1. Articles in category: Cardiology

    25-48 of 3851 « 1 2 3 4 5 ... 159 160 161 »
    1. Covering our tracks – optical coherence tomography to assess vascular healing

      Covering our tracks – optical coherence tomography to assess vascular healing

      Over the better part of two decades, lessons learned from stent failure have led to technical advances that have resulted in current-generation metallic drug-eluting stents (DES) with very low rates of target lesion failure (TLF) and stent thrombosis 1 . Continued efforts have been directed at achieving iterative improvements in the design of DES to enhance adaptive vascular healing following vascular injury. By promoting early strut coverage with minimal neointimal hyperplasia but a functioning endothelial layer, stent thrombosis may be minimised and, by reducing the inflammatory response to the foreign

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    2. Avinger Announces Preliminary Analysis of Results from SCAN Clinical Study

      Avinger Announces Preliminary Analysis of Results from SCAN Clinical Study

      Avinger, Inc. (Nasdaq: AVGR), a leading developer of innovative treatments for peripheral artery disease (PAD), today announced the release of the preliminary analysis of results from its SCAN clinical study, a post-market study comparing optical coherence tomography (OCT) with intravascular ultrasound (IVUS) as a diagnostic imaging tool in the peripheral arteries. Initial analysis of the SCAN data indicated that OCT imaging with Avinger’s Pantheris System showed statistical superiority or equivalence to IVUS on all parameters evaluated. Avinger had previously announced completion of enrollment in the SCAN study in August 2018. During the study, 120 OCT and IVUS matched images ...

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      Mentions: FDA Avinger
    3. Early Follow-Up Optical Coherence Tomographic Findings of Significant Drug-Eluting Stent Malapposition

      Early Follow-Up Optical Coherence Tomographic Findings of Significant Drug-Eluting Stent Malapposition

      Background: Using optical coherence tomography, we evaluated early follow-up findings of significant stent malapposition (SSM) in patients treated with second-generation drug-eluting stent. Methods and Results: From the DETECT-OCT randomized trial (Determination of the Duration of the Dual Antiplatelet Therapy by the Degree of the Coverage of the Struts on Optical Coherence Tomography From the Randomized Comparison Between Everolimus- Versus Biolimus-Eluting Stent), a total of 386 patients (390 lesions) who underwent both postintervention and 3-month follow-up optical coherence tomography examinations were included for the present analysis. SSM was defined as a stent that had a strut with a maximal wall-to-strut distance ...

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    4. Optical coherence tomography guided successful treatment without stent implantation in a patient with non-ST-segment elevation myocardial infarction caused by plaque rapture

      Optical coherence tomography guided successful treatment without stent implantation in a patient with non-ST-segment elevation myocardial infarction caused by plaque rapture

      Rationale: Primary percutaneous coronary intervention (PPCI) with immediate stenting provides effective revascularization. While the risks of no-reflow, stent thrombosis, stent undersizing, and malapposition reduced the benefits in patients with high burden thrombosis. Intravascular imaging, especially optical coherence tomography (OCT), offers potential in optimization of percutaneous coronary intervention. Patient concerns: A 51-year-old male underwent coronary angiography (CAG) due to chest pain with minimal ST-segment depression of the electrocardiogram. Diagnoses: Urgent CAG revealed burden thrombus in the mid left anterior descending coronary artery (LAD) with TIMI grade I distal flow. Interventions: After aspiration thrombectomy, OCT was used to evaluate the target lesion ...

