1. Articles in category: Cardiology

    481-504 of 2326 « 1 2 ... 18 19 20 21 22 23 24 ... 95 96 97 »
    1. Comparison of zotarolimus-eluting stent and everolimus-eluting stent for vascular healing response: serial 3-month and 12-month optical coherence tomography study

      Comparison of zotarolimus-eluting stent and everolimus-eluting stent for vascular healing response: serial 3-month and 12-month optical coherence tomography study

      Background: Everolimus-eluting stents (EES) have shown favorable clinical outcomes. However, there have been no studies evaluating early vascular response after EES implantation. We designed a prospective study to compare the neointimal response between zotarolimus-eluting stents (ZES) and EES at 3 and 12 months using serial optical coherence tomography examinations. Methods and results: Sixty patients who underwent 3-month and 12-month follow-up optical coherence tomography (36 EES, 24 ZES) were included. Neointimal coverage and malapposition were evaluated using a strut-based analysis at both 3 and 12 months. Neointimal hyperplasia area and thrombus were assessed. ZES showed a higher incidence of covered struts ...

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    2. A Rare Mechanism of Very Late Bare Metal Stent Thrombosis—Role of Optical Coherence Imaging in Its Evaluation and Management

      A Rare Mechanism of Very Late Bare Metal Stent Thrombosis—Role of Optical Coherence Imaging in Its Evaluation and Management

      Very late stent thrombosis is an uncommon event following implantation with bare metal stents (BMS) in coronary arteries. Long term follow up studies have shown that a small number of BMS develop very late thrombosis following years of stability. Atherosclerotic transformation of neointimal tissue is increasingly being recognised as the cause of these adverse events. A 49 year-old male presented with acute inferior wall myocardial infarction resulting from thrombosis of the BMS implanted in his right coronary artery five years earlier. He was successfully thrombolysed and his coronary angiogram showed mild diffuse instent restenosis. The intravascular optical coherence tomography revealed ...

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    3. Long-term Morphofunctional Remodeling of Internal Thoracic Artery Grafts: A Frequency-Domain Optical Coherence Tomography Study

      Long-term Morphofunctional Remodeling of Internal Thoracic Artery Grafts: A Frequency-Domain Optical Coherence Tomography Study

      Background— Internal thoracic arteries (ITAs) are frequently anastomosed to the coronary circulation for bypass grafting. The purpose of this research was to investigate in vivo the long-term morphofunctional changes of ITAs after their use as coronary artery bypass conduits, by comparing the morphological features and vasoreactivity of the grafted left ITA (LITA) with the native, nonharvested right ITA (RITA) in the same patient. Methods and Results— At least 10 years after surgery, in 10 patients, LITA graft and nonharvested RITA were assessed by quantitative angiography and frequency-domain optical tomography. Endothelium-dependent and independent vasodilation was tested by selective infusion of acetylcholine ...

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    4. Randomized Controlled Study of the Traditional Percutaneous Coronary Intervention and Intervention Using Optical Coherence Tomography of Incomplete Stent Adhesion and Extent of the Formation of Neointima by Resolute Zotarolimus-eluting Stent Insertion

      Randomized Controlled Study of the Traditional Percutaneous Coronary Intervention and Intervention Using Optical Coherence Tomography of Incomplete Stent Adhesion and Extent of the Formation of Neointima by Resolute Zotarolimus-eluting Stent Insertion

      Optical coherence tomography (OCT) after the stent procedure to improve the adhesion and expansion, or incomplete uncovered struts attached to the main track. OCT in clinical areas by improving the parameters of the best stent will be useful. However, for better results for optical coherence tomography in percutaneous interventions have little useful data on the role. Randomized controlled study of the traditional percutaneous coronary intervention and intervention using optical coherence tomography

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    5. Evolution of Intravascular Assessment Of Coronary Anatomy And Physiology: From Ultrasound Imaging to Optical and Flow Assessmen

      Evolution of Intravascular Assessment Of Coronary Anatomy And Physiology: From Ultrasound Imaging to Optical and Flow Assessmen

      The fact that coronary angiography has limitations in terms of precise estimation and progression of atherosclerosis has been partially overcome during the last years by the use of new techniques. Catheter based invasive modalities are of a profound clinical importance in regards to accurate assessment of coronary anatomy and physiology and the choice of the appropriate treatment strategy for each patient. Also their potential in clinical investigation projects is of great interest. This current review summarizes the basic principles of these methodologies and evidently highlights not only their use in clinical practice but also their contribution in clinical outcomes.

