1. Articles in category: Cardiology

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    1. Feasibility of the Assessment of Cholesterol Crystals in Human Macrophages Using Micro Optical Coherence Tomography

      Feasibility of the Assessment of Cholesterol Crystals in Human Macrophages Using Micro Optical Coherence Tomography

      The presence of cholesterol crystals is a hallmark of atherosclerosis, but until recently, such crystals have been considered to be passive components of necrotic plaque cores. Recent studies have demonstrated that phagocytosis of cholesterol crystals by macrophages may actively precipitate plaque progression via an inflammatory pathway, emphasizing the need for methods to study the interaction between macrophages and crystalline cholesterol. In this study, we demonstrate the feasibility of detecting cholesterol in macrophages in situ using Micro-Optical Coherence Tomography (µOCT), an imaging modality we have recently developed with 1-µm resolution. Macrophages containing cholesterol crystals frequently demonstrated highly scattering constituents in ...

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    2. Long-Term Outcomes of Neointimal Hyperplasia Without Neoatherosclerosis After Drug-Eluting Stent Implantation

      Long-Term Outcomes of Neointimal Hyperplasia Without Neoatherosclerosis After Drug-Eluting Stent Implantation

      Objectives The aim of this study was to investigate the correlation between in-stent neointimal tissue without features of neoatherosclerosis and long-term clinical outcomes. Background Recent studies have reported differential morphological characteristics of in-stent neointimal tissue assessed by optical coherence tomography (OCT). Methods The study population consisted of 336 patients with 368 drug-eluting stent-treated lesions. Patients received a follow-up OCT examination without any intervention. OCT-based neointima was categorized as homogeneous (n = 227 lesions in 208 patients), heterogeneous (n = 79 lesions in 73 patients), or layered (n = 62 lesions in 55 patients). Major adverse cardiac events (MACE) (a composite of cardiac death ...

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    3. Insights of Optical Coherence Tomography in Renal Artery Fibromuscular Dysplasia in a Patient with Spontaneous Coronary Artery Dissection

      Insights of Optical Coherence Tomography in Renal Artery  Fibromuscular Dysplasia in a Patient with Spontaneous Coronary  Artery Dissection

      A 60-year-old woman was admitted for an acute coronary syndrome. Coronary angiography showed a spontaneous coronary artery dissection (SCAD) in the left anterior descending coronary artery (A). A typical image of fibromuscular dysplasia (FMD) was also observed in the right renal artery (B). Optical coherence tomography (OCT) (C) revealed alternating areas of thickening and thinning of the medial layer, corresponding to the typical image of "string of beads" readily identified in the longitudinal reconstruction of the OCT and also in angiography. A very high prevalence of FMD in non-coronary arteries has been recently reported in patients with DCE. Our findings ...

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      Mentions: Fernando Alfonso
    4. Optimal duration of dual antiplatelet therapy after implantation of bioresorbable vascular scaffolds; lessons from optimal coherence tomography

      Optimal duration of dual antiplatelet therapy after implantation of bioresorbable vascular scaffolds; lessons from optimal coherence tomography

      The current case report demonstrates the interesting finding of incomplete bioresorbable vascular scaffold strut coverage at 18 months post implantation for a chronic total occlusion of the left anterior descending coronary artery. In this case, local differences in shear stress could explain the simultaneous presence of well covered and uncovered BVS strut segments in the same optical coherence tomography frame. Even though current standard practice suggests dual antiplatelet therapy (DAPT) for 12 months after BVS implantation, further studies are required to establish optimal duration of DAPT, particularly when tackling complex lesions.

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    5. Comparison of scanning electron microscopy and optical coherence tomography (OCT) for imaging of coronary bifurcation stents

      Comparison of scanning electron microscopy and optical coherence tomography (OCT) for imaging of coronary bifurcation stents

      Background: Optical coherence tomography (OCT) is a new intracoronary imaging modality that has excellent resolution and image quality and has been used to image neointimal coverage after stent implantation. OCT has been compared to histologic, intravascular ultrasound, and scanning electron microscopy (SEM) studies. However, OCT has not been compared with SEM for imaging stent coverage over side branches. Objective: The aim of this study was to compare OCT with scanning electron microscopy (SEM) in imaging neointimal coverage over stent struts bridging coronary side-branch ostia. Methods: Using a balloon-overstretch in-stent restenosis model, we deployed 38 everolimus-eluting stents across coronary bifurcations in ...

