1. Articles in category: Cardiology

    481-504 of 2259 « 1 2 ... 18 19 20 21 22 23 24 ... 93 94 95 »
    1. Predictors and incidence of stent edge dissections in patients with type 2 diabetes as determined by optical coherence tomography

      Predictors and incidence of stent edge dissections in patients with type 2 diabetes as determined by optical coherence tomography

      Patients with type 2 diabetes are at increased risk for post-PCI complications including stent thrombosis and restenosis. Stent edge dissections (SEDs) have been associated with these complications. This study assessed incidence and predictors of SEDs in patients with type 2 diabetes using optical coherence tomography (OCT). Intravascular lesion parameters and plaque morphology were investigated pre- and post-PCI using OCT in 73 type 2 diabetic patients with 90 lesions and 166 visible stent edges. We detected 42 (25.3 %) SEDs in 166 stent edges and 37 (41.1 %) SEDs in 90 lesions. More SEDs occurred if the border of the stent ...

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    2. Very late stent thrombosis after sirolimus-eluting stent implantation: evaluation by intravascular ultrasound and optical coherence tomography

      Very late stent thrombosis after sirolimus-eluting stent implantation: evaluation by intravascular ultrasound and optical coherence tomography

      A 58-year-old man was admitted to our hospital with acute anterior myocardial infarction that occurred 4 years after single sirolimus-eluting stent (SES) implantation in the left anterior descending artery. He had been undergoing continuous dual antiplatelet therapy. Emergency coronary angiography showed total thrombotic occlusion and peri-stent contrast staining at the SES site. The lesion was evaluated using intravascular ultrasound (IVUS) and optical coherence tomography (OCT) after thrombectomy. Vessel remodeling was detected on IVUS, and multiple interstrut hollows and thrombi were observed on OCT. These findings were associated with very late stent thrombosis after SES implantation.

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    3. Spontaneous Recanalization of Coronary Occlusion: Features with Optical Coherence Tomography

      Spontaneous Recanalization of Coronary Occlusion: Features with Optical Coherence Tomography

      Spontaneous recanalization of total coronary occlusions is occasionally found in patients undergoing catheterization. Establishing the accurate diagnosis on angiography can be difficult. 1 We report the case of a 65-yearold man who was referred to our center for a coronary angiogram. His cardiovascular risk factors included hypertension, cigarette smoking, and diabetes. He was completely asymptomatic, with no relevant cardiac or non-cardiac history. The coronary angiogram indicated silent inferior myocardial ischemia, which was documented by scintigraphy. Cardiac enzymes were negative. The electrocardiogram was unremarkable. Transthoracic echocardiography showed normal left ventricular kinetics. The coronary angiogram showed an intermediate stenosis of the left ...

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    4. Imaging Tech Could Lower Heart Disease Deaths

      Imaging Tech Could Lower Heart Disease Deaths

       Under a two-year, $498,325 Small Business Innovation Research (SBIR) Phase II National Science Foundation grant, Wasatch Photonics Inc. will continue the development of its intravascular optical coherence tomography technique, which shows where lesions and plaques have formed. Physicians can use these images to determine the best course of action, and to resolve issues such as stent placement. The technology will provide a new tool to identify and treat coronary artery disease, which “affects an estimated 16 million Americans and is a primary cause of heart attacks and strokes,” said William J. Brown, vice president of business development. “Identifying and ...

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    5. Imaging technology could lower coronary disease mortality rate

      Imaging technology could lower coronary disease mortality rate

      Wasatch Photonics Press Release - Patients undergoing angioplasty or other heart-related medical procedures could benefit from a new technology being developed with funding from the National Science Foundation (NSF). Optical imaging technology from Wasatch Photonics Inc. creates images of coronary artery walls in vivo to show where lesions and plaques have formed. Physicians can use the images to determine the best course of action, including where a stent might be placed. William J. Brown, vice president of business development at Wasatch Photonics, said the outcome of developing the technology will be the availability of a new tool to identify and treat ...

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    6. Coronary Superficial and Spotty Calcium Deposits in Culprit Coronary Lesions of Acute Coronary Syndrome as Determined by Optical Coherence Tomography

      Coronary Superficial and Spotty Calcium Deposits in Culprit Coronary Lesions of Acute Coronary Syndrome as Determined by Optical Coherence Tomography

      The characteristics of coronary artery calcium responsible for vulnerable plaque remain incompletely elucidated. We used optical coherence tomography to investigate the characteristics of coronary calcium in acute myocardial infarction (AMI), unstable angina pectoris (UAP), and stable angina pectoris (SAP). We evaluated calcium deposits in the culprit lesions (30-mm segment) using optical coherence tomography in 187 patients with AMI (n = 44), UAP (n = 73), or SAP (n = 70). The arc, area, and length of calcium were significantly smaller in those with AMI and UAP than in those with SAP (p <0.001). The number of spotty calcium deposits (with an arc ...

