1. Articles in category: Cardiology

    1-24 of 3395 1 2 3 4 ... 140 141 142 »
    1. ROLE OF INTRA CORONARY IMAGING AND PHYSIOLOGY IN DIAGNOSIS AND MANAGEMENT OF CORONARY ARTERY DISEASE

      ROLE OF INTRA CORONARY IMAGING AND PHYSIOLOGY IN DIAGNOSIS AND MANAGEMENT OF CORONARY ARTERY DISEASE

      Coronary artery disease (CAD) is the leading cause of death in the Indo-Pakistan subcontinent as well as globally. Coronary angiography is considered the gold standard test for the diagnosis of CAD. Therefore, an accurate interpretation of coronary angiography is of paramount importance in decision-making to treat patients with CAD. Coronary angiography has the inherent limitation of being a two-dimensional X-Ray lumenogram of a complex three-dimensional vascular structure. Visual assessment of angiogram can lead to both inter- and intra-observer variability in the assessment of the severity and extent of the disease which can lead to differences in management strategies. This issue ...

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    2. Retinal Loop Vessel Captured with Optical Coherence Tomography-Angiography

      Retinal Loop Vessel Captured with Optical Coherence Tomography-Angiography

      A 50-year-old woman with a history of rheumatoid arthritis and macular hydroxychloroquine toxicity presented for a routine eye examination. An incidental loop vessel of the inferior prepapillary arteriole was readily apparent on examination (Fig 1 A ). Three-dimensional optical coherence tomography (OCT; Avanti, Optovue, Fremont, CA) demonstrated the elevation of this vessel into the vitreous (Fig 1 B ). The vessel was also captured on OCT-angiography (Fig 1 C ) with segmentation of the superficial retina and vitreous interface demonstrated by the B-scan image (inset). Retinal loop vessels are a common incidental finding on ophthalmic examination, but they can also be associated with ...

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    3. Optical coherence tomography improves the results of balloon pulmonary angioplasty in inoperable chronic thrombo-embolic pulmonary hypertension

      Optical coherence tomography improves the results of balloon pulmonary angioplasty in inoperable chronic thrombo-embolic pulmonary hypertension

      A 71-year-old woman with non-operable, peripheral type chronic thrombo-embolic pulmonary hypertension (CTEPH) and with World Health Organisation (WHO) class III dyspnoea was admitted to our department for balloon pulmonary angioplasty (BPA). Right heart catheterisation confirmed pulmonary hypertension (mean pulmonary artery pressure (mPAP) 37 mm Hg, mean right atrial pressure (mRAP) 6 mm Hg, pulmonary capillary wedge pressure (PCWP) 13 mm Hg, pulmonary vascular resistance (PVR) 214 dyn · s · cm–5 and cardiac Index (CI) 4.1 l/min · m2 ) and pulmonary scintigraphy showed multiple segmental perfusion defects (segments 1, 2, 8, 9 in the left lung and 2, 3, 4 ...

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      Mentions: St. Jude Medical
    4. Advanced Imaging of Intracranial Atherosclerosis: Lessons from Interventional Cardiology

      Advanced Imaging of Intracranial Atherosclerosis: Lessons from Interventional Cardiology

      ntracranial atherosclerosis is a major cause of ischemic stroke. Patients with a high degree of stenosis have a significant rate of stroke despite medical therapy. Two randomized trials of stenting have failed to show benefit. Improving peri-procedural complication rates and patient selection may improve stenting outcomes. Fractional flow reserve (FFR), intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are intravascular imaging techniques employed to improve patient selection and stent placement in interventional cardiology. FFR has been shown to improve cardiovascular outcomes when used in patient selection for intervention. Studies of FFR in intracranial atherosclerosis show that the measure may predict ...

