarction After Cocaine Intake

      A 28-year old man presented to the Emergency Department with malaise after cocaine intake. After arrival he developed retrosternal chest pain and the electrocardiogram showed ST segment elevations in V1-V2 and ST segment depressions in V5-V6. An acute coronary angiogram revealed a focal non-occlusive lesion with thrombus in the left anterior descending artery. Supplementary optical coherence tomography (OCT) detected plaque erosion with adherent thrombus to be the responsible underlying pathophysiological mechanism. The patient received an effective antithrombotic regimen. Repeat angiogram with additional OCT one month later documented thrombus resolution and complete restoration of the previously eroded coronary vascular surface area.

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    21. Lipoprotein is related to coronary atherosclerotic burden and a vulnerable plaque phenotype in angiographically obstructive coronary artery disease

      Lipoprotein is related to coronary atherosclerotic burden and a vulnerable plaque phenotype in angiographically obstructive coronary artery disease

      Background Lipoprotein Lp(a) has been shown to be an independent risk factor for coronary artery disease (CAD). However, its association with CAD burden in patients with ACS is largely unknown, as well as the association of Lp(a) with lipid rich plaques prone to rupture. Aim We aim at assessing CAD burden by coronary angiography and plaque features including thin cap fibroatheroma (TCFA) by optical coherence tomography (OCT) in consecutive patients presenting with acute coronary syndrome (ACS) and obstructive CAD along with serum Lp(a) levels. Methods This study comprises an angiographic and an OCT cohort. A total of ...

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    22. The use of optical coherence tomography in acute coronary syndrome

      The use of optical coherence tomography in acute coronary syndrome

      Optical coherence tomography (OCT) is an intracoronary imaging modality which utilizes near-infrared light to provide high-resolution cross-sectional in-vivo images of the coronary artery. OCT imaging technique enables detailed evaluation of plaque morphology in patients with acute coronary syndrome and helps to understand the underlying mechanisms including plaque rupture, plaque erosion, and calcified nodule. It is useful to optimize percutaneous coronary intervention, and evaluate vascular response to coronary intervention and pharmacological therapy. Advances in intracoronary OCT and further research on clinical applications have the potential to contribute to a better prognosis in acute coronary syndrome.

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