1. Articles in category: Cardiology

    481-504 of 3260 « 1 2 ... 18 19 20 21 22 23 24 ... 134 135 136 »
    1. Multi-modal optical imaging characterization of atherosclerotic plaques

      Multi-modal optical imaging characterization of atherosclerotic plaques

      We combined cross-polarization optical coherence tomography (CP OCT) and non-linear microscopy based on second harmonic generation (SHG) and two-photon-excited fluorescence (2PEF) to assess collagen and elastin fibers and other vascular structures in the development of atherosclerosis, including identification of vulnerable plaques, which remains an important clinical problem and imaging application. CP OCT's ability to visualize tissue birefringence and cross-scattering adds new information about the microstructure and composition of the plaque. However its interpretation can be ambiguous, because backscattering contrast may have a similar appearance to the birefringence related fringes. Our results represent a step towards minimally invasive characterization and ...

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    2. Association between fractional flow reserve and coronary plaque characteristics assessed by optical coherence tomography

      Association between fractional flow reserve and coronary plaque characteristics assessed by optical coherence tomography

      Background The assessment of fractional flow reserve (FFR) in coronary lesions determines the strategy of percutaneous coronary intervention. However, the association between FFR and characteristics of the underlying coronary plaque has not been sufficiently investigated. Methods A total of 110 coronary lesions in 106 patients were evaluated using both FFR and optical coherence tomography (OCT). Coronary plaques were classified into fibrous, fibrocalcific, or fibroatheroma according to OCT evaluation at the site of minimal lumen area. Plaque microstructures such as cap thickness, macrophage accumulation, intimal vasculature, or cholesterol crystals were also evaluated. Results Lesions with FFR ≤ 0.8 showed a higher ...

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    3. Rotational distortion correction in endoscopic optical coherence tomography based on speckle decorrelation

      Rotational distortion correction in endoscopic optical coherence tomography based on speckle decorrelation

      We present a new technique for the correction of nonuniform rotation distortion in catheter-based optical coherence tomography (OCT), based on the statistics of speckle between A-lines using intensity-based dynamic light scattering. This technique does not rely on tissue features and can be performed on single frames of data, thereby enabling real-time image correction. We demonstrate its suitability in a gastrointestinal (GI) balloon-catheter OCT system, determining the actual rotational speed with high temporal resolution, and present corrected cross-sectional and en face views showing significant enhancement of image quality.

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    4. Novel sirolimus-eluting stent Prolim® with a biodegradable polymer in the all-comers population: one year clinical results with quantitative coronary angiography and optical coherence tomography analysis

      Novel sirolimus-eluting stent Prolim® with a biodegradable polymer in the all-comers population: one year clinical results with quantitative coronary angiography and optical coherence tomography analysis

      Background The aim of this study was to assess the safety and the efficacy of the novel sirolimus-eluting Prolim® stent with a biodegradable polymer in the all-comers population. Methods We prospectively enrolled all patients with stable coronary artery disease or acute coronary syndrome treated with Prolim® stent between January and December 2013 in two interventional cardiology centers in Poland. Angiographic control was planned at 12 months, in which 15 % of patients (randomly chosen) underwent optical coherence tomography imaging. The primary end-point was the cumulative rate of cardiac death, myocardial infarction, and target lesion revascularization at 12 months. Results There were ...

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    5. Comparison of Stent Expansion Guided by Optical Coherence Tomography Versus Intravascular Ultrasound : The ILUMIEN II Study (Observational Study of Optical Coherence Tomography [OCT] in Patients Undergoing Fractional Flow Reserve [FFR] and Percutaneous Co

      Comparison of Stent Expansion Guided by Optical Coherence Tomography Versus Intravascular Ultrasound : The ILUMIEN II Study (Observational Study of Optical Coherence Tomography [OCT] in Patients Undergoing Fractional Flow Reserve [FFR] and Percutaneous Co

      Background The most important predictor of adverse outcomes (thrombosis and restenosis) after stent implantation with IVUS guidance is the degree of stent expansion achieved. Methods We compared the relative degree of stent expansion (defined as the minimal stent area divided by the mean of the proximal and distal reference lumen areas) after OCT-guided stenting in patients in the ILUMIEN (Observational Study of Optical Coherence Tomography [OCT] in Patients Undergoing Fractional Flow Reserve [FFR] and Percutaneous Coronary Intervention) (N = 354) and IVUS-guided stenting in patients in the ADAPT-DES (Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents) study (N = 586). Stent expansion ...

