1. Articles in category: Cardiology

    481-504 of 2590 « 1 2 ... 18 19 20 21 22 23 24 ... 106 107 108 »
    1. Overaggressive stent expansion without intravascular imaging: impact on restenosis

      Overaggressive stent expansion without intravascular imaging: impact on restenosis

      Objective Aggressive stent expansion is required for optimal strut apposition, but risk of stent deformation, fracture and subsequent restenosis is potentially greater when performed without intravascular imaging guidance. We investigated how frequently stents are ‘overexpanded’ and whether this correlates with restenosis. Design and setting Single-centre prospective database study at a high-volume tertiary university hospital. Patients 243 patients undergoing single-vessel stenting for de novo stenosis in 277 lesions. Exclusion criteria were bifurcational, graft or left main disease and intravascular imaging use. All had ischaemia-driven repeat coronary angiography up to 48 months later. Degree of stent overexpansion was the difference between nominal ...

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    2. Optical coherence tomography imaging of intrastent neointimal bridge caused by semicircumferencial dissection after drug eluting balloon dilatation of instent restenosis of sapheneous venous graft

      Optical coherence tomography imaging of intrastent neointimal bridge caused by semicircumferencial dissection after drug eluting balloon dilatation of instent restenosis of sapheneous venous graft

      During redilatation of a stent by a balloon, the dissection of the neointimal tissue commonly can be detected by IVUS or OCT, but the exact clinical relevance of the dissection in variable type is not known in the case of angiographically good result. Sixty-two year old female patient had CABG operation in 1998 (LIMA-LAD, sequential SVG to the 2nd OM branch of the LCx and the PL of the RCA). Between 2006 and 2012 she had 5 PCIs with stent implantations and balloon redilations in the sequential SVG (altogether 5 BM stents and 1 DES were implanted). The last intervention ...

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      Mentions: St. Jude Medical
    3. Optical coherence tomography detection of shear wave propagation in inhomogeneous tissue equivalent phantoms and ex-vivo carotid artery samples

      Optical coherence tomography detection of shear wave propagation in inhomogeneous tissue equivalent phantoms and ex-vivo carotid artery samples

      In this work, we explored the potential of measuring shear wave propagation using optical coherence elastography (OCE) in an inhomogeneous phantom and carotid artery samples based on a swept-source optical coherence tomography (OCT) system. Shear waves were generated using a piezoelectric transducer transmitting sine-wave bursts of 400 μs duration, applying acoustic radiation force (ARF) to inhomogeneous phantoms and carotid artery samples, synchronized with a swept-source OCT (SS-OCT) imaging system. The phantoms were composed of gelatin and titanium dioxide whereas the carotid artery samples were embedded in gel. Differential OCT phase maps, measured with and without the ARF, detected the microscopic ...

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    4. In vivo evaluation of neointimal healing after stenting with optical coherence tomography (Thesis)

      In vivo evaluation of neointimal healing after stenting with optical coherence tomography (Thesis)

      Ischemic heart disease is still today the first cause of mortality in the world, especially in the developed countries. The vast majority of cases are due to atherosclerosis, a complex systemic degenerative process resulting in cholesterol accumulation in the extra-cellular space of the arterial intima, with inflammation, foam-cells formation, and necrosis. The clinical manifestations of coronary atherosclerosis comprise from stable angina, due to flow-limiting stenosis of the artery, to acute myocardial infarction or sudden death, when the atheroma gets complicated by thrombotic phenomena. The first revolution in the treatment of this disease came in 1977, when Andreas Grüntzig performed ...

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    5. Imaging Myocardium at Risk and Coronary Inflammation in Non-ST-Segment Elevation Myocardial Infarction: Combined Use of FDG PET and Optical Coherence Tomography

      Imaging Myocardium at Risk and Coronary Inflammation in Non-ST-Segment Elevation Myocardial Infarction: Combined Use of FDG PET and Optical Coherence Tomography

      Patients with non-ST-segment elevation myocardial infarction (NSTEMI) represent a heterogeneous group in terms of jeopardized myocardium, pathogenetic mechanisms, and risk of recurrent events. In particular, estimation of myocardium at risk may be challenging before angiography. Yet the mechanisms leading to coronary instability underlying acute coronary syndromes (ACS) have not been completely elucidated. In this report (figure), we describe the potential utility of FDG PET in defining the myocardium at risk and to unravel coronary inflammation in one NSTEMI patient with normal level of C-reactive protein. Optical coherence tomography (OCT) images of culprit lesions are also shown.

