1. Articles in category: Cardiology

    481-504 of 3077 « 1 2 ... 18 19 20 21 22 23 24 ... 127 128 129 »
    1. All that glitters ain't gold! A case of embolic STEMI demonstrated by OCT

      All that glitters ain't gold! A case of embolic STEMI demonstrated by OCT

      We have read with interest the paper recently published by Duygu [1] discussing acute myocardial infarction caused by paradoxical coronary embolism. According to his consideration coronary angiography unfortunately remains an approximate rough method to evaluate coronary plaque. In the last years due to its high resolution Optical Coherence Tomography (OCT) [2] has been largely exploited in the evaluation and characterization of plaque features, both in stable and acute coronary artery disease.

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    2. Vasa Vasorum Restructuring in Human Atherosclerotic Plaque Vulnerability

      Vasa Vasorum Restructuring in Human Atherosclerotic Plaque Vulnerability

      Background Previous studies have suggested that vasa vasorum (VV) is associated with plaque progression and vulnerability. Objectives The aim of this study was to investigate the relationship between coronary neovascularization structures and plaque characteristics. Methods We included 53 patients who underwent optical coherence tomography to observe the proximal left anterior descending coronary artery. Patients were classified into 5 groups according to lesion characteristics: normal; fibrous plaque (FP); fibroatheroma (FA); plaque rupture (PR); and fibrocalcific plaque (FC). We defined signal-poor tubuloluminal structures recognized in cross-sectional and longitudinal profiles located in adventitial layer as VV, and within plaque as intraplaque neovessels. Two ...

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    3. Instant Stent-Accentuated Three-Dimensional Optical Coherence Tomography Guided Selection of Proper Distal Cell for Side Branch Dilatation in Bifurcation Stenting

      Instant Stent-Accentuated Three-Dimensional Optical Coherence Tomography Guided Selection of Proper Distal Cell for Side Branch Dilatation in Bifurcation Stenting

      In the bifurcation stenting, the distal rewiring for the side branch postdilatation confirmed by two-dimensional modalities may not lead to favorable results in some cases. If there are two distal cells divided by the link bridging from the carina, the rewiring through the larger distal cell may be recommended for the side branch postdilatation. Detailed confirmation of the rewired cell by the intraprocedural instant stent-accentuated three-dimensional optical coherence tomography is important.

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    4. The coronary substrate determines prognosis in acute coronary syndromes: the kaleidoscope has been shaken ... again!

      The coronary substrate determines prognosis in acute coronary syndromes: the kaleidoscope has been shaken ... again!

      The identification of ‘vulnerable’ or ‘high risk’ coronary plaques has represented the quest for the Holy Grail in interventional cardiology for the past three decades. Plaque rupture (PR), plaque erosion (PE), and complicated calcified nodules (CNs) constitute the most common underlying substrates leading to coronary thrombosis and acute coronary syndromes (ACS). 1 – 3 Despite the advent of novel intracoronary imaging techniques, which are able to disclose unique morphological insights and plaque features similar to those found in plaques already complicated with coronary thrombosis, their value in predicting future clinical events remains limited. 4 – 7 Optical coherence tomography (OCT) is an ...

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    5. The association between in-stent neoatherosclerosis and native coronary artery disease progression: a long-term angiographic and optical coherence tomography cohort study

      The association between in-stent neoatherosclerosis and native coronary artery disease progression: a long-term angiographic and optical coherence tomography cohort study

      bstract AIMS: The purpose of the present study was to investigate the relationship between in-stent neoatherosclerosis (NA) and native atherosclerosis progression of untreated coronary segments. METHODS AND RESULTS: In-stent NA was assessed by optical coherence tomography (OCT) among patients included in the SIRTAX-LATE OCT study 5 years after drug-eluting stent (DES) (sirolimus-eluting and paclitaxel-eluting stents) implantation. Neoatherosclerosis was defined as the presence of fibroatheroma or fibrocalcific plaque within the neointima of stented segments with a longitudinal extension >1.0 mm. Atherosclerosis progression in untreated native coronary segments was evaluated by serial quantitative coronary angiography (QCA). The change in minimal lumen ...