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    5. Changes in Coronary Plaque Composition in Patients With Acute Myocardial Infarction Treated With High-Intensity Statin Therapy (IBIS-4): A Serial Optical Coherence Tomography Study

      Changes in Coronary Plaque Composition in Patients With Acute Myocardial Infarction Treated With High-Intensity Statin Therapy (IBIS-4): A Serial Optical Coherence Tomography Study

      Objectives This study assessed changes in optical coherence tomography (OCT)-defined plaque composition in patients with ST-elevation myocardial infarction (STEMI) receiving high-intensity statin treatment. Background OCT is a high-resolution modality capable of measuring plaque characteristics including fibrous cap thickness (FCT) and macrophage infiltration. There is limited in vivo evidence regarding the effects of statins on OCT-defined coronary atheroma composition and no evidence in the context of STEMI. Methods In the IBIS-4 (Integrated Biomarker Imaging Study-4), 103 patients underwent intravascular ultrasonography and OCT of 2 noninfarct-related coronary arteries in the acute phase of STEMI. Patients were treated with high-dose rosuvastatin for ...

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    6. ‘Full-plastic jacket’ with bioresorbable vascular scaffolds: 5-year optical coherence tomography follow-up

      ‘Full-plastic jacket’ with bioresorbable vascular scaffolds: 5-year optical coherence tomography follow-up

      A 54-year-old male patient with type 2 diabetes mellitus and dyslipidaemia was referred to our catheterization laboratory for unstable angina. Coronary angiography revealed severe diffuse and distal three-vessel coronary artery disease. The patient refused bypass surgery and was therefore scheduled for multivessel percutaneous coronary intervention. Following the PSP (pre-dilatation, vessel sizing, post-dilatation) strategy, three 3.0 × 28 mm everolimus-eluting bioresorbable scaffolds (BRS, Absorb, Abbott Vascular, USA) were implanted in the left anterior descending (LAD) artery, three 3.0 × 28 mm BRS in the right coronary artery (RCA) and one single 2.5 × 28 mm BRS was deployed in the obtuse ...

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    7. Avinger Announces Successful Treatment of 500th Patient with Next-Generation Pantheris Device

      Avinger Announces Successful Treatment of 500th Patient with Next-Generation Pantheris Device

      Avinger, Inc. ( Nasdaq: AVGR ), a leading developer of innovative treatments for peripheral artery disease (PAD), today announced that physicians in 59 sites globally have successfully treated more than 500 patients with the next-generation Pantheris image-guided atherectomy system for the treatment of peripheral artery disease (PAD). The next-generation Pantheris was launched on a limited basis in the U.S. following receipt of 510(k) clearance from the U.S. Food and Drug Administration (FDA) in late May 2018 and features a number of improvements intended to augment the performance and reliability of the product. Importantly, clinical results have remained consistently positive ...

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      Mentions: FDA Avinger
    8. Direct comparison of optical coherence tomography and high-definition 60-MHz intravascular ultrasound imaging of intra-procedural stent thrombosis in a patient with acute coronary syndrome

      Direct comparison of optical coherence tomography and high-definition 60-MHz intravascular ultrasound imaging of intra-procedural stent thrombosis in a patient with acute coronary syndrome

      An 80-year-old man with ST-segment elevation myocardial infraction underwent coronary stenting using an everolimus-eluting stent, which resulted in a good coronary flow with no residual stenosis. However, 10 min after final coronary angiography, the patient complained of chest discomfort and the ECG again showed ST elevation. Repeat coronary angiography revealed multiple contrast filling defects in the stent. High-definition 60-MHz intravascular ultrasound (IVUS) examination showed multiple low echoic structures inside the stent, though its visualization was not clear. We also conducted optical coherence tomography (OCT) for further investigation, which clearly delineated the outline of the thrombus. An additional balloon dilatation was ...

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    9. A novel alignment procedure to assess calcified coronary plaques in histopathology, post-mortem computed tomography angiography and optical coherence tomography

      A novel alignment procedure to assess calcified coronary plaques in histopathology, post-mortem computed tomography angiography and optical coherence tomography

      Purpose Improve mapping and registration of longitudinal view on histopathology vessels in a three-dimensional alignment procedure for postmortem quantitative coronary plaque analyses. This new procedure is applied and results shown using calcified coronary plaque analyses within post-mortem computed tomography angiography (PMCTA), optical coherence tomography (OCT) and the gold standard of histopathology. Results In total, 338 annotated histopathology images were included, 166 PMCTA transversal images and 285 OCT images were aligned in the comparison. The results from the comparison using the alignment procedure showed overall that the calcified plaques seem to be overestimated by PMCTA and underestimated by OCT. Conclusions The ...

