1. Articles in category: Cardiology

    481-504 of 3203 « 1 2 ... 18 19 20 21 22 23 24 ... 132 133 134 »
    1. Regressed Coronary Aneurysm After Kawasaki Disease: An Optical Coherence Tomography (OCT) Study From A Single Institution

      Regressed Coronary Aneurysm After Kawasaki Disease: An Optical Coherence Tomography (OCT) Study From A Single Institution

      Coronary artery aneurysms (CAA) are a serious complication of Kawasaki disease (KD). CAA size regresses in nearly 50% of the cases on follow up. Nevertheless, patients with regressed CAA have an increased risk of ischemic heart disease, myocardial infarction and sudden cardiac death on long-term follow-up. Actual imaging techniques often describe these segments as normal, whereas studies have shown significant endothelial and smooth muscle dysfunction. Optical Coherence Tomography (OCT) is a high-resolution intracoronary imaging modality that characterizes coronary artery wall structure. n.

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    2. Coronary healing after stenting: wounds, faith, and the quest for the perfect stent

      Coronary healing after stenting: wounds, faith, and the quest for the perfect stent

      After coronary angioplasty, the arteries heal by a series of complex and dynamic mechanisms, which aim to restore vessel architecture and ensure laminar flow. With stent implantation, foreign material is introduced: an additional variable that significantly disturbs the healing process. Ideally, the stent struts should be covered by a perfectly functioning neo-endothelium, but this is not always the case. At different stages, peri-strut components induce inflammation with cell infiltration, fibrin, and clot formation. Patient and plaque factors play a role in healing, but we know from early-generation drug-eluting stents (DES) with permanent polymer (PP) that stent factors are crucial. The ...

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    3. Impact of the orbital atherectomy system on a coronary calcified lesion: quantitative analysis by light attenuation in optical coherence tomography

      Impact of the orbital atherectomy system on a coronary calcified lesion: quantitative analysis by light attenuation in optical coherence tomography

      A 64-year-old female with chronic kidney disease was scheduled to undergo stenting of a severely calcified lesion in the left anterior descending coronary artery following “preparation” of the lesion by orbital atherectomy performed with the Diamondback 360 Coronary Orbital Atherectomy System (OAS), 1.25 mm Classic Crown (Cardiovascular Systems, Inc., St. Paul, MN, USA) (Figure 1A) (pre- and post-OAS angiography: Figure 1B-1C and Figure 1B’-1C’ , respectively). The first run was performed at 80,000 rpm for 25 s followed by the second run at 120,000 rpm for 25 s. A 2.75×38 mm everolimus-eluting stent (XIENCE; Abbott ...

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    4. Comparison of neointimal coverage between everolimus-eluting stents and sirolimus-eluting stents: an optical coherence tomography substudy of the RESET (Randomized Evaluation of Sirolimus-eluting versus Everolimus-eluting stent Trial)

      Comparison of neointimal coverage between everolimus-eluting stents and sirolimus-eluting stents: an optical coherence tomography substudy of the RESET (Randomized Evaluation of Sirolimus-eluting versus Everolimus-eluting stent Trial)

      Aims: The aim of the present study was to compare vascular healing response between the first-generation sirolimus-eluting stent (SES) and the second-generation everolimus-eluting stent (EES) by using optical coherence tomography (OCT). Methods and results: The RESET was a prospective, multicentre, randomised, open-label trial comparing EES and SES. Of the 3,197 patients enrolled in the RESET, nine-month follow-up OCT after stent implantation was performed in 100 patients (48 EES-treated lesions in 44 patients and 62 SES-treated lesions in 56 patients), thus constituting the OCT substudy population. The percentage of uncovered struts per lesion (8±15% vs. 14±19%, p=0 ...

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    5. Lumen morphology image reconstruction based on the scan line data of OCT

      Lumen morphology image reconstruction based on the scan line data of OCT

      A method and apparatus of automatically locating in an image of a blood vessel the lumen boundary at a position in the vessel and from that measuring the diameter of the vessel. From the diameter of the vessel and estimated blood flow rate, a number of clinically significant physiological parameters are then determined and various user displays of interest generated. One use of these images and parameters is to aid the clinician in the placement of a stent. The system, in one embodiment, uses these measurements to allow the clinician to simulate the placement of a stent and to determine ...

