1. Articles in category: Cardiology

    481-504 of 2614 « 1 2 ... 18 19 20 21 22 23 24 ... 107 108 109 »
    1. Bikram Yoga and Acute Myocardial Infarction

      Bikram Yoga and Acute Myocardial Infarction

      Bikram yoga (BY) is a specific practice, with thousands of followers over the world, that consists of a series of 26 postures performed in a heated humidified studio 1 . It has been reported that exertion may be a possible trigger for plaque rupture and acute coronary syndromes (ACS) ( 2 ). We present the case of a healthy 53-year-old man without any cardiovascular risk factors who developed ACS with ST-segment elevation during a BY session. Intravenous fibrinolysis was administered with clinical success. A coronary angiogram performed the next day revealed a critical stenosis in the proximal left anterior descending artery (arrow, A ...

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    2. Optical coherence tomography characteristics of in-stent restenosis are different between first and second generation drug eluting stents ☆

      Optical coherence tomography characteristics of in-stent restenosis are different between first and second generation drug eluting stents ☆

      Aims Characterization of neointimal tissue is essential to understand the pathophysiology of in-stent restenosis (ISR) after drug eluting stent (DES) implantation. Using optical coherence tomography (OCT), we compared the morphologic characteristics of ISR between first and second generation DES. Methods and Results OCT was performed in 66 DES-ISR, defined as > 50% angiographic diameter stenosis within the stented segment. Patients with ISR of first generation sirolimus-eluting stents (SES), paclitaxel eluting stents (PES) and second generation zotarolimus-eluting stents (ZES), everolimus-eluting stents (EES) and biolimus-eluting stents (BES) were enrolled. Quantitative and qualitative ISR tissue analysis was performed at 1-mm intervals along the entire ...

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    3. Tissue Characterization of Carotid Plaques

      Tissue Characterization of Carotid Plaques

      Carotid plaque vulnerability has been reported to be associated with stroke and other cerebrovascular events [ 1 , 2 ]. Therefore, tissue characterization of carotid plaques is important to evaluate the risk of cerebrovascular disease and outcome of treatment for carotid arterial stenosis. Stabilization of vulnerable plaques rather than regression of plaque volume is considered the major contributor to beneficial effects on cerebrovascular events [ 3 ]. With respect to the ultrasound technique, ultrasonic tissue characterization of the myocardium with an integrated backscatter (IBS) analysis was developed, which is capable of providing both conventional two-dimensional echographic (2DE) images and IBS images. In studies of the ...

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    4. Incomplete Stent Apposition Causes High Shear Flow Disturbances and Delay in Neointimal Coverage as a Function of Strut to Wall Detachment Distance: Implications for the Management of Incomplete Stent Apposition

      Incomplete Stent Apposition Causes High Shear Flow Disturbances and Delay in Neointimal Coverage as a Function of Strut to Wall Detachment Distance: Implications for the Management of Incomplete Stent Apposition

      BACKGROUND: Lack of re-endothelialization and neointimal coverage on stent struts has been put forward as the main underlying mechanism leading to late stent thrombosis. Incomplete stent apposition (ISA) has been observed frequently in patients with very late stent thrombosis after drug eluting stent implantation, suggesting a role of ISA in the pathogenesis of this adverse event. The aim of this study was to evaluate the impact of different degrees of ISA severity on abnormal shear rate and healing response with coverage, because of its potential implications for stent optimization in clinical practice. METHODS AND RESULTS: We characterized flow profile and ...

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    5. Experimental evaluation of efficacy and healing response of everolimus-eluting stents in the familial hypercholesterolemic swine model: a comparative study of bioabsorbable versus durable polymer stent platforms

      Experimental evaluation of efficacy and healing response of everolimus-eluting stents in the familial hypercholesterolemic swine model: a comparative study of bioabsorbable versus durable polymer stent platforms

      Background: The utility of animal models for the prediction of drug-eluting stent (DES) efficacy in human clinical trials is still unclear. The familial hypercholesterolemic swine (FHS) model has been shown to induce a human-like neointimal response to bare metal stent (BMS) implantation. However, its utility to discriminate efficacy signals following DES implantation is unknown. In this study, we aimed to test the efficacy and healing response of several everolimus-eluting stent (EES) platforms in the coronary territory of the FHS. Methods: A total of 19 EES platforms (SYNERGY=6, SYNERGY1/2-dose=7, and PROMUS Element=6) and an identical BMS control ...

