1. Articles in category: Cardiology

    481-504 of 2504 « 1 2 ... 18 19 20 21 22 23 24 ... 103 104 105 »
    1. A coronary "tunnel": Optical coherence tomography assessment after rotational atherectomy

      A coronary "tunnel": Optical coherence tomography assessment after rotational atherectomy

      A 81-year-old woman was admitted for exertional angina. Coronary angiogram revealed a severely calcific proximal circumflex lesion. Rotational atherectomy was performed with 1.5 and 1.75 burrs, obtaining a good angiographic result. Optical coherence tomography (OCT) assessment revealed a large dissection parallel to the true lumen. We implanted a 3.0 mm × 38 mm Xience Prime ® stent and postdilated it with a 3.0-mm non-compliant balloon. Final OCT pullback showed mild malapposed struts with large lumen area. 3D-OCT reconstruction confirmed a large lumen after stent implantation.

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    2. IS CORONARY ANGIOGRAM STILL THE GOLD STANDARD FOR NON ST ELEVATION MI IMAGING?

      IS CORONARY ANGIOGRAM STILL THE GOLD STANDARD FOR NON ST ELEVATION MI IMAGING?

      Because of the discordant normal echocardiogram with the high elevation in troponin I and the ECG showing deep T waves inversion in the anterior leads, and in the absence of obvious coronary lesion, myocarditis was suspected. A cardiac magnetic resonance imaging scan (MRI) was performed the following day and was in favour of apical necrosis, showing an early inferoapical sub-endocardial perfusion defect and late transmural enhancement with no reflow. The patient was therefore rescheduled for coronary angiogram with intracoronary imaging. Optical coherence tomography (OCT) was performed in the left anterior descending coronary artery (LAD) using radial access (Terumo 6Fr introducer ...

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    3. Dynamics of vessel wall changes following the implantation of the Absorb everolimus-eluting bioresorbable vascular scaffold: a multi-imaging modality study at 6, 12, 24 and 36 months

      Dynamics of vessel wall changes following the implantation of the Absorb everolimus-eluting bioresorbable vascular scaffold: a multi-imaging modality study at 6, 12, 24 and 36 months

      Aims: To assess observations with multimodality imaging of the Absorb bioresorbable everolimus-eluting vascular scaffold performed in two consecutive cohorts of patients who were serially investigated either at 6 and 24 months or at 12 and 36 months. Methods and results: In the ABSORB multicentre single-arm trial, 45 patients (cohort B1) and 56 patients (cohort B2) underwent serial invasive imaging, specifically quantitative coronary angiography (QCA), intravascular ultrasound (IVUS), radiofrequency backscattering (IVUS-VH) and optical coherence tomography (OCT). Between one and three years, late luminal loss remained unchanged (6 months: 0.19 mm, 1 year: 0.27 mm, 2 years: 0.27 mm ...

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    4. Atherectomy catheter with first and second imaging devices

      Atherectomy catheter with first and second imaging devices

      An atherectomy catheter is provided for excising and imaging material in a body lumen. In one embodiment, the catheter comprises a catheter body, a cutting blade, and an imaging device. The cutting blade is mounted on the catheter body and configured to move between a first position and a second position relative to an aperture or cutting window. When the cutting blade is in the second position, the blade substantially closes the aperture on the catheter body. The imaging device which is mounted on or otherwise coupled to the cutting blade is configured to be in an imaging position when ...

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    5. Volcano Corporation Announces $200 Million Share Repurchase Authorization

      Volcano Corporation Announces $200 Million Share Repurchase Authorization

      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 announced that its Board of Directors has authorized a $200 million share repurchase program. The Company intends to fund share repurchases with cash on hand. As part of the program, Volcano will enter into a $100 million Accelerated Share Repurchase ("ASR") with J.P. Morgan Securities LLC ("JPMorgan"), as agent for JPMorgan Chase Bank, National Association, London Branch. Under the ASR agreement, Volcano will pay $100 million to JPMorgan and will receive ...

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    6. Coronary Thrombosis From Large, Nonprotruding, Superficial Calcified Coronary Plaques

      Coronary Thrombosis From Large, Nonprotruding, Superficial Calcified Coronary Plaques

      A 76-year-old man admitted for an acute coronary syndrome showed on angiography diffuse coronary calcification and mild lumen irregularities in the proximal left anterior descending and mid left circumflex coronary arteries. Optical coherence tomography revealed preserved coronary lumen at all segments. No features consistent with thin- or thick-cap fibroatheromas, ruptured plaques, or erosions were detected. However, a massive calcification of the left anterior descending and left circumflex coronary artery was recognized. The pattern of calcification was rather unique, involving the entire vessel circumference (ranging from 120° to 360°) and strikingly superficial, with a characteristic “concave shaped” surface apparently devoid of ...