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    6. Imaging of aortic valve dynamics in 4D OCT New insights into murine aortic valve diseases

      Imaging of aortic valve dynamics in 4D OCT  New insights into murine aortic valve diseases

      The mechanical components of the heart, especially the valves and leaflets, are enormous stressed during lifetime. Therefore, those structures undergo different pathophysiological tissue transformations which affect cardiac output and in consequence living comfort of affected patients. These changes may lead to calcific aortic valve stenosis (AVS), the major heart valve disease in humans. The knowledge about changes of the dynamic behaviour during the course of this disease and the possibility of early stage diagnosis is of particular interest and could lead to the development of new treatment strategies and drug based options of prevention or therapy. 4D optical coherence tomography ...

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    7. Intravascular optical coherence tomography (OCT) as an additional tool for the assessment of stent structures

      Intravascular optical coherence tomography (OCT) as an additional tool for the assessment of stent structures

      Evaluation of the vascular stent position, shape and correct expansion has a high relevance in therapy and diagnosis. Hence, the wall apposition in vessel areas with differing diameters and the appearance of torsions or structural defects of the implant body caused by catheter based device dropping are of special interest. Neurovascular implants like braided flow diverter and laser cut stents consist of metal struts and wires with diameters of about 40 μm. Depending on the implants material composition, visibility is poor with conventional 2D X-ray fluoroscopic and radiographic imaging. The metal structures of the implants also lead to artifacts in ...

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    8. Association between tissue characteristics assessed with optical coherence tomography and mid-term results after percutaneous coronary intervention for in-stent restenosis lesions: a comparison between balloon angioplasty, paclitaxel-coated balloon dilata

      Association between tissue characteristics assessed with optical coherence tomography and mid-term results after percutaneous coronary intervention for in-stent restenosis lesions: a comparison between balloon angioplasty, paclitaxel-coated balloon dilata

      Aims Morphological assessment of neointimal tissue using optical coherence tomography (OCT) is important for clarifying the pathophysiology of in-stent restenosis (ISR) lesions. The aim of this study was to determine the impact of OCT findings on recurrence of ISR after various types of percutaneous coronary intervention (PCI) including plain old balloon angioplasty (POBA), paclitaxel-coated balloon (PCB) dilatation, and drug-eluting stent (DES) implantation. Methods and results Between June 2008 and August 2013, we performed PCI for 428 ISR lesions in 379 patients using POBA (78 lesions, POBA group), PCB dilatation (202 lesions, PCB group), and DES implantation (148 lesions, DES group ...

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    9. Identification of Intrastent Pathology Associated With Late Stent Thrombosis Using Optical Coherence Tomography

      Identification of Intrastent Pathology Associated With Late Stent Thrombosis Using Optical Coherence Tomography

      Objective To better characterize intrastent pathology using optical coherence tomography (OCT) in patients presenting with late and very late stent thrombosis (LST/VLST). Background The contribution of specific intrastent pathologies to the development of LST/VLST is not well understood. Methods In this single-center, retrospective, observational study of 796 consecutive patients treated for ST-segment elevation myocardial infarction (STEMI) with primary PCI we identified 57 patients (7.2%) in whom STEMI resulted from LST/VLST. Of the patients with LST/VLST, 21 patients (37%) had OCT performed at the discretion of the operator during PCI for LST/VLST. Independent reviewers performed ...

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    10. Multi-laboratory inter-institute reproducibility study of IVOCT and IVUS assessments using published consensus document definitions

      Multi-laboratory inter-institute reproducibility study of IVOCT and IVUS assessments using published consensus document definitions

      Aims The aim of this study was to investigate the reproducibility of intravascular optical coherence tomography (IVOCT) assessments, including a comparison to intravascular ultrasound (IVUS). Intra-observer and inter-observer variabilities of IVOCT have been previously described, whereas inter-institute reliability in multiple laboratories has never been systematically studied. Methods and results In 2 independent laboratories with intravascular imaging expertise, 100 randomized matched data sets of IVOCT and IVUS images were analysed by 4 independent observers according to published consensus document definitions. Intra-observer, inter-observer, and inter-institute variabilities of IVOCT qualitative and quantitative measurements vs. IVUS measurements were assessed. Minor inter- and intra-observer variability ...

