1. Articles in category: Cardiology

    25-48 of 4007 « 1 2 3 4 5 ... 165 166 167 »
    1. Effect of drug-coated balloon angioplasty on in-stent restenotic coronary lesions analyzed with optical coherence tomography and serial coronary artery angioscopy

      Effect of drug-coated balloon angioplasty on in-stent restenotic coronary lesions analyzed with optical coherence tomography and serial coronary artery angioscopy

      Drug-coated balloon angioplasty (DCBA) has been recognized for its utility in preventing in-stent re-restenosis (ISR); however, imaging of the neointima immediately after treatment and during follow-up has only been described in a few case reports. This study aimed to determine the efficacy and mechanism of the DCBA using imaging studies both immediately after the DCBA and during the follow-up period. We enrolled 15 consecutive patients who underwent DCBA for in-stent restenosis (ISR). The in-stent neointimal volume was evaluated using optical coherence tomography (OCT), and the in-stent yellow grade was assessed using coronary angioscopy (CAS) immediately after DCBA and during the ...

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    2. Mentice and Siemens Healthineers bring a virtual patient to the angio-suite

      Mentice and Siemens Healthineers bring a virtual patient to the angio-suite

      Siemens Healthineers, a leading medical technology company and Mentice AB, a world leader in simulation solutions for endovascular therapies, announced today the collaboration to fully integrate Mentice’s VIST® Virtual Patient into the Artis icono angiography system from Siemens Healthineers. The VIST® Virtual Patient thus becomes a fully integrated simulation solution for the angio-suite. The global partnership between the two companies will allow interventional radiologists, neuroradiologists, and cardiologists to perform vascular and cardiac interventions on a virtual patient inside the angio-suite. “With an ever-increasing complexity of new interventional procedures, our customers strive to acquire and retain procedural skills while optimizing ...

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      Mentions: Siemens
    3. Refining the management of acute coronary and aortic syndromes

      Refining the management of acute coronary and aortic syndromes

      Stents have revolutionized the treatment of acute coronary syndromes (ACS) 1 . Although drug-coated devices and in particular biolimus-eluting stents with biodegradable polymer are increasingly used in this patient population, their long-term outcomes as compared with bare metal stents in patients with ST-segment elevation myocardial infarction (STEMI) remains unknown. 2 In their article entitled ‘ Five-year clinical outcomes and intracoronary imaging findings of the COMFORTABLE AMI trial: randomized comparison of biodegradable polymer-based biolimus-eluting stents with bare-metal stents in patients with acute ST-segment elevation myocardial infarction ’, 3 Lorenz Räber and colleagues from the Bern University Hospital in Switzerland report the 5-year follow-up ...

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    4. Physiology & Optical Coherence in STEMI

      Physiology & Optical Coherence in STEMI

      The objective of this study is to prospectively evaluate the outcomes of different treatment pathways using a Physiology & Imaging guided PCI in patients with STMEI. A multi-centre study that will prospectively enrol consecutive STEMI patients who don't receive primary PCI within 48 hours after symptom onset because of different reasons. STEMI patients with culprit lesion stenosis between 0%-90% will be included in this study and randomized to angiography-guided, FFR-guided or OCT guided PCI groups.

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    5. Frequency Domain-optical Coherence Tomography of Coronary Arteries Using a Diluted Iodinated Contrast-saline Mix with 5-Fr Guide Catheters

      Frequency Domain-optical Coherence Tomography of Coronary Arteries Using a Diluted Iodinated Contrast-saline Mix with 5-Fr Guide Catheters

      Background Optical coherence tomography (OCT) is currently mostly performed using 6-Fr coronary guide catheters via femoral access. Catheters with such large internal diameters are necessary to deliver viscous contrast media and achieve sufficient red blood cell washout. Currently, undiluted iodinated contrast media (15 mL/injection) is used to clear the coronary arteries of red blood cells (RBCs). This leads to an increase in the total amount of contrast used and often the need for femoral artery access. Our objective is to assess the feasibility of performance of OCT using a 5-Fr guide catheter via radial access using diluted iodinated contrast ...

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    6. Diagnostic accuracy of intracoronary optical coherence tomography-derived fractional flow reserve for assessment of coronary stenosis severity

      Diagnostic accuracy of intracoronary optical coherence tomography-derived fractional flow reserve for assessment of coronary stenosis severity

      ims: A novel method for computation of fractional flow reserve (FFR) from optical coherence tomography (OCT) was developed recently. This study aimed to evaluate the diagnostic accuracy of a new OCT-based FFR (OFR) computational approach, using wire-based FFR as the reference standard. Methods and results: Patients who underwent both OCT and FFR prior to intervention were analysed. The lumen of the interrogated vessel and the ostia of the side branches were automatically delineated and used to compute OFR. Bifurcation fractal laws were applied to correct the change in reference lumen size due to the step-down phenomenon. OFR was compared with ...

