1. Articles in category: Cardiology

    25-48 of 3909 « 1 2 3 4 5 ... 161 162 163 »
    1. Stabilization of High Risk Coronary Plaque on Optical Coherence Tomography and Near-Infrared Spectroscopy by Intensive Lipid-Lowering Therapy With Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitor

      Stabilization of High Risk Coronary Plaque on Optical Coherence Tomography and Near-Infrared Spectroscopy by Intensive Lipid-Lowering Therapy With Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitor

      A 70-year-old woman with hypertension and dyslipidemia underwent drug-eluting stent implantation in the mid-left anterior descending artery (LAD) due to acute coronary syndrome (ACS). Optical coherence tomography (OCT) during the index procedure showed lipid-rich plaque in non-culprit lesions of the proximal LAD and mid-right coronary artery (Figure B,E). Near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) showed plaque with high lipid burden in both sites (Figure C,F). Intensive lipid-lowering therapy with combined strong statin and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor was started after the index procedure. Scheduled 10-month follow-up OCT and NIRS-IVUS showed increase in minimum fibrous cap thickness ...

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    2. 4-D Computational Modeling of Cardiac Outflow Tract Hemodynamics over Looping Developmental Stages in Chicken Embryos

      4-D Computational Modeling of Cardiac Outflow Tract Hemodynamics over Looping Developmental Stages in Chicken Embryos

      Cardiogenesis is interdependent with blood flow within the embryonic system. Recently, a number of studies have begun to elucidate the effects of hemodynamic forces acting upon and within cells as the cardiovascular system begins to develop. Changes in flow are picked up by mechanosensors in endocardial cells exposed to wall shear stress (the tangential force exerted by blood flow) and by myocardial and mesenchymal cells exposed to cyclic strain (deformation). Mechanosensors stimulate a variety of mechanotransduction pathways which elicit functional cellular responses in order to coordinate the structural development of the heart and cardiovascular system. The looping stages of heart ...

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    3. Vascular Stress Analysis During in vivo Intravascular Optical Coherence Tomography Imaging

      Vascular Stress Analysis During in vivo Intravascular Optical Coherence Tomography Imaging

      Intravascular optical coherence tomography (IVOCT) has been employed to clinical coronary imaging for several years. But the influence of flushing and OCT catheter to the blood vessel biomechanical properties have not been studied. In this paper, IVOCT imaging is integrated with the fluid-structure interaction (FSI) simulation to study the blood flow velocity and the stress distribution of a porcine carotid artery during IVOCT imaging. 3D geometric model is built based on the in vivo OCT images, and a hyperelastic model is employed for the material properties of the vascular wall. The blood flow profile and wall stress distributions under various ...

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    4. Vascular Deformation Analysis Based On in vivo Intravascular Optical Coherence Tomography Imaging

      Vascular Deformation Analysis Based On in vivo Intravascular Optical Coherence Tomography Imaging

      Intravascular optical coherence tomography (OCT) has the characteristics of high resolution and fast imaging speed. Continuous images of the same section of the same vessel can reflect the deformation characteristics of the vessel wall under different blood pressure. Digital image processing may be used to segment various structures on the vascular wall and extract the deformation incorporating with biomechanical analysis. Image filtering plays a very important role in image processing. Median filter was used to filter salt and pepper noise in OCT images. Fuzzy function gray processing method was used to suppress irrelevant information and improve image clarity. Dividing point ...

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    5. Automatic Segmentation Methods Based on Machine Learning for Intracoronary Optical Coherence Tomography Image

      Automatic Segmentation Methods Based on Machine Learning for Intracoronary Optical Coherence Tomography Image

      Cardiovascular diseases are closely associated with sudden rupture of atherosclerotic plaques. Previous image modalities such as magnetic resonance imaging (MRI) and intravascular ultrasound (IVUS) were unable to identify vulnerable plaques due to their limited resolution. Optical coherence tomography (OCT) is an advanced intravascular imaging technique developed in recent years which has high resolution approximately 10 microns and could provide more accurate morphology of coronary plaque. In particular, it is now possible to identify plaques with fibrous cap thickness < 65 µm, an accepted threshold value for vulnerable plaques. However, the current segmentation of OCT images are still performed manually by physicians ...

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    6. Probe

      Probe

      A configuration is provided for firmly fixing a transmitting and receiving unit for IVUS and a transmitting and receiving unit for OCT in a probe of an imaging apparatus for diagnosis in which space saving is achieved. The probe includes a cylindrical housing in which an ultrasonic wave transmitting and receiving unit is arranged on a distal side and a light transmitting and receiving unit is arranged on a proximal side. Two signal wires are connected to the ultrasonic wave transmitting and receiving unit and which extend toward the proximal side substantially parallel to each other and which are arranged ...

