1. Articles in category: Cardiology

    481-504 of 2442 « 1 2 ... 18 19 20 21 22 23 24 ... 100 101 102 »
    1. Pancoronary Plaque Vulnerability in Patients with Acute Coronary Syndrome and Ruptured Culprit Plaque: A Three-Vessel Optical Coherence Tomography Study

      Pancoronary Plaque Vulnerability in Patients with Acute Coronary Syndrome and Ruptured Culprit Plaque: A Three-Vessel Optical Coherence Tomography Study

      Background Recent studies described different clinical and underlying plaque characteristics between patients with and without plaque rupture presenting with acute coronary syndrome (ACS). In light of the systemic nature of atherosclerosis, we hypothesized that non-culprit plaques might also express different morphological features in these two groups of patients. Methods Thirty-eight patients with ACS who underwent 3-vessel optical coherence tomography (OCT) imaging were identified from the Massachusetts General Hospital OCT Registry. Based on culprit plaque morphology, the study population was divided into two groups: patients with plaque rupture at the culprit lesion (Group 1), and patients with non-ruptured plaque at the ...

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    2. New 3-D Vessel Reconstruction Technology to Aid Physicians in Stent Placement Launches in the US

      New 3-D Vessel Reconstruction Technology to Aid Physicians in Stent Placement Launches in the US

      St. Jude Medical, Inc. (NYSE:STJ), a global medical device company, today announced U.S. Food and Drug Administration (FDA) approval and launch of its ILUMIEN ™ OPTIS ™ PCI Optimization ™ System, a new technology designed to provide physicians with a comprehensive disease assessment tool for treating patients with coronary artery disease (CAD). The system will be on display for the first time in the U.S. during the 2013 Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium. The ILUMIEN platform helps physicians better understand which arteries should be treated and how best to treat them. It works by integrating both Fractional Flow Reserve ...

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    3. Optical tractography of the mouse heart using polarization-sensitive optical coherence tomography

      Optical tractography of the mouse heart using polarization-sensitive optical coherence tomography

      We developed a method to image myocardial fiber architecture in the mouse heart using a Jones matrix-based polarization-sensitive optical coherence tomography (PSOCT) system. The “cross-helical” laminar structure of myocardial fibers can be clearly visualized using this technology. The obtained myocardial fiber organization agrees well with existing knowledge acquired using conventional histology and diffusion tensor magnetic resonance imaging

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    4. Quantitative angiography and optical coherence tomography for the functional assessment of nonobstructive coronary stenoses: Comparison with fractional flow reserve

      Quantitative angiography and optical coherence tomography for the functional assessment of nonobstructive coronary stenoses: Comparison with fractional flow reserve

      Background The purpose was to compare 3-dimensional quantitative coronary angiography (3D-QCA) with optical coherence tomography (OCT) for the functional assessment of nonobstructive coronary stenoses, as evaluated by fractional flow reserve (FFR). Methods Fifty-five nonobstructive coronary stenoses (30%-50% diameter stenosis by visual estimation) were assessed in 36 patients using FFR, 2-dimensional QCA (2D-QCA), 3D-QCA, and OCT. Results Angiographic stenosis severity by 2D-QCA was 34% ± 13% diameter stenosis, and minimal lumen diameter (MLD) was 1.77 ± 0.58 mm. Fractional flow reserve values were 0.85 ± 0.10. Correlation coefficients between FFR and MLD or minimal lumen area (MLA) were highly ...

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    5. OCT Versus IVUS: Accuracy Versus Clinical Utility

      OCT Versus IVUS: Accuracy Versus Clinical Utility

      The technology of optical coherence tomography (OCT) has evolved from time-domain to frequency-domain imaging. Time-domain OCT is most often performed using proximal balloon occlusion; as such, dimensions are smaller than measured using intravascular ultrasound (IVUS), presumably due to diminished perfusion pressure. Conversely, frequency-domain OCT does not require proximal balloon occlusion, theoretically resulting in more accurate measurements. With this background, Kubo et al. ( 1 ) in this issue of iJACC , conducted a multicenter study to compare pre-intervention quantitative analysis and post-intervention qualitative analysis among frequency-domain OCT, IVUS, and quantitative coronary angiography (QCA). The mean minimum lumen diameter measured by QCA was smaller ...