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    6. Intra-Coronary Imaging Modalities

      Intra-Coronary Imaging Modalities

      The use of intracoronary imaging modalities has seen a significant increase over the past decade, as both imaging quality and delivery systems have improved. Generally accepted best practice indications for using intracoronary imaging include assessment of lesion characteristics prior to stent placement, optimization of stent placement with respect to appropriate sizing, adequate apposition, and expansion and exclusion of edge dissection. Intracoronary imaging plays a particular role in the setting of contemporary left main and bifurcation stenting. Stent interrogation using intracoronary imaging to exclude mechanical causes in the management of in-stent thrombosis has also become conventional. Current clinical guideline recommendations, however ...

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    7. Cardiac Allograft Vasculopathy Can Be Distinguished From Donor-Transmitted Coronary Atherosclerosis by Optical Coherence Tomography Imaging in a Heart Transplantation Recipient Double Layered Intimal Thickness

      Cardiac Allograft Vasculopathy Can Be Distinguished From Donor-Transmitted Coronary Atherosclerosis by Optical Coherence Tomography Imaging in a Heart Transplantation Recipient Double Layered Intimal Thickness

      Although survival after heart transplantation (HTx) has improved in recent years, cardiac allograft vasculopathy (CAV) is still the leading cause of remote morbidity and mortality in HTx recipients, partly because of difficulty with its diagnosis. In general, routine surveillance for CAV is advocated with coronary angiography accompanied by intravascular ultrasound (IVUS) if necessary. However, these modalities have limitations with respect to low spatial resolution, and sufficient qualitative/quantitative assessment of coronary intima has not been accomplished. Recently, optical coherence tomography (OCT) has emerged as a novel intracoronary imaging technique using an optical analogue of ultrasound with a spatial resolution of ...

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    8. Distinct Morphological Features of Ruptured Culprit Plaque for Acute Coronary Events Compared to those with Silent Rupture and Thin-Cap Fibroatheroma: a Combined Optical Coherence Tomography and Intravascular Ultrasound Study

      Distinct Morphological Features of Ruptured Culprit Plaque for Acute Coronary Events Compared to those with Silent Rupture and Thin-Cap Fibroatheroma: a Combined Optical Coherence Tomography and Intravascular Ultrasound Study

      Objectives To identify specific morphological characteristics of ruptured culprit plaques (RCP) responsible for acute events, and compare them with ruptured non-culprit plaques (RNCP) and non-ruptured thin-cap fibroatheroma (TCFA) in patients presenting with acute coronary syndromes (ACS). Background Non-ruptured TCFA and multiple ruptured plaques are detected in the same patients with ACS. It remains unknown whether certain morphological characteristics determine rupture of TCFA and subsequently result in ACS. Methods We analyzed 126 plaques (RCP=49, RNCP=19, TCFA=58) from 82 ACS patients using optical coherence tomography (OCT) and intravascular ultrasound (IVUS). Fibrous cap thickness was determined by OCT. Plaque burden ...

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    9. Stabilizing effect of combined eicosapentaenoic acid and statin therapy on coronary thin-cap fibroatheroma

      Stabilizing effect of combined eicosapentaenoic acid and statin therapy on coronary thin-cap fibroatheroma

      Background The addition of highly purified eicosapentaenoic acid (EPA) to statin therapy prevents cardiovascular events. However, the impact of this treatment on vulnerable plaques remains unclear. The aim of this study was to assess the impact of adding EPA to a standard statin therapy on vulnerable plaques by serial optical coherence tomography (OCT). Methods Forty-nine non-culprit thin-cap fibroatheroma (TCFA) lesions in 30 patients with untreated dyslipidemia were included. Patients were randomly assigned to EPA (1800 mg/day) + statin (23 TCFA, 15 patients) or statin only (26 TCFA, 15 patients) treatment. The statin (rosuvastatin) dose was adjusted to achieve a target ...