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    6. Reproducibility of serial optical coherence tomography measurements for lumen area and plaque components in humans (The CLI-VAR [Centro per la Lotta Contro l’Infarto-variability] II study)

      Reproducibility of serial optical coherence tomography measurements for lumen area and plaque components in humans (The CLI-VAR [Centro per la Lotta Contro l’Infarto-variability] II study)

      Frequency-domain optical coherence tomography (FD-OCT) is a promising intracoronary imaging technique to study atherosclerosis. Indeed, its unprecedented spatial resolution allows the assessment of fibrous cap thickness, lipid pool and features of plaque vulnerability. Aim of this study was to determine the reproducibility of the in vivo FD-OCT measurements of lumen area and plaque components in serial studies. Twenty-six patients undergoing FD-OCT assessment of intermediate lesion during coronary angiography were included in this study. FD-OCT pullbacks were acquired twice from the same coronary segment at interval of 5 min without additional intervention and analyzed off-line at an independent imaging core laboratory ...

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      Mentions: Francesco Prati
    7. Disappearing stent but persisting problems? Optical coherence tomography assessment of intra-scaffold restenosis

      Disappearing stent but persisting problems? Optical coherence tomography assessment of intra-scaffold restenosis

      A 72-year-old male who had performed 13 months earlier a percutaneous coronary intervention (PCI) for unstable angina with 3 overlapping bioresorbable vascular scaffolds (BVSs) (Abbott Vascular, Santa Clara, California) in a long lesion of the left anterior descending (LAD), presented with new onset effort angina. Coronary angiography revealed significant focal in-scaffold restenosis of the distal LAD (Fig. 1, black arrow). Optical coherence tomography (OCT) imaging (Fig. 2) showed good expansion of the scaffolds with minimum neointima coverage (A, D), except for a focal under-expansion with severe prominent neointimal hyperplasia located in the body of the distal scaffold (B, C).

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    8. Novel sirolimus-eluting stent with a biodegradable polymer in the all-comers population - 1-year results with angiographic and OCT analysis

      Novel sirolimus-eluting stent with a biodegradable polymer in the all-comers population - 1-year results with angiographic and OCT analysis

      Aims: First generation drug-eluting stents inhibit physiological healing process of the vessel wall, lengthen inflammatory reactions and adversely affect the restoration of correctly functioning endothelium. It is believed that one possible cause of these adverse events might be the negative influence of the permanent presence of polymer used for stent coating. This scenario could possibly be averted by the use of a biodegradable polymer. Methods and results: Prolim (Balton, Poland) is a balloon expandable, stainless steel (316L), sirolimus-eluting stent dedicated for coronary lesions. The strut thickness is 0.115 mm. Prolim stent is covered with a biodegradable structure containing a ...

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    9. Serial examinations of right coronary artery directly injured by radiofrequency catheter ablation with optical coherence tomography and intravascular ultrasound

      Serial examinations of right coronary artery directly injured by radiofrequency catheter ablation with optical coherence tomography and intravascular ultrasound

      A 42-year-old man was referred for ablation. The origin of VT was localized close to the right coronary ostium. During ablation, the catheter tip inadvertently fell into a RCA ostium. The patient developed chest discomfort and ST-segment elevation in the inferior leads was observed. Coronary angiography confirmed severe narrowing of the ostial RCA. Stenting was deferred after satisfactory dilatation by a balloon. The patient discharged with eventless clinical course afterward. Follow-up coronary angiographic, FD-OCT, IVUS, and iMap examinations were performed at 3, 6, and 15 months after index procedure. The lesion showed progressive positive remodeling associated with intimal proliferation, medial ...

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    10. Diagnostic imaging capabilities of the Ocelot -Optical Coherence Tomography System, ex-vivo evaluation and clinical relevance

      Diagnostic imaging capabilities of the Ocelot -Optical Coherence Tomography System, ex-vivo evaluation and clinical relevance

      Background Optical coherence tomography (OCT) is a high-resolution sub-surface imaging modality using near-infrared light to provide accurate and high contrast intra-vascular images. This enables accurate assessment of diseased arteries before and after intravascular intervention. This study was designed to corroborate diagnostic imaging equivalence between the Ocelot and the Dragonfly OCT systems with regards to the intravascular features that are most important in clinical management of patients with atherosclerotic vascular disease. These intravascular features were then corroborated in vivo during treatment of peripheral arterial disease (PAD) pathology using the Ocelot catheter. Methods In order to compare the diagnostic information obtained by ...

