1. Articles in category: Cardiology

    481-504 of 2542 « 1 2 ... 18 19 20 21 22 23 24 ... 104 105 106 »
    1. Feature Of The Week 1/19/14: Feature Of The Week: Irish Researchers Investigate Correlation of FFR and OCT Measured Parameters for Identifying Coronary Stenosis

      Feature Of The Week 1/19/14: Feature Of The Week: Irish Researchers Investigate Correlation of FFR and OCT Measured Parameters for Identifying Coronary Stenosis

      The usefulness of fractional flow reserve (FFR) in the functional evaluation of intermediate coronary stenosis is well established. Similarly, intracoronary optical coherence tomography (OCT) continues to be a promising imaging technique for the assessment of coronary artery disease. The frequency domain OCT (FD-OCT) provides faster image acquisition speeds, higher frame rates and greater scan depths as compared to time domain OCT while preserving the image quality. The main aim of this study was to determine the correlation between FFR and frequency domain OCT (FD-OCT) measured anatomical parameters that include minimal lumen area (MLA), minimal lumen diameter (MLD) and percent lumen ...

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    2. Integrated IVUS-OCT for Real-Time Imaging of Coronary Atherosclerosis

      Integrated IVUS-OCT for Real-Time Imaging of Coronary Atherosclerosis

      Accurate assessment of atherosclerotic plaque characteristics and the subsequent tailoring of optimal therapy holds great promise for preventing acute coronary syndromes (ACS) and life-threatening sequelae 1 . Combined use of optical coherence tomography (OCT) and intravascular ultrasound (IVUS) was proposed as a potential method for accurate assessment of plaque characteristics and vulnerability ( 2 , ). However, significant challenges remain in trying to adapt an integrated OCT-IVUS system for clinical applications. We report here a fully integrated intracoronary OCT-IVUS imaging technique to visualize atherosclerotic plaque in living animals and human coronary arteries from cadavers with high resolution and deep penetration capability simultaneously.

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    3. Incidences, Predictors, and Clinical Outcomes of Acute and Late Stent Malapposition Detected by Optical Coherence Tomography After Drug-Eluting Stent Implantation

      Incidences, Predictors, and Clinical Outcomes of Acute and Late Stent Malapposition Detected by Optical Coherence Tomography After Drug-Eluting Stent Implantation

      Background— We investigated the incidences, predictors, and clinical outcomes of acute and late stent malapposition detected by optical coherence tomography (OCT) after drug-eluting stent implantation. Methods and Results— We analyzed the OCT images from 351 patients with 356 lesions who received poststent and follow-up OCT examinations. Acute stent malapposition was observed in 62% of lesions. Approximately half of the acute stent malappositions were located within the edges of the stents. Severe diameter stenosis, calcified lesions, and long stents were independent predictors of acute stent malapposition. Follow-up OCT examinations were performed 175±60 days after drug-eluting stent implantation. Thirty-one percent of ...

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    4. Coronary stenting: From optical coherence tomography to fluid dynamic simulations

      Coronary stenting: From optical coherence tomography to fluid dynamic simulations

      The presence of stents within coronary arteries alters the hemodynamic condition. Computational fluid dynamics (CFD) simulations offer the possibility to study local hemodynamics of a stented artery to identify the stimuli of instent restenosis, i.e. the local reduction of lumen size after stent deployment. The results of CFD simulations are more accurate when the analyses are performed with a model reproducing real in vivo conditions. For this purpose, optical coherence tomography (OCT) is a promising tool to reconstruct 3D geometries of stented coronary arteries, due to its higher resolution compared to the other imaging techniques. In the present work ...

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    5. Feature Of The Week 1/12/14: MGH Researchers Demonstrate a Dual-Modality Optical Coherence Tomography & Near Infrared Spectroscopy System and Catheter for Intravascular Imaging

      Feature Of The Week 1/12/14: MGH Researchers Demonstrate a Dual-Modality Optical Coherence Tomography & Near Infrared Spectroscopy System and Catheter for Intravascular Imaging

      Intravascular optical coherence tomography (IVOCT) provides three-dimensional microscopic images of blood vessels, including coronary arteries, in vivo. The ability of IVOCT to capture arterial microstructural detail is potentially very useful in medicine because it enables coronary artery disease (CAD) treatment decisions to be made based on detailed morphologic information, which should result in better interventional outcomes. Furthermore, in vivo microscopy via IVOCT may provide information, such as presence of macrophage accumulations and thickness of fibrous caps, that aids the detection of the so-called “vulnerable plaque” that is a precursor lesion to acute myocardial infarction. Advancing understanding and improving diagnosis of ...

