1. Articles in category: Cardiology

    481-504 of 2312 « 1 2 ... 18 19 20 21 22 23 24 ... 95 96 97 »
    1. 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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    2. 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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    3. 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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    4. 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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    5. 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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    6. 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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    7. 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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    8. 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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    9. 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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    10. 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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    11. Early Effects of Intensive Lipid Lowering Treatment With Ezetimibe/ Simvastatin (Vytorin®) Assessed by Virtual Histology-Intravascular Ultrasound (VH-IVUS) and Optical Coherence Tomography (OCT) on Plaque Characteristics in Patients With Acute Coronary Sy

      Early Effects of Intensive Lipid Lowering Treatment With Ezetimibe/ Simvastatin (Vytorin®) Assessed by Virtual Histology-Intravascular Ultrasound (VH-IVUS) and Optical Coherence Tomography (OCT) on Plaque Characteristics in Patients With Acute Coronary Sy

      Objective: To evaluate the early effects of intensive lipid lowering treatments with ezetimibe/simvastatin (Vytorin®) for each component of coronary plaques. Study Design Prospective, randomized, single-center study of each 80 subjects enrolled Subjects with acute coronary syndrome who meet all inclusion and exclusion criteria will be enrolled. Eligible subjects will be randomized 1:1 to A) Ezetimibe/Simvastatin (n=80) vs. B) Pravastatin (n=80), and each group of patients will be randomized further in a ratio of 1:1 to a) ZES (n=40) vs. b) EES (n=40), according to the type of stent used. All subjects will ...

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    12. Guide wire shadow assessed by shading index is reduced in sparse spring coil wire in optical coherence tomography

      Guide wire shadow assessed by shading index is reduced in sparse spring coil wire in optical coherence tomography

      One of the major problems of a Fourier-domain optical coherence tomography (FD-OCT) is the guide wire (GW) shadow which disturbs precise coronary assessment. If two or more GWs are used in a bifurcation PCI, the GW shadow becomes larger. In FD-OCT, GWs were usually observed as a crescent shape, but GWs with the sparse spring coil were observed as either round or crescent shape. The measured angle making GW shadow of GW without the sparse spring coil was similar to its theoretical angle (30.4 ± 1.7° vs. 30.1 ± 0.7°, p = 0.21); however, the measured angle of ...

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    13. Lightlab Imaging v. Axsun Technologies and Volcano - The National Law Review

      Lightlab Imaging v. Axsun Technologies and Volcano - The National Law Review

      A scientific or technological advantage is something to be protected. A case in the Business Litigation Session of Suffolk Superior Court demonstrates how cutthroat competition can be in the medical device industry and how the law deals with companies that disregard fair trade practices to gain an unfair advantage. In 2007, Lightlab Imaging, a company that provides OCT medical imaging for human coronary arteries, had developed the most powerful laser in the industry. Lightlab had a cooperative relationship with Axsun to convert Axsun’s basic laser into one that could be used by Lightlab. Volcano, a competitor of Lightlab, desired ...

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    14. Detection and Imaging of Cardiac Allograft Vasculopathy

      Detection and Imaging of Cardiac Allograft Vasculopathy

      Cardiac allograft vasculopathy (CAV) is an important cause of morbidity and mortality among cardiac transplant recipients. CAV occurs in approximately 30% of patients by 5 years and 50% by 10 years, and is a major cause of graft loss and death. Early detection of CAV is important because it may allow alterations in medical therapy before progression to the stage that revascularization is required. This has led to routine screening for CAV in transplant recipients, traditionally by invasive coronary angiography (ICA). Recent advances in imaging technology, specifically intravascular ultrasound, now also permit detection of subangiographic CAV. Noninvasive stress testing and ...

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    15. Automatic quantitative analysis of in-stent restenosis using FD-OCT in vivo intra-arterial imaging

      Automatic quantitative analysis of in-stent restenosis using FD-OCT in vivo intra-arterial imaging

      Purpose: A new segmentation technique is implemented for automatic lumen area extraction and stent strut detection in intravascular optical coherence tomography (OCT) images for the purpose of quantitative analysis of in-stent restenosis (ISR). In addition, a user-friendly graphical user interface (GUI) is developed based on the employed algorithm toward clinical use. Methods: Four clinical datasets of frequency-domain OCT scans of the human femoral artery were analyzed. First, a segmentation method based on fuzzy C means (FCM) clustering and wavelet transform (WT) was applied toward inner luminal contour extraction. Subsequently, stent strut positions were detected by utilizing metrics derived from the ...

