1. Articles in category: Cardiology

    481-504 of 3291 « 1 2 ... 18 19 20 21 22 23 24 ... 136 137 138 »
    1. Fatal Kawasaki disease with incomplete criteria: Correlation between optical coherence tomography and pathology

      Fatal Kawasaki disease with incomplete criteria: Correlation between optical coherence tomography and pathology

      Coronary artery aneurysm is a serious complication of Kawasaki disease (KD). A 3-month-old infant presented with severe KD 27 days after onset of fever. The patient presented with shock, inferolateral ischemia on electrocardiogram and high troponin. Echocardiography showed severe myocardial dysfunction with diffuse coronary dilation and right coronary artery aneurysm. Arterial Doppler demonstrated thrombosis of aneurysmal axillary and iliac arteries. Withdrawal of support was implemented due to multi-organ failure. Post-mortem optical coherence tomography correlated with pathology. The pulmonary artery was normal on OCT and histology. Coronary arteries showed aneurysmal dilatation, with intimal hyperplasia and preserved media on OCT. Pathology confirmed ...

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    2. Temporal Trends in Strut-Level Optical Coherence Tomography Evaluation of Coronary Stent Coverage

      Temporal Trends in Strut-Level Optical Coherence Tomography Evaluation of Coronary Stent Coverage

      Objectives We sought to pool data from all studies with reported strut-level data in human subjects evaluated by optical coherence tomography (OCT) surveillance and to compare the aggregate data of stent strut coverage on a longitudinal temporal timeline from initial implantation for different coronary stent subtypes. Background Delayed strut coverage following drug-eluting stent (DES) implantation is an important contributor to late stent thrombosis (LST). OCT can detect stent strut coverage. Methods We conducted a systematic search of published or presented studies reporting OCT stent strut coverage of bare-metal stents (BMS) and DES in PubMed, Embase, Web of Science, and the ...

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    3. Time-related changes in neointimal tissue coverage of a novel Sirolimus eluting stent: Serial observations with optical coherence tomography

      Time-related changes in neointimal tissue coverage of a novel Sirolimus eluting stent: Serial observations with optical coherence tomography

      Background DES has reduced rates of restenosis compared with BMS but it has been associated with delayed healing and increase of stent thrombosis. The aim of our study was to evaluate the vascular time-related changes following implantation of a new SES coated with an amorphous silicon carbide that allows faster re-endothelisation (Orsiro-Biotronik). Methods This prospective registry enrolled STEMI-patients with multi-vessel disease, thus candidates for a two-step procedure. PCI of the culprit lesion was performed with at least one Orsiro stent that was OCT-analysed during the second-step procedure (deferred to 30,90 and 180-days). Results 16 of the 95 patients with ...

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      Mentions: Carlo Di Mario
    4. Imaging Modalities to Identity Inflammation in an Atherosclerotic Plaque

      Imaging Modalities to Identity Inflammation in an Atherosclerotic Plaque

      Atherosclerosis is a chronic, progressive, multifocal arterial wall disease caused by local and systemic inflammation responsible for major cardiovascular complications such as myocardial infarction and stroke. With the recent understanding that vulnerable plaque erosion and rupture, with subsequent thrombosis, rather than luminal stenosis, is the underlying cause of acute ischemic events, there has been a shift of focus to understand the mechanisms that make an atherosclerotic plaque unstable or vulnerable to rupture. The presence of inflammation in the atherosclerotic plaque has been considered as one of the initial events which convert a stable plaque into an unstable and vulnerable plaque ...

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    5. Extremely Late Catch-Up Phenomenon After First-Generation Sirolimus-Eluting Stent in the Left Main Stem

      Extremely Late Catch-Up Phenomenon After First-Generation Sirolimus-Eluting Stent in the Left Main Stem

      A 72-year-old man had undergone angioplasty of the left main stem (LMS) with an implantation of a first-generation drug-eluting stent (DES) (3.5 × 18-mm Cypher stent, Cordis, Johnson & Johnson, Bridgewater, New Jersey) ( Figure 1A ). Post-procedural intravascular ultrasound (IVUS) had shown a well-expanded stent ( Figures 1A′ and 1Aa–c ). Four years later, both angiography and IVUS exhibited no significant in-stent restenosis (ISR) or stent recoil ( Figures 1B, 1B′, and 1Ba′–c′ ). At 7 years, he presented with acute coronary syndrome (ACS) while still on long-term dual antiplatelet therapy. A subsequently obtained coronary angiogram exhibited severe ISR at the midshaft of LMS ...