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    6. Detailed in vivo visualization of stent fracture causing focal restenosis using 3D reconstruction software for high-resolution optical coherence tomography images

      Detailed in vivo visualization of stent fracture causing focal restenosis using 3D reconstruction software for high-resolution optical coherence tomography images

      A 55-year-old female underwent repeat coronary angiography for recurrent angina, 9 months after percutaneous coronary intervention (PCI) of a mid-right coronary artery (RCA) chronic total occlusion with implantation of two overlapping Orsiro™ sirolimus-eluting stents (3.0 × 30 mm at 20 atm; 2.5 × 30 mm at 16 atm) (see Supplementary data online, Video S1). The distal part of the stented segment showed a focal in-stent restenosis (ISR) with the abnormal motion pattern (see Supplementary data online, Video S2). Optical coherence tomography (OCT) with 3D reconstruction confirmed suspected stent

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    7. Serial optical coherence tomography images of trapped balloon catheter after bailout stenting

      Serial optical coherence tomography images of trapped balloon catheter after bailout stenting

      The increased use of endovascular interventions has resulted in a growing number of complications pertaining to unretrievable devices. We report a case of balloon dislodgement in a coronary artery during percutaneous coronary intervention (PCI) with bailout stenting used bare metal stent (BMS). We could not retrieve the remnant despite several attempts and techniques. Thereafter, we deployed BMS to bail out thrombus to recover the coronary flow. Emergency surgery was not considered because of high perioperative mortality (EuroSCORE II 55.91%). We did careful follow up with frequency domain optical coherence tomography (FD-OCT) images, which revealed thick neointima hyperplasia that completely ...

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    8. New Technology Helps Researchers Study Effects of Alcohol on Fetal Hearts

      New Technology Helps Researchers Study Effects of Alcohol on Fetal Hearts

      While some studies have claimed that it is “safe” to consume moderate amounts of alcohol during pregnancy, there is still a cold, hard truth when it comes to alcohol consumption during pregnancy: no one can say for certain how much must be consumed before the damage is done. After using a new imaging method, scientists now believe they are one step closer to proving that even one drinking episode could endanger a developing fetus.

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    9. Optimisation of post mortem cardiac computed tomography compared to optical coherence tomography and histopathology - Technical note

      Optimisation of post mortem cardiac computed tomography compared to optical coherence tomography and histopathology - Technical note

      Introduction Coronary atherosclerosis is a leading cause of mortality. New technological developments in computed tomography (CT), including dual energy, iterative reconstructions and high definition scanning, could significantly improve the non-invasive identification of atherosclerosis plaques. Here, a new method for optimising cardiac coronary CT with optical coherence tomography (OCT) and histopathology is presented. Materials and methods Twenty human hearts obtained from autopsies were used. A contrast agent that solidifies after cooling was injected into the coronary arteries. CT scanning was performed on the heart alone as well as with the heart in a chest phantom. We used eight different CT protocols ...

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    10. Researchers at CWRU and UH receive $1.7 million NIH grant for artery imaging

      Researchers at CWRU and UH receive $1.7 million NIH grant for artery imaging

      A research team at Case Western Reserve University and University Hospitals Case Medical Center has received $1.7 million in National Institutes of Health funding for its work on an imaging technology that gives doctors a detailed look at the life-saving stents that hold blood vessels open after a heart attack. They hope their project will help determine if the stents are working well, if more are needed, or if they’ve failed. The grant, from the National Heart, Lung, and Blood Institute , will help fund three primary investigators at CWRU and UH who are working on the imaging technology ...

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    11. Stent-related defects in patients presenting with stent thrombosis: differences at optical coherence tomography between subacute and late/very late thrombosis in the Mechanism Of Stent Thrombosis (MOST) study

      Stent-related defects in patients presenting with stent thrombosis: differences at optical coherence tomography between subacute and late/very late thrombosis in the Mechanism Of Stent Thrombosis (MOST) study

      Aims: Subacute, late, and very late stent thrombosis (ST) may occur after stent implantation, but they are characterised by different underlying pathophysiological mechanisms. We sought to appraise differences between subacute and late/very late ST at the thrombus site by optical coherence tomography (OCT). The Mechanism Of Stent Thrombosis (MOST) study was a prospective multicentre non-randomised registry which enrolled six subacute ST and six controls (subacute ST study), and 17 late/very late ST and 17 controls (late/very late ST study). Methods and results: Patients with subacute ST had a minimum stent area at the thrombus site of 2 ...