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    7. Apparatus, systems, and methods of in-vivo blood clearing in a lumen

      Apparatus, systems, and methods of in-vivo blood clearing in a lumen

      In one aspect, the invention relates to a computer-implemented method of triggering optical coherence tomography data collection. The method includes collecting optical coherence tomography data with respect to a vessel using an optical coherence tomography probe disposed in the vessel; determining a clearing radius and a quality value for each frame of optical coherence tomography data collected for the vessel using a computer; determining if a blood clearing state has occurred using at least one clearing radius and at least one quality value; and generating a trigger signal in response to the blood clearing state

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    8. Vascular Healing Early After Titanium-Nitride-Oxide-Coated Stent Implantation Assessed by Optical Coherence Tomography

      Vascular Healing Early After Titanium-Nitride-Oxide-Coated Stent Implantation Assessed by Optical Coherence Tomography

      The efficacy and safety of titanium -nitride-oxide-coated bioactive stents (BASs) were demonstrated in prior studies. In a prospective registry, we sought to explore the extent of neointimal coverage of stent struts by optical coherence tomography (OCT) at 30 days following the implantation of BASs in an unselected non-diabetic population. Methods. We enrolled 20 consecutive non-diabetic patients who underwent BAS implantation. OCT images were obtained at 30-day follow-up. Binary stent strut coverage was defined as the number of covered struts as a percentage of all analyzed struts. Results. Patients underwent OCT examination at an average of 30.5 ± 5.7 days ...

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    9. Clinical and Research Applications of Optical Coherence Tomography Imaging in Coronary Artery Disease (Book Chapter)

      Clinical and Research Applications of Optical Coherence Tomography Imaging in Coronary Artery Disease (Book Chapter)

      Optical coherence tomography (OCT) is an optical analog of intravascular ultrasound (IVUS) that allows microscopic visualization of coronary plaque types and intracoronary tissue. The high-resolution images of OCT produce an intense interest in adopting this imaging technique for both clinical and research purposes. In clinical aspects, OCT imaging for undergoing percutaneous coronary intervention (PCI) is feasible and provides superior resolution of arterial pathology than IVUS. During PCI, OCT can assess pre-procedural coronary plaque morphology and acute effects of coronary intervention (dissection, tissue prolapse, thrombi, and incomplete stent apposition (ISA)). Moreover, OCT provides more useful information to consider PCI strategy, such ...

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    10. Optical coherence tomography and hyperspectral imaging of vascular recovery in a model of peripheral arterial disease

      Optical coherence tomography and hyperspectral imaging of vascular recovery in a model of peripheral arterial disease

      Peripheral arterial disease (PAD) leads to an increased risk of myocardial infarction and stroke, increased mortality, and reduced quality of life. The mouse hind limb ischemia (HLI) model is the most commonly used system for studying the mechanisms of collateral vessel formation and for testing new PAD therapies, but there is a lack of techniques for acquiring physiologically-relevant, quantitative data intravitally in this model. In this work, non-invasive, quantitative optical imaging techniques were applied to the mouse HLI model over a time course. Optical coherence tomography (OCT) imaged changes in blood flow (Doppler OCT) and microvessel morphology (speckle variance OCT ...

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    11. Very late stent thrombosis after paclitaxel-eluting stent implantation with full neointimal tissue coverage visualized by optical coherence tomography

      Very late stent thrombosis after paclitaxel-eluting stent implantation with full neointimal tissue coverage visualized by optical coherence tomography

      We present findings of a very late stent thrombosis (VLST) involving paclitaxel-eluting stents (PESs) that were fully covered by thin neointima, visualized by optical coherence tomography (OCT) in a patient receiving dual antiplatelet therapy. A 69-year-old Japanese man had been treated with 2 overlapping PESs for chronic coronary artery disease in the proximal right coronary artery. A follow-up coronary computed tomography angiography showed no restenosis in the stent site, and the result of stress myocardial perfusion imaging showed no ischemic changes. Seventeen months after the percutaneous coronary intervention, he was transported to our clinic with a diagnosis of acute myocardial ...

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    12. Appearance of neointima according to stent type and restenotic phase: analysis by optical coherence tomography

      Appearance of neointima according to stent type and restenotic phase: analysis by optical coherence tomography

      Aims: The features of neointima after bare metal stent (BMS) or drug-eluting stent (DES) implantation have not yet been fully characterised. The aim of this study was to investigate in-stent neointima characteristics according to stent type and restenotic phase. Methods and results: The study included 59 consecutive patients undergoing target lesion revascularisation for in-stent restenosis (ISR) evaluated by optical coherence tomography (OCT) during the early phase (≤1 year, n=30) and late phase (>1 year, n=29) after either BMS (n=37) or DES (n=22) implantation. The OCT signal patterns of tissues at the minimal lumen area were categorised ...