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    6. Coronary bifurcation treated with the hybrid mini-crush approach: a potential application of three-dimensional optical coherence tomography to optimise stent apposition - See more at: http://www.pcronline.com/eurointervention/91st_issue/volume-11/number-8

      Coronary bifurcation treated with the hybrid mini-crush approach: a potential application of three-dimensional optical coherence tomography to optimise stent apposition - See more at: http://www.pcronline.com/eurointervention/91st_issue/volume-11/number-8

      A 55-year-old male underwent an exercise treadmill test which was positive at stage 1. Coronary angiography (Figure 1A, Moving image 1) demonstrated a long segment of disease in the proximal-mid left anterior descending (LAD) artery. A fractional flow reserve study was positive at 0.71, with no localising lesion on hyperaemic pullback. In addition, >5 mm disease was present in the ostial-proximal first diagonal. A hybrid mini-crush approach was adopted. The LAD was predilated with a 3.0 mm non-compliant (NC) balloon. A 2.25×24 mm Promus PREMIER (Boston Scientific, Marlborough, MA, USA) drug-eluting stent (DES) was implanted in ...

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    7. Optical coherence tomography (OCT) evaluation of intermediate coronary lesions in patients with NSTEMI - Cardiovascular Revascularization Medicine

      Optical coherence tomography (OCT) evaluation of intermediate coronary lesions in patients with NSTEMI - Cardiovascular Revascularization Medicine

      Introduction Coronary angiography is commonly performed following non-ST segment elevation myocardial infarction (NSTEMI) to assess the need for revascularization. Some of these patients have myocardial infarction (MI) with no obstructive coronary atherosclerosis (MINOCA). Patients without severe obstructive lesions are usually treated conservatively. However, coronary angiography has known limitations in the assessment of lesion severity. We report our experience of using coronary Optical Coherence Tomography (OCT) in a series of patients without severe obstructive coronary lesions. Methods 165 patients underwent coronary OCT at Vancouver General Hospital. NSTEMI was the clinical presentation in 70 patients and 26 had angiographically intermediate lesions with ...

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    8. The impact of in-stent neoatherosclerosis on long-term clinical outcomes: an observational study from the Kobe University Hospital optical coherence tomography registry

      The impact of in-stent neoatherosclerosis on long-term clinical outcomes: an observational study from the Kobe University Hospital optical coherence tomography registry

      Aims: Although pathological studies have indicated the development of neoatherosclerosis (NA) after stenting, its risk factors and impact on future clinical events remain unclear. We aimed to clarify the possible risk factors for NA development and to evaluate the impact of NA in a large Japanese observational OCT database of patients with coronary heart disease. Methods and results: One hundred and seventy-five consecutive patients (314 lesions) who underwent OCT examination >1 year after bare metal or drug-eluting stent implantation were enrolled. We assessed the presence of NA by follow-up OCT and compared adverse clinical events between NA+ and NA– patients ...

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    9. Optical coherence tomography-guided percutaneous coronary intervention in pre-terminal chronic kidney disease with no radio-contrast administration

      Optical coherence tomography-guided percutaneous coronary intervention in pre-terminal chronic kidney disease with no radio-contrast administration

      A 67-year-old man with advanced chronic kidney disease (CKD) (creatinine = 4.5 mg/dL, eGFR = 13 mL/min/1.73 m 2 ) not requiring haemodialysis presented with progressive angina. Diagnostic angiography with ultra-low radio-contrast volume (12 mL, contrast volume/eGFR ratio <1) revealed significant stenosis in the left anterior descending (LAD) artery ( Panel A ). The lesion was haemodynamically significant (fractional flow reserve: 0.77). Post-angiography, the …

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    10. Impact of Age on Stent Strut Coverage and Neointimal Remodeling as Assessed by Optical Coherence Tomography

      Impact of Age on Stent Strut Coverage and Neointimal Remodeling as Assessed by Optical Coherence Tomography

      Abstract: While older age associates with adverse percutaneous coronary intervention (PCI) outcomes, detailed information relating age to stent strut coverage and neointimal characteristics is lacking. One hundred nineteen patients with 123 sirolimus-eluting stents (SESs) were divided into 3 groups: group A (≤55 years), group B (56–65 years), and group C (>65 years). At 6 and 12 months of follow-up, optical coherence tomography was performed to assess strut coverage and neointimal remodeling. At 6 months, the proportion of uncovered struts increased with age: 6.1% in group A versus 7.3% in group B versus 11.7% in group C ...

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    11. Intravascular fibrin molecular imaging improves the detection of unhealed stents assessed by optical coherence tomography in vivo

      Intravascular fibrin molecular imaging improves the detection of unhealed stents assessed by optical coherence tomography in vivo

      Aims Fibrin deposition and absent endothelium characterize unhealed stents that are at heightened risk of stent thrombosis. Optical coherence tomography (OCT) is increasingly used for assessing stent tissue coverage as a measure of healed stents, but cannot precisely identify whether overlying tissue represents physiological neointima. Here we assessed and compared fibrin deposition and persistence on bare metal stent (BMS) and drug-eluting stent (DES) using near-infrared fluorescence (NIRF) molecular imaging in vivo, in combination with simultaneous OCT stent coverage. Methods and results Rabbits underwent implantation of one BMS and one DES without overlap in the infrarenal aorta ( N = 20 3.5 ...

