1. Articles in category: Cardiology

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    1. Female sex impact on culprit plaque at optical coherence tomography analysis in the setting of acute coronary syndrome in OCT-FORMIDABLE registry

      Female sex impact on culprit plaque at optical coherence tomography analysis in the setting of acute coronary syndrome in OCT-FORMIDABLE registry

      Aim: To evaluate sex difference in culprit plaque features at optical coherence tomography (OCT) and major adverse cardiovascular events at follow-up. Patients and methods: We analyse data from the OCT-FORMIDABLE (OCT-Features Of moRphology, coMposItion anD instABility of culprit and pLaquE in acute coronary syndrome [ACS] patients) registry. A total of 285 patients (20%, 58 females) were included. Results: Females with ST segment elevation myocardial infarction showed a longer ruptured area of the plaque (8.6 ± 7.6 vs 4.6 ± 5.4; p = 0.003) and a major necrotic core macrophage infiltration (43 vs 17%; p = 0.017). Females with ...

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    2. Association of Cholesterol Uptake Capacity, a Novel Indicator for HDL Functionality, and Coronary Plaque Properties: An Optical Coherence Tomography-based Observational Study

      Association of Cholesterol Uptake Capacity, a Novel Indicator for HDL Functionality, and Coronary Plaque Properties: An Optical Coherence Tomography-based Observational Study

      Background Cholesterol efflux from atherosclerotic lesion is a key function of high-density lipoprotein (HDL). Recently, we established a simple, high-throughput, cell-free assay to evaluate the capacity of HDL to accept additional cholesterol, which is herein referred to as “cholesterol uptake capacity (CUC)”. Objective To clarify the cross-sectional relationship between CUC and coronary plaque properties. Methods We enrolled 135 patients to measure CUC and assess the morphological features of angiographic stenosis by optical coherence tomography (OCT). We estimated the extent of the lipid-rich plaque by multiplying the mean lipid arc by lipid length (lipid index). The extent of the OCT-detected macrophage ...

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    3. Coronary Dissection or Pseudoaneurysm? An Ambiguity Resolved by Optical Coherence Tomography

      Coronary Dissection or Pseudoaneurysm? An Ambiguity Resolved by Optical Coherence Tomography

      A 48-year-old male presented to us with recent anterior wall myocardial infarction. Coronary angiography revealed 90% tubular stenosis in the proximal left anterior descending (LAD) with an ambiguous saccular lesion just adjacent to it (outside the boundary of the lumen) and connected to it via a narrow neck [Figure 1] a. Coronary angiographic appearance led to a differential diagnosis of (1) coronary pseudoaneurysm (narrow neck of focal outpouching), (2) coronary dissection (? dissection flap), and (3) coronary aneurysm (focal outpouching but narrow neck against it). Figure 1: (a) Coronary angiography showing a 90% stenosis in proximal left anterior descending with an ...

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    4. Comparison of Diagnostic Performance of Intracoronary Optical Coherence Tomography-based and Angiography-based Fractional Flow Reserve for Evaluation of Coronary Stenosis

      Comparison of Diagnostic Performance of Intracoronary Optical Coherence Tomography-based and Angiography-based Fractional Flow Reserve for Evaluation of Coronary Stenosis

      Aims: To evaluate the diagnostic performance of OCT-based optical flow ratio (OFR) in unselected patients and compare it with angiography-based quantitative flow ratio (QFR), using wire-based FFR as reference standard. Methods and results: All patients with OCT and FFR assessment prior to revascularization were analyzed. OFR and QFR were computed in blinded fashion and compared with FFR, all applying same cut-off value of ≤0.80 to define ischemia. Paired comparison between OFR and QFR was performed in 212 vessels from 181 patients. Average FFR was 0.82±0.10 and 40.1% vessels had FFR≤0.80. OFR showed significant ...

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    5. Ventricular Fibrillation During Optical Coherence Tomography/Optical Frequency Domain Imaging ― A Large Single-Center Experience ―

      Ventricular Fibrillation During Optical Coherence Tomography/Optical Frequency Domain Imaging ― A Large Single-Center Experience ―

      Abstract Background: The risks of ventricular fibrillation (Vfib) associated with frequency-domain optical coherence tomography (OCT)/optical frequency domain imaging (OFDI) remain undetermined. Methods and Results: We retrospectively studied the occurrence of Vfib during OCT/OFDI for unselected indications. The frequency of Vfib and patient and procedural characteristics were investigated. A total of 4,467 OCT/OFDI pullback examinations were performed in 1,754 patients (median of 2.0 [2.0–3.0] pullbacks for 1.0 [1.0–1.3] vessels). OCT/OFDI was performed during PCI in 899 patients (51.3%). The contrast injection volume per pullback was 14 ...