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    10. Calcified neoatherosclerosis causing in-stent restenosis: prevalence, predictors, and implications

      Calcified neoatherosclerosis causing in-stent restenosis: prevalence, predictors, and implications

      Background Neoatherosclerosis has emerged as a major cause of in-stent restenosis (ISR). Although this entity has been described as a unique process, optical coherence tomography (OCT) enables depiction of distinct morphologic patterns, including the presence of calcified sheets within the stent. We sought to assess prevalence, predictors, and implications of calcified neoatherosclerosis (cNA) as the cause of ISR. Methods and results From January 2014 to August 2016, 75 consecutive patients with 81 ISR lesions with a clinical indication for revascularization were evaluated by OCT before reintervention. In 13 (16%) lesions, cNA was the predominant pattern of ISR, all of them ...

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      Mentions: Fernando Alfonso
    11. Deep neural networks for A-line-based plaque classification in coronary intravascular optical coherence tomography images

      Deep neural networks for A-line-based plaque classification in coronary intravascular optical coherence tomography images

      We develop neural-network-based methods for classifying plaque types in clinical intravascular optical coherence tomography (IVOCT) images of coronary arteries. A single IVOCT pullback can consist of >500 microscopic-resolution images, creating both a challenge for physician interpretation during an interventional procedure and an opportunity for automated analysis. In the proposed method, we classify each A-line, a datum element that better captures physics and pathophysiology than a voxel, as a fibrous layer followed by calcification (fibrocalcific), a fibrous layer followed by a lipidous deposit (fibrolipidic), or other. For A-line classification, the usefulness of a convolutional neural network (CNN) is compared with that ...

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    12. Avinger Announces Commercial Launch in Australia

      Avinger Announces Commercial Launch in Australia

      Avinger, Inc. ( NASDAQ: AVGR ), a commercial-stage medical device company that designs and develops the first-ever image-guided, catheter-based system that diagnoses and treats patients with peripheral artery disease (PAD), today announced the commercial launch of its Pantheris image-guided atherectomy system in Australia. Avinger recently completed an exclusive distribution agreement with Diverse Devices Pty Ltd. for the sales and marketing of Avinger’s proprietary Lumivascular products in Australia. In addition, the Company announced it has received notice from Australia’s Therapeutic Goods Administration (TGA) that the Pantheris image-guided atherectomy system has been included on the Australian Register of Therapeutic Goods, which permits ...

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      Mentions: Avinger
    13. Different Neoatherosclerosis Patterns in Drug-Eluting- and Bare-Metal Stent Restenosis ― Optical Coherence Tomography Study ―

      Different Neoatherosclerosis Patterns in Drug-Eluting- and Bare-Metal Stent Restenosis ― Optical Coherence Tomography Study ―

      Abstract Background: There are few reports about the differences between drug-eluting stents (DES) and bare metal stents (BMS) in neoatherosclerosis associated with in-stent restenosis (ISR), so we compared the frequency and characteristics of neoatherosclerosis with ISR evaluated by optical coherence tomography (OCT) in the present study. Methods and Results: Between March 2009 and November 2016, 98 consecutive patients with ISR who underwent diagnostic OCT were enrolled: 34 patients had a BMS, 34 had a 1st-generation DES, and 30 had a 2nd-generation DES. Neoatherosclerosis was defined as a lipid neointima (including a thin-cap fibroatheroma [TCFA] neointima, defined as a fibroatheroma with ...

