1. Articles in category: Cardiology

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    1. Role of Intravascular Imaging in Primary PCI (Book Chapter)

      Role of Intravascular Imaging in Primary PCI (Book Chapter)

      Primary percutaneous coronary intervention (PPCI) is always targeted on the angiographically identified culprit lesion. However, the actual culprit lesion may not compromise the lumen and can be located proximally or distally to the angiographic target lesion. As a result, the risk of incomplete lesion coverage can be high when the PPCI is guided solely by angiography. Furthermore, stent implantation must be optimized, as incomplete apposition and/or edge dissection may result in in-stent restenosis or acute thrombotic events. Thus, invasive coronary imaging using intravascular ultrasound or optical coherence tomography can be useful to guide the PPCI procedure by locating the ...

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    2. OCT vs. Angiography to Guide PCI

      OCT vs. Angiography to Guide PCI

      Study Questions: What is the effect on long-term survival of using optical coherence tomography (OCT) during percutaneous coronary intervention (PCI)? Methods: The investigators conducted a cohort study based on the Pan-London (United Kingdom) PCI registry, which includes 123,764 patients who underwent PCI in National Health Service hospitals in London between 2005 and 2015. Patients undergoing primary PCI or pressure wire use were excluded, leaving 87,166 patients in the study. The primary endpoint was all-cause mortality at a median of 4.8 years. Cox regression analysis was used to estimate hazard ratios (HRs) in the entire population and fully ...

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    3. Optical coherence tomography guided successful fibrinolytic treatment without the need for percutaneous coronary intervention in a patient with acute ST-segment elevation myocardial infarction

      Optical coherence tomography guided successful fibrinolytic treatment without the need for percutaneous coronary intervention in a patient with acute ST-segment elevation myocardial infarction

      A 36-year-old woman was admitted to the coronary care unit with a diagnosis of myocardial infarction with ST-segment elevation (STEMI) after an hour of chest pain. She was a smoker and she had no history of any other atherosclerotic risk factors. She had a stable haemodynamic status without signs of heart failure. An electrocardiogram was obtained, revealing ST-segment elevation in anterior leads and reciprocal changes in inferior leads. Given the ST-segment elevation in the context of new-onset chest pain, she was given 7500 IU of unfractionated heparin, 300 mg of aspirin, and 600 mg of clopidogrel and taken immediately for ...

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    4. Relation of coronary culprit lesion morphology determined by optical coherence tomography and cardiac outcomes to preinfarction angina in patients with acute myocardial infarction

      Relation of coronary culprit lesion morphology determined by optical coherence tomography and cardiac outcomes to preinfarction angina in patients with acute myocardial infarction

      Background While preinfarction angina pectoris (pre-IA) is recognized as favorable effects on acute myocardial infarction (AMI), the detail has not been fully investigated. The aims of the current study were to clarify patient characteristics, lesion morphologies determined by optical coherence tomography (OCT), and cardiac outcomes related to pre-IA in patients with AMI. Methods Clinical data and outcomes were compared between AMI patients with pre-IA (pre-IA group, n = 507) and without pre-IA (non-pre-IA group, n = 653). Angiography and OCT findings were analyzed in patients with pre-intervention OCT and compared between groups of pre-IA ( n = 219) and non-pre-IA ( n = 269). Results ST-segment ...

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      Mentions: Masamichi Takano
    5. Angiography Alone Versus Angiography Plus Optical Coherence Tomography to Guide Percutaneous Coronary Intervention: Outcomes From the Pan-London PCI Cohort

      Angiography Alone Versus Angiography Plus Optical Coherence Tomography to Guide Percutaneous Coronary Intervention: Outcomes From the Pan-London PCI Cohort

      Objectives This study aimed to determine the effect on long-term survival of using optical coherence tomography (OCT) during percutaneous coronary intervention (PCI). Background Angiographic guidance for PCI has substantial limitations. The superior spatial resolution of OCT could translate into meaningful clinical benefits, although limited data exist to date about their effect on clinical endpoints . Methods This was a cohort study based on the Pan-London (United Kingdom) PCI registry, which includes 123,764 patients who underwent PCI in National Health Service hospitals in London between 2005 and 2015. Patients undergoing primary PCI or pressure wire use were excluded leaving 87,166 ...