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    5. Optical Coherence Tomography and Stent Boost Imaging Guided Bioresorbable Vascular Scaffold Overlapping for Coronary Chronic Total Occlusion Lesion

      Optical Coherence Tomography and Stent Boost Imaging Guided Bioresorbable Vascular Scaffold Overlapping for Coronary Chronic Total Occlusion Lesion

      We report herein the optical coherence tomography (OCT) and stent boost imaging guided bioresorbable vascular scaffold (BVS) implantation for right coronary artery (RCA) chronic total occlusion (CTO) lesion. The gold standard for evaluating BVS expansion after percutaneous coronary intervention is OCT. However, stent boost imaging is a new technique that improves fluoroscopy-based assessments of stent overlapping, and the present case shows clinical usefulness of OCT and stent boost imaging guided ‘overlapping’ BVS implantation via antegrade approach for a typical RCA CTO lesion.

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    6. Optical coherence tomography to guide percutaneous treatment of coronary bifurcation disease

      Optical coherence tomography to guide percutaneous treatment of coronary bifurcation disease

      Introduction : Cardiovascular disease remains the most common cause of death worldwide. Enormous progress in the technology and applicability of percutaneous techniques to treat obstructive coronary heart disease has been made, and the number of percutaneous coronary interventions (PCI) is increasing. Coronary bifurcations are involved in a substantial number of PCIs and despite recent advances, bifurcation PCI remains a challenge in terms of immediate success and long-term outcome. Angiography has a limited capacity for showing important features of the 3 dimensional coronary vessel anatomy, position of stent struts and exact wire positions and is therefore suboptimal for guiding bifurcation PCI. Intracoronary ...

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    7. Low Endothelial Shear Stress Predicts Evolution to High-Risk Coronary Plaque Phenotype in the Future A Serial Optical Coherence Tomography and Computational Fluid Dynamics Stud

      Low Endothelial Shear Stress Predicts Evolution to High-Risk Coronary Plaque Phenotype in the Future A Serial Optical Coherence Tomography and Computational Fluid Dynamics Stud

      Background— Low endothelial shear stress (ESS) is associated with plaque progression and vulnerability. To date, changes in plaque phenotype over time in relation to ESS have not been studied in humans. The aim of this study was to investigate whether local ESS can predict subsequent changes to plaque phenotype using optical coherence tomography. Methods and Results— A total of 25 coronary arteries from 20 patients who underwent baseline and 6-month follow-up optical coherence tomography were included. Arteries were divided into serial 3-mm segments, and plaque characteristics were evaluated in each segment. A total of 145 segments were divided into low-ESS ...

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    8. Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions: First Description

      Optical Coherence Tomography Characterization of Coronary Lithoplasty for Treatment of Calcified Lesions: First Description

      Objectives This study sought to determine the mechanistic effects of a novel balloon-based lithoplasty system on heavily calcified coronary lesions and subsequent stent placement using optical coherence tomography (OCT). Background The Shockwave Coronary Rx Lithoplasty System (Shockwave Medical, Fremont, California) delivers localized, lithotripsy-enhanced disruption of calcium within the target lesion (i.e., lithoplasty) for vessel preparation before stent implantation. Methods We analyzed OCT findings in 31 patients in whom lithoplasty was used to treat severely calcified stenotic coronary lesions. Results After lithoplasty, intraplaque calcium fracture was identified in 43% of lesions, with circumferential multiple fractures noted in >25%. The frequency ...

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    9. Prevalence, Predictors, and Clinical Presentation of a Calcified Nodule as Assessed by Optical Coherence Tomography

      Prevalence, Predictors, and Clinical Presentation of a Calcified Nodule as Assessed by Optical Coherence Tomography

      Objectives This study sought to determine the anatomic characteristics and clinical presentation associated with a calcified nodule (CN) as assessed by optical coherence tomography. Background CN is an unusual but demonstrable cause of acute coronary syndromes (ACS). Methods We studied 889 de novo culprit lesions in 889 patients (48% ACS) who underwent optical coherence tomography before intervention. CN was defined as an eruptive accumulation of nodular calcification (small fractured calcifications). Using quantitative coronary angiography, the change in the angle of the lesion between diastole and systole was measured (angiographic Δ angle). Results CN was seen in 4.2% of all lesions ...

