1. Articles in category: Cardiology

    481-504 of 3619 « 1 2 ... 18 19 20 21 22 23 24 ... 149 150 151 »
    1. OCT-guided PCI noninferior to IVUS-guided PCI

      OCT-guided PCI noninferior to IVUS-guided PCI

      Optical coherence tomography-guided PCI was noninferior to IVUS-guided PCI in achieving minimum stent area and in procedural MACE, according to new data from the ILUMIEN III (OPTIMIZE PCI) trial presented at TCT 2016. The trial included 450 patients aged 18 years and older from 29 hospitals in eight countries who had one or more target lesions in a native coronary artery with a visually estimated reference vessel diameter of 2.25 mm to 3.50 mm and length 40 mm. Its purpose was to determine whether an OCT-based stent sizing strategy would result in a minimum stent area better than ...

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    2. Optical Coherence Topography Offers Superior Resolution In Coronary Stent Implantation, According To Study

      Optical Coherence Topography Offers Superior Resolution In Coronary Stent Implantation, According To Study

      Optical coherence tomography (OCT) provides safe and improved guidance for patients undergoing percutaneous coronary intervention to treat coronary artery disease, according to results from the ILLUMIEN III: OPTIMIZE PCI trial. The trial sought to determine whether a novel OCT-based stent sizing strategy would result in a comparable or superior minimal stent area (MSA) as achieved with former stent implant imaging techniques. Researchers from NewYork-Presbyterian/Columbia University Medical Center will present the results as part of the late-breaking clinical trials session at the Transcatheter Cardiovascular Therapeutics (TCT) conference this weekend in Washington, D.C. The study has also been published in ...

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    3. Prevalence and Predictors of Multiple Coronary Plaque Ruptures In Vivo 3-Vessel Optical Coherence Tomography Imaging Study

      Prevalence and Predictors of Multiple Coronary Plaque Ruptures In Vivo 3-Vessel Optical Coherence Tomography Imaging Study

      Objective— Plaque rupture may be the local expression of a widespread coronary instability. This study aimed to investigate: (1) the prevalence and characteristics of nonculprit plaque rupture; (2) the pancoronary atherosclerotic phenotype in patients with and without nonculprit plaque rupture; and (3) the prevalence and predictors of multiple plaque ruptures. Approach and Results— Six hundred and seventy-five nonculprit plaques from 261 patients (34 acute myocardial infarction, 73 unstable angina pectoris, and 154 stable angina pectoris) were analyzed by 3-vessel optical coherence tomography. Nonculprit plaque ruptures were identified in 51 patients (20%). Patients with nonculprit plaque ruptures had higher prevalence of ...

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    4. Avinger Launches Upgraded Lightbox Imaging Console

      Avinger Launches Upgraded Lightbox Imaging Console

      Avinger, Inc. (NASDAQ:AVGR), a leading developer of innovative treatments for peripheral artery disease (PAD), today announced the U.S. launch of an enhanced version of the company’s Lightbox imaging console. The Lightbox provides a dual display of images to physicians using Avinger’s Lumivascular system, the first-ever image-guided atherectomy and chronic total occlusion (CTO) recanalization devices for the treatment of peripheral artery disease (PAD), providing physicians with a view inside diseased arteries. The upgraded Lightbox L250 console is designed to be more intuitive, provide sharper imaging, and reduce start-up times before procedures begin. Physician feedback and a commitment ...

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    5. With FDA nod, Avinger's PAD device becomes both therapeutic and diagnostic tool

      With FDA nod, Avinger's PAD device becomes both therapeutic and diagnostic tool

      The FDA expanded the indication of Avinger’s image-guided atherectomy device for the treatment of peripheral artery disease, allowing its use in both therapeutic and diagnostic procedures. Now, the Pantheris device may be used for diagnostic imaging and treatment of PAD simultaneously. It is the first and only image-guided atherectomy system to be cleared for both, according to a statement. In addition to using the device for atherectomy--a catheter-based treatment that removes plaque from a blood vessel--physicians may also use it to identify features of blood vessels, including necrotic cores, fibroatheromas, calcium and stent struts. Being able to see from ...

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    6. Late stent collapse identified with OCT – An underdiagnosed mechanism of restenosis?

      Late stent collapse identified with OCT – An underdiagnosed mechanism of restenosis?

