1. Articles in category: Cardiology

    1-24 of 3956 1 2 3 4 ... 163 164 165 »
    1. Role of Intracoronary Imaging in Plaque Identification

      Role of Intracoronary Imaging in Plaque Identification

      NSTE-ACS patients are more likely to exhibit high-risk plaque characteristics in non-culprit lesions. Both IVUS and OCT imaging techniques interact in a complementary manner to provide morphological characterization of the atherosclerotic coronary plaques and help identification of high-risk vulnerable plaques. Using morphological parameters obtained from OCT and IVUS, a new plaque vulnerability score will be established for more precise definition of the most vulnerable plaques that carry the greatest risk of rupture and subsequent detrimental clinical outcomes in the future. Such score might help in targeting these plaques with certain therapeutic interventions aiming to their stabilization.

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    2. Avinger Announces Successful Treatment of 1,000th Patient with Next-Generation Pantheris Device

      Avinger Announces Successful Treatment of 1,000th Patient with Next-Generation Pantheris Device

      Avinger, Inc. (AVGR), a commercial-stage medical device company marketing the first and only intravascular image-guided, catheter-based system for diagnosis and treatment of patients with Peripheral Artery Disease (PAD), today announced that physicians in 78 clinical sites have successfully treated more than 1,000 patients with the next-generation Pantheris image-guided atherectomy system. The next-generation Pantheris was launched on a limited basis in the U.S. following receipt of 510(k) clearance by the U.S. Food and Drug Administration (FDA) in late May 2018 and features a number of improvements intended to augment the performance and reliability of the product. Importantly ...

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      Mentions: FDA Avinger
    3. Retinal fingerprints for precision profiling of cardiovascular risk

      Retinal fingerprints for precision profiling of cardiovascular risk

      Retinal microvascular changes are strongly linked to prevalent and incident cardiovascular disease. These changes can now be mapped with unparalleled accuracy using retinal optical coherence tomography. Novel retinal imaging, combined with the power of deep learning, might soon equip clinicians with unique and precise risk-assessment tools that enable truly individualized patient management.

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    4. Optical coherence tomography tissue coverage and characterization with grey-scale signal intensity analysis after bifurcation stenting with new generation bioabsorbable polymer drug-eluting stent

      Optical coherence tomography tissue coverage and characterization with grey-scale signal intensity analysis after bifurcation stenting with new generation bioabsorbable polymer drug-eluting stent

      Purpose Bifurcation stenting is thought to be associated with delayed healing and a subsequent risk of stent failure. The aim of this study was to further evaluate healing of thin-strut bioabsorbable polymer everolimus-eluting stents (EES) post bifurcation stenting by optical coherence tomography (OCT) including grey-scale signal intensity (GSI) analysis. Methods Patients receiving bifurcation stenting with a planned two-stent approach using EES with OCT follow-up at 3–6 months post-stenting were included in this study. Morphometric analysis of contiguous cross-sections was performed at 1 mm longitudinal intervals within the stented segment. GSI analysis of neointimal regions of interest (ROI) overlying stent ...

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    5. Healed Culprit Plaques in Patients With Acute Coronary Syndrome

      Healed Culprit Plaques in Patients With Acute Coronary Syndrome

      ackground Healed plaques, morphologically characterized by a layered phenotype, are frequently found in subjects with sudden cardiac death. However, in vivo data are lacking. Objectives The purpose of this study was to determine the prevalence, morphological characteristics, and clinical significance of healed culprit plaques in patients with acute coronary syndromes (ACS) using optical coherence tomography (OCT). Methods A total of 376 ACS patients (252 ST-segment elevation myocardial infarction [MI] and 124 non–ST-segment elevation acute coronary syndrome) who had undergone pre-intervention OCT imaging of the culprit lesion were enrolled. Patients were stratified according to the presence of layered phenotype, defined ...

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    6. Real-time assessment of catheter contact and orientation using an integrated optical coherence tomography cardiac ablation catheter

      Real-time assessment of catheter contact and orientation using an integrated optical coherence tomography cardiac ablation catheter

      The efficacy of catheter ablation treatment for atrial fibrillation is directly impacted by the quality of lesion formation. Two parameters that are critical for maximizing energy delivery are sustained catheter contact and orientation. Currently, these parameters must be inferred indirectly through tactile feedback or measurements of bioelectrical impedance and tip force. In this work, we propose a method for discerning contact and orientation based on direct endomyocardial imaging mediated by optical coherence tomography (OCT)-integrated ablation catheters. A two-stage classifier is developed to deduce contact parameters from M-mode images. Experimental validation within swine left-atrial specimens demonstrate accuracies of 99.96 ...