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    13. Edge Vascular Response After Percutaneous Coronary Intervention : An Intracoronary Ultrasound and Optical Coherence Tomography Appraisal: From Radioactive Platforms to First- and Second-Generation Drug-Eluting Stents and Bioresorbable Scaffolds

      Edge Vascular Response After Percutaneous Coronary Intervention : An Intracoronary Ultrasound and Optical Coherence Tomography Appraisal: From Radioactive Platforms to First- and Second-Generation Drug-Eluting Stents and Bioresorbable Scaffolds

      The concept of edge vascular response (EVR) was first introduced with bare-metal stents and later with radioactive stents of various activity levels. Although radioactive stents reduced intra-stent neointimal hyperplasia and thereby the incidence of in-stent restenosis in a dose-dependent manner, tissue proliferation at the non-irradiated proximal and distal stent edges resulted in the failure of this invasive treatment. The advent of first- and second-generation drug-eluting stents (DES) reduced in-stent restenosis to approximately 5% to 10%, depending on the lesion subset and DES type. When in-segment restenosis (stent and 5-mm proximal and distal margins) occurred, it was most commonly focal and ...

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    14. Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention

      Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention

      We compared intravascular ultrasound (IVUS) and 2 different generations of optical coherence tomography (OCT)—time-domain OCT (TD-OCT) and frequency-domain OCT (FD-OCT)—for the assessment of coronary disease and percutaneous coronary intervention (PCI) using stents. Background OCT is a promising light-based intravascular imaging modality with higher resolution than IVUS. However, the paucity of data on OCT image quantification has limited its application in clinical practice. Methods A total of 227 matched OCT and IVUS pull backs were studied. One hundred FD-OCT and IVUS pull backs in nonstented (n = 56) and stented (n = 44) vessels were compared. Additionally, 127 matched TD-OCT and ...

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    15. Comparison of Ticagrelor Versus Clopidogrel on Residual Thrombus Burden During PCI: an OCT Study

      Comparison of Ticagrelor Versus Clopidogrel on Residual Thrombus Burden During PCI: an OCT Study

      Subjects with acute coronary syndromes scheduled for cardiac catheterization will be enrolled in this study. Subjects that are to be treated clinically with coronary artery stenting will be randomized to receive a loading dose of clopidogrel versus ticagrelor after diagnostic angiography but prior to stenting. Optical coherence tomography (OCT) will be performed after stenting and the presence of blood clots inside the new stent will be measured and compared between the groups.

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    16. Iatrogenic coronary ostial stenosis of left main stem following aortic valve replacement: Visualization with optical coherence tomography

      Iatrogenic coronary ostial stenosis of left main stem following aortic valve replacement: Visualization with optical coherence tomography

      Iatrogenic coronary ostial stenosis following aortic valve replacement (AVR) occurs in up to 3.4% of cases and usually presents within the first 6 months following surgery. We present the case of an 85 year old man who developed an acute coronary syndrome 2 months following AVR. Coronary angiography revealed a severe de novo lesion in the left main stem, which, on optical coherence tomography, was shown to be due to severe intimal hyperplasia. The most likely underlying mechanism is vessel wall trauma caused by the rigid tip cannula used for administration of cardioplegia solution. Surgeons should be aware of ...

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    17. Non-Culprit Coronary Plaque Characteristics of Chronic Kidney Disease

      Non-Culprit Coronary Plaque Characteristics of Chronic Kidney Disease

      Background —Chronic kidney disease (CKD) promotes the development of atherosclerosis and increases the risk of cardiovascular disease. The aim of the present study was to compare the coronary plaque characteristics of patients with and without CKD using optical coherence tomography (OCT). Methods and Results —We identified 463 non-culprit plaques from 287 patients from the MGH OCT Registry. CKD was defined as estimated glomerular filtration rate (eGFR) < 60ml/min/1.73m 2 . 402 plaques (250 patients) were in the non-CKD group and 61 plaques (37 patients) were in the CKD group. Compared to non-CKD plaques, plaques with CKD had a larger ...

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    18. Tissue Characterization After Drug-Eluting Stent Implantation Using Optical Coherence Tomography

      Tissue Characterization After Drug-Eluting Stent Implantation Using Optical Coherence Tomography

      Objective— To validate optical coherence tomography (OCT) imaging for assessment of vascular healing in a preclinical animal model and human autopsy cases and to translate the findings to the assessment of vascular healing after drug-eluting stent implantation in clinical practice. Approach and Results— Drug-eluting stent and bare metal stents were imaged 28 and 42 days after implantation in atherosclerotic rabbits using OCT and simultaneously evaluated by histology. After coregistration with histology, gray-scale signal intensity (GSI) was measured for identified mature or immature neointimal tissue. Autopsy specimens were imaged with OCT and GSI values correlated with histology. Finally, prospective OCT imaging ...