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    6. Will Optical Coherence Tomography Become the Standard Imaging Tool for Percutaneous Coronary Intervention Guidance?

      Will Optical Coherence Tomography Become the Standard Imaging Tool for Percutaneous Coronary Intervention Guidance?

      Editorial Comment: In the last 3 decades, intravascular ultrasound (IVUS) and, more recently, optical coherence tomography (OCT) have been increasingly used to guide percutaneous coronary intervention (PCI). Although there are randomized trials, registries, and meta-analyses suggesting better outcomes using IVUS to guide PCI (1–3), data on the clinical impact of OCT are still missing. In the United Kingdom, consecutive data of all PCI procedures must be prospectively entered in the registry organized by the British Cardiovascular Interventional Society, endorsed by the United Kingdom Department of Health, with tracking of events based on the complete and unquestionable national statistics. One ...

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      Mentions: Carlo Di Mario
    7. Nondestructive Monitoring of Degradable Scaffold-Based Tissue-Engineered Blood Vessel Development Using Optical Coherence Tomography

      Nondestructive Monitoring of Degradable Scaffold-Based Tissue-Engineered Blood Vessel Development Using Optical Coherence Tomography

      Engineered vascular grafts with structural and mechanical properties similar to natural blood vessels are expected to meet the growing demand for arterial bypass. The characterization of the growth dynamics and remodeling process of degradable polymer scaffold-based tissue-engineered blood vessels (TEBVs) with pulsatile stimulation is crucial for vascular tissue engineering. Optical imaging techniques stand out as powerful tools for monitoring the vascularization of engineered tissue, enabling high-resolution imaging in real-time culture. This paper demonstrates a nondestructive and fast real-time imaging strategy to monitor the growth and remodeling of TEBVs in long-term culture by using optical coherence tomography (OCT). The geometric morphology ...

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    8. Depth-resolved mapping of muscular bundles in myocardium pulmonary junction using optical coherence tomography

      Depth-resolved mapping of muscular bundles in myocardium pulmonary junction using optical coherence tomography

      Atrial fibrillation (AF) is the most common cardiac arrhythmia and has high patient morbidity. One of the root causes of AF is initiating triggers from atrial myocardium extending into the pulmonary veins. Visualizing the muscular bundles of myocardial extension is essential to guide the catheter radio-frequency ablation and confirm the curative tissue necrosis thereafter. We applied optical coherence tomography (OCT) for direct visualization of cardial muscle extension in myocardium pulmonary junction. Two perspectives (cross-sectional and en face images) are presented for imaging myocardial extensions. The results demonstrated that cross-sectional images can quickly locate the myocardium pulmonary junction. And en face ...

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    9. Impact of underlying plaque type on strut coverage in the early phase after drug-eluting stent implantation

      Impact of underlying plaque type on strut coverage in the early phase after drug-eluting stent implantation

      Background The aim of this study was to investigate whether the underlying plaque type affects the neointimal coverage after drug-eluting stent implantation. Methods A total of 1793 struts in 22 zotarolimus-eluting stents were assessed using optical coherence tomography imaging within 3 months of implantation. Neointimal coverage was evaluated within 5 mm from each stent edge on cross-sectional optical coherence tomography images at every 1-mm interval. The percentage of struts covered by neointima was compared among the normal segment group, the fibrous plaque group, and the lipid plaque group on the basis of the underlying plaque type. Results The percentage of ...

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    10. Favorable early vessel healing after everolimus-eluting stent implantation: 3-, 6-, and 12-month follow-up of optical coherence tomography

      Favorable early vessel healing after everolimus-eluting stent implantation: 3-, 6-, and 12-month follow-up of optical coherence tomography

      Background Although a prospective randomized control study revealed that 3-month dual anti-platelet therapy (DAPT) is safe and does not compromise the efficacy of everolimus-eluting stent (EES) in selected patients, detailed vessel healing at early phase after EES implantation has yet to be investigated in Japanese patients. Methods and results A total of 27 lesions in 19 patients treated with EES were serially evaluated by using optical coherence tomography (OCT) at 3, 6, and 12 months after stent implantation. In addition to standard quantitative OCT parameters, the percentage of stents with peri-strut low-intensity area (PLIA, a region around stent struts homogenously ...