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    6. Avinger Enrolls First Patient in IMAGE-BTK Clinical Study Evaluating Safety and Efficacy Endpoints for Pantheris SV

      Avinger Enrolls First Patient in IMAGE-BTK Clinical Study Evaluating Safety and Efficacy Endpoints for Pantheris SV

      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 initiation of the IMAGE-BTK clinical study for its Pantheris SV image-guided atherectomy system. IMAGE-BTK is a post-market trial designed to evaluate safety and efficacy endpoints for Pantheris SV in the treatment of peripheral artery lesions below-the-knee (BTK). Dr. Thomas Davis, an interventional cardiologist at Eastlake Cardiovascular, P.C. in Saint Claire Shores, Michigan, enrolled the first patient in IMAGE-BTK and will serve as the principal investigator of the study. After ...

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      Mentions: Avinger
    7. In-stent restenosis and longitudinal stent deformation: a case report

      In-stent restenosis and longitudinal stent deformation: a case report

      Background Longitudinal stent deformation (LSD) is an infrequent complication of percutaneous coronary intervention (PCI), and it may lead to catastrophic clinical outcomes. However, reports of cardiac adverse events associated with LSD are rare. Case presentation A 55-year-old man with chest pain was treated for a severe left anterior descending branch (LAD)-diagonal 1 (D1) bifurcation lesion by PCI with two stents in the proximal LAD. LSD occurred during the withdrawal of the trapped D1 wire. High-pressure balloon dilatation was performed in the deformed stent, and the end-angiographic appearance was acceptable, but no additional corrective measures were implemented. Ten months later ...

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      Mentions: Bo Yu
    8. Intravascular lithotripsy to treat an underexpanded coronary stent: 4‐Month angiographic and OCT follow‐up

      Intravascular lithotripsy to treat an underexpanded coronary stent: 4‐Month angiographic and OCT follow‐up

      We report the case of a 79‐year‐old man with stable angina who underwent percutaneous coronary intervention to a severe and calcified left circumflex lesion. Despite extensive preparation of the lesion with high‐pressure balloon predilatation and rotablation, the implanted stent was grossly underexpanded and failed to respond to high‐pressure balloon postdilatation. The patient was readmitted 6 weeks later for intravascular lithotripsy that resulted in excellent stent expansion. Coronary angiography with optical coherence tomography 4 months later revealed sustained acute lumen gain with no evidence of stent recoil or in‐stent restenosis.

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    9. Use of optical coherence tomography deemed feasible after first-in-human analysis

      Use of optical coherence tomography deemed feasible after first-in-human analysis

      Results of the first-in-human analysis of acute interactions and healing process after flow diverter implantation using optical coherence tomography (OCT) imaging was presented by Boris Pab ón and Juan Mejia as members of Angioteam, Angiodinamia, Clinica Del Norte, Medellín, Colombia, at the 15 th Congress of the World Federation of Interventional and Therapeutic Neuroradiology (WFITN; 21–24 October 2019, Naples, Italy). Having evaluated three patients at the time of presentation, Pabón said: “The ultimate objective was to evaluate the feasibility and success of OCT technology after deploying dual layer flow diverter stents intracranially and extracranially, and to describe ...

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      Mentions: Gentuity
    10. Correlation of Microvascular Ophthalmic Disease With Macrovascular Coronary Artery Disease in Trinidad

      Correlation of Microvascular Ophthalmic Disease With Macrovascular Coronary Artery Disease in Trinidad

      Coronary artery disease (CAD) is the leading cause of death in Trinidad and Tobago. Early detection and management can help improve morbidity and mortality. Retinal artery microvascular disease has been shown to directly correlate with coronary artery disease. Retinal artery calibre screening via the Optic Coherence Tomography (OCT) will provide a non-invasive method of diagnosing CAD.

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    11. Noninvasive optical coherence tomography imaging correlates with anatomic and physiologic end-organ changes in healthy normotensives with systemic blood pressure variability

      Noninvasive optical coherence tomography imaging correlates with anatomic and physiologic end-organ changes in healthy normotensives with systemic blood pressure variability

      Objective Blood pressure variability (BPV) is considered as a novel risk factor for cardiovascular disease including left ventricular hypertrophy, vascular stiffness, and renal dysfunction. In this study, we aimed to determine the relationship between ambulatory BPV with subclinical organ damage and vascular stiffness parameters in normotensive healthy subjects. Methods A total of 100 healthy subjects over 18 years of age were included in this cross-sectional study. We divided the participants into two groups according to the median value of the SD of mean 24-h blood pressure (BP) (Group 1: SD of mean 24-h BP <10.15 and Group 2: SD ...

