1. Articles in category: Cardiology

    481-504 of 3113 « 1 2 ... 18 19 20 21 22 23 24 ... 128 129 130 »
    1. Assessment of Cardiac Allograft Vasculopathy by Optical Coherence Tomography

      Assessment of Cardiac Allograft Vasculopathy by Optical Coherence Tomography

      Cardiac allograft vasculopathy (CAV) is characterized by marked intimal proliferation and concentric vascular thickening and fibrosis. CAV remains the leading cause of late morbidity and mortality in heart transplant recipients. Optical coherence tomography (OCT) is a new generation catheter-based modality that acquires images at a spatial resolution of 10-20 μm which is 10-fold greater than that of intravascular ultrasound (IVUS). OCT is currently the most sensitive imaging technique for early CAV detection. Recent studies proved that circulating human leukocyte antigen (HLA) directed donor-specific antibodies correlate with increased mortality and CAV. Contradiction of scientific results has been reported regarding increased resting ...

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    2. A Micromotor Catheter for Intravascular Optical Coherence Tomography

      A Micromotor Catheter for Intravascular Optical Coherence Tomography

      We have developed a new form of intravascular optical coherence tomography (IV-OCT) that allows the extremely fast acquisition of high-resolution images of the coronary arteries. This process leads to much better image quality by eliminating cardiac motion artefacts and undersampling. It relies on a catheter that incorporates a synchronous micromotor with a diameter of 1.0 mm and a rotational speed of up to 5600 revolutions per second, enabling an IV-OCT frame rate of 5.6 kHz. This speed is matched by a wavelength-swept laser that generates up to 2.8 million image lines per second. With this setup, our ...

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    3. Critical analysis of the correlation between optical coherence tomography versus intravascular ultrasound and fractional flow reserve in the management of intermediate coronary artery lesion

      Critical analysis of the correlation between optical coherence tomography versus intravascular ultrasound and fractional flow reserve in the management of intermediate coronary artery lesion

      The appropriate assessment of intermediate coronary artery stenosis continues to be a challenge for cardiologists. Several studies have shown that anatomic parameters obtained by intravascular ultrasound (IVUS) and optical coherence tomography (OCT) showed a correlation with fractional flow reserve (FFR) values in identifying hemodynamically severe coronary stenoses. However, the efficacy of IVUS/OCT versus FFR integration in intermediate coronary lesions is still debated. This review will allow for an independent analysis of research data and outlines the diagnostic efficiency of IVUS and OCT derived-anatomical parameters in identifying the hemodynamic significance of an angiographically intermediate stenosis as determined by FFR.

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    4. In Vivo Demonstration of Frail Neointimal Tissue Embolization After Angioplasty With a Drug-Coated Balloon Confirmed by Optical Coherence Tomography and Histology

      In Vivo Demonstration of Frail Neointimal Tissue Embolization After Angioplasty With a Drug-Coated Balloon Confirmed by Optical Coherence Tomography and Histology

      A 60-year-old woman experienced exertional chest pain. She underwent percutaneous coronary intervention with a drug-eluting stent (Nobori, Terumo Corporation, Tokyo) at the midportion of the left anterior descending artery. In the 3-month follow-up angiography, there was an in-stent restenosis at the midportion of the left anterior descending artery, which was also the site of a previous stent implantation (arrow, Figure 1A). In optical coherence tomography, neointimal hyperplasia proliferation with a heterogeneous pattern was observed with a minimal lumen area of 1.7 mm 2 (asterisk, Figure 1A). Angioplasty with a drug-coated balloon (Sequent please; B. Braun, Melsungen, Germany) was performed ...

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    5. The Role of Multiple Imaging Modalities to Disclose the Mechanism of ACS Angioscopy in Comparison to Other Imaging Modalities Including OCT, IVUS and CTA (Book Chapter)

      The Role of Multiple Imaging Modalities to Disclose the Mechanism of ACS Angioscopy in Comparison to Other Imaging Modalities Including OCT, IVUS and CTA (Book Chapter)

      This book presents a thorough review of coronary angioscopy, ranging from instructions on its use to the latest advances. Starting with the structure and fundamental principles of angioscopy, it shows readers how to apply the image to comprehensive care of coronary-artery patients. Plentiful color photos and illustrations will enable readers to investigate and classify plaques and thrombi and to evaluate coronary stent- and drug-based therapies. The authors are leading researchers on angioscopy. This book offers the perfect guide not only for new clinicians but also for cardiologists who have already adopted this technique for medical examination and treatment. Angioscopy is ...

