1. Articles in category: Cardiology

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    1. Computational Fractional Flow Reserve From Coronary Computed Tomography Angiography-Optical Coherence Tomography Fusion Images in Assessing Functionally Significant Coronary Stenosis

      Computational Fractional Flow Reserve From Coronary Computed Tomography Angiography-Optical Coherence Tomography Fusion Images in Assessing Functionally Significant Coronary Stenosis

      Background: Coronary computed tomography angiography (CTA) and optical coherence tomography (OCT) provide additional functional information beyond the anatomy by applying computational fluid dynamics (CFD). This study sought to evaluate a novel approach for estimating computational fractional flow reserve (FFR) from coronary CTA-OCT fusion images. Methods: Among patients who underwent coronary CTA, 148 patients who underwent both pressure wire-based FFR measurement and OCT during angiography to evaluate intermediate stenosis in the left anterior descending artery were included from the prospective registry. Coronary CTA-OCT fusion images were created, and CFD was applied to estimate computational FFR. Based on pressure wire-based FFR as ...

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    2. Synergy Between morpHOlogical and inflammatoRy Evaluation in Predicting Long-term Coronary Plaque Progression

      Synergy Between morpHOlogical and inflammatoRy Evaluation in Predicting Long-term Coronary Plaque Progression

      Data from human autopsy studies have showed that thrombosis of a ruptured plaque with a large necrotic core, inflammatory cells and a thin fibrous cap, the so-called thin cap fibroatheroma (TCFA), represents the main mechanism for acute coronary syndrome (ACS). Optical coherence tomography (OCT) is an imaging technique that provides high-resolution, cross-sectional images of tissue in situ. The resolution of OCT (10 um) is appropriate for measuring a cap thickness less than65 μm, and even the plaque macrophage density. 68Ga-DOTA-(Tyr3)-octreotate/NaI3-octreotide(68Ga-DOTA-TATE/NOC) Positron Emission Tomography (PET)/Computed Tomography coronary angiography (CTCA), targeting the somatostatin receptor subtype-2 selectively ...

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    3. Artificial Intelligence Enhances Potential of Intravascular OCT

      Artificial Intelligence Enhances Potential of Intravascular OCT

      Artificial intelligence ’s (AI) applicability in cardiac imaging is rapidly growing and was a major topic of discussion at this year’s EuroPCR 2022 meeting. Many session speakers discussed how they are using AI tools in their day-to-day practice and in their research to improve decision-making and patient/research outcomes. It’s no secret, however, that AI tools are only as good as the data sets and the thousands of expert opinions used to power them. Implementing AI applications in our day-to-day practice, from an operations standpoint, could mean adjusting clinician workflows and setting aside time to set up and ...

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    4. The Continuum of Invasive Techniques for the Assessment of Intermediate Coronary Lesions

      The Continuum of Invasive Techniques for the Assessment of Intermediate Coronary Lesions

      Ischemic heart disease is one of the most important causes of mortality and morbidity worldwide. Revascularization of coronary stenosis inducing ischemia, either by percutaneous or surgical intervention, significantly reduces major adverse cardiovascular events and improves quality of life. However, in cases of intermediate lesions, classified by a diameter stenosis between 50 and 90% by European guidelines and 40–70% in American counterparts with no clear evidence of ischemia, the indication of revascularization and impact is determined using various methods that altogether comprehensively evaluate the lesions. This review will discuss the various techniques to assess intermediate stenoses, highlighting indications and advantages ...

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    5. Ai, Oct Operate in Tandem to Detect Plaque Erosion in the Heart

      Ai, Oct Operate in Tandem to Detect Plaque Erosion in the Heart

      Researchers from the University of Electronic Science and Technology of China have developed an AI method that can automatically detect plaque erosion in the heart’s arteries using optical coherence tomography (OCT). “If cholesterol plaque lining arteries starts to erode, it can lead to a sudden reduction in blood flow to the heart, known as acute coronary syndrome, which requires urgent treatment,” said research team leader Zhao Wang. “Our new method could help improve the clinical diagnosis of plaque erosion and be used to develop new treatments for patients with heart disease.”

