1. Articles in category: Cardiology

    1-24 of 4007 1 2 3 4 ... 165 166 167 »
    1. Optical coherence tomography-based patient-specific coronary artery reconstruction and fluid–structure interaction simulation

      Optical coherence tomography-based patient-specific coronary artery reconstruction and fluid–structure interaction simulation

      Plaque rupture is related to the mechanical stress it suffered. The value and distribution of the mechanical stress in plaque could help on assessing plaque vulnerability. To look into the stress conditions in the coronary artery, a patient-specific coronary model was created by using optical coherence tomography (OCT) and angiography imaging data. The reconstructed coronary model consisted of the structure of the lumen, the arterial wall and plaque components. Benefited by the high resolution of OCT, detailed structures such as the thin fibrous cap could be observed and built into the geometry. On this reconstructed coronary model, a fully coupled ...

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    2. Illusion or reality? How 3-dimensional optical coherence tomography overcomes the limitations of angiography: OCT-guided percutaneous coronary intervention of left main stem disease involving LAD/LCx bifurcation

      Illusion or reality? How 3-dimensional optical coherence tomography overcomes the limitations of angiography: OCT-guided percutaneous coronary intervention of left main stem disease involving LAD/LCx bifurcation

      Angiography is still the workhorse imaging approach for the vast majority of percutaneous coronary revascularization (PCR) cases. However, the limitations of angiographic guidance for coronary procedures have been well established. This case report demonstrates how 3-dimensional optical coherence tomography (3D OCT) can change the treatment strategy, which, had only the angiography results been considered, seemed to be straightforward. A 67-year-old male patient presented with non-ST-elevation myocardial infarction. A coronary angiogram revealed a tight lesion of the proximal left anterior descending artery (LAD). Angiographically, the vessel ostium appeared not to be involved. To clarify the disease border and determine the right ...

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    3. Assessment of Vascular Patency and Inflammation with Intravascular Optical Coherence Tomography in Patients with Superficial Femoral Artery Disease Treated with Zilver PTX Stents

      Assessment of Vascular Patency and Inflammation with Intravascular Optical Coherence Tomography in Patients with Superficial Femoral Artery Disease Treated with Zilver PTX Stents

      Purpose Zilver PTX nitinol self-expanding drug-eluting stent with paclitaxel coating is effective for treatment of superficial femoral artery (SFA) disease. However, as with any stent, it induces a measure of vascular inflammatory response. The current clinical trial (NCT02734836) aimed to assess vascular patency, remodeling, and inflammatory markers with intravascular optical coherence tomography (OCT) in patients with SFA disease treated with Zilver PTX stents. Methods Serial OCT examinations were performed in 13 patients at baseline and 12-month follow-up. Variables evaluated included neointimal area, luminal narrowing, thrombus area, stent expansion as well as measures of inflammation including, peri-strut low-intensity area (PLIA), macrophage ...

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    4. Avinger Enrolls First 50 Patients in INSIGHT Clinical Trial

      Avinger Enrolls First 50 Patients in INSIGHT Clinical Trial

      Avinger, Inc. (NASDAQ: AVGR), a commercial-stage medical device company marketing the first-ever image-guided, catheter-based system for diagnosis and treatment of Peripheral Artery Disease (PAD), today announced the 50 th patient enrolled in its INSIGHT clinical trial. The INSIGHT trial is a prospective, global, single arm, multi-center study to evaluate the safety and effectiveness of the Pantheris ® Lumivascular atherectomy system for treating in-stent restenosis (ISR) in lower extremity arteries. Dr. Jaafer Golzar, Avinger’s Chief Medical Officer and a highly experienced interventionalist, noted, “We are pleased to have the first 50 cases completed as part of our INSIGHT IDE study. Early ...

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      Mentions: Avinger
    5. Severely Calcified Coronary Lesions Prepared With Rotational Atherectomy and Modified Balloons

      Severely Calcified Coronary Lesions Prepared With Rotational Atherectomy and Modified Balloons

      A prospective single-arm trial to evaluate the acute and long term efficacy of a combined strategy of lesion preparation with rotational atherectomy followed by cutting balloon and by hybrid sirolimus-eluting stent implantation in an angiographically well-defined group of patients with severely calcified coronary lesions.