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    6. Very late acquired peri-stent contrast staining and incomplete stent apposition with biodegradable polymer stents: Insight from optical coherence tomography

      Very late acquired peri-stent contrast staining and incomplete stent apposition with biodegradable polymer stents: Insight from optical coherence tomography

      A 68-year-old female with hypertension, dyslipidemia, and impaired glucose tolerance had undergone percutaneous coronary intervention to the left anterior descending artery (LAD) because of exertion angina pectoris in July 2012. At that procedure, severe intramural hematoma had occurred from the proximal to the distal segment of LAD. Therefore, she had been implanted with three biolimus-eluting stents after ballooning at the proximal to distal LAD (Fig. 1A). After then, she had been relieved from angina symptom.

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    7. Optical coherence tomography assessment of a PLGA-polymer with electro-grafting base layer versus a PLA-polymer sirolimus-eluting stent at three-month follow-up: the BuMA-OCT randomised trial

      Optical coherence tomography assessment of a PLGA-polymer with electro-grafting base layer versus a PLA-polymer sirolimus-eluting stent at three-month follow-up: the BuMA-OCT randomised trial

      Aims: To compare stent strut coverage using optical coherence tomography (OCT) at three-month follow-up between a PLGA-polymer with electro-grafting base layer sirolimus-eluting stent (SES) (BuMA) and a PLA-polymer SES (EXCEL). Methods and results: This prospective, single-centre, non-inferiority randomised BuMA-OCT trial enrolled patients with de novo coronary artery lesions, treated with either the BuMA or the EXCEL stent. The study primary endpoint was OCT-evaluated stent strut coverage at three months. Secondary endpoints were neointimal thickness of stent struts, and incomplete stent apposition evaluated with OCT. A total of 80 patients were randomly assigned to receive the BuMA (n=40) or the ...

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    8. Invasive management without stents in selected acute coronary syndrome patients with a large thrombus burden: a prospective study of optical coherence tomography guided treatment decisions

      Invasive management without stents in selected acute coronary syndrome patients with a large thrombus burden: a prospective study of optical coherence tomography guided treatment decisions

      Aims: To assess whether a strategy of invasive management without stents in selected acute coronary syndrome (ACS) patients with a large thrombus burden (LTB) might be feasible and safe. Methods and results: We performed a prospective non-randomised observational cohort study of invasive treatment decisions guided by optical coherence tomography (OCT) in selected ACS patients with LTB. Among 852 ACS patients who had undergone invasive coronary angiography, 101 (11.8%) patients with large thrombus burden on initial angiography underwent thrombectomy to restore TIMI 3 flow without stenting. All of these patients then had repeat angiography with OCT (days 0-2 [Group 1 ...

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      Mentions: Francesco Prati
    9. Computer-Aided Image Analysis Algorithm to Enhance In Vivo Diagnosis of Plaque Erosion by Intravascular Optical Coherence Tomography

      Computer-Aided Image Analysis Algorithm to Enhance In Vivo Diagnosis of Plaque Erosion by Intravascular Optical Coherence Tomography

      Background —Recent reports show that plaque erosion can be diagnosed in vivo using optical coherence tomography (OCT) in patients with acute coronary syndromes (ACS). However, quantitative OCT image criteria for computer-aided diagnosis of plaque erosion have not been established. Methods and Results —A total of 42 patients with ACS caused by plaque erosion were included. Plaque erosion was identified according to the previously established OCT criteria. Both optical properties and morphological features of the focal eroded region as well as erosion-adjacent region were analyzed using a custom designed computer algorithm. Non-eroded fibrous plaques remote from the erosion site within the ...