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    6. Volcano Reports Fourth Quarter Revenues Increase Six Percent On A Constant Currency Basis

      Volcano Reports Fourth Quarter Revenues Increase Six Percent On A Constant Currency Basis

      Volcano Corporation (Nasdaq: VOLC), a leading developer and manufacturer of precision guided therapy tools designed to enhance the diagnosis and treatment of coronary and peripheral vascular disease, today reported results for the fourth quarter and all of 2013. For the quarter ended December 31, 2013, Volcano reported revenues of $103.3 million versus revenues of $102.5 million in the same period a year ago. On a constant currency basis, revenues increased six percent year-over-year after adjusting for a negative impact of approximately $5.5 millionfrom foreign currency. Medical segment revenues increased approximately one percent and six percent on a ...

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    7. Neoatherosclerosis After Paclitaxel-Coated Balloon Angioplasty for In-Stent Restenosis

      Neoatherosclerosis After Paclitaxel-Coated Balloon Angioplasty for In-Stent Restenosis

      In-stent neoatherosclerosis (NA) has been reported after drug-eluting stent (DES) and bare-metal stent implantation. 1 NA is not only more frequent but also occurs earlier in patients undergoing DES implantation compared with those treated with bare-metal stents. 1 This phenomenon has major potential implications because complicated NA (mainly from rupture of a thin-cap fibroatheroma) may result in very late stent thrombosis. 2 Although NA can be visualized using intravascular ultrasound (IVUS), optical coherence tomography (OCT), because of its unique resolution (15 μm), appears ideally suited to detect this phenomenon in vivo. 2 We report on a patient treated with a ...

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    8. Multivessel Honeycomb-Like Structure Finding in Optical Coherence Tomography

      Multivessel Honeycomb-Like Structure Finding in Optical Coherence Tomography

      A 66-year-old man with a history of chronic atrial fibrillation was referred to our hospital due to pre-operative cardiac evaluation for intestinal stenosis. An electrocardiogram showed negative T in leads II, III, aVF, and V 3 to V 5 , and an echocardiogram showed moderate hypokinesis in the anteroseptal left ventricular wall. Coronary angiography revealed multiple linear filling defects with haziness in the right coronary artery and left anterior descending artery (Figure 1 A and Figure 1 B). After surgery for intestinal stenosis, we performed a staged percutaneous coronary intervention for right coronary artery and left anterior descending artery stenosis. In ...

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      Mentions: St. Jude Medical
    9. Randomised comparison of strut coverage between Nobori biolimus-eluting and sirolimus-eluting stents: an optical coherence tomography analysis

      Randomised comparison of strut coverage between Nobori biolimus-eluting and sirolimus-eluting stents: an optical coherence tomography analysis

      Aims: The aims of this study were to compare strut tissue coverage at six-month follow-up after Nobori biolimus-eluting stent (N-BES) versus sirolimus-eluting stent (SES) implantation. Methods and results: A total of 120 patients with a single stenotic lesion requiring revascularisation were randomly assigned to either N-BES (n=60) or SES (n=60). Baseline optical coherence tomography (OCT) was performed post stent implantation, and follow-up OCT was scheduled at six months. Post-intervention and follow-up OCT analyses were available in 51 (85.0%) and 52 (86.7%) patients, respectively. The primary endpoint was the percentage of uncovered struts at follow-up OCT in ...

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    10. Prevention through imaging: current knowledge and perspectives

      Prevention through imaging: current knowledge and perspectives

      ardiovascular disease (CVD) remains the first cause of mortality, morbidity, and disability worldwide. The World Health Organization Fact Sheet on CVD (No. 317, updated March 2013) states that throughout the world more people die each year from CVD than from any other cause, with 17.3 million deaths in 2008, representing 30% of all global deaths, a figure expected to rise to 23.3 million by 2030. According to SIGN (Scottish Intercollegiate Guidelines Network). Risk Estimation and the Prevention of Cardiovascular Disease. A National Clinical Guideline. 2007. Report No. 97, CVD disability-adjusted life years (DALYs) are expected to rise from ...