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    6. Optical coherence tomography follow-up after bioresorbable in metallic and metallic in bioresorbable stenting: tackling in-stent restenosis in the era of bioresorbable vascular scaffolds

      Optical coherence tomography follow-up after bioresorbable in metallic and metallic in bioresorbable stenting: tackling in-stent restenosis in the era of bioresorbable vascular scaffolds

      A 63-year-old woman with stable angina underwent percutaneous coronary intervention of the left circumflex coronary artery (LCX) and the first obtuse marginal branch (OM1) with biolimus-eluting stents (BES) with the V-stenting technique ( Panels A and A ′). Seven months later due to recurrent angina repeat coronary angiography was performed

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    7. Optical coherence tomography-guided V-stenting in the distal left main

      Optical coherence tomography-guided V-stenting in the distal left main

      An 83-year-old man with hypertension, bilateral carotid disease, porcelain aorta and moderate renal failure was admitted with non-ST-elevation myocardial infarction. Coronary angiography revealed three-vessel disease with distal left main (LM) bifurcation involving the ostia of both the left anterior descending (LAD) and the left circumflex (LCx) coronary arteries (Medina 0,1,1; SYNTAX score 23) ( Figure 1 ). The patient was considered unsuitable for surgery. Optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) was undertaken. Pullbacks from the LAD and LCx ( Figure 2 ) were obtained using frequency-domain OCT (ILUMIEN OPTIS PCI Optimization System, St. Jude Medical, St. Paul, MN). The ...

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      Mentions: St. Jude Medical
    8. Comparison of Strut Coverage With OPTIMAX Versus SYNERGY Stents

      Comparison of Strut Coverage With OPTIMAX Versus SYNERGY Stents

      The purpose of this study is to compare vascular healing of the stented segment after deployment of titanium-nitride-oxide coated cobalt-chromium OPTIMAX™ bio-active stent (BAS) and SYNERGY™ everolimus-eluting stent (EES) in patients with acute coronary syndromes requiring percutaneous coronary intervention. Patients treated with BAS will be treated with DAPT for at least 4 weeks after the procedure followed by aspirin alone, while patients in the EES group will be treated with DAPT, at least for 6 months post procedure. In addition, this study will collect initial information about the safety and effectiveness of the BAS in comparison with EES group at ...

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    9. A 12–month angiographic and optical coherence tomography follow-up after bioresorbable vascular scaffold implantation in patients with ST-segment elevation myocardial infarction

      A 12–month angiographic and optical coherence tomography follow-up after bioresorbable vascular scaffold implantation in patients with ST-segment elevation myocardial infarction

      Objectives The aim of the study was to evaluate the healing process at 12 months after ABSORB™ bioresorbable vascular scaffold (BVS) implantation in patients with ST-segment elevation myocardial infarction (STEMI). Background There is currently no data on long-term BVS performance in the acute thrombotic setting. The underlying altered plaque pathomorphology may impact the neointima healing pattern, potentially making it different to that observed in stable coronary artery disease (CAD). Methods We have performed an angiographic and optical coherence tomography (OCT) 12-month follow-up of 19 STEMI patients who were treated with a BVS implantation (23 scaffolds). An independent core laboratory performed ...

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    10. Intravascular findings of fibromuscular dysplasia on optical coherence tomography

      Intravascular findings of fibromuscular dysplasia on optical coherence tomography

      We present the case of a 29-year-old woman with right renal artery stenosis caused by fibromuscular dysplasia (FMD) who underwent optical coherence tomography (OCT)-guided percutaneous transluminal renal angioplasty. Using OCT, we could clearly observe intimal fibroplasia and medial hyperplasia that was indicative of FMD. Based on diagnosis of FMD by OCT, this patient was treated with plain old balloon angioplasty that resulted in adequate luminal opening without intimal dissection confirmed on final angiography and OCT.

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    11. COmplex coronary Bifurcation lesions: RAndomized comparison of a strategy using a dedicated self-expanding biolimus-eluting stent versus a culotte strategy using everolimus-eluting stents: primary results of the COBRA trial

      COmplex coronary Bifurcation lesions: RAndomized comparison of a strategy using a dedicated self-expanding biolimus-eluting stent versus a culotte strategy using everolimus-eluting stents: primary results of the COBRA trial

      Aims: We aimed to compare healing responses with optical coherence tomography, and clinical and angiographic outcome after treatment of coronary bifurcation lesions with a dedicated stent versus aconventional culotte technique. Methods and results: Forty patients with true and complex coronary bifurcation lesions were randomly assigned to treatment with the Axxess™ bifurcation stent in the proximal main vessel (MV) and additional BioMatrix™ stents in the branches (Biosensors Europe SA, Morges, Switzerland), versus a culotte technique using XIENCE™ stents (Abbott Vascular, Santa Clara, CA, USA). The primary endpoint of percentage of uncovered struts at nine months was similar with the dedicated strategy ...

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    12. Neoatherosclerosis: overview of histopathologic findings and implications for intravascular imaging assessment

      Neoatherosclerosis: overview of histopathologic findings and implications for intravascular imaging assessment

      Despite the reduction in late thrombotic events with newer-generation drug-eluting stents (DES), late stent failure remains a concern following stent placement. In-stent neoatherosclerosis has emerged as an important contributing factor to late vascular complications including very late stent thrombosis and late in-stent restenosis. Histologically, neoatherosclerosis is characterized by accumulation of lipid-laden foamy macrophages within the neointima with or without necrotic core formation and/or calcification. The development of neoatherosclerosis may occur in months to years following stent placement, whereas atherosclerosis in native coronary arteries develops over decades. Pathologic and clinical imaging studies have demonstrated that neoatherosclerosis occurs more frequently and ...