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      Mentions: Osaka University
    14. A Mechanical Approach for Smooth Surface Fitting to Delineate Vessel Walls in Optical Coherence Tomography Images

      A Mechanical Approach for Smooth Surface Fitting to Delineate Vessel Walls in Optical Coherence Tomography Images

      Automated analysis of vascular imaging techniques is limited by the inability to precisely determine arterial borders. Intravascular optical coherence tomography (OCT) offers unprecedented detail of artery wall structure and composition, but does not provide consistent visibility of the outer border of the vessel due to limited penetration depth. Existing interpolation and surface fitting methods prove insufficient to accurately fill the gaps between the irregularly-spaced and sometimes unreliably-identified visible segments of the vessel outer border. This paper describes an intuitive, efficient, and flexible new method of three-dimensional surface fitting and smoothing suitable for this task. An anisotropic linear-elastic mesh is fit ...

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    15. Protocol adaptation of OCT in lower limb arteries revascularisation

      Protocol adaptation of OCT in lower limb arteries revascularisation

      In lower limb arteries, assessment of stent apposition and/or the single opening of the diseased artery remains poor since this relies on 2D angiogram. Extrapolating experience gained with coronary arteries, optical coherence tomography (OCT) could provide 3D reconstructions of the arterial wall and the stent implanted. A modified protocol of OCT acquisition, which usually includes large amount of iodine contrast flush, is presented here in 3 patients with long and complex occlusion of the superficial femoral artery (SFA). Its potential benefits and wider application to improve patient outcomes are discussed.

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    16. Quantification of cerebral vascular perfusion density via optical coherence tomography based on locally adaptive regional growth

      Quantification of cerebral vascular perfusion density via optical coherence tomography based on locally adaptive regional growth

      Optical coherence tomography (OCT) angiography is a noninvasive imaging modality that produces volumetric views of blood flow perfusion in vivo with resolution at capillary level, which has been widely adopted to monitor cerebral perfusion status after stroke in experimental settings. Accurate quantification of cerebral perfusion from OCT angiograms is important for understanding the cerebral vascular pathophysiology and assessing the treatment of ischemic stroke. Quantification of blood vessels from OCT angiography faces some problems; one is uneven backscatter (which causes some blood vessels to be very bright, some very dark), and the other is that the brightness in the same blood ...

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      Mentions: Yi Wang
    17. Incidence of late‐acquired stent malapposition of drug eluting stents with second generation permanent and biodegradable polymer coatings—A prospective, randomized comparison using optical coherence tomography

      Incidence of late‐acquired stent malapposition of drug eluting stents with second generation permanent and biodegradable polymer coatings—A prospective, randomized comparison using optical coherence tomography

      Objectives and Background Polymer coatings of drug‐eluting stents (DES) may induce allergic reactions and inflammation, resulting in late‐acquired stent malapposition (LASM) with the risk of stent thrombosis. This study evaluated, if biodegradable polymer (BP) reduces the incidence of LASM compared to permanent polymer (PP) after treatment with newer generation DES. Methods and Results Fifty patients with 59 lesions were randomized (2:1) to elective treatment with second generation PP‐DES ( n  = 32, 39 stents), either Everolimus‐eluting or Zotarolimus‐eluting stents, or with BP‐DES (Biolimus‐eluting stents [BES]; n  = 18, 20 stents) and underwent optical coherence tomography ...

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    18. Optical coherence tomography for intracranial aneurysms: a new method for assessing the aneurysm structure

      Optical coherence tomography for intracranial aneurysms: a new method for assessing the aneurysm structure

      Background There is a lack of precise methods for predicting the risk of aneurysm rupture. Therefore, prophylactic treatment is used, which leads to unnecessary potential complications. A new modality enabling a more accurate risk assessment is needed. Optical coherence tomography (OCT) is a new-generation imaging technology that has astonishing resolution for vascular imaging. In this study, OCT was used for the evaluation of intracranial aneurysms. Methods In vivo OCT imaging was performed for aneurysms induced in 6 rabbits and in 9 intracranial aneurysm patients. Catheters were cut short to prevent any extra length from damaging aneurysms and tissues. Images of ...

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      Mentions: Fudan University
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