1. Articles in category: Cardiology

    1-24 of 3164 1 2 3 4 ... 130 131 132 »
    1. Optical coherence tomography findings after longitudinal ablation for an underexpanded stent in a heavily calcified lesion: a case repor

      Optical coherence tomography findings after longitudinal ablation for an underexpanded stent in a heavily calcified lesion: a case repor

      Background Heavy coronary artery calcification is responsible for stent underexpansion, which is associated with increased in-stent restenosis. Here we report a case in which optical coherence tomography (OCT) demonstrated that the metal component of an underexpanded stent previously implanted in a heavy calcified lesion had been completely removed after ablation with rotational atherectomy. Case presentation An 83-year-old man with exertional angina was referred to our hospital. Coronary angiography revealed severe stenosis in the proximal portion of the right coronary artery and left circumflex artery and chronic total occlusion (CTO) in the mid portion of the left anterior descending artery (LAD ...

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    2. Accuracy of coronary computed tomography angiography for bioresorbable scaffold luminal investigation: a comparison with optical coherence tomography

      Accuracy of coronary computed tomography angiography for bioresorbable scaffold luminal investigation: a comparison with optical coherence tomography

      To establish the accuracy of coronary computed tomography angiography (CTA) for in-scaffold quantitative evaluation with optical coherence tomography (OCT) as a reference. The translucent backbone of the bioresorbable scaffold allow us to evaluate non-invasively the coronary lumen with coronary CTA. In the ABSORB first-in-man studies, coronary CTA was shown to be feasible for quantitative luminal assessment. Nevertheless, a comparison with an intravascular modality with higher resolution has never been performed. In the ABSORB Cohort B trial, 101 patient with non-complex lesions were treated with the fully biodegradable vascular scaffold. For this analysis, all patients who underwent coronary CTA at 18 ...

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    3. Optical Coherence Tomography-Guided Bioresorbable Vascular Scaffold Implantation With Orbital Atherectomy for Calcified Chronic Total Occlusion

      Optical Coherence Tomography-Guided Bioresorbable Vascular Scaffold Implantation With Orbital Atherectomy for Calcified Chronic Total Occlusion

      A 67-year-old male with a past history of hypertension, diabetes, and dyslipidemia complained of neck and jaw pain after walking. Stress myocardial perfusion imaging showed ischemia in the left anterior descending artery (LAD) area. Coronary angiography at an outside hospital revealed a severely calcified chronic total occlusion of the proximal LAD with collateral flow from the right coronary artery. He was referred for revascularization of the LAD. Bilateral femoral access was obtained to perform simultaneous angiography of the left and right coronary artery systems (Figure 1). A 6 French VL3.5 guide was engaged in the left coronary artery. An ...

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    4. Histopathological Differential Diagnosis of Optical Coherence Tomographic Image Interpretation After Stenting

      Histopathological Differential Diagnosis of Optical Coherence Tomographic Image Interpretation After Stenting

      Objectives The aim of this study was to identify histological features that correlate with terms commonly used to describe optical coherence tomographic (OCT) and optical frequency-domain imaging (OFDI) images of stented vessels, by means of a histopathological validation study using stented human coronary arteries. Background OCT imaging and OFDI are used to evaluate vascular responses to stent implantation. Descriptive terms such as “peristrut low attenuation” and “heterogeneous” have been used to describe neointimal characteristics that may have clinical relevance. However, only limited histopathological correlations are available. Methods Using the CVPath stent registry, 19 cases were identified in whom implantation duration ...

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    5. Three-month evaluation of strut healing using a novel optical coherence tomography analytical method following bioresorbable polymer everolimus-eluting stent implantation in humans: the TIMELESS study

      Three-month evaluation of strut healing using a novel optical coherence tomography analytical method following bioresorbable polymer everolimus-eluting stent implantation in humans: the TIMELESS study

      Aims: Bioresorbable polymer drug-eluting stent technologies have been considered to have the potential to enhance vascular healing by reducing polymer exposure to the vessel wall, potentially allowing the earlier discontinuation of dual antiplatelet therapy. At present, the early vascular healing response to this type of technologies is still unclear. Patients and methods: The TIMELESS study is a multicenter, prospective, single-arm study that enrolled real-world patients undergoing percutaneous coronary intervention. All patients underwent Synergy stent implantation, which consists of a platinum-chromium platform coated with an ultra-thin abluminal bioabsorbable poly-D,L-lactide-co-glycolide polymer-eluting everolimus. Results: A total of 37 patients were included in ...