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    12. Comparison of Intensive versus Moderate Lipid-lowering Therapy on Fibrous Cap and Atheroma Volume of Coronary Lipid-rich Plaque Using Serial Optical Coherence Tomography and Intravascular Ultrasound Imaging

      Comparison of Intensive versus Moderate Lipid-lowering Therapy on Fibrous Cap and Atheroma Volume of Coronary Lipid-rich Plaque Using Serial Optical Coherence Tomography and Intravascular Ultrasound Imaging

      Despite marked clinical benefit, reduction in atheroma volume with statin therapy is minimal. Changes in plaque composition may explain this discrepancy. We aimed in the present study to assess the effect of statin therapy on coronary plaque composition as well as plaque volume using serial multimodality imaging. From an open-label, single-blinded study, patients with angiographically mild to moderate lesion were randomized to receive atorvastatin 60 (AT 60) mg or atorvastatin 20 (AT 20) mg for 12 months. Optical coherence tomography (OCT) was used to assess fibrous cap thickness (FCT) and intravascular ultrasound (IVUS) to assess atheroma burden at three time ...

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    13. Ultrafast optical-ultrasonic system and miniaturized catheter for imaging and characterizing atherosclerotic plaques in vivo

      Ultrafast optical-ultrasonic system and miniaturized catheter for imaging and characterizing atherosclerotic plaques in vivo

      Atherosclerotic coronary artery disease (CAD) is the number one cause of death worldwide. The majority of CAD-induced deaths are due to the rupture of vulnerable plaques. Accurate assessment of plaques is crucial to optimize treatment and prevent death in patients with CAD. Current diagnostic techniques are often limited by either spatial resolution or penetration depth. Several studies have proved that the combined use of optical and ultrasonic imaging techniques increase diagnostic accuracy of vulnerable plaques. Here, we introduce an ultrafast optical-ultrasonic dual-modality imaging system and flexible miniaturized catheter, which enables the translation of this technology into clinical practice. This system ...

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    14. Plasma Pentraxin3 Level Is Associated With Plaque Vulnerability Assessed by Optical Coherence Tomography in Patients With Coronary Artery Disease

      Plasma Pentraxin3 Level Is Associated With Plaque Vulnerability Assessed by Optical Coherence Tomography in Patients With Coronary Artery Disease

      The role of pentraxin 3 (PTX3) has been implicated in the process of plaque vulnerability. However, few studies have addressed the direct relationship between plaque morphology and plasma PTX3. We evaluated the relationship between coronary vulnerable plaque, assessed by optical coherence tomography (OCT), and plasma PTX3 in patients with coronary artery disease (CAD). OCT was used to determine plaque vulnerability in 51 patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS; n = 17) and stable angina (SA; n = 34). Both highly-sensitive C-reactive protein and systemic plasma PTX3 were measured. Based on the OCT findings, patients were divided into 3 groups ...

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    15. High resolution imaging of the fibrous microstructure in bovine common carotid artery using optical polarization tractography

      High resolution imaging of the fibrous microstructure in bovine common carotid artery using optical polarization tractography

      Optical polarization tractography can visualize fiber orientation and alignment in carotid artery. The biomechanical properties of artery are primarily determined by the fibrous structures in the vessel wall. Many vascular diseases are associated with alternations in the orientation and alignment of the fibrous structure in the arterial wall. Knowledge on the structural features of the artery wall is crucial to our understanding of the biology of vascular diseases and the development of novel therapies. Optical coherence tomography (OCT) and polarization-sensitive OCT have shown great promise in imaging blood vessels due to their high resolution, fast acquisition, good imaging depth, and ...

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    16. Optical coherence tomography and coronary angiography as complement in therapeutic decisions

      Optical coherence tomography and coronary angiography as complement in therapeutic decisions

      Optical coherence tomography is an intracoronary diagnostic technique of high resolution, and its arrival has allowed a better diagnosis for the treatment of vascular diseases. The development of new systems for this tomography, which prevent artery occlusion, allows this technique to have greater utility and become standard practice in the hemodynamic laboratories for the characterization of coronary atherosclerotic plaque and for evaluating the inserted stent. The case of a patient that during an acute coronary syndrome with ST segment elevation was treated with thrombolytics and no signs of reperfusion were achieved is presented. Coronary angiography showed no significant stenosis regarding ...

