1. Articles in category: Cardiology

    1-24 of 2979 1 2 3 4 ... 123 124 125 »
    1. Associations between the Framingham Risk Score and coronary plaque characteristics as assessed by three-vessel optical coherence tomography

      Associations between the Framingham Risk Score and coronary plaque characteristics as assessed by three-vessel optical coherence tomography

      Objectives: This study sought to explore the association between the Framingham Risk Score (FRS) and coronary plaque characteristics assessed by optical coherence tomography (OCT) imaging. Background: Clinical prediction models are useful for identifying high-risk patients. However, coronary events often occur in individuals estimated to be at low risk. Methods: A total of 254 patients with coronary artery disease who underwent three-vessel OCT were divided into tertiles according to FRS. Nonculprit plaque characteristics were compared among the three groups. Results: A total of 663 plaques were analyzed. FRS was significantly associated with calcification [37% (low FRS) vs. 46% (intermediate FRS) vs ...

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    2. Recanalization of Organized Thrombi Demonstrated by Coronary CT Angiography Compared With OCT

      Recanalization of Organized Thrombi Demonstrated by Coronary CT Angiography Compared With OCT

      Recanalization of organized thrombi (ROT) is a rarely recognized disease histologically characterized by older coronary thrombi forming small lumens or endothelium-lined neovascular channels within thrombus. Optical coherence tomography (OCT) is the method of choice for diagnosis and shows signal-rich, high backscattered septa dividing the lumen into multiple small channels that communicate with each other (1) . Computed tomography angiography (CTA) in the longitudinal and cross-sectional planes may demonstrate the ROT by showing multiple small contrast-filled spaces divided by low-attenuation septa in agreement with the OCT findings (Figures Figure 1 and Figure 2 ). Given its rarity, CTA findings of ROT have not ...

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    3. Assessment of Vascular Response after Stent Implantation by Intracoronary Optical Coherence Tomograph

      Assessment of Vascular Response after Stent Implantation by Intracoronary Optical Coherence Tomograph

      Optical coherence tomography (OCT) is a high resolution (10-20 μm) imaging modality that provides microscopic visualization of the coronary artery including vascular response after stent implantation. Compared to conventional intravascular ultrasound, OCT can more clearly identify findings immediately after stent implantation, such as tissue protrusion, stent edge dissection, and incomplete stent strut apposition. Furthermore, OCT allows clinicians to accurately assess the late acquired stent malapposition and strut coverage which could be a surrogate marker for stent thrombosis after drug-eluting stent (DES) implantation. OCT can evaluate not only the extent and amount of neointima but also the tissue characteristics of neointimal ...

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    4. Atherectomy catheters with longitudinally displaceable drive shafts

      Atherectomy catheters with longitudinally displaceable drive shafts

      Described herein are atherectomy catheters, systems and methods that include longitudinally displaceable drive shafts that drive actuation of one or more cutters at the distal end of the catheter. The catheters described herein may include one or more imaging sensors for imaging before, during or after cutting tissue. In some variations the imaging sensor may be rotated around the perimeter of the catheter independently of the rotation of the cutter. Also describe herein are imaging catheters that may be used without cutters.

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    5. Atherectomy catheter drive assemblies

      Atherectomy catheter drive assemblies

      A drive assembly for driving an imaging catheter has a rotatable fiber and a rotatable drive shaft. The drive assembly includes a fiber optic rotating junction and a motor configured to rotate the rotatable portion of the fiber optic rotating junction. In some embodiments, the drive assembly includes a sensor configured to detect a rotational position of the fiber optic rotating junction and a processor configured to obtain the detected rotational position and stop the motor only when the fiber optic rotating junction is in a predetermined rotational position. In some embodiments, the motor includes a hollow shaft through which ...

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      Mentions: Avinger
    6. Effects of daily glucose fluctuations on the healing response to everolimus-eluting stent implantation as assessed using continuous glucose monitoring and optical coherence tomography

      Effects of daily glucose fluctuations on the healing response to everolimus-eluting stent implantation as assessed using continuous glucose monitoring and optical coherence tomography

      Background Several studies have revealed that glucose fluctuations provoke oxidative stress that leads to endothelial cell dysfunction, progression of coronary atherosclerosis, and plaque vulnerability. However, little is known regarding their effect on neointimal growth after stenting in patients with coronary artery disease (CAD). We aimed to investigate the effects of glucose fluctuations on neointimal growth after everolimus-eluting stent (EES) implantation. Methods This study examined 50 patients who underwent a 9-month follow-up using optical coherence tomography (OCT) after EES implantation. Glucose fluctuation was expressed as the mean amplitude of glycemic excursion (MAGE), and was determined via continuous glucose monitoring before stenting ...