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      Mentions: Juan F. Granada
    6. Comparison of coronary arterial lumen dimensions on angiography and plaque characteristics on optical coherence tomography images and their changes induced by statin

      Comparison of coronary arterial lumen dimensions on angiography and plaque characteristics on optical coherence tomography images and their changes induced by statin

      Background Coronary angiography (CAG) is widely used to assess lumen dimensions, and optical coherence tomography (OCT) is used to evaluate the characteristics of atherosclerotic plaque. This study was aimed to compare coronary lumen dimensions using CAG and plaque characteristics using OCT and their changes during statin therapy. Methods We identified 97 lipid-rich plaques from 69 statin-naïve patients, who received statin therapy in the following 12 months. CAG and OCT examinations were conducted at baseline and 12-month follow-up period. Results Lesion length, as measured by CAG, was closely correlated with lipid length by OCT (baseline: r = 0.754, p < 0 ...

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      Mentions: Wei Wang Bo Yu
    7. Guiding Light: Insights Into Atherectomy by Optical Coherence Tomography

      Guiding Light: Insights Into Atherectomy by Optical Coherence Tomography

      Coronary calcification presents multiple technical challenges in percutaneous coronary intervention (PCI) and is associated with suboptimal procedural results and an increase in subsequent adverse clinical events (1) . Currently, there is no standardized evidence-based strategy for PCI of calcified coronary lesions. Decisions for the use of adjunctive atheroablation—shown to increase the acute procedural success rates (2) —are based on visual estimation of calcification severity on angiography (with its inherent limitations [3] ) or when delivery of devices is impeded by calcified deposits in the vessel wall. Although the so-called “rota-regret” remains common following suboptimal acute procedural results in calcified plaques not ...

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    8. Impact of branching angle on neointimal coverage of drug-eluting stents implanted in bifurcation lesions

      Impact of branching angle on neointimal coverage of drug-eluting stents implanted in bifurcation lesions

      Objectives: To investigate the impact of branching angle (BA) on neointimal coverage of drug-eluting stents (DESs) in bifurcation lesions. Background: Previous experimental studies indicated that BA influences the local flow turbulence and wall shear stress, which are associated with neointimal coverage of DESs. Methods: Fifty-five bifurcation lesions in 47 patients were evaluated by serial optical coherence tomography (OCT) before DES implantation and at follow-up. Neointimal coverage was assessed in cross-sectional OCT images containing the side branch; regions including the side branch ostium (SO) and vessel wall (VW) were assessed separately. BA was measured using angiography (Angio-BA) and longitudinal OCT imaging ...

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    9. ST Elevation Infarction after Heart Transplantation Induced by Coronary Spasms and Mural Thrombus Detected by Optical Coherence Tomography

      ST Elevation Infarction after Heart Transplantation Induced by Coronary Spasms and Mural Thrombus Detected by Optical Coherence Tomography

      The case illustrates the possible link between coronary spasms, intraluminal thrombus formation, and widespread organized and layered thrombi in HTx patients. Furthermore, the case underlines the clinical value of OCT as a novel method for high-resolution vessel imaging in heart-transplanted (HTx) patients with coronary spasms and suspected coronary artery disease. Coronary spasms and sudden death are frequent complications after HTx. The underlying mechanisms leading to these complications are unknown. The present case displays the clinical course of a 19-year-old HTx patient who was hospitalized due to acute myocardial infarction induced by severe coronary spasms. The patients remained unstable on conservative ...