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    19. In Vivo Flow Simulation at Coronary Bifurcation Reconstructed by Fusion of 3-Dimensional X-ray Angiography and Optical Coherence Tomography [Images and Case Reports in Interventional Cardiology]

      In Vivo Flow Simulation at Coronary Bifurcation Reconstructed by Fusion of 3-Dimensional X-ray Angiography and Optical Coherence Tomography [Images and Case Reports in Interventional Cardiology]

      High-quality reconstruction of coronary bifurcations is crucial in the evaluation of lesions, dedicated bifurcation stents, and stent techniques. Although 3-dimensional (3D) X-ray angiography restores natural bending of vascular structures, optical coherence tomography (OCT) provides an ultra–high resolution of the vessel wall morphology and stents at baseline and follow-up. We present a new method for 3D fusion of the 2 imaging modalities combined with flow simulation at the target bifurcation. A 63-year-old woman was admitted for percutaneous coronary intervention attributable to severe stenosis (Figure 1A) in the left anterior descending artery (LAD) at the bifurcation of the first diagonal branch ...

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    20. Relationship between optical coherence tomography derived intraluminal and intramural criteria and haemodynamic relevance as determined by fractional flow reserve in intermediate coronary stenoses of patients with type 2 diabetes

      Relationship between optical coherence tomography derived intraluminal and intramural criteria and haemodynamic relevance as determined by fractional flow reserve in intermediate coronary stenoses of patients with type 2 diabetes

      Background The relationship between functional relevance and optical coherence tomography (OCT)-derived measurements of coronary lesions is incompletely understood and of critical importance, particularly in cardiovascular high-risk patients with type 2 diabetes. Objective To investigate the association between functional relevance of intermediate grade coronary stenoses as assessed by fractional flow reserve (FFR) and OCT-derived lesion parameters in patients with diabetes. Methods In 46 diabetic patients with stable coronary artery disease, FFR and OCT were performed in 62 coronary lesions with intermediate severity as determined by quantitative coronary angiography. Among lesions haemodynamic relevance was defined as FFR≤0.8. Results There ...

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    21. FFR or OCT Guidance to RevasculariZe Intermediate Coronary Stenosis Using Angioplasty

      FFR or OCT Guidance to RevasculariZe Intermediate Coronary Stenosis Using Angioplasty

      Whether to revascularize patients with angiographically-intermediate coronary lesions (AICL) is a major clinical issue. Intravascular techniques (assessing either the anatomy or the functional effect of coronary stenoses) are routinely used to better characterize coronary lesions. Among these, flow fractional reserve (FFR) provides validated functional insights while optical coherence tomography (OCT) provides high resolution anatomic imaging. Both techniques may be applied to guide decisions regarding the opportunity to revascularize patients with AICL and to optimize the result of percutaneous coronary intervention (PCI). We aim to compare the clinical and the economical impact of FFR versus OCT guidance in the percutaneous management ...

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    22. Very late active stent thrombosis: Contribution of optical coherence tomography

      Very late active stent thrombosis: Contribution of optical coherence tomography

      Angiographic imaging of left anterior descending artery. A. Intrastent proximal LAD occlusion. B. TIMI-3 flow after LAD thrombus aspiration: 50% residual diameter stenosis of LAD, thrombus in first diagonal. C. Angiographic result after repeated thrombus aspiration in LAD. D. Angiographic follow-up at day 2: residual diameter stenosis < 10%. E. Optimal angiographic result at day 30.

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    23. Optical coherence tomography for characterization of cardiac allograft vasculopathy after heart transplantation (OCTCAV study)

      Optical coherence tomography for characterization of cardiac allograft vasculopathy after heart transplantation (OCTCAV study)

      BACKGROUND Optical coherence tomography (OCT) is a novel intravascular imaging modality with excellent spatial resolution. This study explored the utility of OCT in cardiac transplantation for the detection and characterization of early changes associated with coronary allograft vasculopathy (CAV). METHODS Fifteen consecutive patients, 1 to 4 years after transplant with no angiographic evidence of CAV, underwent successful OCT imaging using the Fourier-domain OCT system (C7-XR, St. Jude Medical, St. Paul, MN) in the left anterior descending artery. Analysis included measurements of the lumen, intima, and media layers, and characterization of atherosclerotic plaques. Patients were stratified by intima-to-media (I/M) ratio ...

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