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    6. Very late stent thrombosis related to incomplete neointimal coverage or neoatherosclerotic plaque rupture identified by optical coherence tomography imaging

      Very late stent thrombosis related to incomplete neointimal coverage or neoatherosclerotic plaque rupture identified by optical coherence tomography imaging

      Aims Recent data have reported that neoatherosclerosis could develop long after stent implantation and lead to subsequent rupture and acute coronary syndrome (ACS). We sought to identify the presence of in-stent neoatheroma (ISNA) in patients with very late stent thrombosis (VLST) using optical coherence tomography (OCT). Methods and results All patients from two catheterization centres who presented with ACS related to VLST underwent a standard coronary angiography and intra-coronary OCT. ISNA was defined as the combination of diffuse neointimal proliferation, lipid-laden intima with plaque organization, and fibrous cap rupture with no evidence of an uncovered strut. Out of 2139 ACS ...

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    7. Treatment of a left anterior descending artery chronic total occlusion using a bio-absorbable scaffold, utilising optical coherence tomography

      Treatment of a left anterior descending artery chronic total occlusion using a bio-absorbable scaffold, utilising optical coherence tomography

      A 58year old Nepalese male presented with exertional chest pain. He had experienced similar symptoms 3months previously when out walking. Cardiac risk factors included undiagnosed hypercholesterolaemia (fasting level 8.7mmol/l) and a family history of ischaemic heart disease (mother, previous myocardial infarction). At the time of presentation ECG showed evidence of left bundle branch block (LBBB). High sensitivity troponin was negative. He underwent further risk stratification with an exercise stress ECG. He stopped at 6minutes of a Bruce protocol with chest pain and evidence of anterior J point ST depression (2mm), V1–6. Echocardiography revealed normal LV function. He ...

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    8. A unique stenosis in saphenous vein graft visualized by optical coherence tomography

      A unique stenosis in saphenous vein graft visualized by optical coherence tomography

      We present a case of a unique stenosis in a 12-year-old saphenous vein graft (SVG), to the right coronary artery, which was visualized by optical coherence tomography (OCT), before percutaneous coronary intervention. The patient was an 80-year-old man in whom the stenosis was documented by area-detector coronary computed tomography. OCT imaging demonstrated that the culprit lesion was a venous valve containing a thrombus before preintervention imaging. Coronary stenting was performed with a distal protection device, and pathologic examination of the aspirate verified the OCT findings. Coronary angiography 12 years previously, just after coronary artery bypass surgery (CABG), had shown a ...

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    9. Internal Thoracic Artery Dissection: A Proposed Mechanistic Explanation

      Internal Thoracic Artery Dissection: A Proposed Mechanistic Explanation

      A 61-year-old man with previous single bypass surgery of the left internal thoracic artery to the left anterior descending artery in 1996 presented to the emergency department with chest pain and anterior negative T waves. From time of surgery the patient remained asymptomatic until the day of admission when he experienced a sudden onset of chest pain immediately on raising and hyperextending both arms. On angiography, the native left anterior descending artery remained chronically occluded and the left internal thoracic artery showed an inferiorly displaced and flared ostium with preserved flow but a long, hazy, and severe proximal lesion. Optical ...

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    10. Very Late Stent Thrombosis 5 Years After Implantation of a Sirolimus-Eluting Stent Observed by Angioscopy and Optical Coherence Tomography

      Very Late Stent Thrombosis 5 Years After Implantation of a Sirolimus-Eluting Stent Observed by Angioscopy and Optical Coherence Tomography

      Images of Coronary Angiography and OCT of Pre– and Post–Percutaneous Coronary Intervention (A) Initial coronary angiography demonstrated severe stenosis with a contrast filling defect in the sirolimus-eluting stent (SES) implantation site of the left anterior descending artery (small arrows) . Dashed red line shows SES implantation site. (B) Optical coherence tomography (OCT) revealed massive thrombus in the SES (solid arrows) at the site of the open arrow . (C) Vessel patency was restored after aspiration procedure. Dashed red line shows SES implantation site. (D) The OCT image demonstrated restored vessel patency at the site of the open arrow .