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    7. Optimal Imaging Matches Intravascular Ultrasound for Guiding PCI

      Optimal Imaging Matches Intravascular Ultrasound for Guiding PCI

      Using optimal frequency domain imaging (OFDI) to guide percutaneous coronary intervention (PCI) with second-generation drug eluting stents (DES) achieves equivalent clinical and angiographic outcomes to intravascular ultrasound (IVUS)-guided PCI at 12 months. This conclusion was part of results of the OPINION study, reported in a late-breaker session at EuroPCR 2016. IVUS is an imaging modality used to assess lesion morphology during PCI, and several studies have reported that IVUS guidance in PCI might be helpful to improve outcomes. OFDI is the most recently developed optical coherence tomography (OCT) technology that uses light rather than ultrasound to give high-resolution imaging ...

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    8. Optical coherence tomography assessment of in-stent restenosis after percutaneous coronary intervention with two-stent technique in unprotected left main

      Optical coherence tomography assessment of in-stent restenosis after percutaneous coronary intervention with two-stent technique in unprotected left main

      Background Optical coherence tomography (OCT) has contributed to a better understanding of in-stent restenosis (ISR); however, studies evaluating ISR pattern after two-stent technique in unprotected left main (ULM) are lacking. We aim to evaluate the ISR pattern of proximal LAD and LCX after two-stent technique in ULM. Methods We performed OCT in 26 patients with isolated or combined ISR (identified by angiography as >50%) after two stent implantation in the proximal LCX and LAD. Finally, 13 LAD and 22 LCX ISR lesions underwent OCT assessments. OCT analyses were undertaken in the proximal segments of the LAD and LCX. In addition ...

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    9. Complex bifurcation lesions: Randomized comparison of a fully bioresorbable modified t stenting strategy versus bifurcation reconstruction with a dedicated self-expanding stent in combination with bioresorbable scaffolds, an OCT study: Rationale and desig

      Complex bifurcation lesions: Randomized comparison of a fully bioresorbable modified t stenting strategy versus bifurcation reconstruction with a dedicated self-expanding stent in combination with bioresorbable scaffolds, an OCT study: Rationale and desig

      Objective There is an ongoing controversy regarding the efficacy and safety of different percutaneous stenting techniques for coronary bifurcation lesions needing >1 stent. The promise of safe vessel restoration with bioresorbable scaffolds (BRS) may not be transferable to complex double BRS bifurcation techniques, and permanent metallic scaffolding of the bifurcation core may be needed. We identified modified-T stenting as the most promising fully bioresorbable 2-stent strategy in a preclinical setting. The objective of this study is to assess acute performance and compare long-term vessel healing with this strategy, versus an approach combining BRS with a dedicated metallic drug-eluting bifurcation stent ...

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    10. Very, very late stent thrombosis triggered by in-stent neoatherosclerosis: optical coherence tomography findings

      Very, very late stent thrombosis triggered by in-stent neoatherosclerosis: optical coherence tomography findings

      A 64-year-old woman with dyslipidemia, hypertension and type 2 diabetes plus an existing 4.0-mm × 28-mm bare-metal stent (BMS; Multilink Penta, Abbott Vascular, US) deployed over 10 years ago in the right coronary artery (RCA) was admitted to our emergency department with inferolateral and posterior ST-segment elevation acute myocardial infarction. Coronary angiography showed occlusion and thrombotic plaque in the mid RCA at the site of the prior stent implantation. After thrombectomy, optical coherence tomography (OCT) documented the presence of in-stent neoatherosclerosis with lipid-laden plaque, mild calcification, clustered macrophages and a disrupted thin-cap fibroatheroma (TCFA), a pattern similar to the morphology ...

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    11. New device gives doctors better insight into leg artery blockages

      New device gives doctors better insight into leg artery blockages

      Allegheny General Hospital surgeons are using a newly approved medical device to clear blockages in leg arteries as part of a program to speed technological developments to clinical use. The device, called Pantheris, treats peripheral artery disease, in which plaque builds up in arteries and impedes blood flow. The device uses laser fiber attached to a catheter to help surgeons visualize and remove the plaque with more precision than prior treatments allowed, said Dr. Bart Chess, a vascular surgeon at the North Side hospital. “Now we can actually look from within and directly see where the problems are,” Chess said ...

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    12. Processing to determine optical parameters of atherosclerotic disease from phantom and clinical intravascular optical coherence tomography three-dimensional pullbacks

      Processing to determine optical parameters of atherosclerotic disease from phantom and clinical intravascular optical coherence tomography three-dimensional pullbacks

      Analysis of intravascular optical coherence tomography (IVOCT) data has potential for real-time in vivo plaque classification. We developed a processing pipeline on a three-dimensional local region of support for estimation of optical properties of atherosclerotic plaques from coronary artery, IVOCT pullbacks. Using realistic coronary artery disease phantoms, we determined insignificant differences in mean and standard deviation estimates between our pullback analyses and more conventional processing of stationary acquisitions with frame averaging. There was no effect of tissue depth or oblique imaging on pullback parameter estimates. The method’s performance was assessed in comparison with observer-defined standards using clinical pullback data ...