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    7. Good neointimal coverage of a crushed stent segment protruding into the main vessel by follow-up optical coherence tomography in a patient with a diagonal branch lesion

      Good neointimal coverage of a crushed stent segment protruding into the main vessel by follow-up optical coherence tomography in a patient with a diagonal branch lesion

      There is currently no consensus regarding the optimum treatment strategy for an isolated side branch lesion . The usefulness of a side branch stenting technique with a balloon crushing the segment protruding into the main vessel has been reported; however, there remain concerns about malapposition of crushed stent struts and a consequent risk of stent thrombosis . We herein report a case with a diagonal branch lesion that was successfully treated with this technique. Follow-up optical coherence tomography clearly revealed that the protruding stent struts in the main vessel were crushed and covered almost completely. Our findings may support the feasibility of ...

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    8. OCT Explores Vascular Response and Healing Profile After Stenting in CTO

      OCT Explores Vascular Response and Healing Profile After Stenting in CTO

      True-false-true occurred during wire penetration in coronary CTO procedure. Subintimal stenting influences vascular response. Intravenous ultrasound confirmed wire position in the procedure. Then stenting procedure was performed. Optical coherence tomography was used for exploring long-term vascular response and healing profile after successful coronary stenting in CTO lesions.

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      Mentions: Fudan University
    9. Serial invasive imaging follow-up of the first clinical experience with the Magmaris magnesium bioresorbable scaffold

      Serial invasive imaging follow-up of the first clinical experience with the Magmaris magnesium bioresorbable scaffold

      Objectives: To assess the performance of the commercially available Magmaris sirolimuseluting bioresorbable scaffold (BRS) with invasive imaging at different time points. Background: Coronary BRS with a magnesium backbone have been recently studied as an alternative to polymeric scaffolds, providing enhanced vessel support and a faster resorption rate. We aimed to assess the performance of the commercially available Magmaris sirolimus-eluting BRS at different time points. Methods: A prospective, single-center, nonrandomized study was performed at the Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. Six patients with stable de novo coronary artery lesions underwent single-vessel revascularization with the Magmaris sirolimus-eluting BRS. Invasive follow-up ...

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    10. High frequency optical coherence tomography assessment of homogenous neck coverage by intrasaccular devices predicts successful aneurysm occlusion

      High frequency optical coherence tomography assessment of homogenous neck coverage by intrasaccular devices predicts successful aneurysm occlusion

      Background High frequency optical coherence tomography (HF-OCT) is a novel intravascular imaging technology developed for use in the cerebral vasculature. We hypothesize that HF-OCT characterization of intrasaccular device neck coverage can prognosticate exclusion of the aneurysm from the circulation. Methods Bifurcation and sidewall aneurysms were made in six dogs. Seven aneurysms were treated with next generation intrasaccular devices (NGID) and four with traditional platinum coils. HF-OCT was performed to interrogate gaps in the neck coverage, coil herniation, or acute thrombus formation. Animals were re-imaged at 7, 30, 90, and 180  days following aneurysm embolization. An automated image processing method segmented ...

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    11. Prediction of coronary thin-cap fibroatheroma by intravascular ultrasound-based machine learning

      Prediction of coronary thin-cap fibroatheroma by intravascular ultrasound-based machine learning

      ackground and aims Although grayscale intravascular ultrasound (IVUS) is commonly used for assessing coronary lesion morphology and optimizing stent implantation, detection of vulnerable plaques by IVUS remains challenging. We aimed to develop machine learning (ML) models for predicting optical coherence tomography-derived thin-cap fibroatheromas (OCT-TCFAs). Methods In 517 patients with angina, 414 and 103 coronary lesions were randomized into training vs. test sets. Each of the IVUS-OCT co-registered frames (including 32,807 for training and 8101 for test) was labeled according to the presence vs. absence of OCT-TCFA. Among 1449 computed IVUS features based on two-dimensional geometry and texture, 17 features ...