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    6. Intravascular Ultrasound Versus Optical Coherence Tomography Guidance

      Intravascular Ultrasound Versus Optical Coherence Tomography Guidance

      IVUS Versus Angiography Guidance for DES PlacementFirst Author/Study (Ref. #), Year (Study)nStudy PopulationStudy DesignIVUS Criteria for Optimal ExpansionCriteria FulfilledMain Outcome MeasuresResultsRoy et al. (2), 20081,768De novo native coronary lesions, restenotic and SVG lesionsSingle-center registryDiscretion of the treating operator—Definite stent thrombosis and MACE at 12 monthsIVUS better (stent thrombosis and TLR)Classen et al. (3), 2011 (MATRIX)1,504 (SES)De novo native coronary and restenotic lesionsMulticenter registryDiscretion of the treating operator—30-day, 1-yr, and 2-yr rates of death/MI, MACE, and stent thrombosisIVUS betterPark et al. (4), 2009682Left main lesionsMulticenter registryDiscretion of the treating operator3-yr mortalityIVUS betterChieffo ...

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    7. A GPS Map for Pulmonary Hypertension: A Review of Imaging Modalities

      A GPS Map for Pulmonary Hypertension: A Review of Imaging Modalities

      Pulmonary hypertension (PH) is a lethal disease with a prevalence of 10-20 % in the general population. The current gold standard diagnosis approach is right heart catheterization, directly detecting pulmonary artery pressure. Imaging for PH patients plays an important role in the etiological diagnosis and evaluation of right heart (RV) function, which is a key determinant of morbidity and mortality in PH patients. Currently, echocardiography is the first-line imaging modality for screening PH and evaluating RV function. CMRI is the gold standard method to evaluate RV function. MDCT, radionuclide ventriculography and pulmonary angiography are mostly used in the differential diagnosis of ...

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    8. Coronary evaginations are associated with positive vessel remodelling and are nearly absent following implantation of newer-generation drug-eluting stents: an optical coherence tomography and intravascular ultrasound study

      Coronary evaginations are associated with positive vessel remodelling and are nearly absent following implantation of newer-generation drug-eluting stents: an optical coherence tomography and intravascular ultrasound study

      Objectives The purpose of this study was to assess the occurrence, predictors, and mechanisms of optical coherence tomography (OCT)-detected coronary evaginations following drug-eluting stent (DES) implantation. Background Angiographic ectasias and aneurysms in stented segments have been associated with a risk of late stent thrombosis. Using OCT, some stented segments show coronary evaginations reminiscent of ectasias. Methods Evaginations were defined as outward bulges in the luminal contour between struts. They were considered major evaginations (MEs) when extending ≥3 mm along the vessel length, with a depth ≥10% of the stent diameter. A total of 228 patients who had sirolimus (SES ...

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    9. Automated localization of cysts in diabetic macular edema using optical coherence tomography images

      Automated localization of cysts in diabetic macular edema using optical coherence tomography images

      This paper presents a novel automated system that localizes cysts in optical coherence tomography (OCT) images of patients with diabetic macular edema (DME). First, in each image, six sub-retinal layers are detected using an iterative high-pass filtering approach. Next, significantly dark regions within the retinal micro-structure are detected as candidate cystoid regions. Each candidate cystoid region is then further analyzed using solidity, mean and maximum pixel value of the negative OCT image as decisive features for estimating the area of cystoid regions. The proposed system achieves 90% correlation between the estimated cystoid area and the manually marked area, and a ...

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    10. Fully automated calcium detection using optical coherence tomography

      Fully automated calcium detection using optical coherence tomography

      Optical Coherence Tomography (OCT) is a new invasive technology for performing high-resolution cross-sectional imaging of the coronary arteries. In OCT images only Calcified plaque (CA) components can be accurately depicted as light penetrates hard tissue. In this work we present an automated method for detecting CA in OCT images. The method is fully automated as no user intervention is needed and includes three steps. In the first step the region between the lumen and the maximum penetration depth of OCT from the lumen border is determined. In the second step the region is classified into 3 clusters using the K-means ...

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    11. Morphological Findings in Typical Variant Angina Presenting as Acute Coronary Syndrome Using Optical Coherence Tomography

      Morphological Findings in Typical Variant Angina Presenting as Acute Coronary Syndrome Using Optical Coherence Tomography

      Background Coronary vasospasm causes variant angina, as well as acute myocardial infarction, ventricular tachycardia, and sudden cardiac death. We evaluated morphological changes due to vasospastic lesions, which may cause acute coronary syndrome (ACS), using a novel technique called optical coherence tomography (OCT) . Methods Twenty patients (40–83 years old, 19 males) with vasospasm-induced ACS who visited the emergency room because of continuous chest pain and displayed transient ST segment elevation in their electrocardiogram were enrolled in the study. None of these patients had significant coronary artery disease and all had positive results in the provocation test. OCT examinations were performed ...

