1. Articles in category: Cardiology

    481-504 of 2375 « 1 2 ... 18 19 20 21 22 23 24 ... 97 98 99 »
    1. Stent Evaluation with Optical Coherence Tomography

      Stent Evaluation with Optical Coherence Tomography

      Optical coherence tomography (OCT) has been recently applied to investigate coronary artery disease in interventional cardiology. Compared to intravascular ultrasound, OCT is able to visualize various vascular structures more clearly with higher resolution. Several validation studies have shown that OCT is more accurate in evaluating neointimal tissue after coronary stent implantation than intravascular ultrasound. Novel findings on OCT evaluation include the detection of strut coverage and the characterization of neointimal tissue in an in-vivo setting. In a previous study, neointimal healing of stent strut was pathologically the most important factor associated with stent thrombosis, a fatal complication, in patients treated ...

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    2. Effect of Pretreatment With Ticagrelor on Residual Thrombus After PCI in Patients Presenting With ACS in Comparison With Delayed Treatment at the Time of PCI: an OCT Study

      Effect of Pretreatment With Ticagrelor on Residual Thrombus After PCI in Patients Presenting With ACS in Comparison With Delayed Treatment at the Time of PCI: an OCT Study

      Subjects presenting with probable acute coronary syndromes scheduled for cardiac catheterization will be enrolled in this study. Consented subjects will be randomized to receive ticagrelor started with a loading dose immediately after enrollment versus receiving a loading dose of ticagrelor during cardiac catheterization after diagnostic angiography but prior to stenting. Optical coherence tomography (OCT) will be performed after stenting and the volume of thrombus within the new stent will be measured and compared between the groups.

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    3. Optical coherence tomography analysis of strut coverage in biolimus- and sirolimus-eluting stents: 3-month and 12-month serial follow-up

      Optical coherence tomography analysis of strut coverage in biolimus- and sirolimus-eluting stents: 3-month and 12-month serial follow-up

      Background No randomized studies have been conducted to investigate serial changes in optical coherence tomography (OCT) analyses following implantation of biolimus-A9-eluting stents (BES) and sirolimus-eluting stents (SES). Methods A total of 60 patients fulfilling the study criteria were randomly assigned into BES ( n = 30) and SES ( n = 30) implantation groups. Serial OCT evaluation at post-procedure, 3- and 12-months follow-up was performed in 46 patients [BES ( n = 22) and SES ( n = 24)]. OCT analyses were compared according to the type of stents and the follow-up time intervals. The percentage of uncovered struts was defined as the ratio of uncovered struts to ...

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    4. Correlation Between Degree of Neointimal Hyperplasia and Incidence and Characteristics of Neoatherosclerosis as Assessed by Optical Coherence Tomography

      Correlation Between Degree of Neointimal Hyperplasia and Incidence and Characteristics of Neoatherosclerosis as Assessed by Optical Coherence Tomography

      Emerging evidence suggests that neointimal degenerative changes with development of neoatherosclerosis (NA) may represent an important mechanism for late stent failure. The aim of the present study was to investigate the relation between degree of neointimal hyperplasia and incidence and characteristics of NA using optical coherence tomography. We identified a total of 252 stents with mean neointimal thickness (NIT) >100 μm in 212 patients: 100 bare metal stents (BMSs) and 152 drug-eluting stents (DESs). Based on the values of mean NIT, we divided stents into tertiles and compared neointimal characteristics among the 3 groups. NA was defined as the presence ...

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    5. The invasive assessment of coronary atherosclerosis and stents using optical coherence tomography: a clinical update

      The invasive assessment of coronary atherosclerosis and stents using optical coherence tomography: a clinical update

      Ischaemic heart disease (IHD) remains one of the leading causes of death. Atherosclerosis has been intensely researched given the IHD prevalence and the financial impacts on healthcare systems. More recently, in vivo characterisation of coronary atherosclerotic plaque and tissue responses following stent implantation in a coronary artery has been made possible by a novel technology called optical coherence tomography (OCT). OCT is a light-based, invasive, intracoronary imaging modality long applied to the field of ophthalmology and now in clinical use worldwide. It gives a unique view of within the coronary artery using near-infrared light with a resolution of 15 microns ...