      Very late stent recoil is a rare albeit recognized phenomenon leading to subsequent in-stent restenosis. Angiography alone may not be adequate in making the diagnosis, and intravascular imaging with optical coherence tomography (OCT) is far superior in confirming the diagnosis and guiding subsequent management. We describe a case with interesting coronary angiogram and OCT images demonstrating very rare diagnosis of the late stent collapse. These images provide a valuable insight into a novel mechanism responsible for late target lesion failure. These images highlight the importance of modern intra-coronary imaging techniques in understanding the mechanisms underlying target-lesion failure, and guiding appropriate ...

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    7. Avinger Announces Expanded FDA Indications for Pantheris™ as Diagnostic Imaging Device

      Avinger Announces Expanded FDA Indications for Pantheris™ as Diagnostic Imaging Device

      Avinger, Inc. (NASDAQ: AVGR ), a leading developer of innovative treatments for Peripheral Artery Disease (PAD), today announced that the company has received expanded indications from the U.S. Food and Drug Administration (FDA) recognizing the Pantheris™ Lumivascular atherectomy system as a technology that can be used for both therapeutic and diagnostic purposes. Pantheris is the first and only image-guided atherectomy device to receive clearance for diagnostic imaging as well as for the simultaneous treatment of PAD. This expanded indication clarifies that, in addition to treatment of PAD, Pantheris may be used by physicians to identify the vessel lumen and wall ...

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    8. Variability in the measurement of minimum fibrous cap thickness and reproducibility of fibroatheroma classification by optical coherence tomography using manual versus semi-automatic assessment

      Variability in the measurement of minimum fibrous cap thickness and reproducibility of fibroatheroma classification by optical coherence tomography using manual versus semi-automatic assessment

      Aims: The minimum fibrous cap thickness (FCT) is considered a major criterion of coronary plaque vulnerability according to autopsy studies. We aimed to assess the reproducibility in the measurement of the optical coherence tomography (OCT)-detected minimum FCT and the agreement in the classification of thin-cap fibroatheroma (TCFA), by a software-based semi-automatic method compared with the manual method. Methods and results: A total of 50 frames with fibroatheromas (FA) were randomly selected from the Integrated Biomarker Imaging Study-4 (IBIS-4). Two experienced OCT analysts independently measured the minimum FCT at two different time points, manually and by three different semi-automatic software-based ...

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    9. Shedding light on the mechanisms of stent thrombosis with optical coherence tomography

      Shedding light on the mechanisms of stent thrombosis with optical coherence tomography

      Since the introduction of mechanical devices for the treatment of stenotic coronary artery disease, stent thrombosis (ST) has been an issue of major clinical concern. It is an uncommon but serious complication with high mortality and morbidity that almost always presents as death or myocardial infarction (MI), usually with electrocardiographic ST-segment elevation ( 1 ). Inadequate stent expansion and undersizing of a stent has been recognized as the main reason for acute and subacute ST ( 2 ) following stent implantation. Souteyrand et al . ( 3 ) have done a great job at confirming these findings with the use of optical coherence tomography (OCT). It is ...

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    10. Optical coherence tomography: The next ACE in CTO interventions?

      Optical coherence tomography: The next ACE in CTO interventions?

      When used to guide percutaneous coronary interventions (PCI), intracoronary imaging is associated with improved clinical outcomes [1–4]. Intracoronary imaging guidance during PCI reduces in-stent restenosis and repeat revascularization after bare-metal stent placement [1] and has been shown to reduce major adverse cardiac events (MACE), stent thrombosis, target vessel myocardial infarction, and target lesion revascularization after drug-eluting stent (DES) placement [2–4]. These benefits have been attributed to the use of larger diameter stents and more aggressive post-dilation when intracoronary imaging is used to guide PCI, thus achieving larger lumen areas within the stent than are achieved with angiographic guidance ...

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    11. Neoatherosclerosis causing occlusive in-stent restenosis: Impact of intracoronary imaging in the intensity of lipid-lowering therapy

      Neoatherosclerosis causing occlusive in-stent restenosis: Impact of intracoronary imaging in the intensity of lipid-lowering therapy

      The unique physical properties of optical coherence tomography (OCT) make it a useful technique in the study of restenosis mechanisms. In fact, OCT is able to differentiate between neointimal proliferation and neoatherosclerosis within the stent. We report a rare case of occlusive neoatherosclerosis presenting beyond one year after a successful drug-eluting stent implantation. The impact of OCT findings in the clinical decision making process is emphasized.