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    6. Avinger Announces Commercial Launch of Ocelot in Australia

      Avinger Announces Commercial Launch of Ocelot in Australia

      First Patients Treated Successfully in Australia with Image-Guided CTO-Crossing Device REDWOOD, CA / ACCESSWIRE / July 8, 2019 / Avinger, Inc. (NASDAQ: AVGR ), a commercial-stage medical device company marketing the first-ever image-guided, catheter-based system for the diagnosis and treatment of Peripheral Artery Disease (PAD), today announced the commercial launch of its Ocelot image-guided chronic total occlusion (CTO) crossing system in Australia. As part of the Company’s exclusive distribution agreement with Diverse Devices Pty Ltd. for Avinger’s proprietary Lumivascular products in Australia, Ocelot completed the registration process with the Therapeutic Goods Administration (TGA) and is included on the Australian Register of Therapeutic ...

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      Mentions: Avinger
    7. The Effect of Stent Artefact on Quantification of Plaque Features Using Optical Coherence Tomography (OCT): A Feasibility and Clinical Utility Study

      The Effect of Stent Artefact on Quantification of Plaque Features Using Optical Coherence Tomography (OCT): A Feasibility and Clinical Utility Study

      Background Optical coherence tomography (OCT) can detect detailed plaque features in native coronary arteries. Stent struts cause shadows that partially obscure the vessel wall, but plaque features can still be seen. We investigated the impact of stent artefact on plaque quantification and whether the plaque behind struts is associated with microvascular dysfunction. Methods Patients retrospectively recruited from two centres, underwent OCT pre- and post-stenting on the same vessel segment. Lipid (LA) and calcium (CA) were measured as arcs. Macrophages, microchannels and cholesterol crystals were counted. Subsequently, we determined whether stented plaque features were associated with reduced TIMI flow grade in ...

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    8. Severe acute stent malapposition follow-up: 3-month and 12-month serial quantitative analyses by optical coherence tomography

      Severe acute stent malapposition follow-up: 3-month and 12-month serial quantitative analyses by optical coherence tomography

      Background Optical coherence tomography (OCT) was used to assess serial changes in severe acute stent malapposition (ASM) after drug-eluting stent (DES) implantation. Methods The maximal depth and axial lengths of ASM after DES implantation were serially quantified at percutaneous coronary intervention (PCI), and at 3 and 12-month follow-up, for 100 lesions in 96 patients. Severe ASM was defined as a maximal malapposed depth ≥400 μm or maximal malapposed axial length ≥1 mm. Results Of the 100 lesions, 23 lesions (23%) had a severe ASM depth at PCI. At 3 months, the maximal depth decreased to <400 μm in 12 of ...

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    9. Association between 18F-Sodium Fluoride Positron Emission Tomography Uptake and High-Risk Plaque Features on Optical Coherence Tomography in Patients with Acute Coronary Syndrome

      Association between 18F-Sodium Fluoride Positron Emission Tomography Uptake and High-Risk Plaque Features on Optical Coherence Tomography in Patients with Acute Coronary Syndrome

      18-F Sodium Fluoride Positron Emission Tomography (18F-NaF PET) is a non-invasive molecular imaging technique which identifies early microcalcification, a high-risk feature of coronary atherosclerotic plaques. We aimed to study the association between coronary 18F-NaF uptake and high-risk plaque features on optical coherence tomography (OCT) and evaluate the potential application to patient level risk stratification.

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    10. Magmaris Resorbable Magnesium Scaffold Implantation Assisted by Optical Coherence Tomography to Treat an Acute Coronary Dissection After a Blunt Chest Trauma

      Magmaris Resorbable Magnesium Scaffold Implantation Assisted by Optical Coherence Tomography to Treat an Acute Coronary Dissection After a Blunt Chest Trauma

      A 53-year-old man suffered a high-impact car collision. An increase in troponin levels was detected after 8 hours, so the patient underwent coronary angiography, which demonstrated an annular lesion in the proximal left anterior descending (LAD) artery (Figure 1A). Optical coherence tomography (OCT) showed an intimomedial flap and a double-lumen from the proximal to the mid LAD without significant atherosclerosis (Figure 1B). A 3.5 x 15 mm Magmaris direct magnesium resorbable scaffold (Biotronik) was deployed under OCT guidance. Then, progression of the hematoma to the mid LAD was observed, which precluded balloon postdilation and forced the implantation of a ...

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    11. Myocardial infarction with non-obstructive coronary arteries (MINOCA) in young women: the key role of optical coherence tomography

      Myocardial infarction with non-obstructive coronary arteries (MINOCA) in young women: the key role of optical coherence tomography

      Optical coherence tomography (OCT) is an intracoronary imaging technique providing detailed morphological information on coronary lesions, improving an accurate diagnosis and the selection of an appropriate treatment strategy. A 26-year-old smoking female with no previous medical history and no risk factors for coronary heart disease was admitted to a local non-university hospital with an anterior STsegment elevation myocardial infarction (STEMI). On arrival, she has reported the chest pain lasting for several hours, and the ECG presented ST-segment elevation in all precordial leads. An echocardiogram showed regional motion abnormalities in the anterior wall of the left ventricle with significantly impaired ejection ...