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    7. Usefulness of intracoronary imaging techniques in the percutaneous treatment of in-stent restenosis

      Usefulness of intracoronary imaging techniques in the percutaneous treatment of in-stent restenosis

      We report a case of very late bare-metal stent restenosis, in which assessment by two intracoronary imaging techniques (intravascular ultrasound and optical coherence tomography) revealed the underlying mechanism (neoatherosclerosis) and facilitated percutaneous treatment (direct bare-metal stent-in-stent). We also take the opportunity to briefly describe the advantages and limitations of both techniques in this pathology.

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    8. Co-registration of fractional flow reserve and optical coherence tomography with the use of a three-dimensional angiographic roadmap: an opportunity for optimisation of complex percutaneous coronary interventions

      Co-registration of fractional flow reserve and optical coherence tomography with the use of a three-dimensional angiographic roadmap: an opportunity for optimisation of complex percutaneous coronary interventions

      Angiography of a 63-year-old male patient with unstable angina revealed a tight stenosis in the mid right coronary artery, proximal to a formerly implanted drug-eluting stent (DES). A motorised pullback of the pressure wire at 1 mm/sec during IV adenosine (140 μg/kg/min) permitted co-registration of the pressure-derived fractional flow reserve (FFR) signal along the angiographic roadmap, and the precise length (12 mm) of the segment where the pressure “jump” was derived. Additional OCT co-registration was performed revealing extensive spiral dissection at the proximal edge of the - See more at: http://www.pcronline.com/eurointervention/66th_issue/146/#sthash ...

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    9. IVUS-Guided Percutaneous Coronary Interventions: An Ongoing Odyssey?

      IVUS-Guided Percutaneous Coronary Interventions: An Ongoing Odyssey?

      Coronary angiography falls short in accurately delineating anatomy of epicardial vessels as it provides only a two-dimensional visualization of the lumen. Moreover, angiographic lesion assessment is impeded in cases of diffuse disease of reference vessels, lesion foreshortening and eccentricity as well as overlap of several arterial branches. Conversely, intravascular ultrasound - a sound wave based technology - provides superior spatial resolution of 80-150 μm and extends diagnostic information enabling more precise assessment of lumen and vessel wall dimensions including atheroma burden and vessel remodeling.

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    10. Impact on Optical Coherence Tomographic Coronary Findings of Fluvastatin Alone versus Fluvastatin+ Ezetimibe

      Impact on Optical Coherence Tomographic Coronary Findings of Fluvastatin Alone versus Fluvastatin+ Ezetimibe

      Although lipid lowering therapy by statin and ezetimibe has been reported to provide greater reduction in low-density lipoprotein cholesterol (LDL-C) levels than statin monotherapy, the effect of supplemental therapy on plaque stabilization is yet to be fully elucidated. Cap thickness of fibroatheroma evaluated by Optical coherence tomography (OCT) is a major determinant of vulnerable plaque. The primary objective of this study is to evaluate the effect of ezetimibe in addition to fluvastatin on progression of coronary atherosclerotic plaque evaluated by OCT. Sixty-three angina pectoris patients with intermediate, non-culprit, lipid-rich plaque lesions evaluated by OCT were enrolled. The patients were divided ...

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    11. Comparison of longitudinal geometric measurement in human coronary arteries between frequency-domain optical coherence tomography and intravascular ultrasound

      Comparison of longitudinal geometric measurement in human coronary arteries between frequency-domain optical coherence tomography and intravascular ultrasound

      Previous studies have demonstrated the higher accuracy of frequency-domain optical coherence tomography (FD-OCT) for quantitative measurements in comparison with intravascular ultrasound (IVUS). However, those analyses were based on the cross-sectional images. The aim of this study was to assess the accuracy of FD-OCT for longitudinal geometric measurements of coronary arteries in comparison with IVUS. Between October 2011 and March 2012, we performed prospective FD-OCT and IVUS examinations in consecutive 77 patients who underwent percutaneous coronary intervention with single stent. Regression analysis and Bland-Altman analysis revealed an excellent correlation between the FD-OCT-measured stent lengths and IVUS-measured stent lengths (r = 0.986 ...

