1. Articles in category: Cardiology

    481-504 of 3445 « 1 2 ... 18 19 20 21 22 23 24 ... 142 143 144 »
    1. Processing to determine optical parameters of atherosclerotic disease from phantom and clinical intravascular optical coherence tomography three-dimensional pullbacks

      Processing to determine optical parameters of atherosclerotic disease from phantom and clinical intravascular optical coherence tomography three-dimensional pullbacks

      Analysis of intravascular optical coherence tomography (IVOCT) data has potential for real-time in vivo plaque classification. We developed a processing pipeline on a three-dimensional local region of support for estimation of optical properties of atherosclerotic plaques from coronary artery, IVOCT pullbacks. Using realistic coronary artery disease phantoms, we determined insignificant differences in mean and standard deviation estimates between our pullback analyses and more conventional processing of stationary acquisitions with frame averaging. There was no effect of tissue depth or oblique imaging on pullback parameter estimates. The method’s performance was assessed in comparison with observer-defined standards using clinical pullback data ...

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    2. University of California at Irvine Receives NIH Grant for Phased Resolved ARF optical Coherence Elastography for Intravascular Imaging

      University of California at Irvine Receives NIH Grant for Phased Resolved ARF optical Coherence Elastography for Intravascular Imaging

      University of California at Irvine Receives a 2016 NIH Grant for $721,594 for Phased Resolved ARF optical Coherence Elastography for Intravascular Imaging. The principal investigatoor is Zhonping Chen. The program began in 2014 and ends in 2018. Below is a summary of the proposed work. The broad, long term objective of the proposed grant is to develop an integrated multimodal intravascular imaging system that combines intravascular optical coherence tomography (OCT), ultrasound (US), and phase-resolved acoustic radiation force optical coherence elastography (ARF-OCE). The multimodal intravascular imaging system is unique in that it combines the advantages of the high spatial resolution ...

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    3. Reduction of in-stent thrombus immediately after percutaneous coronary intervention by pretreatment with prasugrel compared with clopidogrel: An optical coherence tomography study

      Reduction of in-stent thrombus immediately after percutaneous coronary intervention by pretreatment with prasugrel compared with clopidogrel: An optical coherence tomography study

      Background Prasugrel is a new-generation thienopyridine antiplatelet agent that provides more consistent and prompt platelet inhibition than clopidogrel. The aim of this study was to compare in-stent thrombus inhibition effect of pretreatment with prasugrel and clopidogrel by using optical coherence tomography (OCT) immediately after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Methods We performed OCT immediately after PCI in 108 ACS patients pretreated with either prasugrel ( n = 51) or clopidogrel ( n = 57). OCT detected thrombus/plaque protrusion in all stented segments. Results Although stent volume (190.4 ± 119.1 mm 3 vs. 189.4 ± 95.8 mm 3 ...

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    4. Thin-cap fibroatheroma and large calcification at the proximal stent edge correlate with a high proportion of uncovered stent struts in the chronic phase

      Thin-cap fibroatheroma and large calcification at the proximal stent edge correlate with a high proportion of uncovered stent struts in the chronic phase

      Objective: A high proportion of uncovered stent struts is associated with late stent thrombosis after drug-eluting stent (DES) implantation, which frequently results in myocardial infarction or death. However, the predictors of uncovered stent struts remain unknown. Here, using optical coherence tomography (OCT), we studied the baseline tissue characteristics of the target coronary segment and evaluated their influence on the neointimal coverage of the strut in the chronic phase. Methods: We analyzed 118 coronary lesions treated with OCT-guided DES implantation. OCT examinations of target lesions were performed before and after DES implantation, and tissue characteristics were evaluated within 5 mm outer ...

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    5. Two Imaging Catheters Unite to Better Detect Dangerous Plaques in Arteries

      Two Imaging Catheters Unite to Better Detect Dangerous Plaques in Arteries

      Collaboration between two National Institute of Biomedical Imaging and Bioengineering (NIBIB)-funded labs has revealed a promising new method for identifying atherosclerotic plaques, the encased deposits in arteries that restrict blood flow and can lead to heart attack or stroke. The technique combines two different types of imaging, allowing for an unprecedented combination of depth and detail. The hybrid technology will provide doctors with a better diagnostic tool for identifying particularly problematic plaques. Heart disease is the leading cause of death worldwide. The majority of deaths from heart disease are caused by the rupture of a plaque lining an artery ...