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    11. Comparison of Iodixanol and Ioxaglate for Coronary Optical Coherence Tomography Imaging

      Comparison of Iodixanol and Ioxaglate for Coronary Optical Coherence Tomography Imaging

      Background. The impact of contrast type on coronary imaging using optical coherence tomography (OCT) has received limited study. We compared OCT imaging obtained using the non-ionic, iso-osmolar iodixanol with the ionic, low-osmolar ioxaglate. Methods. Twenty-two vessels in 20 patients were imaged twice using manual injection of iodixanol and ioxaglate in random order. OCT images were analyzed at 1 mm intervals to determine lumen area, artifact diameter and area, as well as stent strut coverage and malapposition in OCT pullbacks that included stents. Results. There were no complications related to OCT imaging or to contrast administration. A total of 2184 cross-sections ...

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    12. 4D subject-specific inverse modeling of the chick embryonic heart outflow tract hemodynamics

      4D subject-specific inverse modeling of the chick embryonic heart outflow tract hemodynamics

      Blood flow plays a critical role in regulating embryonic cardiac growth and development, with altered flow leading to congenital heart disease. Progress in the field, however, is hindered by a lack of quantification of hemodynamic conditions in the developing heart. In this study, we present a methodology to quantify blood flow dynamics in the embryonic heart using subject-specific computational fluid dynamics (CFD) models. While the methodology is general, we focused on a model of the chick embryonic heart outflow tract (OFT), which distally connects the heart to the arterial system, and is the region of origin of many congenital cardiac ...

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    13. Is high pressure postdilation safe in bioresorbable vascular scaffolds? Optical coherence tomography observations after noncompliant balloons inflated at more than 24 atmospheres

      Is high pressure postdilation safe in bioresorbable vascular scaffolds? Optical coherence tomography observations after noncompliant balloons inflated at more than 24 atmospheres

      Objectives Optical coherence tomography (OCT) was used to investigate integrity and expansion of bioresorbable drug-eluting scaffolds (BVS) after high-pressure postdilation (HPPD). Background Because of concerns about the risk of BVS damage, postdilation was not recommended and applied in the existing randomized studies and most registries. Recent real world data suggest incomplete BVS expansion cause higher rates of thrombosis. In vivo confirmation of the safety of high pressure postdilation is of paramount importance. Methods Data from final OCT examination of consecutive implanted BVS, postdilated with noncompliant (NC) balloons at pressure ≥24 atm were analyzed. The following stent performance indices were assessed ...

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    14. To Study the Efficacy of Laser Peripheral Iridoplasty in the Treatment of Eyes With Primary Angle Closure and Plateau Iris Syndrome, Unresponsive to Laser Peripheral Iridotomy, Using Anterior-Segment OCT as a Tool

      To Study the Efficacy of Laser Peripheral Iridoplasty in the Treatment of Eyes With Primary Angle Closure and Plateau Iris Syndrome, Unresponsive to Laser Peripheral Iridotomy, Using Anterior-Segment OCT as a Tool

      Purpose: To use anterior-segment optical coherence tomography (AS-OCT) as a tool to monitor the outcome of iridoplasty in patients with primary angle closure (PAC) and plateau iris syndrome (PIS), who were unresponsive to a previous laser peripheral iridotomy. Materials and Methods: This was a prospective, observational case control study. Patients diagnosed with PAC and PIS who had undergone laser peripheral iridotomy earlier, but were unresponsive to the procedure, were subjected to an iridoplasty. The intraocular pressure (IOP) and anterior-chamber parameters were measured before and after the procedure, and complications were noted. The patients were followed up for 1 year, and ...