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    13. University of California at Irvine Receives NIH Grant for Phased Resolved ARF optical Coherence Elastography for Intravascular Imaging

      University of California at Irvine Receives NIH Grant for Phased Resolved ARF optical Coherence Elastography for Intravascular Imaging

      University of California at Irvine Receives a 2016 NIH Grant for $721,594 for Phased Resolved ARF optical Coherence Elastography for Intravascular Imaging. The principal investigatoor is Zhonping Chen. The program began in 2014 and ends in 2018. Below is a summary of the proposed work. The broad, long term objective of the proposed grant is to develop an integrated multimodal intravascular imaging system that combines intravascular optical coherence tomography (OCT), ultrasound (US), and phase-resolved acoustic radiation force optical coherence elastography (ARF-OCE). The multimodal intravascular imaging system is unique in that it combines the advantages of the high spatial resolution ...

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    14. Reduction of in-stent thrombus immediately after percutaneous coronary intervention by pretreatment with prasugrel compared with clopidogrel: An optical coherence tomography study

      Reduction of in-stent thrombus immediately after percutaneous coronary intervention by pretreatment with prasugrel compared with clopidogrel: An optical coherence tomography study

      Background Prasugrel is a new-generation thienopyridine antiplatelet agent that provides more consistent and prompt platelet inhibition than clopidogrel. The aim of this study was to compare in-stent thrombus inhibition effect of pretreatment with prasugrel and clopidogrel by using optical coherence tomography (OCT) immediately after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Methods We performed OCT immediately after PCI in 108 ACS patients pretreated with either prasugrel ( n = 51) or clopidogrel ( n = 57). OCT detected thrombus/plaque protrusion in all stented segments. Results Although stent volume (190.4 ± 119.1 mm 3 vs. 189.4 ± 95.8 mm 3 ...

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    15. Thin-cap fibroatheroma and large calcification at the proximal stent edge correlate with a high proportion of uncovered stent struts in the chronic phase

      Thin-cap fibroatheroma and large calcification at the proximal stent edge correlate with a high proportion of uncovered stent struts in the chronic phase

      Objective: A high proportion of uncovered stent struts is associated with late stent thrombosis after drug-eluting stent (DES) implantation, which frequently results in myocardial infarction or death. However, the predictors of uncovered stent struts remain unknown. Here, using optical coherence tomography (OCT), we studied the baseline tissue characteristics of the target coronary segment and evaluated their influence on the neointimal coverage of the strut in the chronic phase. Methods: We analyzed 118 coronary lesions treated with OCT-guided DES implantation. OCT examinations of target lesions were performed before and after DES implantation, and tissue characteristics were evaluated within 5 mm outer ...

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    16. Two Imaging Catheters Unite to Better Detect Dangerous Plaques in Arteries

      Two Imaging Catheters Unite to Better Detect Dangerous Plaques in Arteries

      Collaboration between two National Institute of Biomedical Imaging and Bioengineering (NIBIB)-funded labs has revealed a promising new method for identifying atherosclerotic plaques, the encased deposits in arteries that restrict blood flow and can lead to heart attack or stroke. The technique combines two different types of imaging, allowing for an unprecedented combination of depth and detail. The hybrid technology will provide doctors with a better diagnostic tool for identifying particularly problematic plaques. Heart disease is the leading cause of death worldwide. The majority of deaths from heart disease are caused by the rupture of a plaque lining an artery ...

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    17. Heartbeat OCT and Motion-Free 3D In Vivo Coronary Artery Microscopy

      Heartbeat OCT and Motion-Free 3D In Vivo Coronary Artery Microscopy

      Intravascular optical coherence tomography (IV-OCT) has gained widespread use over the past few years, offering highly detailed images of coronary artery pathologies and interventions (1) . In contrast to the cross-sectional view, longitudinal sections and 3-dimensional (3D) renderings are affected by cardiac motion artifacts and undersampling, complicating interpretation and measurements (2) . We developed Heartbeat OCT, a new OCT method that achieves up to 4,000 frames/s imaging speed for isotropically sampled volume datasets acquired within the diastolic phase of 1 cardiac cycle to restore 3D IV-OCT image fidelity. In this research letter, we present the first in vivo data acquired ...

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    18. Mechanisms of stent thrombosis: insights from optical coherence tomography

      Mechanisms of stent thrombosis: insights from optical coherence tomography

      Although the improvement of coronary stents and medical agents has reduced adverse cardiac events in patients undergoing percutaneous coronary intervention (PCI), stent thrombosis (ST) still remains one of fatal complications of stent therapy. However, the pathophysiology of ST has not been sufficiently established yet, and factors including comorbidities such as diabetes mellitus, stent design, and patients’ response or adherence to antiplatelet therapy have had the association with ST occurrence (1,2). Recently, a large prospective registry study investigating the intravascular morphologies of coronary stents in patients suffering from ST was published (3). Using optical coherence tomography (OCT) that had higher ...

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