1. Articles in category: Cardiology

    481-504 of 2860 « 1 2 ... 18 19 20 21 22 23 24 ... 118 119 120 »
    1. Three-vessel coronary artery disease evaluation by multimodality imaging with Near-Infrared Spectroscopy (NIRS) plus Intravascular Ultrasound (IVUS) and Optical Coherence Tomography (OCT)

      Three-vessel coronary artery disease evaluation by multimodality imaging with Near-Infrared Spectroscopy (NIRS) plus Intravascular Ultrasound (IVUS) and Optical Coherence Tomography (OCT)

      There is a rapid evolution in hybrid intravascular imaging for identifying high-risk biological and structural coronary arterial plaques in vivo and searching the missing pieces of the complex puzzle that determine the pathophysiology of myocardial infarction [1].

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    2. Are the findings of optical coherence tomography sufficient for the evaluation of the safety and efficacy of the next generation of drug eluting stents

      Are the findings of optical coherence tomography sufficient for the evaluation of the safety and efficacy of the next generation of drug eluting stents

      The cr8 stent is a next generation drug eluting stent (DES) with a polymer free abluminal reservoir drug release system. It uses an organic fatty acid permeation enhancer and a carbon surface to increase biocompatibility. The fatty acid enhancer may have beneficial effect in improving drug delivery in diabetic patient where neointimal hyperplasia is particularly problematic[1]. These types of design features are exciting new developments and may provide novel strategies for improving the safety and efficacy of the next generation of coronary stents.

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    3. Insights into the spatial distribution of lipid-rich plaques in relation to coronary artery bifurcations: an in-vivo optical coherence tomography study

      Insights into the spatial distribution of lipid-rich plaques in relation to coronary artery bifurcations: an in-vivo optical coherence tomography study

      Objectives: The aim of this study was to investigate the spatial location of vulnerable plaques at coronary artery bifurcations using frequency domain-optical coherence tomography. Background: In-vivo data on geometric location of vulnerable plaques in relation to coronary bifurcation are limited. Materials and methods: A total of 40 patients with left anterior descending artery bifurcation were studied. Plaque characteristics in five regions in relation to a side branch were compared: opposite flow divider (OFD); bifurcation site (BF); main branch side proximal (MBP); side branch side proximal (SBP); and flow divider (FD). Frequency domain-optical coherence tomography was used for plaque characterization. Results ...

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    4. Optical coherence tomography imaging of inoperable chronic thromboembolic pulmonary hypertension treated with refined balloon pulmonary angioplasty

      Optical coherence tomography imaging of inoperable chronic  thromboembolic pulmonary hypertension treated with refined balloon  pulmonary angioplasty

      Chronic thromboembolic pulmonary hypertension (CTEPH) usually results from the chronic obstruction of the pulmonary arteries by unresolved thromboemboli following acute pulmonary embolism (PE). Surgical pulmonary endarterectomy is the first-line therapy in CTEPH, however some patients are inoperable due to high perioperative risk or distal localization of thrombi. Balloon pulmonary angioplasty (BPA), a new emerging therapy, with growing evidence has been adopted in this group of patients [1]. Recently refined BPA has been described with use of new imaging modalities, which markedly improved both BPA efficacy and safety [2,3]. Optical coherence tomography (OCT) is a novel, promising tool and was ...

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    5. Lipid-rich plaque in possible coronary sequelae of Kawasaki disease detected by optical frequency domain imaging

      Lipid-rich plaque in possible coronary sequelae of Kawasaki disease detected by optical frequency domain imaging

      Potential risk for early development of atherosclerosis in patients with antecedent- Kawasaki disease (KD) is now attracting more attention. A 47-year-old man was admitted to our hospital because of calcification exclusively in the proximal segment of left anterior descending coronary artery (LAD) on chest CT. Coronary CT revealed a severe stenosis at the inlet of the aneurysm with eggshell-like calcification in the proximal LAD, highly suspecting the presence of coronary sequelae of KD. During the rotational atherectomy-based interventional procedure, optical frequency domain imaging, a new generation of optical coherence tomography, clearly depicted lipid deposition in the culprit lesion.