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    12. Utility of optical coherence tomography and intravascular ultrasound for the evaluation of coronary lesions

      Utility of optical coherence tomography and intravascular ultrasound for the evaluation of coronary lesions

      Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) are imaging methods used in the diagnosis of coronary lesions. IVUS is widely used in interventional cardiology laboratories, but OCT is now increasingly used. Conventional coronary angiography can identify different types of coronary lesions but sometimes is unable to diagnose them correctly. Both intravascular imaging methods are useful for better interpretation of these lesions, and can accurately diagnose ruptured plaques, thrombosis, stent restenosis and hazy images. However, the resolution of OCT is ten times higher than IVUS, and so an accurate diagnosis cannot always be achieved with ultrasound imaging. We present three ...

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    13. System, method and computer-accessible medium for tracking vessel motion during three-dimensional coronary artery microscopy

      System, method and computer-accessible medium for tracking vessel motion during three-dimensional coronary artery microscopy

      Exemplary embodiments of apparatus, method and computer accessible medium can be provided which can facilitate a determination of at least one characteristic of a structure. For example, it is possible to use at least one first arrangement which can be structured to provide at least one first transmitted radiation along a first axis and at least one second transmitted radiation along a second axis. The first and second transmitted radiations can impact the structure and generate respective first and second returned radiation. The first and second axis can be provided at a predetermined angle with respect with one another which ...

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    14. Feature Of The Week 11/24/13 : Miniature OCT/IVUS probe for automatically co-registered three-dimensional intracoronary imaging with real-time display

      Feature Of The Week 11/24/13 : Miniature OCT/IVUS probe for automatically co-registered three-dimensional intracoronary imaging with real-time display

      Combined use of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) holds the potential of combining the strengths of both imaging modalities and improving the diagnostic accuracy of atherosclerotic plaque vulnerability. In this manuscript, we reported a co-registered intracoronary OCT-IVUS system and catheter with real-time imaging and polar-coordinate displaying capability, well-suited for clinical utilization in guiding interventional cardiologists. With an eventual goal of clinical use in humans, this novel catheter design and modified software are poised to strengthen the ability to diagnose vulnerable plaques in patients in real-time. We upgraded our old designs in the following aspects. 1) This novel ...

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    15. Mechanical analysis of arterial plaques in native geometry with OCT wall motion analysis

      Mechanical analysis of arterial plaques in native geometry with OCT wall motion analysis

      The mechanical behavior of an atherosclerotic plaque may encode information about the type, composition, and vulnerability to rupture. Human arterial segments with varying plaque burden were analyzed ex vivo with optical coherence tomography (OCT) to determine plaque type and to determine compliance during pulsatile inflation in their native geometry. Calcifications and lipid filled plaques showed markedly different compliance when analyzed with OCT wall motion analysis. There was also a trend towards increased circumferential variation in arterial compliance with increasing plaque burden.

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    16. A Case of In-Stent Neoatherosclerosis 10 Years after Carotid Artery Stent Implantation: Observation with Optical Coherence Tomography and Plaque Histological Findings

      A Case of In-Stent Neoatherosclerosis 10 Years after Carotid Artery Stent Implantation: Observation with Optical Coherence Tomography and Plaque Histological Findings

      We report a patient’s case of slow progressive in-stent restenosis 10 years after bare-metal stent implantation to his carotid artery. We treated the patient with an additional stent placement under a distal filter protection device. Optical coherence tomographic assessment and plaque histology during the carotid artery stenting (CAS) revealed atheromatous change at in-stent neointima, which contained lipid-rich plaque and calcification deposits. These findings suggest that in-stent neoatherosclerosis may play an important role in the pathogenesis of very late stent restenosis after CAS.

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    17. Serial Observation of Drug-Eluting Absorbable Metal Scaffold Multi-Imaging Modality Assessment

      Serial Observation of Drug-Eluting Absorbable Metal Scaffold Multi-Imaging Modality Assessment

      Background— The drug-eluting absorbable metal scaffold has demonstrated feasibility, safety, and promising clinical and angiographic outcomes at 12 months in human coronary arteries. This study aimed to evaluate the degradation rate and long-term vascular responses to drug-eluting absorbable metal scaffold. Methods and Results— BIOSOLVE-I was a multicenter, single-arm, first-in-man trial assessing the safety and performance of drug-eluting absorbable metal scaffold in 46 patients with coronary artery disease. Patients who underwent serial invasive imaging, such as quantitative coronary angiography, intravascular ultrasound, and optical coherence tomography, at 6 and 12 months were included in this study. From postimplantation to follow-up, arterial curvature ...