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    7. Mean platelet volume and coronary plaque vulnerability: an optical coherence tomography study in patients with non-ST-elevation acute coronary syndrome

      Mean platelet volume and coronary plaque vulnerability: an optical coherence tomography study in patients with non-ST-elevation acute coronary syndrome

      Background The association between mean platelet volume (MPV) and coronary plaque vulnerability in patients with non-ST-elevation ACS (NSTE-ACS) has not been investigated. We performed a retrospective study to evaluate the association between MPV and plaque vulnerability using optical coherence tomography (OCT). Methods Consecutive NSTE-ACS patients who underwent pre-intervention OCT examination in our center were included in this study. Features of coronary plaques in the culprit arteries were classified as rupture, nonrupture with thin-cap fibroatheroma (TCFA), and nonrupture and non-TCFA. ROC analyses were used to determine the predictive efficacy of MPV for plaque rupture, and multivariate logistic regression analysis was performed ...

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    8. Optical Coherence Tomography as an Adjunct During Carotid Artery Stenting for Carotid Atherosclerotic Disease

      Optical Coherence Tomography as an Adjunct During Carotid Artery Stenting for Carotid Atherosclerotic Disease

      Purpose Carotid artery stenting (CAS) has been proven to decrease the risk of stroke in symptomatic patients with moderate/high-grade carotid stenosis; however, there is an increased periprocedural risk of stroke with CAS compared to carotid endarterectomy. The goal of this article is to report the utilization of endovascular optical coherence tomography (OCT) during CAS to aid in the identification of stent malapposition, plaque prolapse, and adjacent residual thrombus that could cause periprocedural stroke. Methods Approval was obtained for endovascular OCT imaging in patients undergoing CAS. Images were obtained before and after stenting. Images were acquired with proximal balloon occlusion ...

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    9. Case Western Reserve University Receives NIH Grant for Computer Assisted Coronary Artery Stent Interventions

      Case Western Reserve University Receives NIH Grant for Computer Assisted Coronary Artery Stent Interventions

      Case Western Reserve University Receives a 2019 NIH Grant for $732,934 for Computer Assisted Coronary Artery Stent Interventions. The principal investigator is David WIlson. The program began in 2018 and ends in 2022. Below is a summary of the proposed work. Computer assisted coronary artery stent interventions Summary When treating highly calcified coronary artery lesions with stents, interventional cardiologists, with limited information, make stressful treatment decisions, which can lead to inadequate stent deployment and poor outcomes, or even rare calamitous events. When calcification is present, a cardiologist must choose to use a normal sized angioplasty balloon; a larger angioplasty ...

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    10. Massachusetts General Hospital Receives NIH Grant for Blood Flow-Based Guidance and Diagnostics Using OCT

      Massachusetts General Hospital Receives NIH Grant for Blood Flow-Based Guidance and Diagnostics Using OCT

      Massachusetts General Hospital Receives a 2019 NIH Grant for $164,400 for Blood Flow-Based Guidance and Diagnostics Using OCT. The principal investigator is Nestor Uribe-Patarroyo. The program began in 2017 and ends in 2021. Below is a summary of the proposed work. Diseases diagnosed with assessment of blood flow account for 29% of deaths in the US and are leading causes of premature morbidity, including visual disorders which carry an economic burden of $35 bil- lion per year. The heart disease with the most impact on public health is coronary artery disease (CAD); more than one million percutaneous coronary interventions ...

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    11. Zero-Contrast Optical Coherence Tomography- and Physiology-Guided Percutaneous Coronary Intervention for Severely Calcified Lesion

      Zero-Contrast Optical Coherence Tomography- and Physiology-Guided Percutaneous Coronary Intervention for Severely Calcified Lesion

      An 80-year-old man with severe kidney dysfunction (estimated glomerular filtration rate, 26 mL/min/1.73 m 2 ) not requiring hemodialysis presented with effort angina. Diagnostic angiography with minimum contrast showed a diffuse lesion in the proximal right coronary artery (RCA; Figure A ). On a later day, optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) with dextran injection was performed. Because multiple cracks were seen in the severely calcified lesion after pre-dilation ( Figure B,C ; Supplementary Movie 1 ), an everolimus-eluting stent (3.25–33 mm) was implanted ( Figure D ). The final OCT showed sufficient luminal expansion (minimum stent area ...

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    12. Optical coherence tomography in in-stent restenosis: A challenge made easier

      Optical coherence tomography in in-stent restenosis: A challenge made easier

      In-stent restenosis (ISR) has been an area of concern for the interventional cardiologists since the era of bare-metal stents (BMS). Although the incidence of ISR is more with BMS as compared to drug-eluting stents, due to the underlying pathophysiological differences, between the two; the latter has a more accelerated course and is difficult to treat. In this case report, we try to address this issue of difficult treatment of ISR and the benefit of using optical coherence tomography in these situations.