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    10. Impact of thin-cap fibroatheroma on predicting deteriorated coronary flow during interventional procedures in acute as well as stable coronary syndromes: insights from optical coherence tomography analysis

      Impact of thin-cap fibroatheroma on predicting deteriorated coronary flow during interventional procedures in acute as well as stable coronary syndromes: insights from optical coherence tomography analysis

      The occurrence of deteriorated coronary flow associated with distal embolization during percutaneous coronary intervention results in impaired myocardial perfusion and worsens the clinical prognosis. This study aimed to examine the impact of optical coherence tomography (OCT)-determined coronary plaque morphology on the prediction of deteriorated coronary flow after stent implantation in acute as well as stable coronary syndromes (ACS and SAP, respectively). We studied 126 patients who underwent OCT during stenting for ACS ( n = 44) and SAP ( n = 82) with a de novo lesion. Angiographic deteriorated coronary flow was defined as the deterioration of TIMI flow grade after mechanical dilatation ...

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    11. Intracoronary thrombus on optical coherence tomography in a patient with variant angina; treatment and follow-up

      Intracoronary thrombus on optical coherence tomography in a patient with variant angina; treatment and follow-up

      Variant angina is caused by transient and recurrent coronary spasm leading to episodes of transmural myocardial ischemia with ST segment elevation. Neurological, humoral and local factors have been proposed, and endothelial dysfunction are important predisposing factors 1 . However, intravascular ultrasound studies have shown that atherosclerosis is invariably present at site of focal vasospasm 2 . Intravascular optical coherence tomography (OCT) is a high-resolution imaging method for plaque characterization and detection of intracoronary thrombus 3 .

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      Mentions: Evelyn Regar
    12. Avinger Enrolls First PAD Patient in VISION Global Clinical Trial

      Avinger Enrolls First PAD Patient in VISION Global Clinical Trial

      Avinger Inc., pioneer of the lumivascular approach for treating vascular disease announced today that Dr. John Pigott of Jobst Vascular Institute, Toledo, OH, enrolled the first patient in VISION. VISION is a global IDE clinical trial, approved by the FDA to evaluate Avinger’s PantherisTM catheter for the treatment of Peripheral Artery Disease (PAD). It is estimated that PAD affects 12 million people in the US alone. The PantherisTM system combines directional atherectomy capabilities with real-time intravascular visualization to remove plaque from blocked arteries. The minimally invasive catheter is designed to remove plaque, while avoiding the disruption of normal arterial ...

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    13. Anterior Segment Optical Coherence Tomography Guided Nd:YAG Laser Iridocystotomy in Post Traumatic Iris Cyst

      Anterior Segment Optical Coherence Tomography  Guided Nd:YAG Laser Iridocystotomy in  Post Traumatic Iris Cyst

      A 30 year old female presented with a large post traumatic iris cyst obstructing the visual axis, with a corneal scar inferiorly. Anterior segment optical coherence tomography (AS-OCT) was done to identify the areas of corneal attachment and locate the thinnest area of the cyst. Nd:YAG laser iridocystotomy performed subsequently resulted in immediate deflation of the cyst, excellent restoration of visual acuity and no recurrence till 6 months of follow up. AS-OCT guided laser cystotomy has not been reported previously, to the best of our knowledge.

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    14. In-vivo segmentation and quantification of coronary lesions by optical coherence tomography images for a lesion type definition and stenosis grading

      In-vivo segmentation and quantification of coronary lesions by optical coherence tomography images for a lesion type definition and stenosis grading

      Optical coherence tomography (OCT) is a catheter-based medical imaging technique that produces cross-sectional images of blood vessels. This technique is particularly useful for studying coronary atherosclerosis. In this paper, we present a new framework that allows a segmentation and quantification of OCT images of coronary arteries to define the plaque type and stenosis grading. These analyses are usually carried out on-line on the OCT-workstation where measuring is mainly operator-dependent and mouse-based. The aim of this program is to simplify and improve the processing of OCT images for morphometric investigations and to present a fast procedure to obtain 3D geometrical models ...