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    11. ILUMIEN II Raises Questions as to What OCT Offers Over IVUS

      ILUMIEN II Raises Questions as to What OCT Offers Over IVUS

      Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) guidance each result in comparable levels of stent expansion, according to post-hoc analysis of 2 prospective studies dubbed ILUMIEN II. On IVUS, “the strongest predictor of early stent thrombosis and restenosis is the absolute degree of stent expansion,” Gregg W. Stone, MD, of Columbia University Medical Center (New York, NY), and colleagues write in their paper published in the November 2015 issue of JACC: Cardiovascular Interventions. Lloyd W. Klein, MD, of Rush Medical College (Chicago, IL), while crediting the researchers for “trying to find a way in which OCT could have an ...

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    12. Paclitaxel-coated balloon exerts late vessel healing and enlargement: A documented phenomenon with optical coherence tomography analysis

      Paclitaxel-coated balloon exerts late vessel healing and enlargement: A documented phenomenon with optical coherence tomography analysis

      As by the most recent guidelines on myocardial revascularization underline [1], drug coated balloon (DCB) is an effective and safe treatment for in-stent restenosis (ISR). However this device represents an innovation with a high potential impact currently investigated in other lesion settings, such as the treatment of atherosclerotic native coronary vessels [2,3]

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    13. Advances in Imaging Methods to Detect Vulnerable Plaque: A Review

      Advances in Imaging Methods to Detect Vulnerable Plaque: A Review

      Acute coronary syndromes (ACS) are anticipated to remain the important cause of mortality and morbidity now a days. ACS are mostly caused by plaque rupture. This review paper focuses on the prognostic value of different in vivo determination modalities of vulnerable lesions in coronary artery by OCT, IVUS-VH, intravascular ultrasound (IVUS), intravascular magnetic resonance, Roman and near-infrared spectroscopy, and non-invasive multidetector computed tomography, Positron Emission Tomography (PET) scan, Single Photon Emission Computerized Tomography (SPECT) scan, Magnetic Resonance Imaging (MRI) and their different comb inations in patients undergoing coronary angiography. Coronary angiography is considered the standard modality to estimation of the ...

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    14. Optical coherence tomography of re-pressurized porcine coronary arteries: A systematic study

      Optical coherence tomography of re-pressurized porcine coronary arteries: A systematic study

      Abstract Cardiovascular death is the most frequently reported cause of adult natural death in autopsy reports in the UK. However, the approach used for diagnosing coronary artery disease at autopsy is largely based on visual assessment of coronary artery cross sections to determine the severity of stenosis. This is subject to criticism and heterogeneity. Objective We investigated the potential role of a novel intravascular imaging technique, Optical Coherence Tomography (OCT), in post-mortem diagnosis of coronary artery disease and what effect re-pressurisation has on vessel dimensions, as measured by OCT. Our long term aim is to investigate the role of OCT ...

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    15. Optical coherence tomography of the pulmonary arteries: A systematic review

      Optical coherence tomography of the pulmonary arteries: A systematic review

      Optical coherence tomography (OCT) is an imaging technique extensively used for visualizing the coronary circulation, where it assists clinical decision-making. Along with the new interventional procedures being introduced for pulmonary vascular disease, there is an increasing need for intravascular imaging of the pulmonary arteries. Additionally, measurements of the wall thickness of the pulmonary arteries of patients with various types of pulmonary hypertension (PH) may provide relevant diagnostic and prognostic information. The aim of this review is to summarize all the available evidence on the use of OCT for imaging the pulmonary bed and to describe a simple protocol for OCT ...

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    16. Quantitative analysis of the side-branch orifice after bifurcation stenting using en-face processing of OCT images: a comparison between Xience V and Resolute Integrity stents

      Quantitative analysis of the side-branch orifice after bifurcation stenting using en-face processing of OCT images: a comparison between Xience V and Resolute Integrity stents

      Objective: Methods for intravascular assessment of the side-branch (SB) orifice after stenting are not readily available. The aim of this study was to assess the utility of an en-face projection processing for optical coherence tomography (OCT) images for SB evaluation. Methods: Measurements of the SB orifice obtained using en-face OCT images were validated using a phantom model. Linear regression modeling was applied to estimated area measurements made on the en-face images. The SB orifice was then analyzed in 88 patients with bifurcation lesions treated with either Xience V (everolimus-eluting stent) or Resolute Integrity [zotarolimus-eluting stent (ZES)]. The SB orifice area ...