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    13. Detection of plaque structure and composition using OCT combined with two-photon luminescence (TPL) imaging

      Detection of plaque structure and composition using OCT combined with two-photon luminescence (TPL) imaging

      Background and Objectives Atherosclerosis and plaque rupture leads to myocardial infarction and stroke. A novel hybrid optical coherence tomography (OCT) and two-photon luminescence (TPL) fiber-based imaging system was developed to characterize tissue constituents in the context of plaque morphology. Study Design/Materials and Methods Ex vivo coronary arteries (34 regions of interest) from three human hearts with atherosclerotic plaques were examined by OCT–TPL imaging. Histological sections (4 μm in thickness) were stained with Oil Red O for lipid, Von Kossa for calcium, and Verhoeff–Masson Tri-Elastic for collagen/elastin fibers and compared with imaging results. Results Biochemical components in ...

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    14. OCT for bifurcation stenting: what have we learned?

      OCT for bifurcation stenting: what have we learned?

      Treatment of bifurcation lesions by percutaneous coronary intervention (PCI) shows major variation in complexity. Intravascular optical coherence tomography (OCT) provides high-resolution images of the pathoanatomy, thrombus, wires and stent positions during the procedure. This information may prove crucial in optimising PCI results and clinical outcomes after complex bifurcation treatment. Mounting evidence confirms the feasibility of OCT in bifurcations, and specific steps where OCT may be advantageous in guiding bifurcation PCI have been identified. Awaiting major clinical outcome trials, OCT has already entered the European guidelines for myocardial revascularisation. This paper aims to provide an overview of the potential clinical use ...

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    15. Association of circulating levels of neopterin with non-culprit plaque vulnerability in CAD patients an angiogram, optical coherent tomography and intravascular ultrasound study

      Association of circulating levels of neopterin with non-culprit plaque vulnerability in CAD patients an angiogram, optical coherent tomography and intravascular ultrasound study

      Background Neopterin is a pteridine derivative secreted by activated macrophages. Previous studies have shown that neopterin plays a pivotal role in coronary artery disease (CAD); however, the relationship between circulating neopterin and non-culprit plaque vulnerability in patients with CAD remains unclear. In this study, we investigated the correlation of neopterin and vulnerable plaque features in patients with CAD. Methods One hundred and thirty non-culprit plaques from 81 patients with CAD were assessed by angiogram and optical coherence tomography (OCT) as well as intravascular ultrasound (IVUS) imaging. According to the median value of serum neopterin (10.61 nmol/L), patients were ...

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    16. A 12-month angiographic and optical coherence tomography follow-up after bioresorbable vascular scaffold implantation in patients with ST-segment elevation myocardial infarction

      A 12-month angiographic and optical coherence tomography follow-up after bioresorbable vascular scaffold implantation in patients with ST-segment elevation myocardial infarction

       Objectives The aim of the study was to evaluate the healing process at 12 months after ABSORB™ bioresorbable vascular scaffold (BVS) implantation in patients with ST-segment elevation myocardial infarction (STEMI). Background There is currently no data on long-term BVS performance in the acute thrombotic setting. The underlying altered plaque pathomorphology may impact the neointima healing pattern, potentially making it different to that observed in stable coronary artery disease (CAD). Methods We have performed an angiographic and optical coherence tomography (OCT) 12-month follow-up of 19 STEMI patients who were treated with a BVS implantation (23 scaffolds). An independent core laboratory performed ...

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    17. New Data Further Emphasize the Clinical Benefits of St. Jude Medical’s OCT Technology

      New Data Further Emphasize the Clinical Benefits of St. Jude Medical’s OCT Technology

      St. Jude Medical, Inc. (NYSE:STJ), a global medical device company, today announced preliminary results from the ILUMIEN I trial and final results from the ILUMIEN II clinical study. Taken together, the findings from both studies show that with resolution up to 10 times higher than intravascular ultrasound (IVUS), optical coherence tomography (OCT) imaging can help improve stent selection and deployment, better support clinical decision-making and improve patient outcomes. Data from both studies were presented today as late-breaking clinical trials at EuroPCR 2015, and further advance the use of OCT imaging alongside percutaneous coronary intervention (PCI). During PCI procedures, physicians ...