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    15. The Frequency of Optical Coherence Tomography Testing in Glaucoma at a Single Academic Medical Center

      The Frequency of Optical Coherence Tomography Testing in Glaucoma at a Single Academic Medical Center

      Purpose: To determine the frequency of optical coherence tomography (OCT) examinations compared with clinical examinations and visual field (VF) tests in patients with 5 types of glaucoma. Patients and Methods: A retrospective, longitudinal cohort study was conducted of 5154 patients treated between 2003 and 2010 at a single academic medical center. Patients were classified using billing records as having primary open-angle glaucoma, low-tension open-angle glaucoma (NTG), pigmentary open-angle glaucoma, chronic angle-closure glaucoma, or pseudoexfoliation glaucoma. Analysis of variance, [chi]2 test, and exact [chi]2 test were performed to identify associations between glaucoma type and test frequency. Results: Pigmentary open-angle ...

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    16. MedLumics Technology Validated for Real-time Assessment of Catheter Ablation Treatment of Atrial Fibrillation in Pre-clinical Feasibility Study

      MedLumics Technology Validated for Real-time Assessment of Catheter Ablation Treatment of Atrial Fibrillation in Pre-clinical Feasibility Study

      MedLumics, a medical imaging company specializing in advanced optical coherence tomography (OCT) technology, has announced the completion of a successful single-case pre-clinical feasibility study of its technology in the catheter ablation treatment of atrial fibrillation (AF). The study incorporated a novel catheter capable of simultaneous radiofrequency ablation and imaging based on MedLumics’ polarization-sensitive optical coherence reflectometry and showed that the combined technology may help improve clinical outcomes by providing direct, real-time information on ablation efficacy. 1 Results of the study were published in the August issue of The Journal of Innovations in Cardiac Rhythm Management. “These promising results show the ...

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    17. Fusiform Appearance of Myocardial Bridging Detected by OCT

      Fusiform Appearance of Myocardial Bridging Detected by OCT

      Myocardial bridging (MB) is characterized by epicardial coronary artery tunneling through the myocardium, with angiographic “milking” and an intravascular ultrasound (IVUS) “half-moon” echolucent (1) . Optical coherence tomography (OCT), a light-based technique, can provide unprecedented in vivo imaging of coronary vessel wall structure, especially of intima and plaque composition, with a high resolution of 10 μm. So far, there are no data on visualization of MB using OCT.

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      Mentions: Gary S. Mintz
    18. Incidence and Clinical Significance of Poststent Optical Coherence Tomography Findings: One-Year Follow-Up Study From a Multicenter Registry

      Incidence and Clinical Significance of Poststent Optical Coherence Tomography Findings: One-Year Follow-Up Study From a Multicenter Registry

      Background— Optical coherence tomography (OCT) was recently introduced to optimize percutaneous coronary intervention. However, the exact incidence and significance of poststent OCT findings are unknown. Methods and Results— A total of 900 lesions treated with 1001 stents in 786 patients who had postprocedure OCT imaging were analyzed to evaluate the incidence of poststent OCT findings and to identify the OCT predictors for device-oriented clinical end points, including cardiac death, target vessel–related myocardial infarction, target lesion revascularization, and stent thrombosis. Patients were followed up to 1 year. Stent edge dissection was detected in 28.7% of lesions, and incomplete stent ...

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    19. Inducing Persistent Flow Disturbances Accelerates Atherogenesis and Promotes Thin Cap Fibroatheroma Development in D374Y-PCSK9 Hypercholesterolemic Minipigs

      Inducing Persistent Flow Disturbances Accelerates Atherogenesis and Promotes Thin Cap Fibroatheroma Development in D374Y-PCSK9 Hypercholesterolemic Minipigs

      Background— Although disturbed flow is thought to play a central role in the development of advanced coronary atherosclerotic plaques, no causal relationship has been established. We evaluated whether inducing disturbed flow would cause the development of advanced coronary plaques, including thin cap fibroatheroma. Methods and Results— D374Y -PCSK9 hypercholesterolemic minipigs (n=5) were instrumented with an intracoronary shear-modifying stent (SMS). Frequency-domain optical coherence tomography was obtained at baseline, immediately poststent, 19 weeks, and 34 weeks, and used to compute shear stress metrics of disturbed flow. At 34 weeks, plaque type was assessed within serially collected histological sections and coregistered to ...