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    12. Comparison of paclitaxel-eluting vs. everolimus-eluting stents implanted simultaneously in different lesions of the same coronary artery: 12-month follow-up with optical coherence tomography

      Comparison of paclitaxel-eluting vs. everolimus-eluting stents implanted simultaneously in different lesions of the same coronary artery: 12-month follow-up with optical coherence tomography

      Aims: Optical coherence tomography (OCT) allows a detailed assessment of intimal coverage and strut apposition which are well known substrates for late thrombosis. This study sought to assess and compare long-term coverage and apposition of PES and EES implanted in different lesions of the same coronary artery (and in the same patient). Methods and results: A total of 30 patients were included. In these patients PES and EES were implanted in the same vessel in two similar lesions. The selection of the stent for each lesion was random. At 12 months, 30 PES were examined analysing 154±90 struts/stents ...

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    13. A novel procedure for imaging acute coronary syndrome lesions using frequency-domain optical coherence tomography

      A novel procedure for imaging acute coronary syndrome lesions using frequency-domain optical coherence tomography

      Description Next-generation OCT (frequency-domain optical coherence tomography, FD-OCT) facilitates high-speed pullbacks during image acquisition without necessitating transient balloon occlusion of the coronary artery 1 , 2 , 3 . However, a more robust catheter is necessary to facilitate high-speed pullbacks during FD-OCT. The profile diameter of the FD-OCT catheter is larger than that of the previous generation time-domain OCT (TD-OCT) imaging wire. A larger FD-OCT catheter could occlude severely stenotic lesions, causing insufficient distal contrast flushing. Subsequently, this causes insufficient blood clearance, resulting in poor OCT imaging. We investigated visualisation challenges of FD-OCT in the presence of severely stenotic lesions in an ex ...

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    14. A unique feature of thin flat thrombus visualised by optical coherence tomography

      A unique feature of thin flat thrombus visualised by optical coherence tomography

      Optical coherence tomography (OCT) has recently been developed as a high-resolution intravascular imaging modality, detecting small abnormal structures in the coronary lumen that could not be visualised by intravascular ultrasound (IVUS). A 77-year-old man died with acute myelogenous leukemia. After he died, the coronary artery was imaged by OCT (ImageWire; LightLab Imaging, Westford, MA, USA) and IVUS (Atlantis SR Pro, 40 MHz; Boston Scientific, Natick, MA, USA). OCT clearly demonstrated a thin flat structure in the coronary lumen ( Figure 1A , Moving image 1 ) but not in the IVUS image. This unique structural feature was demonstrated in corresponding histological images ( Figure ...

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    15. Optical coherence tomography-based evaluation of in-stent neoatherosclerosis in lesions with more than 50% neointimal cross-sectional area stenosis

      Optical coherence tomography-based evaluation of in-stent neoatherosclerosis in lesions with more than 50% neointimal cross-sectional area stenosis

      Aims: To use optical coherence tomography (OCT) to evaluate the time course, risk factors, and clinical implication of in-stent neoatherosclerosis. Methods and results: The neointimal characteristics of 152 lesions, 128 drug-eluting stents (DESs) and 24 bare metal stents (BMSs), with >50% percent cross-sectional area (CSA) neointimal stenosis were evaluated. Neoatherosclerosis was defined as neointima with presence of lipid or calcification. Neoatherosclerosis was observed in 54 lesions (35.5%, 35 DESs and 19 BMSs). Median time to follow-up was 70.7 months in lesions with neoatherosclerosis (longer than lesions without neoatherosclerosis [13.4 months, p<0.001]): 58.7 months in ...

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    16. Optical coherence tomography guided primary PCI in STEMI patients. A pilot study

      Optical coherence tomography guided primary PCI in STEMI patients. A pilot study

      Background The objective of our study was to assess whether optical coherence tomography (OCT) guidance could guide intervention in order to avoid balloon angioplasty and stenting during primary PCI. Method One hundred patients with ST-segment elevation myocardial infarction (STEMI) and thrombus containing lesion were enrolled in this study. Thrombus-aspiration was performed in all cases followed by OCT study. Following thrombectomy, no stent was implanted in residual significant stenosis (>50%) if OCT suggested that the occlusion was mostly thrombotic, provided that patient were symptom-free and the TIMI flow was ≥2. All patients managed only by thrombectomy underwent one week and 9- ...