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    13. Optical coherence tomography and intravascular ultrasound in diagnosis of coronary intramural hematoma

      Optical coherence tomography and intravascular ultrasound in diagnosis of coronary intramural hematoma

      Intramural hematoma (IMH) tends to occur in a fibrous plaque secondary to balloon dilatation or stent implantation. They are one of the important causes of unexplained deterioration in coronary flows during percutaneous coronary interventions. These IMHs are barely visible on routine coronary angiograms. In an optical coherence tomography (OCT) image, they give rise to a double-lumen appearance with a glistening intimomedial membrane separating the false and the true lumen [Figure 1] .

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    14. Intravascular ultrasound versus optical coherence tomography

      Intravascular ultrasound versus optical coherence tomography

      Technology is continually evolving in ways that we never dreamed of. Forty years ago, ultrasound technology burst into the forefront of medicine and had developed and become a powerful tool for diagnosis and management of cardiac diseases. Now comes the light technology, and hopefully, it will revolutionize the way that medicine is practiced. This light technology is used in medical imaging and is termed optical coherence tomography or OCT for short.

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    15. Title Automated Plaque Characterization of Intravascular Optical Coherence Tomography (IVOCT) Images Using 3D Cryo-image/Histology Validation (Thesis)

      Title Automated Plaque Characterization of Intravascular Optical Coherence Tomography (IVOCT) Images Using 3D Cryo-image/Histology Validation (Thesis)

      Intravascular optical coherence tomography (IVOCT) is a high-resolution (10-20 µm), high-contrast, catheter-based imaging technology that can identify major coronary plaques types (fibrous, lipid, and calcium). However, with >500 images generated in a single 2.5 second scan, automation is needed to facilitate live-time clinical use and off-line assessment of drug therapeutics. Therefore, we developed machine learning approaches for automated plaque characterization using cryo-imaging/histology for validation. However, we confronted a challenge in that IVOCT images are obtained perpendicular to the imaging catheter, while cryo-image volumes display the true 3D vessel geometry at a higher sampling rate. Our solution was to ...

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    16. DNA Damage and Repair in Patients with Coronary Artery Disease: Correlation with Plaque Morphology Using Optical Coherence Tomography (DECODE Study)

      DNA Damage and Repair in Patients with Coronary Artery Disease: Correlation with Plaque Morphology Using Optical Coherence Tomography (DECODE Study)

      Objective The aim of this study was to examine DNA ligase activity and expression of DNA damage response pathway (DDR) genes in patients with stable angina (SA) and non-ST elevation myocardial infarction (NSTEMI) and determine whether they correlate with plaque morphology. Background Patients with coronary artery disease (CAD) have evidence of deoxyribonucleic acid (DNA) damage in peripheral blood mononuclear cells (PBMCs). It is unclear whether this represents excess damage or defective DNA repair activity. Methods DNA ligase activity and the expression of 22 DDR genes were measured in PBMCs of patients (both SA ( n = 47) and NSTEMI ( n = 42)) and ...

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    17. Functional assessment of tandem coronary artery stenosis by intracoronary optical coherence tomography-derived virtual fractional flow reserve: a case series

      Functional assessment of tandem coronary artery stenosis by intracoronary optical coherence tomography-derived virtual fractional flow reserve: a case series

      Background Optical coherence tomography (OCT)-derived fractional flow reserve (FFR)—which may be calculated using fluid dynamics—demonstrated an excellent correlation with the wire-based FFR. However, the applicability of the OCT-derived FFR in the assessment of tandem lesions is currently unclear. Case summary We present two cases of tandem lesions in the mid segment of the left anterior descending (LAD) artery which could have assessed accurately by OCT-derived FFR. The first patient underwent wire-based FFR at the far distal site of LAD, showed a value of 0.66. The OCT-derived FFR was calculated, yielding a value of 0.64. In ...

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    18. Intravascular modality‐guided versus angiography‐guided percutaneous coronary intervention in acute myocardial infarction

      Intravascular modality‐guided versus angiography‐guided percutaneous coronary intervention in acute myocardial infarction

      Background Few data are available for current usage patterns of intravascular modalities such as intravascular ultrasound (IVUS), optical coherence tomography (OCT), and fractional flow reserve (FFR) in acute myocardial infarction (AMI). Moreover, patient and procedural‐based outcomes related to intravascular modality guidance compared to angiography guidance have not been fully investigated yet. Methods We examined 11,731 patients who underwent percutaneous coronary intervention (PCI) from the Korea AMI Registry–National Institute of Health database. Patient‐oriented composite endpoint (POCE) was defined as all‐cause death, any infarction, and any revascularization. Device‐oriented composite endpoint (DOCE) was defined as cardiac death ...