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    18. Optical coherence tomography following percutaneous coronary intervention with Excimer laser coronary atherectomy

      Optical coherence tomography following percutaneous coronary intervention with Excimer laser coronary atherectomy

      The indications for Excimer laser coronary atherectomy (ELCA) have been refined in modern interventional practice. With the expanding role for optical coherence tomography (OCT) providing high-resolution intra-coronary imaging, this article examines the appearance of the coronary lumen after ELCA. Each indication for ELCA is discussed and illustrated with a clinical case, followed by detailed analysis of the OCT imaging pre and post ELCA. The aim of the article is to provide information to interventional cardiologists to facilitate decision making during PCI, when ELCA has been used as part of the interventional strategy.

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    19. Frequency-domain optical coherence tomography findings in patients with bifurcated lesions undergoing provisional stenting

      Frequency-domain optical coherence tomography findings in patients with bifurcated lesions undergoing provisional stenting

      Aims Bifurcations represent challenging lesions which may benefit from improved understanding of stent-related vessel complications. Since optical coherence tomography (OCT) allows us to detect post-stenting vessel injuries, we sought to assess the geographic pattern of stent-related complications occurring during provisional stenting of bifurcated lesions. Methods and results Fifty-one patients with bifurcated lesions treated by provisional stenting and undergoing intra-procedural OCT assessment were enrolled. OCT images were acquired with the aim of guiding the percutaneous coronary intervention but were re-analysed off-line for the present study. The stented bifurcation was divided into four segments [three in the main vessel (MV) and one ...

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    20. Carotid Artery OCT in Cerebral Infarction

      Carotid Artery OCT in Cerebral Infarction

      In a recent issue of iJACC , Prati et al. 1 suggested that plaque characterization by newer imaging modalities such as intracoronary optical coherence tomography (OCT) may help optimize management strategies in acute coronary events. Although OCT imaging has been extensively performed for the characterization of culprit plaques in acute coronary events ( 2 ), the intravascular imaging data defining plaque composition in the acute cerebral events is rather sparse 3 . We present anecdotal examples of internal carotid artery (ICA) OCT images of plaque morphology in the patients afflicted by acute cerebral infarction. An 83-year-old man presented with sudden hemiplegia while praying in ...

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      Mentions: St. Jude Medical
    21. Optical coherence tomography reveals a non-spasm pseudo-coronary artery stenosis: a case report and review of literature

      Optical coherence tomography reveals a non-spasm  pseudo-coronary artery stenosis: a case report and  review of literature

      We described a case of angiographic stenosis that was highly suitable for stenting and it remained even after repeated intracoronary administration of nitroglycerin. However, optical coherence tomography showed the stenosis disappeared and the artery wall was smooth. It was therefore speculated that this was a just non-spasm pseudo-coronary artery stenosis. We hope that sharing this experience can aid cardiologists to avoid unnecessary implantation of stents.

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    22. In-stent neoatherosclerosis 10 years after bare metal stent implantation: ruptured vulnerable plaque by optical coherence tomography

      In-stent neoatherosclerosis 10 years after bare metal stent implantation: ruptured vulnerable plaque by optical coherence tomography

      In-stent neoatherosclerosis has recently been described as an important mechanism of late stent failure. A 56-year-old man with a single bare metal stent implantation ten years previously presented with new-onset chest pain. Coronary angiography revealed a right coronary artery with focal in-stent restenosis (Online Figure 1). Optical coherence tomography (OCT) demonstrated the presence of fibroatheroma throughout the entire length of the stent. At one point (panel C), a thin-cap fibroatheroma (TCFA) with plaque rupture is noted (Figure 1, Online Figure 2) - 

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    23. Relationship between endothelial vasomotor function and strut coverage after implantation of drug-eluting stent assessed by optical coherence tomography

      Relationship between endothelial vasomotor function and strut coverage after implantation of drug-eluting stent assessed by optical coherence tomography

      The use of drug-eluting stent (DES) has been associated with incomplete endothelialization and coronary endothelial dysfunction. However, the relationship between endothelial vasomotor function and strut coverage evaluated by optical coherence tomography (OCT) has not been sufficiently assessed. Therefore, we evaluated the relationship between endothelial vasomotor function and the degree of stent strut coverage after DES implantation. Coronary angiography and OCT were performed in 112 patients at the 6-month follow-up after DES implantation. The patients were divided into tertiles according to the degree of strut coverage as was assessed by OCT. Endothelial vasomotor function was evaluated with intracoronary infusion of incremental ...

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