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      Mentions: Duke University
    12. Ticagrelor versus clopidogrel in patients undergoing implantation of paclitaxel-eluting stent in the femoropopliteal district: A randomized pilot study using frequency-domain optical coherence tomography

      Ticagrelor versus clopidogrel in patients undergoing implantation of paclitaxel-eluting stent in the femoropopliteal district: A randomized pilot study using frequency-domain optical coherence tomography

      Objectives Aim of this study was to evaluate different response in platelet reactivity and vessel healing using high-resolution frequency-domain optical coherence tomography (FD-OCT) in patients with femoropopliteal artery disease treated with ZILVER PTX drug eluting stents (DES), and randomly assigned to clopidogrel or ticagrelor for 12 months. Background The optimal antithrombotic regimen for long-term management of patients with peripheral artery disease (PAD) after revascularization is poorly defined and often extrapolated from trials performed on patients undergoing percutaneous coronary intervention. Methods In this single center randomized trial 40 patients with femoropopliteal artery disease treated with ZILVER PTX DES stents, were randomized ...

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    13. Measuring coronary artery flow rates using intravascular optical coherence tomography to improve the assessment of percutaneous coronary intervention (Thesis)

      Measuring coronary artery flow rates using intravascular optical coherence tomography to improve the assessment of percutaneous coronary intervention (Thesis)

      In this project, a blood flow quantification technique was developed based on a novel backscattering indicator-dilution approach for intravascular optical coherence tomography (IV-OCT). It achieved the goal of obtaining the flow velocity in a coronary artery of interest by analyzing the backscattering signal from blood after passage of a bolus of Ringer's lactate or another transparent injectate, in parallel to thermodilution coronary flow reserve (CFR). In contrast to thermodilution CFR, the structural OCT image can be used to determine the bolus volume and transit time, as well as used to account for motion and volume change between the two ...

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    14. Optical Coherence Tomography for Coronary Bioresorbable Vascular Scaffold Implantation

      Optical Coherence Tomography for Coronary Bioresorbable Vascular Scaffold Implantation

      Background: We investigated whether optical coherence tomography (OCT) guidance would reduce nonoptimal bioresorbable vascular scaffold (BVS) deployment. Methods: This was a randomized controlled trial. Patients who required percutaneous coronary intervention for ischemic heart disease were recruited from 2 centers in Korea. The enrolled patients were randomly assigned to receive either OCT-guided BVS (Absorb; Abbott Vascular) implantation or angiography-guided BVS implantation using an optimized technique. The primary outcome was nonoptimal deployment, which was a composite outcome of the following parameters assessed by OCT: a minimal scaffold area <5 mm 2 , residual area stenosis >20%, incomplete apposition of the scaffold struts >5 ...

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    15. Extracorporeal Photopheresis and Early Cardiac Graft Vasculopathy

      Extracorporeal Photopheresis and Early Cardiac Graft Vasculopathy

      Heart transplantation is a golden standard for the treatment of terminal heart failure. The major cause of death in late posttransplant period is cardiac allograft vasculopathy (CAV). This posttransplant complication develops slowly over several years, and when diagnosed either by conventional coronary angiography or due to graft failure, it is often too advanced and difficult to treat since it is diffuse coronary artery disease. Therefore, early prevention of CAV is a subject of major interest in the transplant cardiology. Since CAV is associated with immune factors, immunomodulatory therapeutic options, like extracorporeal photopheresis are lately being investigated. Unlike conventional coronary angiography ...

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    16. Randomized Comparison Between Everolimus-Eluting Bioresorbable Scaffold and Metallic Stent Multimodality Imaging Through 3 Years

      Randomized Comparison Between Everolimus-Eluting Bioresorbable Scaffold and Metallic Stent Multimodality Imaging Through 3 Years

      Objectives The aim of this study was to investigate the vascular responses and fates of the scaffold after bioresorbable vascular scaffold (BVS) implantation using multimodality imaging. Background Serial comprehensive image assessments after BVS implantation in the context of a randomized trial have not yet been reported. Methods In the ABSORB Japan trial, 400 patients were randomized to a BVS (n = 266) or a cobalt-chromium everolimus-eluting stent (n = 134). Through 3 years, patients underwent serial angiography and intravascular ultrasound or optical coherence tomography (OCT). Results Luminal dimension at 3 years was consistently smaller with the BVS than with the cobalt-chromium everolimus-eluting ...

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    17. Quantitative flow reserve virtual stenting and post stenting measurements to predict fractional flow reserve post stenting from the DOCTORS study population

      Quantitative flow reserve virtual stenting and post stenting measurements to predict fractional flow reserve post stenting from the DOCTORS study population

      Background Quantitative flow reserve (QFR) is a computation of fractional flow reserve (FFR) based on angiography without use of a pressure wire. The ability to predict post-PCI FFR using pre-PCI QFR analysis with a virtual PCI and the correlation between post-PCI QFR compared to post-PCI FFR remains unknown. We sought to evaluate the correlations of pre-PCI QFR analysis with virtual PCI called residual QFR and post-PCI QFR compared to post-PCI FFR. Methods From the DOCTORS (Does Optical Coherence Tomography Optimize Results of Stenting) study population; we blindly analyzed residual QFR and post-PCI QFR from angiographies and compared them to post-PCI ...