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    10. Strategy for optimal side-branch positioning of bioresorbable vascular scaffolds in dedicated 2-stent techniques: Insights from optical coherence tomography

      Strategy for optimal side-branch positioning of bioresorbable vascular scaffolds in dedicated 2-stent techniques: Insights from optical coherence tomography

      We present a case of a left anterior descending artery/diagonal branch bifurcation successfully treated with a dedicated 2-stent technique utilizing bioresorbable vascular scaffolds, where the bifurcation angle did not strictly allow a T-stenting approach. We also propose a strategy to avoid or reduce scaffold overlap in the main branch, especially important in view of the bulkier size of these novel devices.

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      Mentions: St. Jude Medical
    11. Variation in cross-correlation as a discriminator for microvessel imaging using clinical intravascular optical coherence tomography systems

      Variation in cross-correlation as a discriminator for microvessel imaging using clinical intravascular optical coherence tomography systems

      Cross-correlation of Intravascular Optical Coherence Tomography (IV-OCT) images is affected by image distortion due to the non-uniform rotational velocity of the imaging catheter. It results in non-representative cross-correlation maps such that for a static scan, the coefficients fluctuate from high to low correlation values. The variation in cross-correlation at flow locations is muted, in comparison to stationary regions. In the present study, the variation of correlation values and its standard deviation (SD) is used to suppress the distortion related noise effects and to extract flow maps from static scan images. The standard deviation of the cross-correlation variation can distinguish flow ...

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    12. Association between inflammatory biomarkers and in-stent restenosis tissue features: an Optical Coherence Tomography Study

      Association between inflammatory biomarkers and in-stent restenosis tissue features: an Optical Coherence Tomography Study

      Aims Inflammatory reaction after stent impl an tation is associated with in-stent restenosis (ISR). We assessed the association of optical coherence tomography (OCT) features of neointima with systemic levels of high-sensitivity C-reactive protein (hs-CRP) and eosinophil cationic protein (ECP) measured at the time of ISR detection. Methods and results Patients presenting with symptomatic an giographically documented ISR (diameter stenosis ≥50% by visual estimation) were included. Qu an titative OCT an alysis included the measurement of minimal lumen diameter, minimal luminal area, stent and neointimal area, stent and restenosis length, restenotic tissue burden, and symmetry ratio. Qualitative OCT an alysis included ...

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    13. Simultaneous single-vessel plaque rupture causing acute coronary syndrome detected by optical coherence tomography

      Simultaneous single-vessel plaque rupture causing acute coronary syndrome detected by optical coherence tomography

      A 67-year-old male presented with non-ST segment elevation myocardial infarction accompanied by inferior electrocardiogram (ECG) changes. Coronary angiography demonstrated a dominant right coronary artery (RCA) with two discrete regions of angiographic haziness, suggesting possible plaque ulceration and the presence of thrombus ( Panel A ). Prior studies have demonstrated non-culprit plaque rupture in acute myocardial infarction patients; however,

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    14. Mechanisms of Postintervention and Nine-Month Luminal Enlargement After Treatment of Drug-Eluting In-Stent Restenosis With a Drug-Eluting Balloon

      Mechanisms of Postintervention and Nine-Month Luminal Enlargement After Treatment of Drug-Eluting In-Stent Restenosis With a Drug-Eluting Balloon

      Using optical coherence tomography (OCT), the mechanisms of postintervention and 9-month luminal enlargement in drug-eluting stent in-stent restenosis (ISR) lesions treated with a drug-eluting balloon (DEB) were evaluated. A total of 42 patients with DEB-treated drug-eluting stent ISR lesions underwent serial OCT examination before intervention, after intervention, and at 9-month follow-up. Preintervention OCT-derived neointima was classified as either a homogeneous or nonhomogeneous pattern. Ten ISR lesions with homogeneous neointima were identified and compared with 32 ISR lesions with nonhomogeneous neointima. When comparing pre- and postintervention evaluations, changes in luminal cross-sectional area (CSA) were 3.4 mm 2 in ISR lesions ...