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    12. Association between asymmetric dimethylarginine and in-stent restenosis tissue characteristics assessed by optical coherence tomography

      Association between asymmetric dimethylarginine and in-stent restenosis tissue characteristics assessed by optical coherence tomography

      Background Impaired bioavailability of endothelium-derived nitric oxide (NO) and endothelial dysfunction may play a pivotal role in the pathogenesis of in-stent restenosis (ISR) after coronary stenting. We aimed to investigate the relation between asymmetric dimethylarginine (ADMA), an endogenous NO synthase inhibitor, and the ISR lesions tissue characteristics assessed by optical coherence tomography (OCT). Methods and results Forty-five patients with symptomatic ISR lesions (17 bare metal stents, 28 drug-eluting stents, medium implantation duration: 58.0 months) were evaluated by OCT for in-stent tissue characteristics and calcification. We defined neoatherosclerosis as the presence of lipid or calcified neointima in ISR lesions, and ...

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    13. Coronary Stent Fracture: Still a Cause of Stent Failure

      Coronary Stent Fracture: Still a Cause of Stent Failure

      A 43-year-old man presented to his cardiologist’s office with a history of exertion-related chest pain. His past medical history included type 2 diabetes mellitus, hypercholesterolemia, smoking, and a family history of coronary artery disease. His physical examination was normal. After positive exercise-induced chest discomfort, the patient underwent coronary computed tomography angiography (CCTA), which showed marked and diffuse calcified coronary plaques (calcium score, 2011 HU; >90th percentile for age) and severe stenosis in the proximal right coronary artery (RCA) (Figure 1A). He was referred to our catheterization laboratory for an elective coronary angiogram, which confirmed proximal and mid RCA stenoses ...

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    14. Optical Coherence Tomography Evaluation of Superficial Femoral Artery Directional Atherectomy

      Optical Coherence Tomography Evaluation of Superficial Femoral Artery Directional Atherectomy

      A 70-year-old man presented with lifestyle-limiting intermittent claudication (Rutherford stage III) affecting the right lower extremity. Physical examination of the right lower limb revealed weak distal pulses and a diminished ankle-brachial index of 0.6. Peripheral angiogram showed diffuse 80% stenosis over the right distal superficial femoral artery (SFA). The HawkOne directional atherectomy system (Medtronic Peripheral) was used to restore blood flow by removing plaque. After placing a 7 mm SpiderFX device (Medtronic Peripheral), optical coherence tomography (OCT) was acquired to assess baseline plaque load (Figure 1). Several runs of directional atherectomy were done. Angiogram and OCT were then obtained ...

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    15. Routine use of optical coherence tomography in bioresorbable vascular scaffold implantation: insights on technique optimization and long-term outcomes

      Routine use of optical coherence tomography in bioresorbable vascular scaffold implantation: insights on technique optimization and long-term outcomes

      Background Data from prior studies have shown increased risk of adverse outcomes with bioresorbable vascular scaffolds (BVS) compared with drug-eluting stents. Objective The objective of this study was to study the long-term outcomes with routine use of optical coherence tomography (OCT) for optimization of BVS implantation. Patients and methods Clinical, procedural, and outcome data were collected for all patients who received ABSORB BVS between February 2014 and March 2016 in our tertiary center ( n =86). Preimplantation and postimplantation OCT was performed in all cases. Outcomes of interest included acute device success and long-term clinical outcomes including cardiac mortality, target vessel ...

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    16. Design and development of optical reflectance spectroscopy and optical coherence tomography catheters for myocardial tissue characterization (Thesis)

      Design and development of optical reflectance spectroscopy and optical coherence tomography catheters for myocardial tissue characterization (Thesis)

      atheter ablation therapy attempts to restore sinus rhythm in arrhythmia patients by producing site-specific tissue modification along regions which cause abnormal electrical activity. This treatment, though widely used, often requires repeat procedures to observe long-term therapeutic benefits. This limitation is driven in part by challenges faced by conventional schemes in validating lesion adequacy at the time of the procedure. Optical techniques are well-suited for the interrogation and characterization of biological tissues. In particular, optical coherence tomography (OCT) relies on coherence gating of singly-scattered light to enable high-resolution structural imaging for tissue diagnostics and procedural guidance. Alternatively, optical reflectance spectroscopy (ORS ...

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    17. Characterization and modeling of the human left atrium using optical coherence tomography (Thesis)

      Characterization and modeling of the human left atrium using optical coherence tomography (Thesis)

      With current needs to better understand the interaction between atrial tissue microstructure and atrial fibrillation dynamics, micrometer scale imaging with optical coherence tomography has significant potential to provide further insight on arrhythmia mechanisms and improve treatment guidance. However, optical coherence tomography imaging of cardiac tissue in humans is largely unexplored, and the ability of optical coherence tomography to identify the structural substrate of atrial fibrillation has not yet been investigated. Therefore, the objective of this thesis was to develop an optical coherence tomography imaging atlas of the human heart, study the utility of optical coherence tomography in providing useful features ...