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    17. Analysis of the Usefulness of Optical Coherence Tomography and Intravascular Ultrasonography for the Examination of Rabbit Atherosclerotic Plaques

      Analysis of the Usefulness of Optical Coherence Tomography and Intravascular Ultrasonography for the Examination of Rabbit Atherosclerotic Plaques

      In the present study, we aimed to establish a rabbit atherosclerosis model and examine atherosclerotic plaques by using optical coherence tomography (OCT) and intravascular ultrasonography (IVUS) to evaluate the clinical usefulness of these diagnostic tools in the detection of atherosclerotic plaques. Twenty healthy New Zealand rabbits were fed on a high-fat diet for 4 weeks and then subjected to abdominal aortic intimal injury. The OCT and IVUS were performed after 8 weeks. The distal and proximal plaque images were marked to observe the plaque thickness and features of the lesions at the tunica intima and tunica media. Moreover, a pathological ...

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    18. Clinical Impact of OCT Findings During PCI: The CLI-OPCI II Study

      Clinical Impact of OCT Findings During PCI: The CLI-OPCI II Study

      Objectives The goal of this study was to assess the clinical impact of optical coherence tomography (OCT) findings during percutaneous coronary intervention (PCI). Background OCT provides unprecedented high-definition visualization of plaque/stent structures during PCI; however, the impact of OCT findings on outcome remains undefined. Methods In the context of the multicenter CLI-OPCI (Centro per la Lotta contro l’Infarto–Optimisation of Percutaneous Coronary Intervention) registry, we retrospectively analyzed patients undergoing end-procedural OCT assessment and compared the findings with clinical outcomes. Results A total of 1,002 lesions (832 patients) were assessed. Appropriate OCT assessment was obtained in 98.2 ...

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    19. Intravascular ultrasound, optical coherence tomography and near infrared spectroscopy

      Intravascular ultrasound, optical coherence tomography and near infrared spectroscopy

      Intravascular ultrasound (IVUS), optical coherence tomography (OCT) and near infrared spectroscopy (NIRS) allows for a thorough analysis of the atheroma's morphology in vivo . Moreover, it helps to guide coronary intervention and assess the results of stenting. IVUS, OCT and NIRS provide unique data about the analyzed tissue and thus all of them complement each other. Their application in daily clinical practice helps to understand the underlying pathology of disease and may contribute to the improvement of outcomes in coronary interventions.

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    20. Optical Coherence Tomography for Assessment of Percutaneous Coronary Intervention with Excimer Laser Coronary Atherectomy (Book Chapter)

      Optical Coherence Tomography for Assessment of Percutaneous Coronary Intervention with Excimer Laser Coronary Atherectomy (Book Chapter)

      The indications for Excimer laser coronary atherectomy (ELCA) have been refined in modern interventional practice. With the expanding role for optical coherence tomography (OCT) providing high-resolution intra-coronary imaging, this article examines the appearance of the coronary lumen after ELCA. Each indication for ELCA is discussed and illustrated with a clinical case, followed by detailed analysis of the OCT imaging pre and post ELCA. The aim of the article is to provide information to interventional cardiologists to facilitate decision making during PCI, when ELCA has been used as part of the interventional strategy.

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    21. A novel characterization of posterior keratoconus using anterior segment optical coherence tomography in an infant: a case report

      A novel characterization of posterior keratoconus using anterior segment optical coherence tomography in an infant: a case report

      Background Posterior keratoconus is a rare cause of a corneal opacity in an infant. It is characterized by thinning of the posterior cornea without ectasia of the anterior cornea. Imaging of this condition with anterior segment optical coherence tomography (AS-OCT) has not been reported in the literature. Case presentation A six week old African-American male presented with a congenital corneal opacity of the right eye. He underwent an examination under anesthesia in which photography and AS-OCT were performed. AS-OCT confirmed the diagnosis of posterior keratoconus. The patient subsequently underwent an optical iridectomy for visual development. Conclusion AS-OCT is a useful ...

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    22. Plaque morphologies and the clinical prognosis of acute coronary syndrome caused by lesions with intact fibrous cap diagnosed by optical coherence tomography

      Plaque morphologies and the clinical prognosis of acute coronary syndrome caused by lesions with intact fibrous cap diagnosed by optical coherence tomography

      Background Pathological studies have suggested that acute coronary syndrome (ACS) may be caused by culprit lesions with intact fibrous cap (IFC), including plaque erosions. This study sought to evaluate the morphological features and clinical outcomes of patients with ACS caused by lesions with IFC. Methods A total of 318 patients with ACS who underwent optical coherence tomography (OCT) of a culprit lesion were investigated. The culprit lesions were categorized as follows: those with plaque rupture (PR group), those with an IFC (IFC group), and those with a massive thrombus precluding plaque visualization (MT group). Intravascular ultrasound (IVUS) was performed in ...

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