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    15. Use of Optical Coherence Tomography (OCT) to Cross Peripheral Arterial Chronic Total Occlusions

      Use of Optical Coherence Tomography (OCT) to Cross Peripheral Arterial Chronic Total Occlusions

      Published on Jul 14, 2014 In this series of XLPAD webinars, Dr. Ian Cawich presents a novel application of optical coherence tomography (OCT) in the use of crossing infrainguinal chronic total occlusions (CTO). Dr. Cawich has trained physicians worldwide on how to use the Ocelot (Avinger, Redwood City, CA) CTO crossing device, and he displays his expertise in this webinar, highlighting the keys to using this device and answering questions from experienced peripheral interventionists. Recorded July 10, 2014.

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      Mentions: Avinger
    16. Peri-strut low-intensity areas in optical coherence tomography correlate with peri-strut inflammation and neointimal proliferation: an in-vivo correlation study in the familial hypercholesterolemic coronary swine model of in-stent restenosis

      Peri-strut low-intensity areas in optical coherence tomography correlate with peri-strut inflammation and neointimal proliferation: an in-vivo correlation study in the familial hypercholesterolemic coronary swine model of in-stent restenosis

      Background: Peri-strut low-intensity area (PLI) is a common imaging finding during the evaluation of in-stent neointima using optical coherence tomography (OCT). We aimed to determine the biological significance of PLI by comparing in-vivo OCT images with the corresponding histological sections obtained from the familial hypercholesterolemic swine model of coronary stenosis. Methods: A total of 26 coronary vessels of nine familial hypercholesterolemic swine were injured with 30% balloon overstretch and then immediately followed by everolimus eluting or bare metal stent placement at 20% overstretch. At 30 days, all stented vessels were subjected to in-vivo OCT analysis and were harvested for histological ...

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    17. Visualization of Complete Regression of Pulmonary Arterial Remodeling on Optical Coherence Tomography in a Patient With Pulmonary Arterial Hypertension

      Visualization of Complete Regression of Pulmonary Arterial Remodeling on Optical Coherence Tomography in a Patient With Pulmonary Arterial Hypertension

      Optical coherence tomography (OCT) is an interferometer- based imaging modality with a high resolution and its usefulness has recently attracted much attention in cardiovascular medicine.1–3 We have recently shown that OCT is useful in the management of pulmonary hypertension, not only for diagnosis but also for evaluation of treatment.4 Here, we show that OCT is also useful to document regression of pulmonary arterial remodeling in response to medical treatment. A 35-year-old woman with an 18-year history of Sjögren syndrome treated with oral prednisolone had a 4-year history of shortness of breath on exertion. On her first ...

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    18. Optical coherence tomography-guided treatment of very late stent thrombosis caused by inaccurate stent deployment in a bifurcation

      Optical coherence tomography-guided treatment of very late stent thrombosis caused by inaccurate stent deployment in a bifurcation

      A 65-year-old man presented at our institution with anterior wall reinfarction, due to very late stent thrombosis, 4 years after primary angioplasty on the first bifurcation of the left anterior descending artery. Using intravascular optical coherence tomography, we identified stent malapposition in the proximal left anterior descending artery, occurring during the first primary angioplasty, as the probable cause of the very late stent thrombosis. Imaging with optical coherence tomography guided our treatment strategy of mechanical and pharmacological thrombectomy, followed by staged stent postdilatation.

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    19. Quantitative Assessment of Tissue Prolapse on Optical Coherence Tomography and its Relation with Underlying Plaque Morphologies and Clinical Outcome in Patients with Elective Stent Implantation

      Quantitative Assessment of Tissue Prolapse on Optical Coherence Tomography and its Relation with Underlying Plaque Morphologies and Clinical Outcome in Patients with Elective Stent Implantation

      Background Tissue prolapse (TP) is sometimes observed after percutaneous coronary intervention (PCI), but its clinical significance remains unclear. We investigated the relationship between TP volume on optical coherence tomography (OCT) after PCI and underlying plaque morphologies, and the impact of TP on clinical outcomes. Methods We investigated 178 native coronary lesions with normal pre-PCI creatine kinase-myocardial band (CK-MB) values (154 lesions with stable angina; 24 with unstable angina). TP was defined as tissue extrusion from stent struts throughout the stented segments. All lesions were divided into tertiles according to TP volume. The differences in plaque morphologies and 9-month clinical outcomes ...