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    19. Intravascular Ultrasound and Optical Coherence Tomography in the Procedural Planning and Execution of Left Main Coronary Artery Percutaneous Coronary Intervention

      Intravascular Ultrasound and Optical Coherence Tomography in the Procedural Planning and Execution of Left Main Coronary Artery Percutaneous Coronary Intervention

      Purpose of Review Left main coronary artery disease (LMCAD) is a frequently encountered, high-risk presentation of atherosclerosis, traditionally managed with surgical bypass grafting. Percutaneous coronary intervention (PCI) for LMCAD is an increasingly attractive option for patients with low to intermediate complexity disease or patients at extremely high or prohibitive surgical risk. The goal of this review is to outline the current indications and guideline recommendations regarding PCI for LMCAD and the role of intracoronary imaging in optimizing these cases. Recent Findings Several recent randomized controlled trials have demonstrated the non-inferiority of PCI in LMCAD compared with CABG. Further, the use ...

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    20. Optical coherence tomography imaging of cardiac substrates

      Optical coherence tomography imaging of cardiac substrates

      Cardiovascular disease is the leading cause of morbidity and mortality in the United States. Knowledge of a patient’s heart structure will help to plan procedures, potentially identifying arrhythmia substrates, critical structures to avoid, detect transplant rejection, and reduce ambiguity when interpreting electrograms and functional measurements. Similarly, basic research of numerous cardiac diseases would greatly benefit from structural imaging at cellular scale. For both applications imaging on the scale of a myocyte is needed, which is approximately 100 µm × 10 µm. The use of optical coherence tomography (OCT) as a tool for characterizing cardiac tissue structure and function has been ...

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    21. Combined intracoronary assessment and treatment of a patient with coronary plaque rapid progression prior to acute myocardial infarction A case report

      Combined intracoronary assessment and treatment of a patient with coronary plaque rapid progression prior to acute myocardial infarction A case report

      Rational: Plaque rapid progression prior to acute myocardial infarction is not a common phenomenon, and its mechanism remains unknown. Intracoronary imaging may help to assess the plaque characteristics and progression. Patient concern: A 37-year-old male patient suffered an acute myocardial infarction (AMI) 1 month after the diagnosis of a mildly stenosed coronary artery. Intracoronary imaging was done to seek the underlying causes and guide further treatment. Diagnosis: Two coronary angiograms in 1 month showed plaque rapid progressing prior to the AMI. Intracoronary optical coherence tomography (OCT) post-AMI showed plaque erosion and heavy burden of thrombus. Intervention: The patient was advised ...

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    22. Optical coherence tomography in varying aetiologies of renal artery stenosis: a case series

      Optical coherence tomography in varying aetiologies of renal artery stenosis: a case series

      Background Renal artery stenosis (RAS) is a common cause of secondary hypertension. The most common aetiology is atherosclerosis; however, other causes like fibromuscular dysplasia (FMD) and Takayasu arteritis (TA) are also frequently encountered. The lesion characteristics and its response to percutaneous intervention depend upon the aetiology of RAS. Optical coherence tomography (OCT) is an excellent imaging modality to analyse coronary lesions during percutaneous coronary interventions. The data regarding the utility of OCT in renal artery imaging is limited, consisting of a few case reports. Case summary We hereby report four cases of RAS, each of different aetiology (atherosclerotic, FMD, post-transplant ...

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      Mentions: Takashi Akasaka
    23. First Report of Edge Vascular Response at 12 Months of Magmaris, A Second-Generation Drug-Eluting Resorbable Magnesium Scaffold, Assessed by Grayscale Intravascular Ultrasound, Virtual Histology, and Optical Coherence Tomography. A Biosolve-II Trial Sub-S

      First Report of Edge Vascular Response at 12 Months of Magmaris, A Second-Generation Drug-Eluting Resorbable Magnesium Scaffold, Assessed by Grayscale Intravascular Ultrasound, Virtual Histology, and Optical Coherence Tomography. A Biosolve-II Trial Sub-S

      Introduction and objective The edge vascular response (EVR) remains unknown in second generation drug-eluting Resorbable Magnesium Scaffold (RMS), such as Magmaris. The aim of the study was to evaluate tissue modifications in the RMS edges over time, assessed by different invasive imaging modalities. Methods The patients treated with the device were assessed by optical coherence tomography (OCT), grayscale intravascular ultrasound (IVUS), and virtual histology IVUS at baseline and 12 months. The EVR study performed a segment- and frame-level analysis of the 5 mm segments proximal and distal of the actual RMS. Results The segment-level grayscale IVUS (n = 10), virtual histology ...

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