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    15. Korea Research Team Develops Tech for 3D Blood Vessel Endoscope

      Korea Research Team Develops Tech for 3D Blood Vessel Endoscope

      The Korea Advanced Institute of Science and Technology (KAIST) announced on March 12 that a research team lead by Professor Oh Wang-yuhl from the Department of Mechanical Engineering at KAIST has developed a technology to make a world-class blood vessel endoscope system. The diagnostic imaging technology provides cross-sectional images of the blood vessel walls, up to 3.5 times faster than using the existing blood vessel endoscope system. Therefore, the tech is expected to help in diagnosing and treating cardiovascular diseases. The new optical coherence tomography (OCT) is a method that captures micrometer-resolution, three-dimensional images of blood vessels by inserting ...

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    16. Analysis of Long-term Arterial Healing Following Implantation of Different Types of Stents by Optical Coherence Tomography

      Analysis of Long-term Arterial Healing Following Implantation of Different Types of Stents by Optical Coherence Tomography

      Background Although drug-eluting stents have significantly reduced the mid-term incidence of target lesion revascularization, however, in vivo studies on long-term vessel healing of sirolimus-eluting and paclitaxel-eluting stents (SES and PES) are limited. So the aim of this study was to compare long-term arterial healing in SES and PES. Methods We evaluated 27 SES (23 patients) and 21 PES (20 patients) by serial optical coherence tomography (OCT) at 6 months (mid-phase) and ≥3 years (late-phase) after stenting and evaluated the change of neointimal thickness (NIT), the percentages of uncovered and malapposed struts, peri-strut low intensity area (region around stent struts homogenously ...

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    17. Different serial changes in the neointimal condition of sirolimus-eluting stents and paclitaxel-eluting stents: an optical coherence tomographic study

      Different serial changes in the neointimal condition of sirolimus-eluting stents and paclitaxel-eluting stents: an optical coherence tomographic study

      Aims: Detailed long-term changes of the neointima in sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) are still unclear. Methods and results: We consecutively enrolled 14 patients (18 SES) and 12 patients (13 PES) who underwent optical coherence tomography (OCT) serially at eight months and 18 months after stent implantation. For 18 SES and 13 PES, OCT was used to visualise 2,486 and 1,361 stent struts at the eight-month and 2,199 and 1,309 stent struts at the 18-month follow-up, respectively. The OCT parameters, including incidence of uncovered and malapposed struts (uncovered and malapposed percentage), average neointimal hyperplasia ...

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    18. Clinical use of Optical Coherence Tomography to identify angiographic silent stent thrombosis

      Clinical use of Optical Coherence Tomography to identify angiographic silent stent thrombosis

      Objectives: Patients previously treated with coronary stents may suffer an acute coronary syndrome (ACS) without any evidence of thrombus formation on coronary angiography (CAG). This may be due to partial, non-occlusive stent thrombosis with microembolization. In this paper we illustrate possible mechanisms both with Optical coherence tomography (OCT) and histology. Design: We present two cases with ACS from very late stent thrombosis, both previously treated with first generation drug eluting stents (DES). Results: The first patient had ACS 15 months after DES implantation. The angiogram (CAG) was near normal with slight peri-stent contrast staining. OCT revealed abnormalities including thrombus not ...