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    16. Intravascular optical coherence tomography imaging at 3200 frames per second

      Intravascular optical coherence tomography imaging at 3200 frames per second

      We demonstrate intravascular optical coherence tomography (OCT) imaging with frame rate up to 3.2 kHz (192,000 rpm scanning). This was achieved by using a custom-built catheter in which the circumferential scanning was actuated by a 1.0 mm diameter synchronous motor. The OCT system, with an imaging depth of 3.7 mm (in air), is based on a Fourier domain mode locked laser operating at an A-line rate of 1.6 MHz. The diameter of the catheter is 1.1 mm at the tip. Ex vivo images of human coronary artery (78.4 mm length) were acquired at ...

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    17. Relationship between aspirin/clopidogrel resistance and intra-stent thrombi assessed by follow-up optical coherence tomography after drug-eluting stent implantation

      Relationship between aspirin/clopidogrel resistance and intra-stent thrombi assessed by follow-up optical coherence tomography after drug-eluting stent implantation

      Aims No data exist regarding the relationship between aspirin/clopidogrel resistance and intra-stent thrombi on follow-up optical coherence tomography (OCT) after drug-eluting stent (DES) implantation. The purpose of this study was to evaluate the relationship between aspirin/clopidogrel resistance and intra-stent thrombi on the follow-up OCT in DES-treated patients. Methods and results A total of 308 DES-treated patients who underwent follow-up OCT and simultaneous measurement of aspirin reaction unit (ARU) and P2Y12 reaction unit (PRU) using the VerifyNow assay system were selected for the study. Aspirin and clopidogrel resistance were defined as ARU ≥550 and PRU ≥275, respectively. Intra-stent thrombi ...

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    18. Serial EValuation of multiplE Coronary Artery Diseases by an Optical Coherence Tomography; Assessment of the Changes of de Novo Lesions and Comparisons of Neointimal Coverage Between Xience Prime® Versus Cypher SelectTM Stents; SEVEN-Xience Study

      Serial EValuation of multiplE Coronary Artery Diseases by an Optical Coherence Tomography; Assessment of the Changes of de Novo Lesions and Comparisons of Neointimal Coverage Between Xience Prime® Versus Cypher SelectTM Stents; SEVEN-Xience Study

      This study is a prospective open-labeled, randomized study to compare the neointimal coverage at 3 months and 12 months and its serial changes between 3 months and 12 months according to the implanted DES and evaluate the serial changes in the proximal portions of 3 epicardial coronary artery and left main artery including the assessment of fibrous cap thickness and lipid pool for vulnerable plaques by OCT. In addition, the investigators will compare the changes such as plaques and neointimal coverage from serial OCT follow-up according to the different statin strategy.

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    19. The use of dextran and carbon dioxide for optical coherence tomography in the superficial femoral artery

      The use of dextran and carbon dioxide for optical coherence tomography in the superficial femoral artery

      The following case report describes using carbon dioxide (CO 2 ) as contrast media for intravascular optical coherence tomography (OCT) imaging in the superficial femoral artery. For initial OCT imaging, 20 mL of iodinated contrast was used during automated pullback. This was followed by 20 mL of hand-injected dextran 40 in normal saline, and finally hand-injected 50 mL of CO 2 . CO 2 gave comparable erythrocyte clearance and imaging quality compared with dextran and iodinated contrast. To our knowledge, this is the first reported case using both dextran and CO 2 with OCT imaging of the superficial femoral artery. Using CO ...