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    18. Influence of ezetimibe on plaque morphology in patients with ST Elevation Myocardial Infarction assessed by Optical Coherence Tomography: An OCTIVUS sub-study

      Influence of ezetimibe on plaque morphology in patients with ST Elevation Myocardial Infarction assessed by Optical Coherence Tomography: An OCTIVUS sub-study

      Aims The aim of the trial was to examine the influence of ezetimibe on plaque morphology in patients with ST-segment Elevation Myocardial Infarction (STEMI) with respect to fibrous cap thickness (FCT) and arcs of lipid plaque, calcific plaque, and macrophages using Optical Coherence Tomography (OCT). Methods and results In 87 statin naïve patients with STEMI treated with primary percutaneous intervention, a non-culprit study plaque in a non-infarct related coronary artery was assessed with OCT at baseline and after 12 months. Patients were treated with atorvastatin 80 mg and randomized (1:1) to ezetimibe 10 mg (n = 43) or placebo ...

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    19. Serial invasive imaging follow‐up of the first clinical experience with the Magmaris magnesium bioresorbable scaffold

      Serial invasive imaging follow‐up of the first clinical experience with the Magmaris magnesium bioresorbable scaffold

      Objectives To assess the performance of the commercially available Magmaris sirolimus‐eluting bioresorbable scaffold (BRS) with invasive imaging at different time points. Background Coronary BRS with a magnesium backbone have been recently studied as an alternative to polymeric scaffolds, providing enhanced vessel support and a faster resorption rate. We aimed to assess the performance of the commercially available Magmaris sirolimus‐eluting BRS at different time points. Methods A prospective, single‐center, nonrandomized study was performed at the Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. Six patients with stable de novo coronary artery lesions underwent single‐vessel revascularization with the Magmaris ...

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    20. Incidental Finding of Strut Malapposition Is a Predictor of Late and Very Late Thrombosis in Coronary Bioresorbable Scaffolds

      Incidental Finding of Strut Malapposition Is a Predictor of Late and Very Late Thrombosis in Coronary Bioresorbable Scaffolds

      Malapposition is a common finding in stent and scaffold thrombosis (ScT). Evidence from studies with prospective follow-up, however, is scarce. We hypothesized that incidental observations of strut malapposition might be predictive of late ScT during subsequent follow-up. One hundred ninety-seven patients were enrolled in a multicentre registry with prospective follow-up. Optical coherence tomography (OCT), performed in an elective setting, was available in all at 353 (0–376) days after bioresorbable scaffold (BRS) implantation. Forty-four patients showed evidence of malapposition that was deemed not worthy of intervention. Malapposition was not associated with any clinical or procedural parameter except for a higher ...

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    21. Optical coherence tomography-guided balloon pulmonary angioplasty of a web lesion

      Optical coherence tomography-guided balloon pulmonary angioplasty of a web lesion

      We present the case of a 73-year-old woman with a history of pulmonary embolism referred to our department due to suspected pulmonary hypertension . She was in WHO II functional class and the transthoracic echocardiogram showed pulmonary artery systolic pressure of 58 mmHg, with no right ventricular dilatation or dysfunction. Ventilation/perfusion scan after 3 months of oral anticoagulation confirmed the perfusion defects and right heart catheterization confirmed precapillary pulmonary hypertension (mean pulmonary artery pressure 36 mmHg, pulmonary vascular resistance 5.19 Wood units), so a diagnosis of chronic thromboembolic pulmonary hypertension was established. The patient refused pulmonary thromboendarterectomy and vasodilator ...

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    22. Restenosis of a Polytetrafluoroethylene-Covered Stent Visualized by Coronary Angioscopy and Optical Coherence Tomography: A Case Report

      Restenosis of a Polytetrafluoroethylene-Covered Stent Visualized by Coronary Angioscopy and Optical Coherence Tomography: A Case Report

      An expandable polytetrafluoroethylene (PTFE)-covered stent graft is beneficial for the treatment of coronary perforations. However, several reports have shown that restenosis and thrombotic occlusion occasionally occur in the stented segment after PTFE-covered stent implantation. A restenosis case after treatment with PTFE-covered stent against saphenous vein graft (SVG) perforation has never been evaluated with optical coherence tomography (OCT) or coronary angioscopy (CAS). This case report presents a 75-year-old man treated with a PTFE-covered stent after he suffered from SVG perforation 6 months ago. He was found to have a focal restenosis of the distal edge of the PTFE-covered stent and ...

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