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      Mentions: Osaka University
    11. Intracoronary Optical Coherence Tomography and Histology of Overlapping Everolimus-Eluting Bioresorbable Vascular Scaffolds in a Porcine Coronary Artery Model : The Potential Implications for Clinical Practice

      Intracoronary Optical Coherence Tomography and Histology of Overlapping Everolimus-Eluting Bioresorbable Vascular Scaffolds in a Porcine Coronary Artery Model : The Potential Implications for Clinical Practice

      Objectives This study sought to assess the vascular response of overlapping Absorb stents compared with overlapping newer-generation everolimus-eluting metallic platform stents (Xience V [XV]) in a porcine coronary artery model. Background The everolimus-eluting bioresorbable vascular scaffold (Absorb) is a novel approach to treating coronary lesions. A persistent inflammatory response, fibrin deposition, and delayed endothelialization have been reported with overlapping first-generation drug-eluting stents. Methods Forty-one overlapping Absorb and overlapping Xience V (XV) devices (3.0 × 12 mm) were implanted in the main coronary arteries of 17 nonatherosclerotic pigs with 10% overstretch. Implanted coronary arteries were evaluated by optical coherence tomography (OCT ...

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    12. Unfurling the Coronary: A Novel “Flyover” 3-Dimensional Optical Coherence Tomography Reconstruction Method

      Unfurling the Coronary: A Novel “Flyover” 3-Dimensional Optical Coherence Tomography Reconstruction Method

      “Flyover” view of the endoluminal surface over the entire interrogated segment, showing side branch ostia marked * (A) PROMUS 3 × 12.0 mm Everolimus-Eluting Coronary Stent marked †, with an arrow marking the ostia of a jailed side branch. (B) 2D-OCT image of proximal edge in-stent dissection (C) . 3D reconstruction of vessel adjacent to proximal in-stent edge dissection, (arrow) (D) . 2D-OCT image of stent strut position over side branch ostium (E) . 3D-OCT reconstruction of vessel adjacent stent struts over jailed side branch ostium. Online Video 1

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    13. Frequency domain optical coherence tomography for guidance of coronary stenting

      Frequency domain optical coherence tomography for guidance of coronary stenting

      Objective To evaluate the role of Frequency domain optical coherence tomography (FD-OCT) in guiding stent implantation procedures. Methods Dragonfly™-imaging catheter was used pre-intervention, after pre-dilatation or at various stages of stent deployment/post-dilatation to assess lesion severity, characteristics and guide stent expansion/apposition. Results We performed 398 OCT pull-backs in 108 consecutive patients. The 371 pull-backs analysable, had an average length of 35 mm and encompassed 193 lesions (1.8 lesions per patient). Seventy-six percent of patient had AHA-ACC-class B–C lesions. In the pre-intervention group deferral of treatment was decided for 13/68 pullbacks (19.1%), whereas strategies ...

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    14. OCT-verified neoatherosclerosis in BMS restenosis at 10 years

      OCT-verified neoatherosclerosis in BMS restenosis at 10 years

      Values are median (interquartile range [IQR]) or n (%). Continuous variables were compared using nonparametric Mann-Whitney test, and categorical variables were compared by chi-square statistics or Fisher exact test. Significant IH is defined as %IH/stent area >50%. Underexpansion is defined as MSA <7.0 mm2.IH = intimal hyperplasia; IVUS = intravascular ultrasound; MLA = minimal lumen area; MSA = minimal stent area; OCT = optical coherence tomography; TCFA = thin-cap fibroatheroma.

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    15. Phenomenon of elongated struts: Is optical coherence tomography accurate enough to analyze scaffold area?