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    10. In Vivo Calcium Detection by Comparing Optical Coherence Tomography, Intravascular Ultrasound, and Angiography

      In Vivo Calcium Detection by Comparing Optical Coherence Tomography, Intravascular Ultrasound, and Angiography

      Objectives The aim of this study was to evaluate optical coherence tomography (OCT) and intravascular ultrasound (IVUS) versus coronary angiography in the assessment of target lesion calcification and its effect on stent expansion. Background IVUS is more sensitive than angiography in the detection of coronary artery calcium, but the relationship among IVUS, OCT, and angiography has not been studied. Methods Overall, 440 lesions (440 patients with stable angina) underwent OCT- and IVUS-guided stent implantation. Coronary calcification was evaluated using: 1) angiography; 2) IVUS (maximum calcium angle and the surface pattern); and 3) OCT (mean and maximum calcium angle, calcium length ...

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    11. Optical coherence tomography in imaging of peripheral pulmonary arteries

      Optical coherence tomography in imaging of peripheral pulmonary arteries

      Background: To establish an optical coherence tomography (OCT)-based method for imaging peripheral pulmonary arteries. Methods: We recruited eight patients (five men; average age, 48±12 years; peripheral pulmonary artery thrombosis, three patients; idiopathic pulmonary hypertension, three patients; interstitial lung disease, two patients) who underwent OCT of the peripheral pulmonary arteries in the First Affiliated Hospital of Guangzhou Medical University and Guangzhou Institute of Respiratory Diseases, between September 2009 and September 2010. OCT was performed using both the conventional OCT imaging method (COI) and the improved pulmonary artery imaging method (IPI). In the IPI, contrast agent was used as an ...

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    12. Optical coherence tomography or intravascular ultrasound to optimize coronary stent implantation

      Optical coherence tomography or intravascular ultrasound to optimize coronary stent implantation

      Optical coherence tomography (OCT) provides high-resolution tomographic images of the coronary arteries. 1 , 2 Spatial resolution of OCT (∼15 μm) is 10 times better than that of intravascular ultrasound (IVUS) (∼150 μm). 1 , 2 However, OCT needs complete blood clearance from the coronary lumen and, therefore, requires the use of contrast media. 1 , 2 OCT is unable to penetrate and see throughout red thrombus (that casts major dorsal shadowing) whereas IVUS is unable to see through heavily calcified plaques. IVUS has a deeper penetration on the vessel wall and, therefore, is better suited to detect...

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    13. Main stem erosion as cause of acute coronary syndrome-short-term optical coherence tomography therapy control

      Main stem erosion as cause of acute coronary syndrome-short-term optical coherence tomography therapy control

      In the Western countries morbidity caused by coronary heart disease is still accelerating and plenty of patients suffer from acute coronary syndrome (ACS). Plaque rupture (PR) and plaque erosion (PE) are important underlying substrates leading to ACS. To differentiate between these underlying substrates optical coherence tomography (OCT) is a suitable imaging modality, which is generally not performed in clinical routine so far. Therefore, coronary stents are placed in most lesions in ACS. We present a case of an ACS patient with PE diagnosed and followed up with OCT, treated without coronary stents but dual platelet therapy (DAPT) alone. In the ...

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    14. Intravascular imaging for characterization of coronary atherosclerosis

      Intravascular imaging for characterization of coronary atherosclerosis

      This short review surveys recent developments in coronary intravascular imaging technologies. We present an outline of the applications of intravascular imaging for guidance of percutaneous coronary interventions and imaging of atherosclerosis, along with emerging clinical evidence for use. Imaging of tissue composition is important for understanding the relation between the presence of a lesion and clinical sequelae. We describe the recent innovations to enable imaging of unstable atherosclerotic plaques, focusing on the emergence of experimental multimodal imaging technology.