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    11. Head-to-Head Comparison of a Drug-Free Early Programmed Dismantling Polylactic Acid Bioresorbable Scaffold and a Metallic Stent in the Porcine Coronary Artery Six-Month Angiography and Optical Coherence Tomographic Follow-Up Study

      Head-to-Head Comparison of a Drug-Free Early Programmed Dismantling Polylactic Acid Bioresorbable Scaffold and a Metallic Stent in the Porcine Coronary Artery Six-Month Angiography and Optical Coherence Tomographic Follow-Up Study

      Background— We aimed to evaluate a new drug-free fully bioresorbable lactic acid–based scaffold designed to allow early dismantling synchronized with artery wall healing in comparison with a bare metal stent (BMS). Methods and Results— Twenty-three BMS (3.0×12 mm) and 36 lactic acid–based bioresorbable scaffolds (BRS, 3.0×11 mm) were implanted in porcine coronary arteries. QCA and optical coherence tomographic analyses were performed immediately after implantation and repeated after 1, 3, and 6 months. Microcomputed tomography was used to detect scaffold dismantling. Polymer degradation was evaluated throughout the study. The primary end-point was late lumen loss ...

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    12. Clinical Utility of Intravascular Imaging and Physiology in Coronary Artery Disease

      Clinical Utility of Intravascular Imaging and Physiology in Coronary Artery Disease

      Available intravascular imaging and physiology techniques and technologies include fractional flow reserve; grayscale intravascular ultrasound (IVUS); IVUS radiofrequency tissue characterization; optical coherence tomography, the light analogue of IVUS; and near infrared spectroscopy that detects lipid within the vessel wall and that has recently been combined with grayscale IVUS in a single catheter as the first combined imaging device. They can be used to answers questions that occur during daily practice including 1) Is this stenosis significant? 2) Where is the culprit lesion? 3) Is this a vulnerable plaque? 4) What is the likelihood of distal embolization or peri-procedural myocardial infarction ...

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      Mentions: Gary S. Mintz
    13. Effect of the Endothelial Shear Stress Patterns on Neointimal Proliferation Following Drug-Eluting Bioresorbable Vascular Scaffold Implantation : An Optical Coherence Tomography Study

      Effect of the Endothelial Shear Stress Patterns on Neointimal Proliferation Following Drug-Eluting Bioresorbable Vascular Scaffold Implantation : An Optical Coherence Tomography Study

      Objectives The goal of this study was to investigate the effect of endothelial shear stress (ESS) on neointimal formation following an Absorb bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) implantation. Background Cumulative evidence, derived from intravascular ultrasound–based studies, has demonstrated a strong association between local ESS patterns and neointimal formation in bare-metal stents, whereas in drug-eluting stents, there are contradictory data about the effect of ESS on the vessel wall healing process. The effect of ESS on neointimal development following a bioresorbable scaffold implantation remains unclear. Methods Twelve patients with an obstructive lesion in a relatively straight ...

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    14. 3D optical coherence tomography: new insights into the process of optimal rewiring of side branches during bifurcational stenting

      3D optical coherence tomography: new insights into the process of optimal rewiring of side branches during bifurcational stenting

      Aims: We describe three-dimensional optical coherence tomography (3D-OCT) guided bifurcation stenting and the clinical utility of 3D-OCT. Methods and results: Twenty-two consecutive patients who underwent OCT examination to confirm the recrossing position after stent implantation in a bifurcation lesion were enrolled. Frequency domain OCT images were obtained to check the recrossing position and 3D reconstructions were performed off-line. The recrossing position was clearly visualised in 18/22 (81.8%) cases. In 13 cases, serial 3D-OCT could be assessed both before and after final kissing balloon post-dilation (FKBD). We divided these cases into two groups according to the presence of the ...