      Phenomenon of elongated struts: Is optical coherence tomography accurate enough to analyze scaffold area?

      A team of Prof. Serruys during 2009–2012 published some results of multi-modality imaging studies within ABSORB (a bioabsorbable everolimus-eluting coronary stent system for patients with single de novo coronary artery lesions) trial. The first two publications of the first generation Absorb BVS (bioresorbable vascular scaffold) reported few observations made at 6- and 24-month follow-ups using different imaging modalities: 1) complete bioresorption; 2) physiologically or pharmacologically induced vasomotion, and 3) between 6 and 24months, late lumen enlargement with plaque media regression without pathological remodeling has been established. The second generation of Absorb BVS (n=101 with two subgroups: B1 — clinical ...

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    16. Can we adapt histological injury score for optical coherence tomography of coronaries?

      Can we adapt histological injury score for optical coherence tomography of coronaries?

      Coronary angioplasty and stenting invariably produces iatrogenic coronary artery injury; the extent of which is exuberant neointimal formation . Different injury scores have been described during last 20 years to quantify the severity of deep injury for the artery wall with further late arterial response after stent deployment, but in the case of histologic analysis in animal studies only. Two commonly used injury scores are Schwartz score2 and Gunn's score1 (, ), and both have been shown to predict outcomes in pre-clinical studies. As an example, the analysis of 2 frames with 30 struts is presented at the .

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    17. Serial Morphological and Functional Assessment of Drug-Eluting Balloon for In-Stent Restenotic Lesions : Mechanisms of Action Evaluated With Angiography, Optical Coherence Tomography, and Fractional Flow Reserve

      Serial Morphological and Functional Assessment of Drug-Eluting Balloon for In-Stent Restenotic Lesions : Mechanisms of Action Evaluated With Angiography, Optical Coherence Tomography, and Fractional Flow Reserve

      Objectives This study sought to elucidate the underlying mechanism through which drug-eluting balloons (DEB) restore coronary blood flow, by assessing the coronary vessel before, immediately after, and at 6-month follow-up with angiography, optical coherence tomography (OCT), and fractional flow reserve (FFR). Background In-stent restenosis (ISR) treatment remains challenging. Drug-eluting balloons have been shown to be a valid treatment option in several studies. These studies focused on efficiency of the device, whereas the mechanisms of action of DEB in ISR treatment have not been investigated. Methods In this prospective, single-center observational study, patients with ISR were treated with a second-generation DEB ...

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    18. Use of optical coherence tomography to guide treatment of an undeployed stent trapped in the right coronary artery to cover a proximal stent outflow dissection

      Use of optical coherence tomography to guide treatment of an undeployed stent trapped in the right coronary artery to cover a proximal stent outflow dissection

      A 73 year old man with a background history of hypercholesterolaemia, type II diabetes, and peripheral vascular disease presented with Canadian Cardiac Society (CCS) class III symptoms. ECG revealed no significant changes and high-sensitivity troponin was negative. Further risk stratification with an exercise stress test was positive (2mm J-point ST depression II, III, AVF), and he was referred for diagnostic coronary angiography.

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    19. Visualisation of a coronary stent presenting late mechanical failure in an aberrant left circumflex artery with coronary computed tomography angiography and optical coherence tomography

      Visualisation of a coronary stent presenting late mechanical failure in an aberrant left circumflex artery with coronary computed tomography angiography and optical coherence tomography

      A 56-year-old male was admitted with NSTEMI and underwent percutaneous coronary intervention with bare metal (cobalt-chromium) stent implantation (3.0×24 mm, 16 atm, post-dilated with 3.0×20 mm non-compliant balloon, 20 atm) in the mid segment of an anomalous circumflex artery (retroaortic course from the right sinus of Valsalva). The patient remained asymptomatic for five years post-procedure, when he presented with mild atypical chest pain. Myocardial stress perfusion scintigraphy detected no transient ischaemia; however, due to his persisting symptoms, a coronary computed tomography angiography was performed. This revealed restenosis and chronic recoil in the implanted stent (Online Figure ...