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    20. Localization of Coronary High-Intensity Signals on T1-Weighted MR Imaging : Relation to Plaque Morphology and Clinical Severity of Angina Pectoris

      Localization of Coronary High-Intensity Signals on T1-Weighted MR Imaging : Relation to Plaque Morphology and Clinical Severity of Angina Pectoris

      Objectives This study sought to investigate the relationship between localization of high-intensity signals (HISs) on T1-weighted imaging (T1WI) with the noncontrast magnetic resonance technique and plaque morphology detected on optical coherence tomography, and the clinical severity of angina pectoris. Background Since the introduction of the T1WI noncontrast magnetic resonance technique for plaque imaging, some groups have reported that HISs in the coronary artery on T1WI are associated with a vulnerable morphology and future cardiac events. However, the association between the localization of HISs, such as coronary intrawall or intraluminal, and plaque morphology has not been investigated. Methods One hundred lesions ...

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      Mentions: Osaka University
    21. The role of vascular imaging in guiding routine Percutaneous Coronary Interventions: A meta-analysis of Bare Metal Stent and Drug-Eluting Stent trials

      The role of vascular imaging in guiding routine Percutaneous Coronary Interventions: A meta-analysis of Bare Metal Stent and Drug-Eluting Stent trials

      Background The routine use of vascular imaging including intravascular ultrasound (IVUS) and Optical Coherence Tomography (OCT) in guiding percutaneous coronary interventions (PCI) is still controversial especially when using drug-eluting stents. A meta-analysis of trials using bare metal stents was previously published Methods We conducted a meta-analysis of available published trials that compared imaging-guided PCI and angiography-guided PCI in patients undergoing routine PCI only. Trials that enrolled patients with acute coronary syndrome were excluded to decrease heterogeneity. We aimed to study both drug-eluting stents (DES) as well as bare metal stents (BMS). We identified 7 randomized controlled trials on IVUS-guided bare ...

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    22. Evaluation of Coronary Arterial Calcification - Ex-vivo Assessment by Optical Frequency Domain Imaging

      Evaluation of Coronary Arterial Calcification - Ex-vivo Assessment by Optical Frequency Domain Imaging

      Aims The purpose of this study was to determine the diagnostic ability of optical frequency domain imaging (OFDI) to carry out quantitative and qualitative evaluation of coronary calcification in comparing with ex vivo human autopsy heart specimens. Methods Analysis was carried out in 25 coronary artery specimen obtained from 16 cadavers that were imaged ex-vivo imaging by OFDI and intravascular ultrasound (IVUS). Of 235 cross-sections obtained for histologic evaluation, 149 were classified as showing calcified plaques, and in this group a comparison between histology versus co-registered images by OFDI and IVUS was performed. Results Maximum thickness of calcification measured by ...

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    23. A Challenging Case of Bifurcation Lesion in Left Anterior Descending Artery: Managed Successfully with Everolimus-Eluting Bioresorbable Vascular Scaffold and Kissing Balloon Technique under Optical Coherence Tomography Guidance

      A Challenging Case of Bifurcation Lesion in Left Anterior Descending Artery: Managed Successfully with Everolimus-Eluting Bioresorbable Vascular Scaffold and Kissing Balloon Technique under Optical Coherence Tomography Guidance

      A 54-year-old Indian male patient was presented to our hospital with the complaints of chest pain since 1-day prior to admission. He was diagnosed, elsewhere, with anterior-wall myocardial infarction and was treated with tenecteplase. Subsequently, he was referred to us for the management of postinfarction angina. He was a known case of hypertension and had no family history of coronary artery disease. Echocardiogram demonstrated hypokinesia of anterolateral wall with normal left ventricular function. Angiography revealed a single vessel disease-99% stenosis in the mid-segment of left anterior descending (LAD) coronary artery with significant narrowing at the proximal site of diagonal 1 ...

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    24. Stent collapse after guide extension catheter collision. Signature procedural finding by optical coherence tomography

      Stent collapse after guide extension catheter collision. Signature procedural finding by optical coherence tomography

      Excessive deformation of stents can lead to strut fracture and subsequent stent collapse. Procedural damages to the stent are rarely visible by angiography during implantation but may be detected by OCT. Here we present a case with a subtle but signature finding by OCT indicative of stent fracture.

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