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    18. Cut-off value of strut-vessel distance for the resolution of acute incomplete stent apposition in the early phase using serial optical coherence tomography after cobalt-chromium everolimus-eluting stent implantation

      Cut-off value of strut-vessel distance for the resolution of acute incomplete stent apposition in the early phase using serial optical coherence tomography after cobalt-chromium everolimus-eluting stent implantation

      Objective The purpose of this study was to identify a cut-off value to predict the resolution of incomplete-stent-apposition (ISA) after cobalt-chromium everolimus-eluting stent (CoCr-EES) implantation at early follow-up. Background To date, appropriate stent apposition at the acute period using intracoronary imaging has been recommended because persistent ISA is considered to be a risk factor for stent thrombosis. We examined the indices for resolving acute ISA. In particular, we determined the cut-off value for strut vessel distance (SV-distance) as visualized by optical coherence tomography (OCT) at 8 months after CoCr-EES implantation. However, the cut-off value of SV-distance for the earlier resolution ...

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    19. Characterization of the calcium component of vulnerable coronary plaque in patients with NSTEMI: Prospective comparison between coronary CT and optical coherence tomography

      Characterization of the calcium component of vulnerable coronary plaque in patients with NSTEMI: Prospective comparison between coronary CT and optical coherence tomography

      Background Acute Coronary Syndrome (ACS) remains a leading cause of mortality worldwide. Several studies have demonstrated a role for Coronary Computed Tomographic Angiography (CCTA) to predict the vulnerability of the plaque. Recent works suggest a role for calcification in this vulnerability. Purpose To assess if the CCTA study of the calcium component of plaques can predict plaque vulnerability defined by intracoronary OCT analysis in patients with non-ST elevation myocardial infarction (NSTEMI). Methods Prospective study of consecutive patients with NSTEMI and elevated high-sensitivity cardiac troponin I level > 50 ng/ml from January to October 2018. CCTA was performed before coronary angiography ...

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    20. Avinger Announces Successful First Procedures in Europe with Ocelaris Chronic Total Occlusion (CTO) Image-Guided Crossing Device

      Avinger Announces Successful First Procedures in Europe with Ocelaris Chronic Total Occlusion (CTO) Image-Guided Crossing Device

      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 first clinical experiences with the Ocelaris next-generation CTO crossing system utilizing Avinger's proprietary image-guided technology platform. Dr. Arne Schwindt, a vascular surgeon at St. Franziskus Hospital Münster, and Dr. Michael Lichtenberg, an interventional angiologist at Klinikum Hochsauerland, Arnsberg, used Ocelaris in multiple procedures across a variety of different lesion types and anatomy both above and below the knee. Avinger plans to continue supporting first cases with Ocelaris at ...

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    21. Absorb bioresorbable vascular scaffold outcomes following implantation with routine intravascular imaging guidance

      Absorb bioresorbable vascular scaffold outcomes following implantation with routine intravascular imaging guidance

      Objectives We sought to describe the outcomes of BVS use from a single‐center experience in which scaffold implantation was guided by intravascular imaging (ultrasound and/or optical coherence tomography) to identify and treat mechanical factors potentially related to BVS failure. Background The Absorb bioresorbable vascular scaffold (BVS) has been associated with an unexpectedly high incidence of thrombosis. Methods Between 11/2014 and 10/2016, 100 patients were treated with BVS. Intravascular imaging assessment before and after BVS implantation was performed in all cases. Results Mean age was 58.1 years; 88% were male, 31% had diabetes, and 28% presented ...

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    22. Massachusetts General Hospital Receives NIH Grant for Unique Value of Real-Time Shear Stress To Enhance Coronary Disease Management

      Massachusetts General Hospital Receives NIH Grant for Unique Value of Real-Time Shear Stress To Enhance Coronary Disease Management

      Massachusetts General Hospital Receives a 2020 NIH Grant for $771,279 for Unique Value of Real-Time Shear Stress To Enhance Coronary Disease Management. The principal investigator is Guillermo Tearney. Below is a summary of the proposed work. Management of CAD is hindered by our inability to investigate fundamental pathobiologic processes that lead to individual coronary plaque progression, destabilization, and adverse clinical events. A critical mechanism responsible for plaque behavior is local endothelial shear stress (ESS), the frictional force of blood flowing across the endothelium, which is governed by the artery’s detailed local geometry. Focal regions of low ESS drive ...

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