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    15. Intracoronary Optical Coherence Tomography-Derived Virtual Fractional Flow Reserve for the Assessment of Coronary Artery Disease

      Intracoronary Optical Coherence Tomography-Derived Virtual Fractional Flow Reserve for the Assessment of Coronary Artery Disease

      Fractional flow reserve (FFR) is widely used for the assessment of myocardial ischemia. Optical coherence tomography (OCT) provides accurate visualization of coronary artery morphology. The aim of this study was to investigate the relationship between FFR and OCT-derived FFR. We retrospectively analyzed 31 lesions (25 left anterior descending arteries, 2 left circumflex arteries, and 4 right coronary arteries) in 31 patients with moderate -severe coronary stenosis, who underwent OCT and FFR measurements simultaneously. OCT-derived FFR was calculated by the original algorithm, which was calculated using following equation based on fluid dynamics: ΔP = FV + SV 2 , where V is the flow ...

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    16. EuroIntervention Optical Coherence Tomography Assessment of New Generation Mesh-Covered Stents after Carotid Stenting

      EuroIntervention Optical Coherence Tomography Assessment of New Generation Mesh-Covered Stents after Carotid Stenting

      As a public service to our readership, this article - peer reviewed by the Editors of EuroIntervention - has been published immediately upon acceptance as it was received. The content of this article is the sole responsibility of the authors, and not that of the journal or its publishers. As a public service to our readership, this article - peer reviewed by the Editors of EuroIntervention - has been published immediately upon acceptance as it was received.

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    17. OCT in Borderline Coronary Artery Lesions (OCT-borderline)

      OCT in Borderline Coronary Artery Lesions (OCT-borderline)

      To find out the safety and efficacy of Optical Coherence Tomography (OCT) in the evaluation and treatment of angiographically borderline coronary artery lesions in a Chinese population, and to compare the effectiveness of OCT versus SPECT in treating such subjects. All patients included in the study will be those that are found to have borderline coronary artery lesions on coronary angiography, in whom we feel that OCT will be useful to assess whether PCI will be of benefit to the treatment of the lesion pathology, or whether optimal medical therapy is the most appropriate treatment modality. Those patients who declined ...

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    18. Optical coherence tomography- vs. intravascular ultrasound-guided percutaneous coronary intervention (Editorial)

      Optical coherence tomography- vs. intravascular ultrasound-guided percutaneous coronary intervention (Editorial)

      Coronary angiography is routinely used to guide percutaneous coronary interventions (PCI) despite obvious limitations of this lumen based approach. Intravascular imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT) represent two techniques that provide essential information on pre-procedural lesion characteristics (i.e., lesion severity, landing zone, and plaque composition) and the result after stent implantation (i.e., stent expansion and eccentricity, strut apposition, lesion coverage, tissue protrusion, and dissections). A total of 11 randomized controlled trials investigated the effect of IVUS-guided PCI with mixed results ( 1 - 11 ). Of note, studies including patients with an increased complexity [i.e., chronic ...

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    19. Impact of Cigarette Smoking and Smoking Cessation on Stent Changes as Determined by Optical Coherence Tomography after Sirolimus Stent Implantation

      Impact of Cigarette Smoking and Smoking Cessation on Stent Changes as Determined by Optical Coherence Tomography after Sirolimus Stent Implantation

      There is debate regarding whether smoking results in microstructural changes after stenting. The aim of this study was to evaluate the microstructural changes after stenting in patients with different smoking statuses. We retrospectively identified 220 sirolimus-eluting stents in 179 patients who underwent follow-up optical coherence tomography examination 12 months after sirolimus stenting. Subjects were classified as current smokers (CS, n=31), smoking cessation ≤1 year (SC1Y, n=36), smoking cessation >1 year (SC>1Y, n=27) and never smokers (NS, n=85). The neointimal hyperplasia (NIH) area was larger in CS than NS (1.04±0.72 mm 2 versus ...