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    17. First Optical Coherence Tomography Imaging of Takayasu Coronary Arteritis

      First Optical Coherence Tomography Imaging of Takayasu Coronary Arteritis

      Coronary angiogram (cranial right view) showing a long severe stenosis (arrow) of the mid-portion of the LAD and FD– OCT showing a homogenous concentric stenosis, with high tissue backscatter, without any major lipid plaque (C7 Dragonfly FD-OCT catheter, St Jude Medical): longitudinal axis view (center panel) , cross sectional images (A to E) .

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      Mentions: St. Jude Medical
    18. Natural history of low-intensity neointimal tissue after an everolimus-eluting stent implantation: a serial observation with optical coherence tomography

      Natural history of low-intensity neointimal tissue after an everolimus-eluting stent implantation: a serial observation with optical coherence tomography

      Although previous optical coherence tomography (OCT) studies reported that restenosis tissue after implantation of a drug-eluting stent (DES) was composed of a variety of cells, the clinical significance of morphologic characteristics for in-stent neointimal tissue as assessed by OCT has not been clarified. We experienced a patient with stable angina who underwent percutaneous coronary intervention with a 2.5 × 18-mm DES implantation 6 months before the OCT examination. OCT imaging showed a mild intimal hyperplasia (39 % neointimal hyperplasia) with eccentric, heterogeneous tissue, predominantly of low signal intensity. Seventeen months after the initial procedure, OCT revealed a significant increase in percent ...

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    19. Method Of Processing Optical Coherence Tomography Images

      Method Of Processing Optical Coherence Tomography Images

      An automatic or semiautomatic method of processing intravascular Optical Coherence Tomography (OCT) images, comprising: pre-processing the primary image by segmenting the guidewire in the lumen to exclude it from the image, determining whether the lumen is open or closed; if the lumen is determined to be closed, performing a first automatic lumen segmentation procedure on the pre-processed image to define a perimeter line of the lumen, corresponding to the inner edge of the vessel wall, and determine a centroid CL of the lumen area; if the lumen is determined not to be closed, sequentially performing an automatic lumen closing procedure ...

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    20. Beware women who do binge drinking

      Beware women who do binge drinking

      Women who do binge drinking face a risk of birth defects known as fetal alcohol syndrome (FAS) that leads to growth retardation, head and face abnormalities and neurological problems. Till date, it was believed that FAS also caused heart problems in just over half of those with this condition but remained largely a mystery how. To unlock this mystery, a team led by an Indian-American researcher Ganga Karunamuni at Case Western University in Cleveland, Ohio, studied heart formation in quail embryos, whose heart development is very similar to that of humans. The team used optical coherence tomography - an innovative imaging ...

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    21. Evaluation of hemodynamically severe coronary stenosis as determined by fractional flow reserve with frequency domain optical coherence tomography measured anatomical parameters

      Evaluation of hemodynamically severe coronary stenosis as determined by fractional flow reserve with frequency domain optical coherence tomography measured anatomical parameters

      Objectives The main objective of this study is to determine the correlation between fractional flow reserve (FFR)- and frequency domain optical coherence tomography (FD-OCT)-measured lumen parameters, and to determine the diagnostic competence of FD-OCT concerning the identification of severe coronary stenosis. Methods A total of 41 coronary stenoses in 30 patients were assessed consecutively by quantitative coronary angiography (QCA), FFR, and FD-OCT. Stenoses were labeled severe if FFR ≤ 0.80. The minimal lumen area (MLA), minimal lumen diameter (MLD), and percent lumen area stenosis (%AS) were measured using FD-OCT. Results FFR was ≤0.80 in 10 stenoses (24.4 ...

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    22. Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque

      Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque

      Patients with Kawasaki disease (KD) not treated with immunoglobulin therapy have a 25% risk of developing coronary aneurysms, which lead to adverse cardiovascular events such as myocardial infarction and death . In addition, these individuals frequently present significant calcium deposits in regions of previous inflammation in the coronaries . OCT assessment of stent-vessel interactions seems to be more accurate than IVUS' in patients with highly calcified plaques .

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    23. Comprehensive overview of definitions for optical coherence tomography-based plaque and stent analyses

      Comprehensive overview of definitions for optical coherence tomography-based plaque and stent analyses

      Optical coherence tomography (OCT) is the current state-of-the-art intracoronary imaging modality that allows visualization of detailed morphological characteristics of both atherosclerotic plaque and stent. So far, three expert review documents have been released for standardization of OCT image analysis. In the real world, a variety of definitions are being used by different groups and by different core laboratories to analyze OCT findings because of different clinical/procedural contexts in which OCT research has been carried out. This comprehensive overview is aimed to summarize different applicable definitions used by different research groups in plaque and stent analysis using OCT. In addition ...

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