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    6. Dual role of circulating endothelial progenitor cells in stent struts endothelialisation and neointimal regrowth: a substudy of the IN-PACT Coro trial

      Dual role of circulating endothelial progenitor cells in stent struts endothelialisation and neointimal regrowth: a substudy of the IN-PACT Coro trial

      Background Endothelialisation is a crucial event after percutaneous coronary intervention (PCI). Endothelial progenitor cells (EPC) are bone marrow derived elements with reparative properties. We aimed to assess the relationship between circulating EPC levels and stent neointimal hyperplasia (NIH) using frequency domain optical coherence tomography (FD-OCT). Methods Patients undergoing elective PCI to native vessels and randomized to bare metal stent (BMS) alone versus BMS plus drug coated balloon (DCB) were included. At six months, angiographic follow-up and FD-OCT were performed to measure percentage neointimal hyperplasia volume obstruction (%NIHV), and percentage of uncovered stent struts (%US). Venous blood samples were obtained before ...

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      Mentions: Francesco Prati
    7. Vascular Healing After Deployment of Titanium-nitride-oxide-coated OPTIMAX™ Stent and PROMUS-ELEMENT™ Everolimus-Eluting Stent

      Vascular Healing After Deployment of Titanium-nitride-oxide-coated OPTIMAX™ Stent and PROMUS-ELEMENT™ Everolimus-Eluting Stent

      The purpose of this study is to compare vascular healing of the stented segment after deployment of titanium-nitride-oxide coated cobalt-chromium Optimax™-stent stent and Promus-Element™ everolimus-eluting stent in patients with acute coronary syndromes requiring percutaneous coronary intervention. Comparison of OCT and CFR findings of titanium-nitride-oxide coated cobalt-chromium Optimax™-stent and Promus-Element™ everolimus-eluting stent at two months after the index procedure. Comparison of intravascular coronary flow reserve measurement to non-invasive transthoracic echocardiography-derived coronary flow reserve measurement. Comparison of epicardial vasodilation to coronary microcirculatory vasodilation

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    8. Identification of vessel wall degradation in ascending thoracic aortic aneurysms with OCT

      Identification of vessel wall degradation in ascending thoracic aortic aneurysms with OCT

      Degradation of the wall of human ascending thoracic aorta has been assessed through Optical Coherence Tomography (OCT). OCT images of the media layer of the aortic wall exhibit micro-structure degradation in case of diseased aortas from aneurysmal vessels. The OCT indicator of degradation depends on the dimension of areas of the media layer where backscattered reflectivity becomes smaller due to a disorder on the morphology of elastin, collagen and smooth muscle cells (SMCs). Efficient pre-processing of the OCT images is required to accurately extract the dimension of degraded areas after an optimized thresholding procedure. OCT results have been validated against ...

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    9. Measurement of the blood flow rate and velocity in coronary artery stenosis using intracoronary frequency domain optical coherence tomography: Validation against fractional flow reserve

      Measurement of the blood flow rate and velocity in coronary artery stenosis using intracoronary frequency domain optical coherence tomography: Validation against fractional flow reserve

      Objectives The main objective of this study was to assess the blood flow rate and velocity in coronary artery stenosis using intracoronary frequency domain optical coherence tomography (FD-OCT). A correlation between fractional flow reserve (FFR) and FD-OCT derived blood flow velocity is also included in this study. Methods & Results A total of 20 coronary stenoses in 15 patients were assessed consecutively by quantitative coronary angiography (QCA), FFR and FD-OCT. A percutaneous coronary intervention (PCI) optimization system was used in this study which combines wireless FFR measurement and FD-OCT imaging in one platform. Stenoses were labelled severe if FFR ≤ 0.8 ...