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    7. Analysis of optical tomography (OCT) images

      Analysis of optical tomography (OCT) images

      A method includes storing three-dimensional image data acquired intravascularly via an optical coherence tomography (OCT) apparatus. The image data is analyzed to compute a probability estimate of stent presence at support positions appearing in an A-line. Stent strut locations are located in three-dimensional space based on the computed probability estimate of stent presence.

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    8. Assessment of strut coverage of everolimus-eluting platinum chromium stent 2 weeks after implantation by optical coherence tomography

      Assessment of strut coverage of everolimus-eluting platinum chromium stent 2 weeks after implantation by optical coherence tomography

      The SYNERGY coronary stent is new-generation drug-eluting stents, which has a thin-strut platinum–chromium platform with everolimus in a biodegradable polymer applied to the abluminal surface. It would be speculated that favorable arterial healing with early strut coverage could be achieved. The present study investigated the degree of strut coverage using optical coherence tomography (OCT) 2 weeks after SYNERGY implantation and clinical factors contributing to strut coverage. A total of 29 patients who underwent staged percutaneous coronary intervention (PCI) to residual lesions 2 weeks after the index PCI with SYNERGY stent implantation were enrolled. At the time of staged PCI ...

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      Mentions: Kenichi Fujii
    9. Qualitative and quantitative neointimal characterization by optical coherence tomography in patients presenting with in-stent restenosis

      Qualitative and quantitative neointimal characterization by optical coherence tomography in patients presenting with in-stent restenosis

      Aims To describe optical coherence tomography (OCT) findings in patients with in-stent restenosis (ISR) and determine predictors of neointimal patterns and neoatherosclerosis. Methods and results Patients undergoing OCT prior to PCI for ISR in three European centres were included. Analyses were performed in a core laboratory. Qualitative and quantitative [gray-scale signal intensity (GSI)] neointima analyses were performed on a per quadrant basis. A total of 107 patients were included. Predominantly homogeneous lesions included 4.5% (0.0–14.3) non-homogeneous quadrants, while predominantly non-homogeneous ones included 28.1% (20.3–37.5) homogeneous quadrants. Mean GSI values differed significantly between ...

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    10. Optical coherence tomography and intravascular ultrasound assessment of the anatomic size and wall thickness of a muscle bridge segment

      Optical coherence tomography and intravascular ultrasound assessment of the anatomic size and wall thickness of a muscle bridge segment

      Objective To use optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in assessing myocardial bridging (MB) vessel size and wall thickness. Background During stent implantation, MB is associated with complications, especially perforation. Methods OCT and IVUS were performed in 56 patients with typical angiographic “milking” from November 2016 to May 2017. The vessel area and thickness in the MB segments and adjacent proximal and distal reference segments were measured and compared with eight normal left anterior descending (LAD) segment (no atherosclerosis in a segment that was at least 20 mm long and that began ~40 mm distal to the LAD ...

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    11. Impact of Accumulated Serum Uric Acid on Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Cardiac Outcomes in Patients with Acute Coronary Syndrome

      Impact of Accumulated Serum Uric Acid on Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Cardiac Outcomes in Patients with Acute Coronary Syndrome

      Objectives: We aimed to examine the relations of very high levels of serum uric acid (sUA) with features of culprit lesion plaque morphology determined by optical coherence tomography (OCT) and adverse clinical outcomes in patients with acute coronary syndrome (ACS). Methods: We retrospectively compared ACS patients according to sUA levels of > 8.0 mg/dL ( n = 169), 7.1–8.0 mg/dL ( n = 163), 6.1–7.0 mg/dL ( n = 259), and ≤6.0 mg/dL ( n = 717). Angiography and OCT findings were analyzed in patients with preintervention OCT and the 4 sUA groups (> 8.0 mg/dL ...

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    12. Optical coherence tomography probe for crossing coronary occlusions

      Optical coherence tomography probe for crossing coronary occlusions

      Systems and methods for controlling a guide with the aid of optical coherence tomography (OCT) data are described. A guide wire includes at least one optical fiber, a flexible substrate, and one or more optical elements. The at least one optical fiber transmits a source beam of radiation. The flexible substrate includes a plurality of waveguides. At least one of the plurality of waveguides transmits one or more beams of radiation away from the guide wire, and at least one of the plurality of waveguides receives one or more beams of scattered radiation that have been reflected or scattered from ...