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    6. Heartbeat OCT and Motion-Free 3D In Vivo Coronary Artery Microscopy

      Heartbeat OCT and Motion-Free 3D In Vivo Coronary Artery Microscopy

      Intravascular optical coherence tomography (IV-OCT) has gained widespread use over the past few years, offering highly detailed images of coronary artery pathologies and interventions (1) . In contrast to the cross-sectional view, longitudinal sections and 3-dimensional (3D) renderings are affected by cardiac motion artifacts and undersampling, complicating interpretation and measurements (2) . We developed Heartbeat OCT, a new OCT method that achieves up to 4,000 frames/s imaging speed for isotropically sampled volume datasets acquired within the diastolic phase of 1 cardiac cycle to restore 3D IV-OCT image fidelity. In this research letter, we present the first in vivo data acquired ...

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    7. Mechanisms of stent thrombosis: insights from optical coherence tomography

      Mechanisms of stent thrombosis: insights from optical coherence tomography

      Although the improvement of coronary stents and medical agents has reduced adverse cardiac events in patients undergoing percutaneous coronary intervention (PCI), stent thrombosis (ST) still remains one of fatal complications of stent therapy. However, the pathophysiology of ST has not been sufficiently established yet, and factors including comorbidities such as diabetes mellitus, stent design, and patients’ response or adherence to antiplatelet therapy have had the association with ST occurrence (1,2). Recently, a large prospective registry study investigating the intravascular morphologies of coronary stents in patients suffering from ST was published (3). Using optical coherence tomography (OCT) that had higher ...

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    8. Optical Coherence Tomography: Role in Percutaneous Coronary Intervention (Book Chapter)

      Optical Coherence Tomography: Role in Percutaneous Coronary Intervention (Book Chapter)

      Optical coherence tomography (OCT) is an imaging modality that utilizes back-reflection of near-infrared light. Superior resolution intra-coronary imaging, including assessment of plaque morphology and characteristics as well as imaging stents and post-stent complications have made OCT a powerful research tool, and more recently a clinical tool for guidance of PCI. Visualization of coronary lesions with OCT and their characterization as lipid-rich, fibrous, or fibro-calcific plaque can influence percutaneous coronary intervention (PCI) procedural planning. OCT has contributed significantly to the understanding of culprit lesion pathophysiology in acute coronary syndromes (ACS). ACS culprit lesions have been categorized by OCT features as resulting ...

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    9. Cholesterol crystal as a new feature of coronary vulnerable plaques: An optical coherence tomography study

      Cholesterol crystal as a new feature of coronary vulnerable plaques: An optical coherence tomography study

      Background Previous pathohistological studies demonstrated that cholesterol crystals (CCs) are frequently observed in atherosclerotic plaques, and are usually present abundantly in vulnerable plaques. However, the role of CCs in plaque destabilization, as well as their origin and composition, is unknown. Optical coherence tomography (OCT) imaging system is a high-resolution imaging device, which allows the in vivo identification of CCs accumulating within atherosclerotic plaques. The aim of this study was to investigate the relationship between the presence of CCs, other plaque morphologies assessed by OCT, and patients’ clinical characteristics including acute coronary syndrome (ACS). Methods and results Preinterventional OCT images of ...

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    10. A 2-step optical coherence tomography guided therapeutic approach to acute myocardial infarction secondary to stent thrombosis

      A 2-step optical coherence tomography guided therapeutic approach to acute myocardial infarction secondary to stent thrombosis

      Myocardial infarction secondary to stent thrombosis has high mortality and recurrence rate. Emergency PCI has high risk of no-reflow. We used a 2-step approach of early recanalization with minimal mechanical intervention followed by delayed PCI 1–2 days later guided by Optical Coherence Tomography (OCT). From October 2011 to December 2013, we treated 5 patients with this approach. Time from early recanalization to the delayed definitive PCI was 1 day (median, range 1–3 days). All the OCT images were diagnostic with a clear view of the underlying structures. Summary A 2-step approach to treat stent thrombosis appears beneficial with ...

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    11. Ruptured plaque in the renal artery by optical coherence tomography

      Ruptured plaque in the renal artery by optical coherence tomography

      Coronary plaque rupture (PR) may be the trigger for platelet accumulation, subsequent thrombus formation, and acute coronary syndrome (ACS). Case series have suggested that conservative treatment of no-flow limiting coronary lesions with the feature of PR is relatively safe. Little is known about PR in the renal arteries. We present a case of PR in the renal artery confirmed by optical coherence tomography (OCT). A 67-year-old male patient with chronic kidney disease stage 3, arterial hypertension, and diffuse atherosclerosis was referred for renal arteriography. Having been treated with four antihypertensive drugs, the patient’s blood pressure (BP) was suboptimal. The ...