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    6. Fewer Women Than Men Get Intracoronary Imaging in PCI, but Why?

      Fewer Women Than Men Get Intracoronary Imaging in PCI, but Why?

      Women undergoing PCI in England and Wales are less likely to receive intracoronary imaging than their male counterparts, data from the British Cardiovascular Intervention Society (BCIS) registry show. The situation grew worse, not better, over a 14-year period. Importantly, female patients may be paying a penalty, too, in terms of survival and major adverse outcomes, Muhammad Rashid, MBBS (Keele University, Stoke-on-Trent, England), and colleagues point out in a new paper, which was published online earlier this week in JACC: Cardiovascular Interventions . Rashid told TCTMD that their study comes on the heels of others showing women have worse outcomes when they ...

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    7. Avinger Expands International Presence with First Commercial Shipment to Chile

      Avinger Expands International Presence with First Commercial Shipment to Chile

      Avinger, Inc. (NASDAQ:AVGR), a commercial-stage medical device company marketing the first and only intravascular image-guided, catheter-based system for diagnosis and treatment of Peripheral Artery Disease (PAD), today announced the expansion of its international presence with the commercial launch of its Lumivascular products in Chile. Avinger's new Lightbox 3 imaging console will be used exclusively to support the launch of the Lumivascular platform in Chile. To support the entry into this new international market, Avinger has signed an exclusive distribution agreement with Importadora y Distribuidora Arquimed Ltda for the sale and marketing of Avinger's proprietary Lightbox 3 imaging ...

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      Mentions: Avinger
    8. Optical coherence tomography-derived lipid core burden index and clinical outcomes: results from the CLIMA registry

      Optical coherence tomography-derived lipid core burden index and clinical outcomes: results from the CLIMA registry

      Aims: The aim of this study was to assess the morphological characteristics and prognostic implications of the optical coherence tomography (OCT)-derived lipid core burden index (LCBI). Methods and results: OCT-LCBI was assessed in 1003 patients with 1-year follow-up from the CLIMA multicentre registry using a validated software able to automatically obtain a maximum OCT-LCBI in 4 mm (maxOCT-LCBI4mm). Primary composite clinical endpoint included cardiac death, myocardial infarction, and target-vessel revascularization. A secondary analysis using clinical outcomes of CLIMA study was performed. Patients with a maxOCT-LCBI4mm ≥ 400 showed higher prevalence of fibrous cap thickness (FCT) <75 μm [odds ratio (OR ...

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    9. A Randomized Comparison of the Healing Response Between the Firehawk Stent and the Xience Stent in Patients With ST-Segment Elevation Myocardial Infarction at 6 Months of Follow-Up (TARGET STEMI OCT China Trial): An Optical Coherence Tomography Study

      A Randomized Comparison of the Healing Response Between the Firehawk Stent and the Xience Stent in Patients With ST-Segment Elevation Myocardial Infarction at 6 Months of Follow-Up (TARGET STEMI OCT China Trial): An Optical Coherence Tomography Study

      Background: The healing response of the Firehawk stent in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. Aim: We compared the vascular healing of a biodegradable polymer sirolimus-eluting stent (Firehawk) vs. a durable polymer everolimus-eluting stent (Xience) at 6 months after percutaneous coronary intervention (PCI) in patients with STEMI. Methods: In this prospective, multicenter, randomized, non-inferiority study, patients within 12 h of STEMI onset were randomized in a ratio of 1:1 to receive Firehawk or Xience stents. Optical coherence tomography (OCT) follow-up was performed 6 months after the index procedure and assessed frame by frame. The primary endpoint ...