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    20. Early vascular healing with biodegradable polymer coated sirolimus-eluting coronary stent implantation: assessed by optical coherence tomography results at 4-month follow-up

      Early vascular healing with biodegradable polymer coated sirolimus-eluting coronary stent implantation: assessed by optical coherence tomography results at 4-month follow-up

      Aim: The aim of this study was to evaluate the strut apposition and neointimal coverage of Supralimus-Core stent struts at 4 months after implantation using optical coherence tomography (OCT). Methods: The Supralimus-Core OCT study is a retrospective, single-center study evaluating strut apposition and neointimal coverage with OCT at 4 months after stent implantation. A total of 12 patients, who had 15 stents implanted were included in the study. The OCT was obtained using a C7-XR FD-OCT (frequency-domain OCT) intravascular imaging system. Strut apposition, neointimal hyperplasia (NIH) thickness and stent coverage on each stent strut were evaluated. Results: A total of ...

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    21. Longitudinal extent of lipid pool assessed by optical coherence tomography predicts microvascular no-reflow after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

      Longitudinal extent of lipid pool assessed by optical coherence tomography predicts microvascular no-reflow after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction

      Background Distal embolization during percutaneous coronary intervention (PCI) may deteriorate microvascular reperfusion in patients with ST-elevation myocardial infarction (STEMI). Reperfusion at the coronary microvascular level is important for STEMI and culprit plaque is associated with distal embolization and microvascular reperfusion. ST-segment resolution (ST-R) in the electrocardiogram reflects microvascular reperfusion after primary PCI. Longitudinal extent of lipid pool assessed by optical coherence tomography (OCT) may predict the risk of failure of microvascular reperfusion after primary PCI. Methods and results This study consisted of 39 patients with STEMI who underwent primary PCI within 24 h after the onset of chest pain. Immediately ...

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    22. St. Jude Medical Announces European Approval of 3-D Vessel Reconstruction Technology to Aid Physicians in Stent Placement

      St. Jude Medical Announces European Approval of 3-D Vessel Reconstruction Technology to Aid Physicians in Stent Placement

      St. Jude Press Release - St. Jude Medical, Inc. (NYSE:STJ), a global medical device company, today announced CE Mark approval of its ILUMIEN™ OPTIS™ PCI Optimization System™, a new technology designed to provide physicians with a comprehensive disease assessment tool for treating patients with coronary artery disease (CAD). The system will be on display for the first time in Europe during EuroPCR. 3-D image of a stent inside a coronary artery taken using the ILUMIEN(TM) OPTIS(TM) (Photo: St. Jude Medical, Inc.) The ILUMIEN OPTIS system provides enhancements to the ILUMIEN ™ system, including first-of-its-kind stent planning software tools to ...

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    23. Inter-Scan Reproducibility of Geometric Coronary Artery Measurements Using Frequency-Domain Optical Coherence Tomography

      Inter-Scan Reproducibility of Geometric Coronary Artery Measurements Using Frequency-Domain Optical Coherence Tomography

      Frequency-domain optical coherence tomography (FD-OCT) is a novel technology which provides high-resolution cross-sectional images of coronary arteries. The aim of this study was to evaluate the inter-scan reproducibility of geometric FD-OCT measurements in the clinical setting. We examined 20 coronary lesions using FD-OCT. Following the FD-OCT image acquisition (1 st pullback), and after the disengagement and re-engagement of the guiding catheter, an additional acquisition (2 nd pullback) was performed using a new FD-OCT catheter. There was excellent correlation for minimum lumen area ( r = 0.99, P < 0.001), lesion length ( r = 0.99, P < 0.001) and lumen volume ( r ...

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    24. From the epicardial adipose tissue to vulnerable coronary plaques

      From the epicardial adipose tissue to vulnerable coronary plaques

      Thin cap fibroatheromas (TCFAs) are the most common underlying substrate in patients suffering acute coronary thrombotic events. Recently, an interesting association between TCFAs and a particular depot of visceral fat called epicardial adipose tissue has been suggested. In this study, we review some basic and clinical aspects of behind this interesting association as well as the value of optical coherence tomography in the diagnosis of TCFAs.

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