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    11. Performance of modern stents in stable and acute coronary disease

      Performance of modern stents in stable and acute coronary disease

      Since Grüntzig’s seminal first procedure in 1977, 1 percutaneous coronary intervention or PCI has made impressive progress. Most importantly, the introduction of stents has markedly improved the acute and long-term results. 2–4 The first stent implantations were performed in patients with dissection and acute occlusions, 5 but their long-term follow-up also showed that restenosis rates were lower in those receiving a stent. A major breakthrough was the introduction of drug-eluting stents 6–9 which over time brought restenosis and stent thrombosis to an all-time low. With drug-eluting stents, delayed healing and endothelial dysfunction may occur, which favours ...

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    12. Delayed Appearance of Intramural Hematoma After Stent Implantation: Diagnosis by Optical Coherence Tomography

      Delayed Appearance of Intramural Hematoma After Stent Implantation: Diagnosis by Optical Coherence Tomography

      A 55-year-old man presented with an inferior myocardial infarction successfully treated with fibrinolysis. Elective coronary angiography revealed a tight lesion at the most proximal segment of the right coronary artery ( Video1 ). Following lesion predilation a drug-eluting stent (DES) was implanted and subsequently optimized using optical coherence tomography (OCT) guidance (Video 2). OCT confirmed an excellent final result. In particular, the distal edge of the stent was nicely expanded and apposed against the vessel wall and no edge-dissections were detected ( Figure 1A-D, Video 3 )

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      Mentions: Fernando Alfonso
    13. Procedural and One-Year Outcomes of Patients Treated with Orbital and Rotational Atherectomy with Mechanistic Insights from Optical Coherence Tomography

      Procedural and One-Year Outcomes of Patients Treated with Orbital and Rotational Atherectomy with Mechanistic Insights from Optical Coherence Tomography

      Aims: We sought to evaluate procedural complications and 1-year clinical outcomes for patients who underwent percutaneous coronary intervention (PCI) with orbital (OA) and rotational atherectomy (RA). Methods and results: From a total of 13,467 patients who underwent PCI in our hospital between January 2013 and June 2016, 1149 consecutive patients were treated with atherectomy for moderately-severely calcified lesions (184 with OA, 965 with RA). Procedural complications were similarly observed in 2 groups except for higher dissection and perforation rates with OA. Major adverse cardiovascular events (MACE) were defined as the composite of death, myocardial infarction and target lesion revascularization ...

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    14. Optical Coherence Tomography Compared With Intravascular Ultrasound to Guide High-speed Rotational Before Stent Implantation in the Treatment of Moderate-to-severe Calcified Lesion in Coronary Artery

      Optical Coherence Tomography Compared With Intravascular Ultrasound to Guide High-speed Rotational Before Stent Implantation in the Treatment of Moderate-to-severe Calcified Lesion in Coronary Artery

      This study is a prospective, multi-center, randomized controlled clinical trial, aims to assess the safety and effectiveness of Optical Coherence Tomography or Intravascular Ultrasound to guide high-speed rotational before Firehawk stent implantation , and compared with angiography guided stent implantation in the treatment of moderate-to-severe calcified lesion in coronary artery.

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    15. Mother-and-Child Catheter-Induced Retrograde Dissection of the Left Main Coronary Artery During Optical Coherence Tomography Examination

      Mother-and-Child Catheter-Induced Retrograde Dissection of the Left Main Coronary Artery During Optical Coherence Tomography Examination

      A 54-year-old man presented with non-ST elevation myocardial infarction. Coronary angiogram showed two-vessel disease with severe stenosis in the mid left anterior descending (LAD) artery and proximal and distal left circumflex (LCX) artery (Figure 1). Percutaneous coronary intervention (PCI) to the LCX was performed under optical coherence tomography (OCT) guidance. A 3 x 40 mm drug-eluting stent (DES) was implanted in the LCX, but landed more proximally than intended due to breathing motion. As a result, there was gross malapposition of the proximal stent as shown by OCT (Figure 2). To facilitate delivery of a 4 mm non-compliant balloon across ...