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    12. Optical Coherence Tomographic and Angioscopic Assessments of Arterial Healing in Coronary Artery Perforation After Implantation of Zotarolimus-Eluting Stent

      Optical Coherence Tomographic and Angioscopic Assessments of Arterial Healing in Coronary Artery Perforation After Implantation of Zotarolimus-Eluting Stent

      We report the case of a 69-year-old male whose left circumflex coronary artery was perforated immediately after implantation of an Endeavor zotarolimus-eluting stent (E-ZES). Despite successful hemostasis by long balloon inflation, a coronary pseudoaneurysm remained at the E-ZES-implanted segment. Coronary angiography performed one year after the coronary perforation showed the pseudoaneurysm had disappeared. Simultaneous optical coherence tomography and coronary angioscopy revealed that stent struts of the E-ZES were fully covered with thick neointima. This is the first case report of a relatively rapid healing process for an E-ZES-related coronary pseudoaneurysm.

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    13. Serial Evaluation of Drug-Eluting Stents Using OCT (STRUT-OCT)

      Serial Evaluation of Drug-Eluting Stents Using OCT (STRUT-OCT)

      The study is proposed as a 48-patient randomized-controlled pilot study that will use Optical Coherence Tomography (OCT) imaging to compare stent strut coverage and malapposition of three second-generation Drug Eluting Stents (DES) [Xience EES (Abbott Vascular, Santa Clara, CA), Resolute Integrity ZES (Medtronic, Minneapolis, MN) and Promus Element EES (Boston Scientific, Natick, MA)] at 6 weeks post implantation. Study Hypothesis is that the rates of stent strut coverage and malapposition of the Xience EES, Promus EES and will be similar to each other and improved (higher rates of stent strut coverage and lower rates of malapposition) compared to the Resolute ...

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    14. 2013 ESC guidelines on the management of stable coronary artery disease

      2013 ESC guidelines on the management of stable coronary artery disease

      Guidelines summarize and evaluate all evidence available, at the time of the writing process, on a particular issue with the aim of assisting physicians in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines are not substitutes but are complements for textbooks, and cover the ESC Core Curriculum topics. Guidelines and recommendations should help physicians to make decisions in their daily practice: however, the final decisions concerning an individual patient must be made by the ...

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    15. Disruption of Sarcoendoplasmic Reticulum Calcium ATPase Function in Drosophila Leads to Cardiac Dysfunction

      Disruption of Sarcoendoplasmic Reticulum Calcium ATPase Function in Drosophila Leads to Cardiac Dysfunction

      Abnormal sarcoendoplasmic reticulum Calcium ATPase (SERCA) function has been associated with poor cardiac function in humans. While modifiers of SERCA function have been identified and studied using animal models, further investigation has been limited by the absence of a model system that is amenable to large-scale genetic screens. Drosophila melanogaster is an ideal model system for the investigation of SERCA function due to the significant homology to human SERCA and the availability of versatile genetic screening tools. To further the use of Drosophila as a model for examining the role of SERCA in cardiac function, we examined cardiac function in ...

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    16. The bumpy road to evidence: why many research findings are lost in translation

      The bumpy road to evidence: why many research findings are lost in translation

      We have come a long way When, more than 2500 years ago, Thales of Milet (624–547 BC) claimed that nature was ruled by laws and not by gods, he changed the world. 1 Such a concept allowed for the discovery and mathematical proof of impersonal causation of what, until then, had been a mystery ruled by unpredictable gods. Indeed, ever since then the understanding of nature—today we would call it the natural sciences—has become a major activity of mankind. With this strategy, we have come a long way. Initially, it allowed us to use the position of ...

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    17. Novel use of optical coherence tomography

      Novel use of optical coherence tomography

      Currently in use by interventional cardiology for the intravascular evaluation of coronary arteries, optical coherence tomography (OCT) has proven to be effective in the evaluation of atherosclerotic disease and further therapeutic management. We report a novel use of OCT technology in the case of a 46-year-old man with sudden onset blurred vision and greater than 70% stenosis of his left vertebral artery. To date, no detailed descriptions or case reports have previously been reported regarding the use of neuroendovascular OCT in diseased arteries.