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    19. Comparison of Biodegradable Stents: Orsiro and BioMatrix

      Comparison of Biodegradable Stents: Orsiro and BioMatrix

      The use of a biodegradable polymer has the potential to reduce the sustained inflammatory response of the arterial wall, facilitating re-endothelialization and minimizing the risk of thrombus formation and late restenosis. In the study, we are going to two biodegradable polymer stents, Orsiro and BioMatrix, especially regarding the stent strut coverage by optical coherence tomography at 3 months after stent implantation. The primary objective of this study is to test the hypothesis that Orsiro is non-inferior to Biomatrix in terms of stent strut coverage by optical coherence tomography at 3 months. The secondary endpoint is clinical outcomes up to 1 ...

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    20. Comparison of frequency domain optical coherence tomography and quantitative coronary angiography for the assessment of coronary lesions

      Comparison of frequency domain optical coherence tomography and quantitative coronary angiography for the assessment of coronary lesions

      Quantitative coronary angiography (QCA) has been used as a standard technique for the evaluation of coronary artery disease for many years. Intracoronary optical coherence tomography (OCT) offers higher resolution, faster image acquisition speeds and greater sensitivity than the intravascular ultrasound (IVUS). Recently developed frequency domain OCT (FD-OCT) systems overcome many technical limitations of conventional time domain OCT systems (TDOCT). The main objective of this study was to compare the FD-OCT and QCA measurements for the assessment of coronary lesions. A total of 21 stenoses in 18 patients were analysed using QCA and FD-OCT. The average minimum lumen diameter (MLD) and ...

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    21. Side branch complication after a single-stent crossover technique: prediction with frequency domain optical coherence tomography

      Side branch complication after a single-stent crossover technique: prediction with frequency domain optical coherence tomography

      Objectives: To identify preprocedural predictors of side branch (SB) complications after coronary bifurcation stent implantation using frequency domain optical coherence tomography (FD-OCT). Background: Coronary bifurcation lesions are common but difficult to treat. Longitudinal reconstruction images of FD-OCT have high image quality and less motion artifacts. Methods: Among 49 patients (age: 69.9 years) who underwent elective coronary stenting, 52 bifurcation lesions without baseline SB stenosis were studied. SB complication was defined as angiographic worsening of SB stenosis (>75%). On the basis of preprocedural FD-OCT imaging, plaque distribution, SB angle, carina tip angle (CT angle), and length between proximal branching point ...

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    22. Worsening late-acquired incomplete stent apposition after sirolimus-eluting stent implantation for a chronic total occlusion lesion

      Worsening late-acquired incomplete stent apposition after sirolimus-eluting stent implantation for a chronic total occlusion lesion

      A 70-year-old man underwent percutaneous coronary intervention (PCI) using sirolimus-eluting stent (SES) at the just proximal site of left anterior descending coronary artery. Six months after SES implantation, he suffered from late stent thrombosis. Intravascular ultrasound (IVUS) images demonstrated positive remodeling of the vessel, indicating late-acquired incomplete stent apposition (ISA). An angioplasty with a bigger balloon was performed to obtain sufficient stent struts apposition. Twenty-six months after the second PCI, he developed ST-elevation myocardial infarction and his CAG showed re-occlusion of the SES. Optical coherence tomography showed ISA and IVUS revealed further enlargement of the coronary artery around the SES.

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    23. Better Inflation Time of Stent Balloon for Second-Generation Drug-Eluting Stent Expansion and Apposition: An Optical Coherence Tomography Study

      Better Inflation Time of Stent Balloon for Second-Generation Drug-Eluting Stent Expansion and Apposition: An Optical Coherence Tomography Study

      Objectives We tried to determine the effect of stent balloon inflation time on stent expansion and apposition using optical coherence tomography . Background Second-generation drug-eluting stents (DES) have thin struts; however, inflation times for optimal stent expansion and apposition are unknown in vivo . Methods Subjects included 17 patients (18 de novo coronary artery lesions), in whom Resolute Integrity → (n = 9) and Xience Prime → (n = 9) DES were deployed. All stents were inflated 3 times to the nominal inflation pressure (8.9 ± 0.6 atm) using the stent delivery balloon. The first inflation continued until the stent was angiographically fully expanded; the ...

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