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    13. Impact of MEditerranean Diet, Inflammation and Microbiome After an Acute Coronary Syndrome

      Impact of MEditerranean Diet, Inflammation and Microbiome After an Acute Coronary Syndrome

      In the MEDIMACS project, we will use a randomized clinical-trial design to address the effects of mediterranean diet on atherosclerotic plaque vulnerability and coronary endothelial function in order to decipher complex interplays between diet, microbiome, immunological and metabolic responses and coronary atherosclerosis. We will focus on patients after an episode of acute coronary syndrome and use state-of-the-art techniques to address atherosclerotic plaque composition and coronary endothelial function. A number of different -omic approaches will be used to address effector pathways. The insights provided by this study will allow identifying potential new dietary, microbiota and/or metabolic targets for the treatment ...

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    14. Association of endothelial function with thin-cap fibroatheroma as assessed by optical coherence tomography in patients with acute coronary syndromes

      Association of endothelial function with thin-cap fibroatheroma as assessed by optical coherence tomography in patients with acute coronary syndromes

      Background: Thinning of the fibrous cap of atherosclerotic plaque is a major component of plaque vulnerability. The high resolution of optical coherence tomography (OCT) provides an accurate measurement of fibrous-cap thickness. Endothelial dysfunction is associated with inflammation and enhanced local expression of matrix metalloproteinases. We investigated the association between endothelial dysfunction and OCT-derived thin-cap fibroatheroma (TCFA) in patients with acute coronary syndromes (ACS). Methods: Seventy-four patients with ACS, who underwent both OCT examinations of the culprit lesion before percutaneous coronary intervention and peripheral endothelial function assessment as assessed by logarithmic value of reactive hyperemia index (Ln_RHI), were enrolled. Age-, sex- ...

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    15. Incidence, factors, and clinical significance of cholesterol crystals in coronary plaque: An optical coherence tomography study

      Incidence, factors, and clinical significance of cholesterol crystals in coronary plaque: An optical coherence tomography study

      Background and aims Intraplaque cholesterol crystal (CC) is recognized as a component of vulnerable plaques. However, the clinical characteristics of patients with CC and the impact of CC on clinical events remain unknown. Methods A total of 340 consecutive patients who underwent optical coherence tomography (OCT) imaging of culprit lesions were included in the study. CC was defined as a thin linear structure with high reflectivity and low signal attenuation on OCT images. The incidence of major adverse cardiovascular events (MACE) at 1-year was compared between patients with CC (CC group) and those without CC (non-CC group). MACE included cardiac ...

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    16. Role of Optical Coherence Tomography in the Diagnosis of Spontaneous Coronary Artery Dissection

      Role of Optical Coherence Tomography in the Diagnosis of Spontaneous Coronary Artery Dissection

      Spontaneous coronary artery dissection (SCAD) is an infrequent and often missed diagnosis among patients with acute coronary syndrome (ACS), especially young healthy females. Unfortunately, SCAD can result in significant morbidity, such as ischemia and infarction. Currently, there has been a surge in the diagnosis of SCAD due to the widespread use of new intracoronary imaging modalities, especially optical coherence tomography (OCT).However, no specific guidelines exist concerning appropriate treatment for SCAD. Moreover, the role of intracoronary imaging with OCT has yet to be fully established. The aim of our review is to provide a comprehensive contemporary update of SCAD; the ...

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    17. Comparison of clinical outcomes between intravascular optical coherence tomography-guided and angiography-guided stent implantation: A meta-analysis of randomized control trials and systematic review

      Comparison of clinical outcomes between intravascular optical coherence tomography-guided and angiography-guided stent implantation: A meta-analysis of randomized control trials and systematic review

      Objective: This systematic review was designed to evaluate the overall efficacy of optical coherence tomography (OCT)-guided implantation versus angiography -guided for percutaneous coronary intervention . Methods: The following electronic databases, such as CENTRAL, PubMed, Cochrane, and EMBASE were searched for systematic reviews to investigate OCT-guided and angiography -guided implantation. We measured the following 7 parameters in each patient: stent thrombosis, cardiovascular death, myocardial infarction, major adverse cardiac events (MACE), target lesion revascularization (TLR), target vessel revascularization (TVR), all-cause death. Results: In all, 11 studies (6 RCTs and 5 observational studies) involving 4026 subjects were included, with 1903 receiving intravascular ultrasound-guided ...

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    18. Intraoperative Endoluminal Quality Control of Saphenous Vein Grafts with Optical Coherence Tomography in Coronary Artery Bypass Grafting

      Intraoperative Endoluminal Quality Control of Saphenous Vein Grafts with Optical Coherence Tomography in Coronary Artery Bypass Grafting

      Introduction: During bypass surgery, saphenous vein grafts (SVGs) remain a widely used conduit. From earlier studies, we know that graft harvesting can lead to endothelial lesions which result in graft failure or poor quality of anastomosis. There is no intraoperative endothelial quality control durable, which enables the assessment of the inner layer of the vein, the inner diameter, and morphologic disorders endoluminal including venous valves. We need a fast, dynamic and direct control for conduit and anastomosis intraoperative. Optical coherence tomography (OCT) with its very high resolution in time and space offers a new possibility to evaluate luminal features and ...