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    10. Outcomes of everolimus-eluting stent incomplete stent apposition: a serial optical coherence tomography analysis

      Outcomes of everolimus-eluting stent incomplete stent apposition: a serial optical coherence tomography analysis

      Aim The aim of the present study was to evaluate the natural course of acute incomplete stent apposition (ISA) after second-generation everolimus-eluting stent (EES) when compared with first-generation sirolimus-eluting stent (SES) by using optical coherence tomography (OCT). Methods and results From the OCT substudy of the RESET trial, we identified 77 patients (EES = 38 and SES = 39) who successfully underwent serial OCT examination at post-stenting and 8–12-month follow-up. The presence of ISA was assessed in the OCT images, and ISA distance was measured from the centre of the strut blooming to the adjacent lumen border. Incomplete stent apposition was ...

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    11. Optical coherence tomography investigation of ischemic stroke inside a rodent model

      Optical coherence tomography investigation of ischemic stroke inside a rodent model

      Although already in use in several medical domains, only recently optical coherence tomography (OCT) has been applied in the study of ischemic events. In this paper, we will focus on characterizing ischemic stroke, in a rat model, by OCT. Investigations were carried on a set of 25 rats, on which ischemic stroke was inflicted by a transient occlusion of the middle cerebral artery (tMCAO). Animals were sacrificed 1, 3, 7 and 28 days after occlusion. We tested the OCT’s power of detection and discrimination of stroke area compared to both normal, contralateral hemisphere and non-affected brain tissue, together with ...

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    12. Very late neoatherosclerotic plaque rupture in drug-eluting stent restenosis

      Very late neoatherosclerotic plaque rupture in drug-eluting stent restenosis

      A 71-year-old man presented in emergency department for non-ST-elevation myocardial infarction. At admission, 12-lead ECG was in sinus rhythm without sign of myocardial ischemia, and troponin slightly increased. The only notable feature of the patient's medical history was single-vessel coronary artery disease revealed 10 years previously, treated by stenting of the second segment of the right coronary artery with a 3.0 x 25 mm bare metal stent. Three months later, intrastent restenosis was managed by implantation of a 3.0 x 28 mm paclitaxel-eluting stent. Two years before the present admission, following a non contributive stress test for ...

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    13. Optical Coherence Tomography Guided Percutaneous Coronary Intervention With Stent Implantation

      Optical Coherence Tomography Guided Percutaneous Coronary Intervention With Stent Implantation

      Coronary artery disease is one of the most prevalent diseases in the western countries. A waxy substance called plaque can build up inside the coronary arteries. Over time, plaque can harden or rupture, and cause narrowing (stenosis) of the arteries and reduce the flow of oxygen-rich blood to the heart. The standard treatment of symptomatic coronary stenosis is percutaneous coronary intervention (PCI) with balloon dilation followed by stent implantation. A stent is a small metallic grid that stabilizes the coronary vessel wall after the balloon dilation. Currently, drug-eluting stents (DES) are the most widely used stent types. DESs consist of ...

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    14. Comparison of Circulating Dendritic Cells and Monocyte Subsets at Different Stages of Atherosclerosis: insights from optical coherence tomography

      Comparison of Circulating Dendritic Cells and Monocyte Subsets at Different Stages of Atherosclerosis: insights from optical coherence tomography

      Objectives Proinflammatory dendritic cells (DC) and monocytes are critically involved in the proceeding and destabilization of atherosclerosis. Recent studies have reported potential associations of specific patterns of circulating DCs and monocytes with the incidence of coronary artery disease (CAD) and ST-elevation myocardial infarction (STEMI); however, further information of DC and monocyte subsets on plaque morphology and vulnerability is uncertain and required. Methods Forty-seven CAD patients with borderline lesions (stenosis 50%-70%) by coronary angiography (CAG) were enrolled, while 31 subjects free of luminal diameter narrowing ≥ 50% served as controls. Likewise, 35 patients with STEMI were enrolled and confirmed with the ...

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    15. The Role of Multimodality Imaging Approach in Diagnosis and Stratification of Aborted Sudden Cardiac Death

      The Role of Multimodality Imaging Approach in Diagnosis and Stratification of Aborted Sudden Cardiac Death

      A 34-year-old man was admitted after an episode of aborted SCD. The initial investigation including electrocardiogram, chest X-ray, transthoracic echocardiogram and biomarkers were normal. Although coronary angiography showed non-severe stenosis, optical coherence tomography revealed severe obstruction in the artery with a layered appearance of the vessel wall; it was consistent with the presence of mural thrombus.