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    10. Disruption of bioresorbable vascular scaffold struts due to loss of radial integrity: insights from optical coherence tomography

      Disruption of bioresorbable vascular scaffold struts due to loss of radial integrity: insights from optical coherence tomography

      Strut disruption of bioresorbable vascular scaffold is a known potential concern, although uncommon when adequate lesion preparation is achieved and nominal size of the scaffold is respected. It is usually difficult to detect with angiography and/or intravascular ultrasound. Three-dimensional reconstructions of optical coherence tomography facilitates understanding of complex luminal anatomy and configuration of stent struts, providing evaluation of stent integrity immediately after deployment and therefore optimization of the complex revascularization procedure. The present article reports a case where this image modality enabled successful use of a drug-eluting stent inside a bioresorbable vascular scaffold to restore the luminal integrity, jeopardized ...

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    11. Optical coherence tomography: influence of contrast concentration on image quality and diagnostic confidence

      Optical coherence tomography: influence of contrast concentration on image quality and diagnostic confidence

      OCT requires intracoronary injection of contrast agent to remove blood from the coronary lumen during data acquisition, which is a possible limitation of this method. Aim of this study was to analyze the influence of iodine concentration on image quality and diagnostic certainty of optical coherence tomography (OCT). OCT sequences acquired using contrast agent with a reduced concentration of 150 mg iodine/ml and a standard concentration of 350 mg iodine/ml were analyzed. Cross-sectional images with a spacing of 10 mm were evaluated regarding image quality and diagnostic confidence. A total of 67 OCT sequences acquired in 24 patients ...

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    12. Aortic and Cardiac Structure and Function Using High-Resolution Echocardiography and Optical Coherence Tomography in a Mouse Model of Marfan Syndrome

      Aortic and Cardiac Structure and Function Using High-Resolution Echocardiography and Optical Coherence Tomography in a Mouse Model of Marfan Syndrome

      Marfan syndrome (MFS) is an autosomal-dominant disorder of connective tissue caused by mutations in the fibrillin-1 (FBN1) gene. Mortality is often due to aortic dissection and rupture. We investigated the structural and functional properties of the heart and aorta in a [ Fbn1 C1039G/+ ] MFS mouse using high-resolution ultrasound (echo) and optical coherence tomography (OCT). Echo was performed on 6- and 12-month old wild type (WT) and MFS mice (n = 8). In vivo pulse wave velocity (PWV), aortic root diameter, ejection fraction, stroke volume, left ventricular (LV) wall thickness, LV mass and mitral valve early and atrial velocities (E/A) ratio ...

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    13. Suppression of Cardiac Motion Artifacts in Sequential Intracoronary Optical Coherence Images

      Suppression of Cardiac Motion Artifacts in Sequential Intracoronary Optical Coherence Images

      Background : Intracoronary optical coherence tomography (IC-OCT), an interventional imaging modality, has been used in clinical diagnosis of cardiac vessel diseases for decades. Motion artifacts caused by cardiac motion and pulsatile blood flow always hamper the visualization of sequential IC-OCT images acquired by continuously pulling back the imaging catheter within the vascular lumen. Method : Suppression of cardiac motion artifacts in an IC-OCT image sequence was addressed in this study. A signal implying cardiac phases was detected based on the cyclic variation of gray-scale features or the location of the lumen contour centroid along the overall image sequence. The local extrema of ...

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    14. Safety of optical coherence tomography in pediatric heart transplant patients

      Safety of optical coherence tomography in pediatric heart transplant patients

      Background Cardiac allograft vasculopathy (CAV) is a crucial problem after heart transplantation, in adults as well as in children. CAV is the main risk factor for a reduced long-term graft survival. The early diagnosis and treatment of CAV is essential for a successful long-term preservation of the donor heart. However, asymptomatic progression of CAV and concentric hyperplasia of the coronary arteries may complicate the early diagnosis by conventional measures. Intravascular imaging, such as are intravascular ultrasound and optical coherence tomography (OCT), enables the diagnosis of early stage CAV. To date, there is little known about OCT in children. We present ...

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    15. Mechanical abnormalities associated with first and second-generation drug eluting stent thrombosis analyzed by optical coherence tomography in the national PESTO French registry

      Mechanical abnormalities associated with first and second-generation drug eluting stent thrombosis analyzed by optical coherence tomography in the national PESTO French registry

      Background and objectives DES thrombosis may be triggered by different mechanisms that are difficult to identify by angiography alone. This work aimed to investigate and compare the characteristics of stent thrombosis (ST) between 1 st and 2 nd generation drug eluting stents (DES) among a large cohort of patients explored by optical coherence tomography (OCT). Methods and results The PESTO study was a prospective national registry involving 29 French catheterization facilities. Patients with acute coronary syndromes were prospectively screened for presence of definite ST and analyzed by OCT after culprit lesion deocclusion The analysis involved 71 subjects including 34 patients ...