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    10. Clinical Outcomes Following Hemodynamic Parameter or Intravascular Imaging-Guided Percutaneous Coronary Intervention in the Era of Drug-Eluting Stents: An Updated Systematic Review and Bayesian Network Meta-Analysis of 28 Randomized Trials and 11,860 Pati

      Clinical Outcomes Following Hemodynamic Parameter or Intravascular Imaging-Guided Percutaneous Coronary Intervention in the Era of Drug-Eluting Stents: An Updated Systematic Review and Bayesian Network Meta-Analysis of 28 Randomized Trials and 11,860 Pati

      Background: Coronary angiography (CAG) is the standard imaging modality for guiding percutaneous coronary interventions (PCI). Intracoronary imaging techniques such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT), and hemodynamic parameter like fractional flow reserve (FFR) can overcome some limitations of CAG. Objective: We sought to explore the clinical outcomes of different PCI guidance modalities in the era of drug-eluting stent (DES). Methods: A network meta-analysis of 28 randomized trials and 11,860 patients undergoing different modalities-guided PCI in the era of DES was performed. Odds ratio (OR) with 95% credible interval (CrI) were calculated. Results: In comparison with CAG ...

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    11. Measurement of Layer-Specific Mechanical Properties of Intact Blood Vessels Based on Intravascular Optical Coherence Tomography

      Measurement of Layer-Specific Mechanical Properties of Intact Blood Vessels Based on Intravascular Optical Coherence Tomography

      Purpose: The biomechanical analysis of stress and strain state of multilayered blood vessels has shown great importance in vascular pathology and physiology. However, there is a lack of method in measuring the mechanical property of each layer of a vascular sample without splitting up the wall. Methods: Here we develop a vascular inflation test method based on intravascular optical coherence tomography (IVOCT) imaging and inverse parametric estimation. We propose a three-step inverse parametric estimation method to solve the six constitutive parameters of the GOH models for the intima-media and adventitia of the coronaries simultaneously. A bilayer silicone vascular phantom inflation ...

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    12. Cholesterol crystals in non-culprit plaques of STEMI patients: A 3-vessel OCT study

      Cholesterol crystals in non-culprit plaques of STEMI patients: A 3-vessel OCT study

      Background: Cholesterol crystals (CCs) are regular microstructures found within the necrotic core of atherosclerotic plaques and have been hypothesized to be related to plaque destabilization. We attempted to investigate the potential association between CCs and non-culprit plaque vulnerability in patients with ST-segment elevated myocardial infarction (STEMI) and study morphological features of CCs in ruptured non-culprit plaques. Methods: A total of 261 patients with ST-segment elevation myocardial infarction who underwent 3-vessel optical coherence tomography (OCT) imaging were included. Non-culprit plaques were divided into two groups according to the presence or absence of CCs in the plaque to compare the morphological characteristics ...

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    13. In vivo detection of plaque erosion by intravascular optical coherence tomography using artificial intelligence

      In vivo detection of plaque erosion by intravascular optical coherence tomography using artificial intelligence

      Plaque erosion is one of the most common underlying mechanisms for acute coronary syndrome (ACS). Optical coherence tomography (OCT) allows in vivo diagnosis of plaque erosion. However, challenge remains due to high inter- and intra-observer variability. We developed an artificial intelligence method based on deep learning for fully automated detection of plaque erosion in vivo , which achieved a recall of 0.800 ± 0.175, a precision of 0.734 ± 0.254, and an area under the precision-recall curve (AUC) of 0.707. Our proposed method is in good agreement with physicians, and can help improve the clinical diagnosis of plaque ...

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    14. AI-Based Image Analysis Automatically Detects Serious Heart Condition

      AI-Based Image Analysis Automatically Detects Serious Heart Condition

      Researchers have developed a new artificial intelligence (AI) method that can automatically detect plaque erosion in the heart’s arteries using optical coherence tomography (OCT) images. Monitoring plaque in the arteries is important because when plaque breaks apart it can block blood flow to the heart, leading to a heart attack or other serious conditions. “If cholesterol plaque lining arteries starts to erode it can lead to a sudden reduction in blood flow to the heart known as acute coronary syndrome, which requires urgent treatment,” said research team leader Zhao Wang from the University of Electronic Science and Technology of ...