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    16. Progress of Intravascular Optical Coherence Tomography Image Technology and Vascular Three-Dimensional Reconstruction

      Progress of Intravascular Optical Coherence Tomography Image Technology and Vascular Three-Dimensional Reconstruction

      Intravascular optical coherence tomography (IV-OCT) is a new intervention imaging technology for the diagnosis of coronary heart disease. Because of its high-resolution and non-invasive characteristics, it is widely used in clinical medicine. It has a revolutionary impact on coronary artery disease diagnosis, prognosis and treatment decisions. This paper studied this hot topic, gave the basic concepts of intravascular OCT image sequences. In accordance with current development studies, the key technology for three-dimensional reconstruction of the coronary vascular system is proposed and analyzed. On this basis, we proposed future research directions on IV-OCT vascular three-dimensional reconstruction, including clinical trial frequency domain ...

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    17. Optical Coherence Tomography (OCT) Findings of Coronary Computed Tomography Angiography (CTA) Detected Vulnerable Plaque

      Optical Coherence Tomography (OCT) Findings of Coronary Computed Tomography Angiography (CTA) Detected Vulnerable Plaque

      Background: Recently, coronary computed tomography angiography (CTA) findings of positive vessel remodeling (PR) and low-attenuation plaque (LAP) have been reported to be associated with the development of acute coronary syndromes (ACS). The aim of this study was to examine the CTA detected vulnerable plaque characteristics by using intracoronary optical coherence tomography (OCT). Method and Result: A total of 16 patients with 16 lesions underwent PCI by using intracoronary OCT, after coronary CTA examination, were enrolled in this study. The CTA detected vulnerable plaque (CT-VP) was defined as LAP (<30 hounsfield unit (HU)) with PR of at least 110%. The lesions ...

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    18. Longitudinal necrotic shafts near TCFAs—A potential novel mechanism for plaque rupture to trigger ACS?

      Longitudinal necrotic shafts near TCFAs—A potential novel mechanism for plaque rupture to trigger ACS?

      It has been questioned for over 15 years why only less than 20% of TCFAs trigger ACS. We illustrate TCFA rupture into adjacent longitudinal necrotic shafts of massive amounts of thrombogenic material into the blood, leading to catastrophic clot formation. This is the potential mechanism for TCFAs triggering ACS. One case presented also illustrates the dangers of stent edges rupturing TCFAs.

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    19. Spontaneous coronary artery dissection: a case series and literature review

      Spontaneous coronary artery dissection: a case series and literature review

      Spontaneous coronary artery dissection (SCAD) is a rare and often lethal cause of acute coronary syndrome, which typically affects young women and otherwise healthy individuals. SCAD can be diagnosed in patients undergoing coronary angiography and can be underestimated. Special techniques such as optical coherence tomography (OCT) and intravascular ultrasound should be used when there is suspicion of the condition. In the majority of cases, the left anterior descending (LAD) artery is involved; however, a few cases of the right coronary artery (RCA) involvement have been reported. This article describes three cases of SCAD in women of different ages, all presenting ...

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    20. Follow up evaluation of unapposed bioresorbable vascular scaffold at a coronary bifurcation using optical coherence tomography

      Follow up evaluation of unapposed bioresorbable vascular scaffold at a coronary bifurcation using optical coherence tomography

      The acute and long term performance of bioresorbable scaffolds (BVS) in treating ostial or bifurcation coronary lesions has not been established. In particular, treatment of these lesions presents the potential problems of non-apposition of struts proximal to the ostium of the vessel or in side branches. Data is also lacking as to whether additional scaffolds can be delivered through struts into side branches for two stent approaches to bifurcations. Despite this there have very few reports of any adverse consequences resulting from their use in these lesions.

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    21. 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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