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    20. In search for the Holy Grail: Suggestions for studies to define delta changes to diagnose or exclude acute myocardial infarction: a position paper from the study group on biomarkers of the Acute Cardiovascular Care Association

      In search for the Holy Grail: Suggestions for studies to define delta changes to diagnose or exclude acute myocardial infarction: a position paper from the study group on biomarkers of the Acute Cardiovascular Care Association

      A changing pattern of values, termed a delta value, is an essential component of the diagnosis of acute myocardial infarction (AMI) both with CK-MB and even more so with cardiac troponins (cTn). 1 Given the low index of individuality in studies of biological variation, 2 as well as clinical experience, it is clear that a changing pattern of values (A delta) will be important. 3 ⇓ ⇓ ⇓ – 7 As cTn assays become more sensitive, such a strategy will become more essential as the frequency of chronic elevations will increase. 8 Studies defining the delta that might distinguish AMI from other diseases, including ...

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    21. Quantification of manual thrombus removal in patients with acute coronary syndromes: a study exploiting serial frequency domain-optical coherence tomography

      Quantification of manual thrombus removal in patients with acute coronary syndromes: a study exploiting serial frequency domain-optical coherence tomography

      Aims: Thrombus aspiration is useful in improving myocardial reperfusion in comparison to conventional percutaneous coronary intervention in patients with acute myocardial infarction. Nonetheless, assessment of thrombus aspiration efficacy is lacking. Aim of this study was to quantify by frequency domain optical coherence tomography (OCT) the amount of thrombus removal in patients with acute coronary syndromes undergoing manual thrombus aspiration, correlating it with the actual size of the retrieved material. Methods: Twenty-five consecutive patients with acute coronary syndrome were enrolled. OCT assessment of thrombotic lesions was performed before and after thrombus aspiration and repeated after stent deployment. OCT thrombus assessment was ...

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      Mentions: Francesco Prati
    22. Can Optical Coherence Tomography Findings Be Used as Surrogates for Vessel Healing After Drug-Eluting Stent Implantation?

      Can Optical Coherence Tomography Findings Be Used as Surrogates for Vessel Healing After Drug-Eluting Stent Implantation?

      Drug-eluting stents (DES) inhibit neointimal proliferation and reduce the rates of subsequent target lesion revascularization as compared with bare-metal stents in randomized clinical trials.1,2 However, too much inhibition of neointimal hyperplasia might cause delayed vascular healing with incomplete endothelialization, which has been associated with an increase risk of stent thrombosis.3,4 Therefore, accurate assessment of the neointimal coverage in DES may be critical in prognosticating their safety. Optical coherence tomography (OCT) uses near-infrared light and generate crosssectional images by measuring the echo time delay and intensity of light that is reflected or back-scattered from the tissue. The ...

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      Mentions: Kenichi Fujii
    23. Intravascular Optical Coherence Tomography System with Pressure Monitoring Interface and Accessories

      Intravascular Optical Coherence Tomography System with Pressure Monitoring Interface and Accessories

      An optical coherence tomography system and method with integrated pressure measurement. In one embodiment the system includes an interferometer including: a wavelength swept laser; a source arm in communication with the wavelength swept laser; a reference arm in communication with a reference reflector; a first photodetector having a signal output; a detector arm in communication with the first photodetector, a probe interface; a sample arm in communication with a first optical connector of the probe interface; an acquisition and display system comprising: an A/D converter having a signal input in communication with the first photodetector signal output and a ...

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    1-24 of 2261 1 2 3 4 ... 93 94 95 »
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