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    17. Opsens eyes C$5M public offering

      Opsens eyes C$5M public offering

      Opsens , the Canada-based producer of fiber-optic sensors, is aiming to raise C$5 million in a new public offering of shares on the Toronto Stock Exchange. News of the offering comes shortly after the Quebec-based firm announced plans to move into a new facility as it looked to ramp production in early 2016. Opsens says that it is selling around 5.7 million stock "units" in co-operation with lead agent Paradigm Capital, as well as RBC Capital Markets and M Partners, Inc. The cash is set to be used to "prepare the commercialization and marketing strategy" of its fiber-optic pressure ...

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      Mentions: OpenSens
    18. Feature Of The Week 12/06/2015: Heartbeat Optical Coherence Tomography

      Feature Of The Week 12/06/2015: Heartbeat Optical Coherence Tomography

      Intravascular optical coherence tomography (IV-OCT) has gained widespread use over the past few years, offering highly detailed images of the coronary artery pathologies and interventions. In contrast to the cross-sectional view, longitudinal sections and three-dimensional (3D) renderings are affected by cardiac motion artifacts and undersampling, complicating interpretation and measurements. We developed Heartbeat OCT, a new OCT method that overcomes these issues. This study aims to demonstrate in vivo Heartbeat OCT in a preclinical setting, imaging eliminating cardiac motion artifacts, undersampling and non-uniform rotational distortion, to generate high-quality OCT volumes. Using a micro motor actuated catheter and a MHz sweep rate ...

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    19. VIDEO: Session explores benefits of OCT in cardiac cath lab

      VIDEO: Session explores benefits of OCT in cardiac cath lab

      In this video, Farouc Jaffer, MD, PhD, medical director of the CAD program at Massachusetts General Hospital, addresses the clinical utility of optical coherence tomography in the cardiac cath lab, which was discussed during a session on imaging modalities at the American Heart Association Scientific Session. Jaffer said the primary advantage of OCT is its "exquisitely high resolution," which is approximately 10 times that of intravascular ultrasound. One of the most important applications for OCT, he said, is improving understanding of the mechanisms of stent thrombosis. The increased detail of imaging obtained via OCT enables clinicians to determine whether a ...

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    20. Bioresorbable vascular scaffold treatment induces the formation of neointimal cap that seals the underlying plaque without compromising the luminal dimensions: a concept based on serial optical coherence tomography data

      Bioresorbable vascular scaffold treatment induces the formation of neointimal cap that seals the underlying plaque without compromising the luminal dimensions: a concept based on serial optical coherence tomography data

      Aims: To evaluate the implications of an Absorb bioresorbable vascular scaffold (Absorb BVS) on the morphology of the superficial plaques. Methods and results: Forty-six patients who underwent Absorb BVS implantation and 20 patients implanted with bare metal stents (BMS) who had serial optical coherence tomographic examination at baseline and follow-up were included in this analysis. The thin-capped fibroatheromas (TCFA) were identified in the device implantation regions and in the adjacent native coronary segments. Within all regions, circumferential locations of TCFA and calcific tissues were identified, and the neointimal thickness was measured at follow-up. At six to 12-month follow-up, only 8 ...

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    21. Co-registration of angiography and intravascular ultrasound images through image-based device tracking

      Co-registration of angiography and intravascular ultrasound images through image-based device tracking

      Objectives To determine the feasibility of automated co-registration of angiography and intravascular ultrasound (IVUS) to facilitate integration of these two imaging modalities in a synchronous manner. Background IVUS provides cross-sectional imaging of coronary arteries but lacks overview of the vascular territory provided by angiography. Co-registration of angiography and IVUS would increase utility of IVUS in the clinical setting. Methods Forty-nine consecutive patients undergoing surveillance for cardiac allograft vasculopathy with angiography and IVUS of the left anterior descending artery (LAD) were enrolled. A pre-IVUS angiogram of the LAD was performed followed by an ECG-triggered fluoroscopy (ECGTF) during IVUS pullback at 0 ...

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      Mentions: Siemens Amir Lerman
    22. OCT imaging of aorto-coronary vein graft pathology modified by external stenting: 1-year post-surgery

      OCT imaging of aorto-coronary vein graft pathology modified by external stenting: 1-year post-surgery

      Aims The Venous External Support Trial (VEST) evaluated whether a novel external stent attenuated saphenous vein graft (SVG) disease assessed with intravascular ultrasound 1 year following coronary artery bypass graft (CABG) surgery. This sub-study assessed SVGs with and without external stenting using optical coherence tomography (OCT). The aim of this study was to accurately compare quantitative and qualitative features of SVGs with and without a novel external stent using OCT. Methods and results Twenty-four of 30 patients (65 ± 8 years) enrolled in VEST underwent coronary angiography with OCT imaging using a non-occlusive technique. Quantitative analysis of lumen area was performed ...

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