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    15. Cleveland Clinic Receives NIH Grant for Broad Bandwidth Transducers for High Resolution Information Rich IVUS

      Cleveland Clinic Receives NIH Grant for Broad Bandwidth Transducers for High Resolution Information Rich IVUS

      Cleveland Clinic Received a 2022 NIH Grant for $390,345 for Broad Bandwidth Transducers for High Resolution Information Rich IVUS. The principal investigator is Aaron Fleischman. Below is a summary of the proposed work. Intra-coronary imaging is a powerful clinical tool for decision making, treatment planning, and assessment of stent deployment. It is also a powerful research tool for plaque progression/regression, drug treatments, and device interventions. There are clear advantages and disadvantages of common intravascular imaging methods. Intravascular ultrasound (IVUS) provides good resolution and allows one to measure lumen narrowing, wall thickening, atheroma burden, and to a lesser extent ...

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    16. Automated Coronary Optical Coherence Tomography Feature Extraction with Application to Three-Dimensional Reconstruction

      Automated Coronary Optical Coherence Tomography Feature Extraction with Application to Three-Dimensional Reconstruction

      Coronary optical coherence tomography (OCT) is an intravascular, near-infrared light-based imaging modality capable of reaching axial resolutions of 10-20 µm. This resolution allows for accurate determination of high-risk plaque features, such as thin cap fibroatheroma; however, visualization of morphological features alone still provides unreliable positive predictive capability for plaque progression or future major adverse cardiovascular events (MACE). Biomechanical simulation could assist in this prediction, but this requires extracting morphological features from intravascular imaging to construct accurate three-dimensional (3D) simulations of patients' arteries. Extracting these features is a laborious process, often carried out manually by trained experts. To address this challenge ...

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    17. Optical coherence tomography criteria for stent optimisation

      Optical coherence tomography criteria for stent optimisation

      Intravascular optical coherence tomography (OCT) is a valuable imaging tool for guiding percutaneous coronary intervention (PCI). Previous OCT studies have demonstrated that stent abnormalities such as underexpansion, dissection, malapposition, and tissue protrusions are associated with PCI outcomes1. However, the quantitative OCT criteria of those stent abnormalities for the requirement of additional procedures have not yet been clarified. Interventional cardiologists have determined PCI endpoints based on their own experience or local rules in OCT-guided PCI. To standardise OCT-guided PCI, it is necessary to develop quantitative OCT criteria for stent optimisation.

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    18. Comparing Optical Coherence Tomography and Intravascular Ultrasound Guidance for Percutaneous Coronary Intervention

      Comparing Optical Coherence Tomography and Intravascular Ultrasound Guidance for Percutaneous Coronary Intervention

      Background: Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) optimize percutaneous coronary intervention (PCI) by characterizing lesion morphology, accurately measuring vessel dimensions, and optimizing stent characteristics. We sought to compare the utilization of OCT and IVUS to guide inpatient PCI and their relative association with in-hospital mortality and readmission rates. Methods: We queried the National Readmission Database to identify patients undergoing intracoronary imaging-guided PCI from 2010 to 2019 and compared outcomes and readmission rates between patients undergoing OCT-guided PCI and IVUS-guided PCI. Multivariable logistic regression was performed to generate adjusted odds ratios (aOR) of adverse outcomes between the 2 groups ...

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    19. The relation between red blood cell distribution width and coronary atherosclerotic plaque vulnerability detected by intracoronary optical coherence tomography

      The relation between red blood cell distribution width and coronary atherosclerotic plaque vulnerability detected by intracoronary optical coherence tomography

      Background: A higher red blood cell distribution width (RDW) predicts major adverse cardiac events in patients with coronary artery disease (CAD). However, there are only few studies regarding the relationship between RDW and vulnerable plaques. Thus, the purpose of present study is to retrospectively explore the predictive value of the association between RDW and plaque vulnerability assessed by optical coherence tomography (OCT) in patients with cardiovascular (CV) diseases. Methods: This study included 35 patients with stable angina pectoris (SAP) and 70 patients with acute coronary syndrome (ACS). We documented clinical features as well as peripheral RDW. Plaque vulnerability was determined ...