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    15. Methodology for fully automated segmentation and plaque characterization in intracoronary optical coherence tomography images

      Methodology for fully automated segmentation and plaque characterization in intracoronary optical coherence tomography images

      Optical coherence tomography (OCT) is a light-based intracoronary imaging modality that provides high-resolution cross-sectional images of the luminal and plaque morphology. Currently, the segmentation of OCT images and identification of the composition of plaque are mainly performed manually by expert observers. However, this process is laborious and time consuming and its accuracy relies on the expertise of the observer. To address these limitations, we present a methodology that is able to process the OCT data in a fully automated fashion. The proposed methodology is able to detect the lumen borders in the OCT frames, identify the plaque region, and detect ...

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    16. Optical Coherence Tomography to Improve Clinical Outcomes During Coronary Angioplasty

      Optical Coherence Tomography to Improve Clinical Outcomes During Coronary Angioplasty

      Coronary artery stenting has evolved as an effective treatment for angina and involves stretching up narrowings within the heart arteries using a balloon (coronary angioplasty) before implanting a small metal scaffold (stent) to splint the artery open. It is imperative that stents are fully expanded when they are deployed. If not, then patients are exposed to the serious risk of a blood clot forming in the stent (stent thrombosis), or the stent renarrowing (restenosis). One fifth of patients experiencing stent thrombosis will die and 70% will suffer a heart attack. Restenosis is associated with recurrent angina and heart attacks. Arguably ...

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    17. Assessment of Characteristics of Neointimal Hyperplasia after Drug-Eluting Stent Implantation in Patients with Diabetes Mellitus: An Optical Coherence Tomography Analysis

      Assessment of Characteristics of Neointimal Hyperplasia after Drug-Eluting Stent Implantation in Patients with Diabetes Mellitus: An Optical Coherence Tomography Analysis

      Objective: This study aims to assess the characteristics of neointimal hyperplasia after drug-eluting stent (DES) implantation in patients with diabetes mellitus (DM) by optical coherence tomography (OCT). Methods: OCT was performed in 109 patients (45 with DM and 64 without DM) 1 year after DES implantation. Neointimal coverage and thickness on the luminal side were measured. The characteristics of neointimal hyperplasia were classified into three patterns, namely, high signal pattern, low signal pattern and layered signal pattern, according to the neointimal signal intensity. The development of in-stent neoatherosclerosis was also examined. In the DM group, glycated hemoglobin (HbA 1c ) levels ...

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    18. Pattern of inner retinal layers involvement in pigmented paravenous retinochoroidal atrophy as determined by SD-OCT: case report

      Pattern of inner retinal layers involvement in pigmented paravenous retinochoroidal atrophy as determined by SD-OCT: case report

      Pigmented paravenous retinochoroidal atrophy is an ocular disease characterized by outer retina and choroidal atrophy often with overlying intraretinal bone spicule pigment deposition along the retinal veins. As a rare condition, there is scant information in the literature regarding the pattern of inner retinal layers involvement. We present a case of a 41-year-old white man initially referred for a glaucoma evaluation. Fundoscopy revealed patches of retinochoroidal atrophy and light pigmentation extending from the optic nerve head along the inferior-temporal retinal veins in both eyes. Using different spectral-domain optical coherence tomography (SD-OCT) protocols we identified a significant thinning of the inner ...

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    19. Light-based technology could prevent unforeseen heart attacks

      Light-based technology could prevent unforeseen heart attacks

      Shedding light on plaque that causes unexpected heart attacks and strokes is the goal of Jennifer Phipps, Ph.D., a postdoctoral fellow at the UT Health Science Center San Antonio. Dr. Phipps is using light to help physicians see where “vulnerable plaque” is building up so they can help prevent and treat cardiac events. No warning signs with vulnerable plaque Vulnerable plaque is different from “stable plaque” that builds up inside arteries and causes symptoms like chest pain, breathlessness or numbness. Vulnerable plaque causes heart attacks and strokes without any warning signs. It is not easily seen by the current ...