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    12. Cardiac allograft vasculopathy: optical coherence guided innovative treatment options with the bioresorbable vascular scaffold – proof of concept

      Cardiac allograft vasculopathy: optical coherence guided innovative treatment options with the bioresorbable vascular scaffold – proof of concept

      AIM: The aim of our work, was to assess a novel interventional therapy option in cardiac allograft vasculopathy (CAV), a complex form of coronary disease presenting only in heart transplant (HTx) recipients. It is typically a rapidly progressing phenomenon, affecting the entire coronary circulation causing diffuse, severe coronary lesions and has no one unique cause. Treatment options are limited, but where eligible, palliation via percutaneous revascularization (PCI) mainly using new generation drug eluting stents (DES) is recommended. METHOD: Our working group sought to assess outcomes of CAV PCI using an Absorb (Abbott Vascular, Santa Clara, CA, USA) fully bioresorbable, everolimus ...

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    13. Coronary Pleating Mimicking Coronary Ruptures, Dissections, and Thrombi on Optical Coherence Tomography

      Coronary Pleating Mimicking Coronary Ruptures, Dissections, and Thrombi on Optical Coherence Tomography

      Introduction Straightening of tortuous coronaries by intracoronary guidewires may generate intimal wrinkles or coronary pleating and lead to the development of different abnormal angiographic findings widely known as pseudostenosis or accordion effect. 1 We report the unique findings disclosed by optical coherence tomography (OCT) in 3 patients developing coronary pleating. Patient 1 An 84-year-old woman with severe aortic stenosis was referred for coronary angiography before transcatheter aortic valve implantation. A severe stenosis in the mid segment of the right coronary artery was treated with a bare metal stent. The guidewire induced a new moderate focal lesion at the most proximal ...

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      Mentions: Fernando Alfonso
    14. OPTICAL COHERENCE TOMOGRAPHY GUIDED ANGIOPLASTY IN A RIGHT CORONARY ARTERY. DR BINOY JOHN (JAN 2015)

      OPTICAL COHERENCE TOMOGRAPHY GUIDED ANGIOPLASTY IN A RIGHT CORONARY ARTERY. DR BINOY JOHN (JAN 2015)

      Optical coherence tomography is the latest technology, beyond conventional contrast guided angiography, used in excellent imaging of the coronary arteries from inside the artery using near-infra-red light source delivered via an optical fibre placed which is positioned inside the artery of interest. OCT provides a lot of information not otherwise available from conventional angiograms using dye or contrast. OCT can also be used to guide angioplasty and stenting with far superior results and long term safety from complications. The best use of OCT is to confirm good apposition of stents to the artery wall after angioplasty. Malapposition of stents can ...

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    15. Optical coherence tomography guided approach to postpartum coronary artery dissection: a case report

      Optical coherence tomography guided approach to postpartum coronary artery dissection: a case report

      Postpartum spontaneous coronary dissection (SCAD) is a rare and dramatic complication of pregnancy. SCAD is a separation of the coronary artery wall by intramural hematoma which can occur by a spontaneous intramedial hemorrhage with or without intimal rupture. Diagnosis and treatment can be difficult from a clinical and an angiographic point of view.1,2,3 In this setting intravascular imaging can be essential because it allows to confirm diagnosis, to detect possible intimal ruptures or thrombus and it can guide the treatment. Our case is about a SCAD of ambiguous angiographic diagnosis, the use of optical coherence tomography (OCT ...

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    16. Recanalized Image of a Thrombotic Occlusion: A Lotus Root-Like Panda Face Appearance by Optical Coherence Tomography

      Recanalized Image of a Thrombotic Occlusion: A Lotus Root-Like Panda Face Appearance by Optical Coherence Tomography

      In OCT, images of recanalized thrombotic occlusion have a lotus root-like appearance. This is due to septa that divide the lumen into multiple channels that communicate together and converge into a single lumen in the proximal and distal sites of the occlusion. We report a case of a recanalized mid left anterior descending (LAD) occlusion confirmed by OCT, where the lotus root appearance has a delightful panda face.

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    17. Late Stent Strut Apposition and Coverage After Drug-Eluting Stent Implantation by OCT in Patients With AMI

      Late Stent Strut Apposition and Coverage After Drug-Eluting Stent Implantation by OCT in Patients With AMI

      The purpose of this study is to evaluate the incidence of late incomplete stent apposition (ISA) and un-coverage by optical coherence tomography (OCT) following everolimus-eluting stent (EES) with bioabsorbable polymer (SYNERGY™, Boston Scientific,Nattick, MA, USA) versus zotarolimus-eluting stent (ZES) with permanent polymer(Resolute Onyx™, Medtronic, Santa Rosa, CA, USA) implantation in patients with AMI at 12 months.