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    16. Comparison of two different sampling intervals for optical coherence tomography evaluation of neointimal healing response after coronary stent implantation

      Comparison of two different sampling intervals for optical coherence tomography evaluation of neointimal healing response after coronary stent implantation

      Optical coherence tomogra Background/Objectives Optical coherence tomography (OCT) is widely used for evaluation of healing response to stent implantation. We sought to test the agreement between the 1-mm and 0.6-mm sampling intervals for assessment of the percentage of uncovered and malapposed struts by OCT. Methods Thirty­eight patients presenting with acute coronary syndrome were randomized to receive either a titanium­nitride­oxide­coated stent (n = 19) or an everolimus­eluting stent (n = 19). Neointimal strut coverage and strut apposition were evaluated by OCT at 2­month follow­up. Two independent investigators performed offline OCT image analysis at 1 ...

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    17. St. Jude Medical Reaches Primary Endpoint for OCT Trial

      St. Jude Medical Reaches Primary Endpoint for OCT Trial

      A trial undertaken by medical device company St. Jude Medical Inc. has met its primary endpoint as the first multicenter, prospective, randomized, controlled study comparing optical coherence tomography- (OCT), intravascular ultrasound- (IVUS) and angiography-guided outcomes for percutaneous coronary intervention (PCI). The ILUMIEN III study demonstrated PCI guided by OCT to be superior to angiography in stent expansion and procedural success and non-inferior to IVUS-guided PCI in post-procedure minimal stent area (MSA). Physicians employed the St. Jude Medical OPTIS Integrated and ILUMIEN OPTIS PCI optimization systems, along with the Dragonfly imaging catheters designed for high-resolution imaging, to assess vessel and lesion ...

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      Mentions: St. Jude Medical
    18. Single cardiac cycle three-dimensional intracoronary optical coherence tomography

      Single cardiac cycle three-dimensional intracoronary optical coherence tomography

      While high-speed intracoronary optical coherence tomography (OCT) provides three-dimensional (3D) visualization of coronary arteries in vivo , imaging speeds remain insufficient to avoid motion artifacts induced by heartbeat, limiting the clinical utility of OCT. In this paper, we demonstrate development of a high-speed intracoronary OCT system (frame rate: 500 frames/s, pullback speed: 100 mm/s) along with prospective electrocardiogram (ECG) triggering technology, which enabled volumetric imaging of long coronary segments within a single cardiac cycle (70 mm pullback in 0.7 s) with minimal cardiac motion artifact. This technology permitted detailed visualization of 3D architecture of the coronary arterial wall ...

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    19. Guiding coronary stent implantation

      Guiding coronary stent implantation

      Although percutaneous coronary intervention (PCI) is most commonly guided by angiography alone, results from a new study investigating adjunctive imaging modalities showed that the use of a novel optical coherence tomography (OCT)-based stent sizing strategy results in similar minimal stent area (MSA) compared to intravascular ultrasound (IVUS)-guided PCI. Imaging-guided PCI (with both OCT and IVUS) also resulted in improved stent expansion and acute stent-based procedural success compared to angiography-guided PCI.

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    20. Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial

      Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial

      Background Percutaneous coronary intervention (PCI) is most commonly guided by angiography alone. Intravascular ultrasound (IVUS) guidance has been shown to reduce major adverse cardiovascular events (MACE) after PCI, principally by resulting in a larger postprocedure lumen than with angiographic guidance. Optical coherence tomography (OCT) provides higher resolution imaging than does IVUS, although findings from some studies suggest that it might lead to smaller luminal diameters after stent implantation. We sought to establish whether or not a novel OCT-based stent sizing strategy would result in a minimum stent area similar to or better than that achieved with IVUS guidance and better ...

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    1-24 of 3164 1 2 3 4 ... 130 131 132 »
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