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      Mentions: Fernando Alfonso
    12. Combined optical coherence tomography morphologic and fractional flow reserve hemodynamic assessment of non- culprit lesions to better predict adverse event outcomes in diabetes mellitus patients: COMBINE (OCT–FFR) prospective study. Rationale and design

      Combined optical coherence tomography morphologic and fractional flow reserve hemodynamic assessment of non- culprit lesions to better predict adverse event outcomes in diabetes mellitus patients: COMBINE (OCT–FFR) prospective study. Rationale and design

      Background Fractional flow reserve (FFR) is a widely used tool for the identification of ischaemia-generating stenoses and to guide decisions on coronary revascularisation. However, the safety of FFR-based decisions in high-risk subsets, such as patients with Diabetes Mellitus (DM) or vulnerable stenoses presenting thin-cap fibro-atheroma (TCFA), is unknown. This study will examine the impact of optical coherence tomography (OCT) plaque morphological assessment and the identification of TCFA, in combination with FFR to better predict clinical outcomes in DM patients. Methods COMBINE (OCT–FFR) is a prospective, multi-centre study investigating the natural history of DM patients with ≥1 angiographically intermediate target ...

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      Mentions: Fernando Alfonso
    13. IVUS Guidance for Complex Lesion Stenting Tied to Fewer MIs (CME/CE)

      IVUS Guidance for Complex Lesion Stenting Tied to Fewer MIs (CME/CE)

      To guide implantation of newer-generation drug-eluting stents (DES) in complex lesions, intravascular ultrasound (IVUS) beat angiography for reduced rates of subsequent MI, according to a meta-analysis. One year after stenting, major adverse cardiovascular events -- the composite of cardiac death, MI, and stent thrombosis -- had occurred in 0.4% of IVUS-guided DES recipients and 1.2% of their peers who underwent angiography-guided DES placement (HR 0.36, 95% CI 0.13-0.99), according to Myeong-Ki Hong, MD, PhD , of Korea's Yonsei University College of Medicine, and colleagues. "These findings were consistent across the clinical (lesion/patient) subgroups and were stronger ...

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    14. Targeted Near-Infrared Fluorescence Imaging of Atherosclerosis

      Targeted Near-Infrared Fluorescence Imaging of Atherosclerosis

      Objectives This study sought to determine whether indocyanine green (ICG)–enhanced near-infrared fluorescence (NIRF) imaging can illuminate high-risk histologic plaque features of human carotid atherosclerosis, and in coronary atheroma of living swine, using intravascular NIRF-optical coherence tomography (OCT) imaging. Background New translatable imaging approaches are needed to identify high-risk biological signatures of atheroma. ICG is a U.S. Food and Drug Administration–approved NIRF imaging agent that experimentally targets plaque macrophages and lipid in areas of enhanced endothelial permeability. However, it is unknown whether ICG can target atheroma in patients. Methods Eight patients were enrolled in the BRIGHT-CEA (Indocyanine Green ...

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    15. Five-Year Optical Coherence Tomography in Patients With ST-Segment–Elevation Myocardial Infarction Treated With Bare-Metal Versus Everolimus-Eluting Stents

      Five-Year Optical Coherence Tomography in Patients With ST-Segment–Elevation Myocardial Infarction Treated With Bare-Metal Versus Everolimus-Eluting Stents

      Background— The main causes of late (>1 month) stent thrombosis (ST) are stent uncoverage, malapposition, and neoatherosclerosis. First-generation drug-eluting stents were associated with higher rate of late ST compared with bare-metal stents (BMS), especially in patients with ST-segment–elevation myocardial infarction. Second-generation everolimus-eluting stents (EES) have shown similar rate of late ST than BMS. The aims of the study are to compare the ratio of uncovered to total struts per cross-section ≥30% and other optical coherence tomographic findings associated with ST between EES and BMS in patients with ST-segment–elevation myocardial infarction at 5 years. Methods and Results— One hundred ...

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    16. Does Residual Thrombus After Aspiration Thrombectomy Affect the Outcome of Primary PCI in Patients With ST-Segment Elevation Myocardial Infarction? An Optical Coherence Tomography Study

      Does Residual Thrombus After Aspiration Thrombectomy Affect the Outcome of Primary PCI in Patients With ST-Segment Elevation Myocardial Infarction? An Optical Coherence Tomography Study

      Objectives The aim of this study was to evaluate if residual thrombus burden after aspiration thrombectomy affects the outcomes of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction (STEMI). Background Recent studies failed to show clinical benefit of aspiration thrombectomy in STEMI patients. This might be due to insufficient removal of thrombus at the culprit lesion. Methods A total of 109 STEMI patients who underwent aspiration thrombectomy followed by stenting within 24 h from symptom onset were included. Optical coherence tomography was performed after thrombectomy to measure residual thrombus burden. Patients were divided into tertiles based on ...