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    16. Optical Coherence Tomography for Guiding Plaque Stabilization in a Patient With Myocardial Infarction and Massive Coronary Thrombosis

      Optical Coherence Tomography for Guiding Plaque Stabilization in a Patient With Myocardial Infarction and Massive Coronary Thrombosis

      A 22-year-old, obese male smoker with untreated hyperlipidemia and family history of coronary artery disease presented with chest pain and ST-segment elevation in anterolateral leads at ECG following heavy marijuana and alcohol abuse. Coronary angiography showed a moderate stenosis in the proximal left anterior descending (LAD) coronary artery along with distal embolization (Figure 1A; Video 1). No concomitant coronary stenoses were noted, and TIMI 3 flow was present in the LAD. Optical coherence tomography (OCT) revealed plaque erosion with massive thrombi involving the distal left main coronary artery (LMCA) and ostial to mid LAD (Figure 1A; Video 2), along with ...

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    17. Algorithmic Approach for Optical Coherence Tomography–Guided Stent Implantation During Percutaneous Coronary Intervention

      Algorithmic Approach for Optical Coherence Tomography–Guided Stent Implantation During Percutaneous Coronary Intervention

      Intravascular imaging plays a key role in optimizing outcomes for percutaneous coronary intervention (PCI). Optical coherence tomography (OCT) utilizes a user-friendly interface and provides high-resolution images. OCT can be used as part of daily practice in all stages of a coronary intervention: baseline lesion assessment, stent selection, and stent optimization. Incorporating a standardized, algorithmic approach when using OCT allows for precision PCI.

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    18. Optimized Automated Segmentation and 3D Reconstruction Using Intracoronary Optical Coherence Tomography

      Optimized Automated Segmentation and 3D Reconstruction Using Intracoronary Optical Coherence Tomography

      Real time segmentation and three-dimensional (3D) reconstruction of the coronary arteries is challenging and limited by the increased computational time of the developed computer-aided methods. We present a novel and time-efficient method for intracoronary lumen detection which produces 3D coronary arteries using Optical Coherence Tomographic (OCT) images. OCT images are acquired for multiple patients and longitudinal cross-section (LOCS) images are reconstructed using different acquisition angles. The lumen contours for each LOCS image are extracted and translated to 2D cross-sectional images. Using two angiographic projections the centerline of the coronary vessel is reconstructed in 3D and the detected 2D contours are ...

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    19. OCT Measures Predicting FFR

      OCT Measures Predicting FFR

      Background: the decision-making process of patients with angiographically-intermediate coronary lesions (ICL) is clinically challenging and may benefit from adjunctive invasive techniques. Fractional-flow-reserve (FFR) represents the gold standard to evaluate ICL but optical-coherence-tomography (OCT) is a novel, promising, high resolution coronary imaging technique. Objectives: Investigate the relation between OCT and FFR parameters in ICL and understand if OCT measures may predict FFR. Understand if OCT parameters may predict clinical outcome of patients with ICL not underwent revascularization on the bases of negative FFR. Study design: multicentre, international, individual patient's level data pooled analysis.

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    20. Noninvasive Cardiac Imaging in Vasospastic Angina Korean Registry (NAVIGATOR)

      Noninvasive Cardiac Imaging in Vasospastic Angina Korean Registry (NAVIGATOR)

      With regard to the characteristics of spasm segment, had been clearly described by other invasive imaging methods including intravascular ultrasound and optical coherence tomography . However, there is potential risk during these invasive procedures, such as severe myocardial ischemia or fatal arrhythmia. Presently available imaging test for coronary artery disease in multi detector-row computed tomography angiography (MDCTA) evaluation has high diagnostic accuracy to evaluate coronary artery stenosis. However, previous report assessing imaging findings or diagnostic accuracy of MDCTA in patients with vasospastic angina (VSA) is lacking.

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    1-24 of 3678 1 2 3 4 ... 152 153 154 »
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