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    6. Excellent very early neointimal coverage of bioactive stents by optical coherence tomography

      Excellent very early neointimal coverage of bioactive stents by optical coherence tomography

      Objectives: In a prospective study, we explored the extent of neointimal coverage of stent struts by optical coherence tomography 14 days following the implantation of bioactive stents in an unselected cohort. Design: We enrolled 15 consecutive patients who underwent bioactive stent implantation. Optical coherence tomography images were obtained at 14-day follow-up. Morphometric analysis, strut coverage , strut apposition, neointimal hyperplasia and possible thrombosis were evaluated at 1-mm intervals. Binary stent strut coverage was defined as the percentage of covered struts of all analyzed struts. Results: Patients underwent optical coherence tomography examination at an average of 14.5 ± 2.3 days following ...

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    7. Intravascular ultrasound and optical coherence tomography imaging of coronary atherosclerosis

      Intravascular ultrasound and optical coherence tomography imaging of coronary atherosclerosis

      Invasive imaging modalities, in particular intravascular ultrasound (IVUS) and optical coherence tomography (OCT), have become established tools for the in vivo study of coronary atherosclerosis. Their use in clinical studies has confirmed histopathological observations that certain important plaque features, such as thin fibrous caps and large lipid cores, are associated with plaque rupture, the precipitating event for the majority of myocardial infarctions. Serial imaging studies have also successfully been used for the evaluation of potential disease modifying pharmacological agents. Recent prospective IVUS studies have confirmed specific baseline imaging features associated with subsequent adverse clinical outcomes, although absolute event rates were ...

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    8. The basics of intravascular optical coherence tomography

      The basics of intravascular optical coherence tomography

      Optical coherence tomography (OCT) has opened new horizons for intravascular coronary imaging. It utilizes near-infrared light to provide a microscopic insight into the pathology of coronary arteries in vivo . Optical coherence tomography is also capable of identifying the chemical composition of atherosclerotic plaques and detecting traits of their vulnerability. At present it is the only tool to measure the thickness of the fibrous cap covering the lipid core of the atheroma, and thus it is an exceptional modality to detect plaques that are prone to rupture (thin fibrous cap atheromas). Moreover, it facilitates distinguishing between plaque rupture and plaque erosion ...

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    9. Coronary Conference to be Held

      Coronary Conference to be Held

      Interventional Cardiologists from across the country will come together for a conference on coronary imaging and physiology in the city this week. The conference on the advancements in coronary imaging and physiology will be held at Hotel Taj Vivanta in Thycaud on Saturday and Sunday. Governor P Sathasivam will inaugurate the meet on Saturday at 7 pm. Explaining the significance of coronary imaging, organising chairpersons of the conference Dr C G Bahuleyan and Dr Ajith Kumar V K said that it holds the key to the highest level of precision in coronary angioplasty. The imaging of inner walls of blood ...

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    10. Atypical “vacuum” inside of neoatherosclerosis long term after DES implantation: Insights from optical coherence tomography

      Atypical “vacuum” inside of neoatherosclerosis long term after DES implantation: Insights from optical coherence tomography

      Percutaneous coronary intervention (PCI) with stenting is the most widely performed procedure for the treatment of symptomatic coronary artery disease [1], and the technological developments of drug-eluting stents (DES) have reduced the rates of in-stent restenosis and target lesion revascularization of bare-metal stent [2-5]. Clinical and histological studies of DES have confirmed evidence that restenosis is the result of arterial damage with subsequent neointimal tissue proliferation, which was named as “late catch-up” phenomenon [6-7].

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    11. Impact of Side Branch Modeling on Computation of Endothelial Shear Stress in Coronary Artery Disease Coronary Tree Reconstruction by Fusion of 3D Angiography and OCT

      Impact of Side Branch Modeling on Computation of Endothelial Shear Stress in Coronary Artery Disease Coronary Tree Reconstruction by Fusion of 3D Angiography and OCT

      Background Computational fluid dynamics allow virtual evaluation of coronary physiology and shear stress (SS). Most studies hitherto assumed the vessel as a single conduit without accounting for the flow through side branches. Objectives This study sought to develop a new approach to reconstruct coronary geometry that also computes outgoing flow through side branches in hemodynamic and biomechanical calculations, using fusion of optical coherence tomography (OCT) and 3-dimensional (3D) angiography. Methods Twenty-one patients enrolled in the DOCTOR (Does Optical Coherence Tomography Optimize Revascularization) fusion study underwent OCT and 3D-angiography of the target vessel (9 left anterior descending, 2 left circumflex, 10 ...