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    18. Natural history of optical coherence tomography-detected non-flow-limiting edge dissections following drug-eluting stent implantation

      Natural history of optical coherence tomography-detected non-flow-limiting edge dissections following drug-eluting stent implantation

      Aims: Angiographic evidence of edge dissections has been associated with a risk of early stent thrombosis. Optical coherence tomography (OCT) is a high-resolution technology detecting a greater number of edge dissections -particularly non-flow-limiting- compared to angiography. Their natural history and clinical implications remain unclear. The objectives of the present study were to assess the morphology, healing response, and clinical outcomes of OCT-detected edge dissections using serial OCT imaging at baseline and at one year following drug-eluting stent (DES) implantation. Methods and results: Edge dissections were defined as disruptions of the luminal surface in the 5 mm segments proximal and distal ...

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    19. Late stent malapposition combined by thrombus resolution after primary stenting in acute myocardial infarction: Optical coherence tomography findings

      Late stent malapposition combined by thrombus resolution after primary stenting in acute myocardial infarction: Optical coherence tomography findings

      The late stent malapposition (LSM) is defined as a separation of the stent struts from the intima of the coronary artery wall which was not present just after implanting the stent. Although drug-eluting stents (DESs) dramatically reduce the in-stent restenosis, several studies have reported a higher frequency of LSM on follow-up intravascular ultrasound (IVUS) examination after DES implantation compared with bare metal stents (1). Several postulated mechanisms of LSM after DES implantation have been suggested, but the mechanisms and clinical impact of LSM have not been clear. We report a case of LSM after primary DES implantation and the optical ...

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    20. Identification of concomitant ruptured plaque and intracoronary thrombus by optical coherence tomography

      Identification of concomitant ruptured plaque and intracoronary thrombus by optical coherence tomography

      A 74-year-old man was admitted with a non-ST segment elevation myocardial infarction with no localising electrocardiogram changes. Coronary angiography showed a severe eccentric stenosis with possible overlying thrombus in a moderate caliber first diagonal artery, and severe stenosis in proximal left anterior descending artery. Optical coherence tomography (OCT) was done to assess whether the stenosis in the first diagonal artery was the culprit stenosis. A ruptured thin cap fibrous atheroma with overlying thrombus was identified in the first diagonal artery, showing an actively developing acute coronary syndrome ( figure ). The lesion was successfully stented, and excellent stent apposition was confirmed on ...

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    21. Increased Thin-Cap Neoatheroma and Periprocedural Myocardial Infarction in Drug-Eluting Stent Restenosis Multimodality Intravascular Imaging of Drug-Eluting and Bare-Metal Stents

      Increased Thin-Cap Neoatheroma and Periprocedural Myocardial Infarction in Drug-Eluting Stent Restenosis  Multimodality Intravascular Imaging of Drug-Eluting and Bare-Metal Stents

      Background— Re-endothelialization is delayed after drug-eluting stent (DES) implantation. In this setting, neointima is more prone to become lipid laden and develop neoatherosclerosis (NA), potentially increasing plaque vulnerability. Methods and Results— Optical coherence tomography and near-infrared spectroscopy with intravascular ultrasound were used to characterize NA in 65 (51 DES and 14 bare-metal stents) consecutive symptomatic patients with in-stent restenosis. Median duration poststent implantation was 33 months. Optical coherence tomography–verified NA was observed in 40 stents with in-stent restenosis (62%), was more prevalent in DES than bare-metal stents (68% versus 36%; P =0.02), and demonstrated significantly higher prevalence of ...

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    22. Intracoronary Optical Coherence Tomography: Experience and Indications for Clinical Use

      Intracoronary Optical Coherence Tomography: Experience and Indications for Clinical Use

      Optical coherence tomography (OCT) is a light based technology that provides very high spatial resolution images. OCT has been initially employed as a research tool to investigate plaque morphology and stent strut coverage. The introduction of frequency domain OCT, allowing fast image acquisition during a prolonged contrast injection via the guiding catheter, has made OCT applicable for guidance of coronary interventions. In this manuscript the various applications of OCT are reviewed, from assessment of plaque vulnerability and severity to characteristics of unstable lesions and thrombus burden to stent optimization and evaluation of late results

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