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    20. Myocardial Infarction Due to Intracoronary Embolization of Percutaneous Coronary Intervention Packaging

      Myocardial Infarction Due to Intracoronary Embolization of Percutaneous Coronary Intervention Packaging

      Intracoronary device loss is occasionally encountered and removal is commonly performed at the time of the procedure. We report a case of removal of a retained coronary balloon protective plastic tubing inadvertently left in the coronary artery for a month and associated with myocardial infarction. Optical coherence tomography was used to visualize the foreign body prior to removal with a snare. To our knowledge this is the first report of a removal of disposable packaging equipment after prolonged intracoronary dwell time.

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    21. Evolutive Recanalization of Spontaneous Coronary Artery Dissection: Insights From a Multimodality Imaging Approach

      Evolutive Recanalization of Spontaneous Coronary Artery Dissection: Insights From a Multimodality Imaging Approach

      A 50-year-old man, a former smoker, presented with an ST-segment elevation anterior myocardial infarction that was treated with thrombolysis in another center. Because of the absence of reperfusion criteria, he was referred to our hospital for a rescue coronary intervention. A transthoracic echocardiogram showed that the overall left-ventricle systolic function was preserved but with apical akinesia. Coronary angiography revealed an occlusive lesion (100%) in the mid-left anterior descending coronary artery distal to a segment with a tapering caliber (Figure 1A). At that time, the patient was asymptomatic, and, therefore, a conservative management was decided, including dual antiplatelet therapy and full ...

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      Mentions: Fernando Alfonso
    22. Feature Of The Week 2/9/14: Incidences, Predictors, and Clinical Outcomes of Acute and Late Stent Malapposition Detected by Optical Coherence Tomography After Drug-Eluting Stent Implantation

      Feature Of The Week 2/9/14: Incidences, Predictors, and Clinical Outcomes of Acute and Late Stent Malapposition Detected by Optical Coherence Tomography After Drug-Eluting Stent Implantation

      Background—We investigated the incidences, predictors, and clinical outcomes of acute and late stent malapposition detected by optical coherence tomography (OCT) after drug-eluting stent implantation. Methods and Results—We analyzed the OCT images from 351 patients with 356 lesions who received poststent and follow-up OCT examinations. Acute stent malapposition was observed in 62% of lesions. Approximately half of the acute stent malappositions were located within the edges of the stents. Severe diameter stenosis, calcified lesions, and long stents were independent predictors of acute stent malapposition. Follow-up OCT examinations were performed 175±60 days after drug-eluting stent implantation. Thirty-one percent of ...

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    23. Difference of neointimal growth patterns in bifurcation lesions among four kinds of drug-eluting stents: An optical coherence tomographic study

      Difference of neointimal growth patterns in bifurcation lesions among four kinds of drug-eluting stents: An optical coherence tomographic study

      Aim : Neointimal proliferation of bifurcation lesions after implantation of drug-eluting stents (DES) has not been well evaluated. Thus, we compared neointimal proliferation of bifurcation lesions among four DES using optical coherence tomography (OCT). Methods : Eight-month follow-up OCT was performed in 68 bifurcation lesions treated by 15 sirolimus-eluting stents (SES) and 17 paclitaxel-eluting stents (PES) as first-generation DES, and by 17 zotarolimus-eluting stents (ZES) and 19 everolimus-eluting stents (EES) as second-generation DES. Cross-sectional images of the bifurcation lesion using OCT were analyzed every 450 µm. All images were divided into three areas: inner wall of the bifurcation (IB), outer wall of ...

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    24. Healing course of acute vessel wall injury after drug-eluting stent implantation assessed by optical coherence tomography

      Healing course of acute vessel wall injury after drug-eluting stent implantation assessed by optical coherence tomography

      BACKGROUND: Vessel wall injury after drug-eluting stent (DES) implantation can be characterized in detail by optical coherence tomography (OCT). Little is known about the healing course of these phenomena. METHODS AND RESULTS: In 62 lesions (62 patients), the incidence of acute vessel trauma was assessed in the stented region and the edge segments immediately after DES implantation. The healing course of these injuries was assessed at 9-month OCT follow-up using a software algorithm allowing for reliable spatial comparison of baseline and follow-up cross-sectional images. Tissue prolapse (TP) and tissue protrusions were detected in 81 and 35% of lesions, respectively. A ...

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