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    12. Radiotherapy-induced vascular damage in mammary arterial graft: correlations between optical coherence tomography and pathology

      Radiotherapy-induced vascular damage in mammary arterial graft: correlations between optical coherence tomography and pathology

      A 53-year-old man with a previous history of mediastinal radiotherapy was referred to our institution for coronary artery bypass graft and aortic valve replacement. Per-operative surgical analysis revealed poor flow within left and right internal mammary arteries (LIMA and RIMA), making their use as peducunlated conduits unsuitable. The proximal end arteries were removed and both vessels were harvested as free grafts.

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    13. Differences in Vessel Healing between Sirolimus- and Everolimus-eluting Stent Implantation for Bifurcation Lesions: The J-REVERSE OCT Sub-study

      Differences in Vessel Healing between Sirolimus- and Everolimus-eluting Stent Implantation for Bifurcation Lesions: The J-REVERSE OCT Sub-study

      Background We aimed to clarify the differences in vessel healing after stenting for bifurcation lesions using sirolimus-eluting stent (SES) or everolimus-eluting stent (EES). Methods J-REVERSE is a prospective multicenter registry of 303 bifurcation lesions that were treated with provisional SES or EES with or without final kissing inflation. The first 115 lesions at selected study sites were predefined for inclusion in the optical coherence tomography (OCT) sub-study and 9-month follow-up OCT was conducted in 64 lesions (SES: n = 18, EES: n = 46). In addition to standard OCT parameters, stent eccentricity index (SEI; minimum divided by the maximum stent diameter), neointimal ...

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    14. Role of Optical Coherence Tomography in the assessment of Stent Deformation

      Role of Optical Coherence Tomography in the assessment of Stent Deformation

      Longitudinal stent deformation (LSD) is a recognized complication of stenting procedure, characterized by stent distortion, affecting its length. LSD requires prompt recognition and treatment to avoid potential risk of stent thrombosis. Here we present a case of LSD, confirmed by optical coherence tomography. This case highlights importance of intravascular imaging in recognition of this complication.

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    15. To see or not to see: An eye opening optical coherence tomography

      To see or not to see: An eye opening optical coherence tomography

      The clinical problem described in this case arose from a few technical misjudgments. As difficult as it is to be a Monday morning Quarter Back or post one-day cricket analysis, this post PCI complication is further magnified when decisions were made to use a BVS without clear visibility and wires that were not clearly separated. Was this complication avoidable remains to be the question? As the number of percutaneous coronary interventions are growing around the world, more outside US currently than in the USA that was in the lead for past 2 decades, one has to wonder whether the devices ...

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      Mentions: FDA
    16. Early Phase Arterial Reaction Following Drug-Eluting and Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction Optical Coherence Tomography Assessment at 2 Weeks

      Early Phase Arterial Reaction Following Drug-Eluting and Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction Optical Coherence Tomography Assessment at 2 Weeks

      The early phase arterial reaction after implantation of second-generation drug-eluting stents (2nd DES) and baremetal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. The MECHANISM pilot study is a multi-center prospective registry that enrolled 24 STEMI patients (from 11 centers) who had undergone implantation of everolimus-eluting ( n = 6), biolimus A9-eluting ( n = 6) or zotarolimus-eluting stents ( n = 6), or BMS ( n = 6). Scheduled optical coherence tomography (OCT) was performed 2 weeks after implantation, and images were independently analyzed at a core laboratory in a blinded fashion. Intra-stent thrombus was quantitatively analyzed in terms of the maximal area ...

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    17. Hazy filling defect on coronary angiography: insights from optical coherence tomography

      Hazy filling defect on coronary angiography: insights from optical coherence tomography

      A middle-aged patient with previous stent to the left circumflex artery (LCx) 12 months before suffering from angina, now presented with acute-onset severe retrosternal chest pain with an ECG showing ST-elevation in the precordial leads (see online supplementary figure S1). He underwent emergency coronary angiography, which showed normal flow in all arteries and a patent LCx stent. The left anterior descending artery (LAD) contained a hazy filling defect in the mid vessel (figure 1A). Following administration of heparin, the filling defect in the mid-LAD resolved (figure 1B). The left ventriculogram showed severe systolic dysfunction involving the mid and apical segments ...