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    12. Challenging treatment of in-stent restenosis in a coronary bifurcation by implantation of a bioresorbable scaffold under optical coherence tomography guidance

      Challenging treatment of in-stent restenosis in a coronary bifurcation by implantation of a bioresorbable scaffold under optical coherence tomography guidance

      A 67-year-old male patient with stable angina, hypertension and hypercholesterolemia who underwent bare metal stent (BMS) implantation in the distal right coronary artery (RCA) (Azule 3 × 9 mm) and everolimus-eluting stent (EES) implantation in the first diagonal branch (D1) (Xience 2.25 × 18 mm) and in the proximal circumflex branch (LCx) (Xience 3 × 28 mm). One year subsequent to the precedure the patient was readmitted for relapse of the angina Canadian Cardiovascular Society scale II, exhibiting a positive exercise test. The coronary angiography showed a distal-edge in-stent restenosis (ISR) in the distal RCA, extending to the posterior descending artery (PDA ...

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    13. Severe acute stent malapposition follow-up: 3-month and 12-month serial quantitative analyses by optical coherence tomography

      Severe acute stent malapposition follow-up: 3-month and 12-month serial quantitative analyses by optical coherence tomography

      Background Optical coherence tomography (OCT) was used to assess serial changes in severe acute stent malapposition (ASM) after drug-eluting stent (DES) implantation. Methods The maximal depth and axial lengths of ASM after DES implantation were serially quantified at percutaneous coronary intervention (PCI), and at 3 and 12-month follow-up, for 100 lesions in 96 patients. Severe ASM was defined as a maximal malapposed depth ≥400 μm or maximal malapposed axial length ≥1 mm. Results Of the 100 lesions, 23 lesions (23%) had a severe ASM depth at PCI. At 3 months, the maximal depth decreased to <400 μm in 12 of ...

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    14. Intravascular optical coherence tomography image segmentation based on Gaussian mixture model and adaptive fourth-order PDE

      Intravascular optical coherence tomography image segmentation based on Gaussian mixture model and adaptive fourth-order PDE

      The accuracy of the fibrotic plaque segmentation is vital in identifying the coronary artery stenosis. In this paper, we address an automated approach (APDE-GMM) for separating the fibrotic plaque area of intravascular optical coherence tomography (IV-OCT) images. Under this approach, an objective function consisting of a new energy functional with Rayleigh distribution and the negative log-likelihood function of Gaussian mixture model (GMM) is developed. Also, the study presents an adaptive diffusivity function where the gradient threshold can be associated to suppress the effect of speckle noise. The parameter estimation is carried out by the expectation–maximization technology. In addition, this ...

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    15. Laser Imaging: Unraveling Laser Atherectomy Mechanisms of Action with Optical Coherence Tomography

      Laser Imaging: Unraveling Laser Atherectomy Mechanisms of Action with Optical Coherence Tomography

      Purpose of Review The goal is to review the current data regarding excimer laser coronary atherectomy (ELCA) through optical coherence tomography (OCT) imaging. We aim to reveal the mechanisms of action and principles of use for laser, and to analyze the current supportive data. Recent Findings ELCA is an adjuvant procedure to percutaneous coronary intervention, aimed at properly preparing coronary lesions to optimize stenting. It is an effective atherectomy device that requires a short period of training and works on a standard 0.014″ guidewire. Laser modifies coronary vessels by three distinct mechanisms: photoablation, chemoablation and thermoablation. Accordingly, it plays ...

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      Mentions: Hiram G. Bezerra
    16. The impact of blood pressure variability on coronary arterial lumen dimensions as assessed by optical coherence tomography in patients with ST-elevation myocardial infarction

      The impact of blood pressure variability on coronary arterial lumen dimensions as assessed by optical coherence tomography in patients with ST-elevation myocardial infarction

      Background Patients with ST-elevation Myocardial Infarction treated by primary percutaneous coronary intervention (PPCI) experience drastic hemodynamic systemic changes (i.e., blood pressure) during the different phases of the procedure. Optical coherence tomography is often used to unveil the underlying cause of STEMI (pre-PCI) and to optimize stent implantation (post-PCI). The impact of blood pressure variability on coronary lumen remains uncertain. This study aimed to investigate the relationship between blood pressure variability, before and after PCI, and coronary arterial lumen dimensions of the infarct-related artery. Methods We measured systolic, diastolic and mean arterial blood pressure (SBP, DBP, and MAP; respectively) at ...