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    20. Optical Coherence Tomography Findings in Patients with Coronary Stent Thrombosis: A Report of the PREvention of Late Stent Thrombosis by an Interdisciplinary Global European Effort (PRESTIGE) Consortium

      Optical Coherence Tomography Findings in Patients with Coronary Stent Thrombosis: A Report of the PREvention of Late Stent Thrombosis by an Interdisciplinary Global European Effort (PRESTIGE) Consortium

      Background —Stent thrombosis (ST) is a serious complication following coronary stenting. Intravascular optical coherence tomography (OCT) may provide insights into mechanistic processes leading to ST. We performed a prospective, multicenter study to evaluate OCT findings in patients with ST. Methods —Consecutive patients presenting with ST were prospectively enrolled in a registry using a centralized telephone registration system. After angiographic confirmation of ST, OCT imaging of the culprit vessel was performed with frequency domain OCT. Clinical data were collected according to a standardized protocol. OCT acquisitions were analyzed at a core laboratory. Dominant and contributing findings were adjudicated by an imaging ...

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    21. Differences in coronary plaque characteristics between patients with and those without peripheral arterial disease

      Differences in coronary plaque characteristics between patients with and those without peripheral arterial disease

      Introduction: Cardiovascular mortality of patients with combined peripheral arterial disease (PAD) and coronary artery disease (CAD) is twice as high as that in those with either disease alone. It is known that patients with PAD undergoing percutaneous coronary intervention have a higher incidence of adverse cardiac events such as myocardial infarction or target vessel revascularization. Objective: In this study, we compared the detailed characteristics of culprit and nonculprit plaques between patients with and those without PAD using optical coherence tomography. Patients and methods: We performed propensity score matching using the following variables: (i) age; (ii) sex; (iii) clinical presentation; (iv ...

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    22. Optical Coherence Tomography Assessment of Glucose Fluctuation Impact on the Neointimal Proliferation After Stent Implantation in a Diabetic/Hypercholesterolemic Swine Model

      Optical Coherence Tomography Assessment of Glucose Fluctuation Impact on the Neointimal Proliferation After Stent Implantation in a Diabetic/Hypercholesterolemic Swine Model

      The aim of the present study was to investigate the effects of glucose fluctuation on neointimal proliferation after stent implantation by optical coherence tomography (OCT) in a diabetic/hypercholesterolemic (DM/HC) swine model. A total of 24 everolimus-eluting stents (EES) were implanted in the right coronary artery (RCA) of the animals using a 20% overstretch ratio. The 24 swines were divided into a DM-high glucose fluctuation (HGF) group (n = 8), DMlow glucose fluctuation (LGF) group (n = 8), and a control group (n = 8). Percent diameter stenosis (%DS), late loss (LL), percent area stenosis (%AS), and neointimal thickness (NIT) were analyzed ...

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    23. Dynamic neointimal pattern after drug-eluting stent implantation defined by optical coherence tomography

      Dynamic neointimal pattern after drug-eluting stent implantation defined by optical coherence tomography

      Objectives: Certain neointimal patterns including neoatherosclerosis (NA) are known to be associated with poor clinical outcome. The prevalence and time course of different neointimal patterns have not been studied systematically. The aim of this study was to investigate the serial changes in neointimal pattern after drug-eluting stent implantation. Patients and methods: A total of 132 patients with 207 drug-eluting stents, who underwent two follow-up optical coherence tomography studies at 6 and 12 months, were included. Neointimal patterns were categorized as homogeneous, heterogeneous, layered, or NA using optical coherence tomography. Quantitative and qualitative analyses of neointima were carried out. Results: Both ...

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