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    19. Dyad Medical Incorporated Receives NIH Grant for Software for OCT Analysis of Vascular Stents

      Dyad Medical Incorporated Receives NIH Grant for Software for OCT Analysis of Vascular Stents

      Dyad Medical Incorporated Receives a 2019 NIH Grant for $1,265,906 for Software for OCT Analysis of Vascular Stents. The principal investigator is Ronny Shalev The program began in 2017 and ends in 2021. Below is a summary of the proposed work. Dyad Medical, Inc. will create intravascular Optical Coherence Tomography (IVOCT) software for clinical, live time determination of stent apposition and for offline analysis of stent implantation. Every year, 100s of thousands of patients in the US are treated with intravascular stents creating an opportunity for both solutions. Although advancements such as drug eluting metal stents hinder restenosis ...

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    20. Intimal lesions detected by optical coherence tomography herald intraluminal progression of cardiac allograft vasculopathy associated with humoral rejection

      Intimal lesions detected by optical coherence tomography herald intraluminal progression of cardiac allograft vasculopathy associated with humoral rejection

      This case illustrates humoral-rejection related cardiac graft vasculopathy (CAV) in a 44-year-old heart transplant recipient. In March 2018, at 3 years post-transplant de novo anti-HLA Class II donor-specific antibodies (DSA: DQ2 + DQ7 >25 000 MFI) were detected. The coronary angiogram (CA) in 2016 had been unsuspicious ( Panels A and B ; left), whereas optical coherence tomography (OCT) had noted a pathologic intima: media thickness ratio of 2:1 ( Panel C , left). The CA in March 2018, however, showed mild Type C CAV lesions in the distal LAD and RCA ( Panels A and B ; middle). Moreover, OCT marked intimal ‘opacity’ ( Panel C ,...

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    21. Establishment of an Automated Algorithm Utilizing Optical Coherence Tomography and Micro-Computed Tomography Imaging to Reconstruct the 3D Deformed Stent Geometry

      Establishment of an Automated Algorithm Utilizing Optical Coherence Tomography and Micro-Computed Tomography Imaging to Reconstruct the 3D Deformed Stent Geometry

      Percutaneous coronary intervention (PCI) is the prevalent treatment for coronary artery disease, with hundreds of thousands of stents implanted annually. Computational studies have demonstrated the role of biomechanics in the failure of vascular stents, but clinical studies is this area are limited by a lack of understanding of the deployed stent geometry, which is required to accurately model and predict the stent induced in vivo biomechanical environment. Herein, we present an automated method to reconstruct the 3D deployed stent configuration through the fusion of optical coherence tomography (OCT) and micro-computed tomography (μCT) imaging data. In an experimental setup, OCT and ...

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    22. Automatic Plaque Detection in IVOCT Pullbacks Using Convolutional Neural Networks

      Automatic Plaque Detection in IVOCT Pullbacks Using Convolutional Neural Networks

      Coronary heart disease is a common cause of death despite being preventable. To treat the underlying plaque deposits in the arterial walls, intravascular optical coherence tomography can be used by experts to detect and characterize the lesions. In clinical routine, hundreds of images are acquired for each patient, which require automatic plaque detection for fast and accurate decision support. So far, automatic approaches rely on classic machine learning methods and deep learning solutions have rarely been studied. Given the success of deep learning methods with other imaging modalities, a thorough understanding of deep learning-based plaque detection for future clinical decision ...

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    23. Stent malapposition, strut coverage and atherothrombotic prolapse after percutaneous coronary interventions in ST-segment elevation myocardial infarction

      Stent malapposition, strut coverage and atherothrombotic prolapse after percutaneous coronary interventions in ST-segment elevation myocardial infarction

      Aims Stent implantation in ST-segment elevation myocardial infarction (STEMI) patients can be challenging and sometimes associated with immediate and long-term suboptimal results. Stent malapposition and strut uncoverage, predictors of stent thrombosis, are frequently detected in STEMI patients at medium/long-term follow-up. Nevertheless, data at a short follow-up are missing. We aimed to assess the extent of stent malapposition and struts coverage in the subacute phase of STEMI after stent implantation in primary or rescue percutaneous coronary intervention (PCI). Methods STEMI patients undergone primary or rescue PCI and scheduled for a second coronary angiography after 2–7 days were enrolled. During ...

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    25-48 of 3909 « 1 2 3 4 5 ... 161 162 163 »
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