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    18. Internal Mammary Artery Atherosclerosis Use of Optical Coherence Tomography to Characterize Lesions and Guide Intervention

      Internal Mammary Artery Atherosclerosis Use of Optical Coherence Tomography to Characterize Lesions and Guide Intervention

      A 59-year-old man with prior coronary artery bypass surgery underwent cardiac catheterization for worsening angina. Angiogram showed severe native coronary artery disease with 2 patent vein grafts. However, a left internal mammary artery graft to the left anterior descending artery was found to have a long lesion (Figure 1 ). Spasm was excluded by intra-arterial nitroglycerin administration. After discussing the options, optical coherence tomography (OCT)–guided percutaneous intervention was pursued.

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    19. New implication of three-dimensional optical coherence tomography in optimising bifurcation PCI

      New implication of three-dimensional optical coherence tomography in optimising bifurcation PCI

      With the advance of optical coherence tomography (OCT) technology, three-dimensional (3D) reconstruction based on the optical coherence tomography has become feasible. In bifurcation lesions, 3D OCT may guide positioning of the wire through the appropriate (distal) cells. The early studies suggested that such a guidance strategy could reduce the incidence of malapposition in bifurcation lesions. The pre-installed “real-time” 3D OCT on the console will promote the utilisation of 3D assessment in bifurcation treatment and possibly establish the clinical benefit of such guidance in the near future when investigated in a prospective study.

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    20. Restenosis After Drug-Eluting Stent Implantation in a Patient With Polycythemia Vera Optical Coherence Tomography and Pathological Findings

      Restenosis After Drug-Eluting Stent Implantation in a Patient With Polycythemia Vera Optical Coherence Tomography and Pathological Findings

      An 83-year-old woman was referred to our hospital due to diverticular bleeding of the colon. She had a history of everolimus-eluting stent implantation in the left anterior descending artery (31 months before) and the right coronary artery (20 and 31 months before) because of stable angina. She was prescribed aspirin 100 mg/day and clopidogrel 75 mg/day, followed by single antiplatelet therapy by aspirin during the last 8 months. Aspirin was discontinued for the endoscopic therapy at her admission. Complete blood count showed hemoglobin of 17.5 g/dl and hematocrit of 55.2%, from which polycythemia vera (PV ...

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    21. Culprit lesion thrombus burden after manual thrombectomy or percutaneous coronary intervention-alone in ST-segment elevation myocardial infarction: the optical coherence tomography sub-study of the TOTAL (ThrOmbecTomy versus PCI ALone) tria

      Culprit lesion thrombus burden after manual thrombectomy or percutaneous coronary intervention-alone in ST-segment elevation myocardial infarction: the optical coherence tomography sub-study of the TOTAL (ThrOmbecTomy versus PCI ALone) tria

      Aims Manual thrombectomy has been proposed as a strategy to reduce thrombus burden during primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). However, the effectiveness of manual thrombectomy in reducing thrombus burden is uncertain. In this substudy of the TOTAL (ThrOmbecTomy versus PCI ALone) trial, we compared the thrombus burden at the culprit lesion using optical coherence tomography (OCT) in patients treated with thrombectomy vs. PCI-alone. Methods and results The TOTAL trial ( N = 10 732) was an international, multicentre, randomized trial of thrombectomy (using the Export catheter, Medtronic Cardiovascular, Santa Rosa, CA, USA) in STEMI ...

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    22. Cyphering the Mechanism of Late Failure of Bioresorbable Vascular Scaffolds in Percutaneous Coronary Intervention of the Left Main Coronary Artery

      Cyphering the Mechanism of Late Failure of Bioresorbable Vascular Scaffolds in Percutaneous Coronary Intervention of the Left Main Coronary Artery

      A 48-year-old woman with history of multiple percutaneous coronary interventions and bypass grafting on the left anterior descending coronary artery presented with unstable angina. Coronary angiography showed a patent left internal mammary artery and de novo critical stenoses of the mid-shaft left main and the unprotected left circumflex coronary artery (LCX). Both lesions were treated with 2 nonoverlapping bioresorbable vascular scaffolds (BVS) (Absorb, Abbott Vascular, Santa Clara, California) 3.5 × 12 mm at 16 atm and 3.0 × 18 mm at 12 atm, respectively. Optical coherence tomography (OCT) confirmed good expansion and apposition of the BVS (Figure 1 ). A short ...

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    23. Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)

      Coronary Wall Structural Changes in Patients With Kawasaki Disease: New Insights From Optical Coherence Tomography (OCT)

      Background Coronary artery aneurysms (CAA) are serious complications of Kawasaki disease (KD). Optical coherence tomography (OCT) is a high‐resolution intracoronary imaging modality that characterizes coronary artery wall structure. The purpose of this work was to describe CAA wall sequelae after KD. Methods and Results KD patients scheduled for routine coronary angiography underwent OCT imaging between March 2013 and August 2014. Subjects’ clinical courses, echocardiography, and coronary angiography examinations were reviewed retrospectively. OCT was performed in 18 patients aged 12.4±5.5 years, 9.0±5.1 years following onset of KD. Of those, 14 patients (77.7%) had ...

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