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    17. In-stent restenosis caused by calcified nodule 11 years after paclitaxel eluting stent implantation treated with drug-coated balloon following rotational atherectom

      In-stent restenosis caused by calcified nodule 11 years after paclitaxel eluting stent implantation treated with drug-coated balloon following rotational atherectom

      n 82-year-old man with dyslipidemia, diabetes mellitus and chronic kidney disease was admitted to our hospital for heart failure. He was treated with 3 paclitaxel eluting stents in the proximal and mid-right coronary artery (RCA) for silent myocardial ischemia 11 years previously. 2 years after the initial procedure, angioplasty was performed for in-stent restenosis (ISR) in the RCA. He had been stable with optimal medical therapy until the present admission. After admission, CAG upon stabilization of heart failure with medical therapy showed ISR in the mid-RCA (Fig. 1 a). On the first session, neither a 1.0-mm balloon nor imaging ...

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    18. Imaging assessment and accuracy in coronary artery autopsy: comparison of frequency-domain optical coherence tomography with intravascular ultrasound and histology

      Imaging assessment and accuracy in coronary artery autopsy: comparison of frequency-domain optical coherence tomography with intravascular ultrasound and histology

      ptical coherence tomography (OCT) is a coronary artery imaging technique with high resolution. Second-generation frequency-domain OCT (FD-OCT) technology allows safer and faster clinical application compared with first-generation time-domain OCT (TD-OCT). Only limited validation studies compare FD-OCT with other modes of analysis: histology, which is the current gold standard, and intravascular ultrasound (IVUS). This study therefore aims to demonstrate the accuracy of FD-OCT images compared with IVUS and histology. FD-OCT and IVUS images were acquired from 203 segments from 31 coronary arteries obtained at autopsy from 20 cadavers. Of these, 30 randomly-selected pairs were used to create three classifications of plaque ...

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    19. Rationale and design of the optical coherence tomography observation of pulmonary ultra-structural changes in heart failure (OCTOPUS-CHF) study

      Rationale and design of the optical coherence tomography observation of pulmonary ultra-structural changes in heart failure (OCTOPUS-CHF) study

      The assessment of vascular remodeling using optical coherence tomography (OCT) has been previously described in some types of pulmonary hypertension. However, evidence about its feasibility and clinical utility for evaluation of pulmonary arterial vasculopathy in advanced heart failure (HF) is scarce. Optical Coherence Tomography Observation of Pulmonary Ultra-Structural Changes in Heart Failure (OCTOPUS-CHF) study is designed to study the correlation between OCT-morphometric parameters and hemodynamic data measured or derived from right heart catheterization (RHC). Methods OCTOPUS-CHF is an observational, prospective, multicentre study aiming to recruit 100 patients with advanced HF referred for heart transplantation (HTx) evaluation. As part of such ...

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    20. Lipoprotein (a) level is associated with plaque vulnerability in patients with coronary artery disease: An optical coherence tomography study

      Lipoprotein (a) level is associated with plaque vulnerability in patients with coronary artery disease: An optical coherence tomography study

      Background High lipoprotein (a) [Lp(a)] levels are an independent factor for worse prognosis in patients with coronary artery disease (CAD). However, the association between serum Lp(a) level and coronary plaque vulnerability remains to be determined. Methods A total of 255 consecutive patients with CAD who underwent optical coherence tomography imaging of culprit lesions were included. Patients were divided into 2 groups according to their Lp(a) levels (the higher Lp(a) group [≥25 mg/dL], n = 87; or the lower Lp(a) group [<25 mg/dL], n = 168). Results The prevalence of thin-cap fibroatheroma (TCFA) was significantly higher ...

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    21. Suitability of intravascular imaging for assessment of cerebrovascular diseases

      Suitability of intravascular imaging for assessment of cerebrovascular diseases

      Purpose Arteriosclerosis of the vascular system is associated with many accompanying diseases. Especially cerebral arteriosclerosis is a main risk factor for ischemic strokes. We want to verify the practicability of intravascular imaging like intravascular ultrasound and optical coherence tomography for the assessment of cerebral vessel walls and plaques. Methods We examined 18 Circuli arteriosi willisii postmortem. The data contained 48 plaques from 48 different vessel parts. The samples underwent intravascular and histological imaging to conduct a quantitative assessment of vessel wall parameters (healthy vessel wall, thinnest vessel wall, plaque thickness and vessel diameter) as well as to qualitatively evaluate the ...

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