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    18. St. Jude Medical Announces Launch of the First International Trial to Compare OCT-Guided Stent Implantation to IVUS or Angiography-Guided PCI

      St. Jude Medical Announces Launch of the First International Trial to Compare OCT-Guided Stent Implantation to IVUS or Angiography-Guided PCI

      St. Jude Medical, Inc. (NYSE:STJ), a global medical device company, today announced the launch of the ILUMIEN III clinical trial, a prospective, international, randomized trial evaluating the clinical benefits of the company’s optical coherence tomography (OCT) guidance during stent implantation. The ILUMIEN III study will compare OCT-guided stent implantation to implantation guided by intravascular ultrasound (IVUS) or angiography alone, diagnostic tools that offer less resolution than OCT during intravascular assessments and percutaneous coronary intervention (PCI). The ILUMIEN III study is the largest multicenter randomized study to date to compare PCI outcomes associated with all three imaging tools. By ...

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      Mentions: St. Jude Medical
    19. Multimodality Intra-Arterial Imaging Assessment of the Vascular Trauma Induced by Balloon-Based and Nonballoon-Based Renal Denervation Systems

      Multimodality Intra-Arterial Imaging Assessment of the Vascular Trauma Induced by Balloon-Based and Nonballoon-Based Renal Denervation Systems

      Background— Renal denervation is a new treatment considered for several possible indications. As new systems are introduced, the incidence of acute renal artery wall injury with relation to the denervation method is unknown. We investigated the acute repercussion of renal denervation on the renal arteries of patients treated with balloon-based and nonballoon-based denervation systems by quantitative angiography, intravascular ultrasound, and optical coherence tomography (OCT). Methods and Results— Twenty-five patients (50 renal arteries) underwent bilateral renal denervation with 5 different systems, 3 of which balloon-based (Paradise [n=5], Oneshot [n=6], and Vessix V2 [n=5)]) and 2 nonballoon-based (Symplicity [n ...

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    20. A Combined Optical Coherence Tomography and Intravascular Ultrasound Study on Plaque Rupture, Plaque Erosion, and Calcified Nodule in Patients With ST-Segment Elevation Myocardial Infarction : Incidence, Morphologic Characteristics, and Outcomes After Per

      A Combined Optical Coherence Tomography and Intravascular Ultrasound Study on Plaque Rupture, Plaque Erosion, and Calcified Nodule in Patients With ST-Segment Elevation Myocardial Infarction : Incidence, Morphologic Characteristics, and Outcomes After Per

      Objectives This study sought to evaluate the incidence of plaque rupture (PR), plaque erosion (PE), and calcified nodule (CN) using optical coherence tomography (OCT) in patients with ST-segment elevation myocardial infarction (STEMI); to compare detailed morphologic plaque characteristics of PR, PE, and CN with optical coherence tomography and intravascular ultrasound; and to compare the post-procedure outcomes among PR, PE, and CN. Background The incidence and detailed morphologic characteristics of PR, PE, and CN in STEMI patients and their outcome after percutaneous coronary intervention (PCI) are unknown. Methods A total of 112 STEMI patients who underwent PCI within 12 h from ...

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    21. Comparison of Neoatherosclerosis and Neovascularization Between Patients With and Without Diabetes : An Optical Coherence Tomography Study

      Comparison of Neoatherosclerosis and Neovascularization Between Patients With and Without Diabetes : An Optical Coherence Tomography Study

      Objectives This study aimed to investigate the characteristics of neoatherosclerosis (NA) in patients with diabetes mellitus (DM) after drug-eluting stent (DES) implantation using optical coherence tomography. Background NA is an important substrate for stent failure. In vivo NA characteristics in DM patients have not been investigated. Methods A total of 397 patients with 452 DES who underwent follow-up optical coherence tomography examination after DES implantation were enrolled. Characteristics of NA were compared between DM and non-DM patients. Neovascularization was defined as signal-poor holes or tubular structures with a diameter of 50 to 300 μm. Results A total of 123 DES ...

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