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    18. Coronary Pleating Mimicking Coronary Ruptures, Dissections, and Thrombi on Optical Coherence Tomography

      Coronary Pleating Mimicking Coronary Ruptures, Dissections, and Thrombi on Optical Coherence Tomography

      Introduction Straightening of tortuous coronaries by intracoronary guidewires may generate intimal wrinkles or coronary pleating and lead to the development of different abnormal angiographic findings widely known as pseudostenosis or accordion effect. We report the unique findings disclosed by optical coherence tomography (OCT) in 3 patients developing coronary pleating. Patient 1 An 84-year-old woman with severe aortic stenosis was referred for coronary angiography before transcatheter aortic valve implantation. A severe stenosis in the mid segment of the right coronary artery was treated with a bare metal stent. The guidewire induced a new moderate focal lesion at the most proximal segment ...

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      Mentions: Fernando Alfonso
    19. Vessel-contrast enhancement in label-free optical coherence angiography based on phase and amplitude speckle variability

      Vessel-contrast enhancement in label-free optical coherence angiography based on phase and amplitude speckle variability

      Recently proposed in vivo label-free optical coherence angiography techniques based on phase and amplitude speckle variability often require additional signal pre- and post processing operations to enhance vessel-contrast. We observe here 1) contrast enhancement by optimizing the signal normalization/weighing before processing; 2) algorithm based on Kasai estimator for phase compensation between processed A-scans to reduce masking role of motion artifacts; and 3) image projection through the imaging depth for en face plotting. We demonstrate the efficiency of proposed additional algorithms as for the microcirculation imaging of hamsters cheek in vivo as for the preliminary microcirculation imaging of patients after ...

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    20. Improved vascular healing after successful treatment of very late sirolimus-eluting stent thrombosis with a bare metal stent implantation - A serial optical coherence tomography study

      Improved vascular healing after successful treatment of very late sirolimus-eluting stent thrombosis with a bare metal stent implantation - A serial optical coherence tomography study

      We present a case of a patient with non-ST-elevation myocardial infarction due to very late stent thrombosis, 2 years after a sirolimus-eluting stent implantation (SES). Optical coherence tomography (OCT) imaging identified vessel wall destruction of the whole stented coronary segment with multiple cavity formations along the entire stent length, severe struts malapposition and thrombi. The patient was treated successfully with the implantation of a bare metal stent (BMS). Follow-up OCT imaging at 12 months revealed improvement of vascular healing with complete re-endothelialization of the distal parts of the new BMS, while the stent body remained partly uncover suggesting vascular toxicity ...

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    21. Abbott Agrees to Buy St. Jude in $25 Billion Deal

      Abbott Agrees to Buy St. Jude in $25 Billion Deal

      Abbott Laboratories agreed to acquire St. Jude Medical Inc. in a cash-and-stock deal valued at $25 billion that would create one of the leading makers of heart-related devices. Under the deal, Abbott agreed to swap $46.75 in cash and 0.8708 shares for each St. Jude share. The offer values each St. Jude share at about $85, representing a 37% premium to the stock’s closing price Wednesday. Shares of Abbott fell 7% to $40.60 in early trading, while St. Jude rose 25% to $77.70. The companies said the deal merges St. Jude’s strong positions in ...

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      Mentions: St. Jude Medical
    22. Hybrid intravascular imaging: recent advances, technical considerations, and current applications in the study of plaque pathophysiology

      Hybrid intravascular imaging: recent advances, technical considerations, and current applications in the study of plaque pathophysiology

      Cumulative evidence from histology-based studies demonstrate that the currently available intravascular imaging techniques have fundamental limitations that do not allow complete and detailed evaluation of plaque morphology and pathobiology, limiting the ability to accurately identify high-risk plaques. To overcome these drawbacks, new efforts are developing for data fusion methodologies and the design of hybrid, dual-probe catheters to enable accurate assessment of plaque characteristics, and reliable identification of high-risk lesions. Today several dual-probe catheters have been introduced including combined near infrared spectroscopy-intravascular ultrasound (NIRS-IVUS), that is already commercially available, IVUS-optical coherence tomography (OCT), the OCT-NIRS, the OCT-near infrared fluorescence (NIRF) molecular ...

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