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    20. Optical Coherence Tomography: An Eye Into the Coronary Artery

      Optical Coherence Tomography: An Eye Into the Coronary Artery

      Optical coherence tomography (OCT) is slowly but surely gaining a foothold in the hands of interventional cardiologists. Intraluminal and transmural contents of the coronary arteries are no longer elusive to the cardiologist's probing eye. Although the graduation of an interventionalist in imaging techniques right from naked eye angiographies to ultrasound-based coronary sonographies to the modern light-based OCT has been slow, with the increasing regularity of complex coronary cases in practice, such a transition is inevitable. Although intravascular ultrasound (IVUS) due to its robust clinical data has been the preferred imaging modality in recent years, OCT provides a distinct upgrade ...

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    21. Optimising PCI by Intracoronary Image-guidance

      Optimising PCI by Intracoronary Image-guidance

      Evidence to support the use of intracoronary imaging (ICI) in guiding percutaneous coronary intervention (PCI) is growing, with observational and randomized controlled trials demonstrating a benefit in acute procedural and clinical outcomes. ICI provides an opportunity to guide PCI, detailing the nature of the coronary disease, potentially influencing lesion preparation and stent selection. Following stent deployment, ICI offers a detailed assessment of lesion coverage, associated vessel trauma and stent expansion. Consensus statements have emphasized the role of ICI and detailed the parameters of stent optimization. However, intracoronary imaging is not adopted widely yet. Significant global differences in the uptake of ...

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    22. The fingerprints of plaque rupture healing as detected by serial optical coherence tomography imaging

      The fingerprints of plaque rupture healing as detected by serial optical coherence tomography imaging

      Plaque rupture healing detected by serial optical coherence tomography imaging. A-B) RCA angiogram showing a focal, complex lesion at the crux (red arrow in magnification). C-D) 3D and 2D longitudinal OCT views showing a plaque rupture (red arrows) with a large empty cavity (asterisks). E) Thin-cap fibroatheroma (white arrowheads). F-G) Ruptured plaque, with a fibrous cap discontinuity (red arrows) and a cavity (asterisks). H) Layered pattern (white arrowheads). A’-B’) Follow-up RCA angiogram showing a resolution of the ulceration and a smooth vessel profile (red arrow in magnification). C’-D’) Follow-up 3D and 2D 

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    23. Acute Myocardial Infarction Caused by Plaque Erosion After Recovery From COVID-19 Infection Assessed by Multimodality Intracoronary Imaging

      Acute Myocardial Infarction Caused by Plaque Erosion After Recovery From COVID-19 Infection Assessed by Multimodality Intracoronary Imaging

      We report a case of non-ST-elevation acute myocardial infarction after recovery from COVID-19 infection. An emergency coronary angiography revealed 50% stenosis with thrombotic occlusion in the middle left anterior descending artery. Optical coherence tomography and coronary angioscopy revealed plaque erosion with mixed thrombus on a lipid-rich plaque. This case report may help to understand the underlying mechanisms of cardiac complications following COVID-19 infection.

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      Mentions: Abbott
    24. Use of Optical Coherence Tomography in MI with Non-obstructive Coronary Arteries

      Use of Optical Coherence Tomography in MI with Non-obstructive Coronary Arteries

      MI with non-obstructive coronary arteries (MINOCA) comprises an important minority of cases of acute MI. Many different causes have been implicated in the pathogenetic mechanism of MINOCA. Optical coherence tomography (OCT) is an indispensable tool for recognising the underlying pathogenetic mechanism when epicardial pathology is suspected. OCT can reliably identify coronary lesions not apparent on conventional coronary angiography and discriminate the various phenotypes. Plaque rupture and plaque erosion are the most frequently found atherosclerotic causes of MINOCA. Furthermore, OCT can contribute to the identification of ischaemic non-atherosclerotic causes of MINOCA, such as spontaneous coronary artery dissection, coronary spasm and lone ...

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