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    17. Depth-resolved 3D visualization of coronary microvasculature with optical microangiography

      Depth-resolved 3D visualization of coronary microvasculature with optical microangiography

      In this study, we propose a novel implementation of optical coherence tomography-based angiography combined with ex vivo perfusion of fixed hearts to visualize coronary microvascular structure and function. The extracorporeal perfusion of Intralipid solution allows depth-resolved angiographic imaging, control of perfusion pressure, and high-resolution optical microangiography. The imaging technique offers new opportunities for microcirculation research in the heart, which has been challenging due to motion artifacts and the lack of independent control of pressure and flow. With the ability to precisely quantify structural and functional features, this imaging platform has broad potential for the study of the pathophysiology of microvasculature ...

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    18. Comparison of acute expansion of bioresorbable vascular scaffolds versus metallic drug-eluting stents in different degrees of calcification

      Comparison of acute expansion of bioresorbable vascular scaffolds versus metallic drug-eluting stents in different degrees of calcification

      Objectives The acute expansion of bioresorbable vascular scaffolds (BRS) and drug-eluting stents (DES) in lesions with different extent of calcification was compared by Optical Coherence Tomography (OCT). Background The acute mechanical performance of polymeric BRS in calcified lesions is poorly understood. Methods Acute device performance in lesions treated with either BRS( N  = 50) or DES ( N  = 50) was compared using Optical Coherence Tomography (OCT). According to angiographic degree of calcification the lesions were divided in three groups: no/mild, moderate and heavy calcification. Device performance was assessed with the following parameters by OCT: mean scaffold area, eccentricity index (EI), symmetry ...

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    19. Optical coherence tomography in drug-eluting stent restenosis: a technique in need of a strategy

      Optical coherence tomography in drug-eluting stent restenosis: a technique in need of a strategy

      Despite the high anti-restenotic efficacy of contemporary percutaneous interventional techniques, a substantial number of patients who undergo percutaneous coronary intervention (PCI) still present with restenosis. Despite iterations of devices– from plain balloon angioplasty to bare metal stenting (BMS) to drug-eluting stent (DES) therapy – have granted a progressive decline in the rate of this complication, in-stent restenosis remains a critical issue encountered in clinical practice. Owing to the overall increase in the use of DES, the number of patients presenting with DES restenosis is not insignificant in absolute terms. When DES restenosis occurs, it represents a challenging clinical entity in terms ...

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    20. Optical Coherence Tomography Predictors for Edge Restenosis After Everolimus-Eluting Stent Implantation

      Optical Coherence Tomography Predictors for Edge Restenosis After Everolimus-Eluting Stent Implantation

      Background— Stent edge restenosis (SER) remains a potential limitation of drug-eluting stents. The aim of this study was to determine optical coherence tomography (OCT) predictors for angiographic late SER after everolimus-eluting stent implantation. Methods and Results— We retrospectively analyzed 319 patients who underwent OCT immediately after everolimus-eluting stent implantation and scheduled 9- to 12-month follow-up angiography. The binary angiographic SER rate was 10% (32/319) in the patients, 8.4% (32/382) in lesions, and 4.4% (33/744) in stent edge segments. In the stent edge segments at post stenting, OCT-derived lipidic plaque (61% versus 20%; P <0.001 ...

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    21. Utility of near-infrared spectroscopy for detection of thin-cap neoatherosclerosis

      Utility of near-infrared spectroscopy for detection of thin-cap neoatherosclerosis

      Aims Near-infrared spectroscopy (NIRS) has been employed to assess the composition of the atherosclerotic plaques in native coronary arteries. However, little is known about the detection of neoatherosclerosis by NIRS in in-stent restenosis (ISR). The aim of the study was to assess the relationship between the distribution of lipid determined by NIRS and morphology of ISR on optical coherence tomography (OCT). Methods and results We performed both NIRS and OCT in 39 drug-eluting stents with ISR. Values of lipid-core burden index (LCBI) derived by NIRS were compared with the OCT-derived thickness of the fibrous cap covering neoatherosclerotic lesions. A total ...

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