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    20. In vivo detection of lipid-rich plaque by using a 40-MHz intravascular ultrasound: a comparison with optical coherence tomography findings

      In vivo detection of lipid-rich plaque by using a 40-MHz intravascular ultrasound: a comparison with optical coherence tomography findings

      iMAP™ has recently been introduced as a new tissue characterization method using the 40-MHz intravascular ultrasound (IVUS). However, few data have been published on the comparative findings of other imaging modalities in vivo. We examined 108 matched lesions from 70 patients (35 with stable angina and 35 with acute coronary syndrome) that underwent percutaneous coronary intervention (PCI) using pre-PCI OCT and IVUS. Identification of OCT-derived lipid-rich plaques and thin-cap fibroatheroma (TCFA) was performed using iMAP™. OCT-derived lipid-rich plaques and TCFAs were detected in 56 (51.8 %) and 20 (18.6 %) lesions, respectively. The iMAP™ analysis identified significantly greater percentage of ...

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    21. A “Stable” Coronary Plaque Rupture Documented by Repeated OCT Studies

      A “Stable” Coronary Plaque Rupture Documented by Repeated OCT Studies

      Letter to the Editor. Angiographic and OCT Findings at Baseline and 6 Months Later Coronary angiography of the left anterior descending (LAD) coronary artery and frequency domain-optical coherence tomography (FD-OCT) of the ruptured plaque at the first assessment (A, B, C) and second assessment (D, E, F) . (A) Angiography shows a de novo coronary stenosis (red arrow) located distally compared with the previous stented segment (blue line) . (B) FD-OCT cross-section shows the mid portion of the ruptured plaque (asterisk) characterized by a smooth floor and ruptured fibrous cap (arrows) . Arrowheads indicate side branches. (C) FD-OCT cross-section shows the distal portion ...

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      Mentions: Francesco Prati
    22. Tissue coverage and neointimal hyperplasia in overlap versus nonoverlap segments of drug-eluting stents 9 to 13 months after implantation: In vivo assessment with optical coherence tomography

      Tissue coverage and neointimal hyperplasia in overlap versus nonoverlap segments of drug-eluting stents 9 to 13 months after implantation: In vivo assessment with optical coherence tomography

      Background: Histologic experimental studies have reported incomplete neointimal healing in overlapping with respect to nonoverlapping segments in drug-eluting stents (DESs), but these observations have not been confirmed in human coronary arteries hitherto. On the contrary, angiographic and optical coherence tomography studies suggest that DES overlap elicits rather an exaggerated than an incomplete neointimal reaction.Methods: Optical coherence tomography studies from 2 randomized trials including sirolimus-eluting, biolimus-eluting, everolimus-eluting, and zotarolimus-eluting stents were analyzed at 9- to 13-month follow-up. Coverage in overlapping segments was compared versus the corresponding nonoverlapping segments of the same stents, using statistical pooled analysis.Results: Forty-two overlaps were ...

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    23. Intracoronary imaging using attenuation-compensated optical coherence tomography allows better visualisation of coronary artery diseases

      Intracoronary imaging using attenuation-compensated optical coherence tomography allows better visualisation of coronary artery diseases

      Purpose To allow an accurate diagnosis of coronary artery diseases by enhancing optical coherence tomography (OCT) images of atheromatous plaques using a novel automated attenuation compensation technique. Background One of the major drawbacks of coronary OCT imaging is the rapid attenuation of the OCT signal, limiting penetration in tissue to only few millimetres. Visualisation of deeper anatomy is however critical for accurate assessment of plaque burden in-vivo. Methods A compensation algorithm, previously developed to correct for light attenuation in soft tissues and to enhance contrast in ophthalmic OCT images, was applied to intracoronary plaque imaging using spectral-domain OCT. Results Application ...

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    24. Endothelial Injury and Development of Coronary Intimal Thickening After Heart Transplantation

      Endothelial Injury and Development of Coronary Intimal Thickening After Heart Transplantation

      Coronary allograft vasculopathy (CAV) is the leading cause of late graft failure and second leading cause of late mortality after heart transplantation. CAV has been associated with a variety of traditional risk factors for atherosclerosis; however, immune mediated injury from development of de-novo donor-specific antibodies after transplantation also likely plays an important role. Similar to the progression of traditional atherosclerosis, it is likely that endothelial dysfunction is the precursor to the development of intimal thickening and CAV. The investigators hypothesize that coronary allograft vasculopathy after heart transplantation as defined by progressive neointimal hyperplasia is preceded by endothelial dysfunction, which in ...

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