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    6. Automatic characterization of neointimal tissue by intravascular optical coherence tomography

      Automatic characterization of neointimal tissue by intravascular optical coherence tomography

      Intravascular optical coherence tomography (IVOCT) is rapidly becoming the method of choice for assessing vessel healing after stent implantation due to its unique axial resolution < 20     μ m . The amount of neointimal coverage is an important parameter. In addition, the characterization of neointimal tissue maturity is also of importance for an accurate analysis, especially in the case of drug-eluting and bioresorbable stent devices. Previous studies indicated that well-organized mature neointimal tissue appears as a high-intensity, smooth, and homogeneous region in IVOCT images, while lower-intensity signal areas might correspond to immature tissue mainly composed of acellular material. A new method for automatic ...

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    7. First-in-human description of everolimus-eluting bioabsorbable vascular scaffold implantation for the treatment of drug-eluting stent failure: Insights from optical coherence tomography

      First-in-human description of everolimus-eluting bioabsorbable vascular scaffold implantation for the treatment of drug-eluting stent failure: Insights from optical coherence tomography

      Drug-eluting stents (DES) markedly reduce new episodes of revascularization compared with bare-metal stents; nevertheless, the prevalence of DES in-stent restenosis (ISR) is not insignificant as a large population is treated with these devices worldwide . In addition, concerns regarding long-term safety of metallic DES stimulated investigators to seek for improvement of this therapy. Everolimus-eluting bioabsorbable vascular scaffolds (BVS, Abbott Vascular, Santa Clara, CA, USA) emerged as an interesting alternative, as they enable vessel scaffolding in short-term and anti-restenotic drug delivery, while avoiding long-term limitations of metallic DES (i.e., prolonged metal exposure to coronary circulation in case of delayed healing). Indeed ...

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    8. Bioabsorbable scaffold optimization in provisional stenting: insight from optical coherence tomography

      Bioabsorbable scaffold optimization in provisional stenting: insight from optical coherence tomography

      Since the emergence of biabsorbable vascular scaffolds (BVS), treatment of bifurcation lesions with these devices has remained a source of question. Although SB dilatation has been previously performed with BVS, it is not yet clear how dilatation across BVS strut may impact scaffold structure. A 74-year-old lady with hypercholesterolaemia and …

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    9. Automatic assessment of stent neointimal coverage by intravascular optical coherence tomography

      Automatic assessment of stent neointimal coverage by intravascular optical coherence tomography

      Aims This study aimed to validate automatic intravascular optical coherence tomography (IVOCT) analysis for the evaluation of neointimal coverage in response to stent implantation. Methods and results Fourteen stented segments in common iliac arteries, acquired from a total of seven adult male New Zealand White rabbits, were interrogated in vivo by IVOCT. Durable polymer everolimus-eluting stents (EES; Xience V, Abbott Vascular, Santa Clara, CA, USA) were used exclusively. Comparison with histology was made in a total of 63 pairs of images, where neointimal thickness over corresponding individual stent struts was assessed. A high correlation coefficient ( R = 0.85, P < 0 ...

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    10. Two-week interval optical coherence tomography: Imaging evidence on neointimal coverage completion after implantation of the endeavor zotarolimus-eluting stent

      Two-week interval optical coherence tomography: Imaging evidence on neointimal coverage completion after implantation of the endeavor zotarolimus-eluting stent

      Objective : To obtain imaging evidence by 2-week optical coherence tomography (OCT) on the completion of neointimal coverage (NIC; the percentage of stent strut coverage and thickness of the formed neointima) completion after implantation of the Endeavor zotarolimus-eluting stent (E-ZES). Background : Despite the fact that NIC is a cardinal process in the pathomechanism of late stent thrombosis, little imaging information is available on morphological changes thereof on a short-time interval basis. Methods : 27 Japanese patients with stable angina pectoris and de novo native coronary artery lesions were enrolled, and 27 lesions (30 implantations) were examined. OCT was performed at weeks 2 ...

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    11. Forward looking imaging guidewire

      Forward looking imaging guidewire

      The systems and methods described herein provide for a forward looking guidewire having a reduced radial cross-section for increased maneuverability and use of the guidewire within more narrow vasculature. The guidewire can include an elongate tubular member having a distal region, proximal region and inner lumen and a forward looking imaging device coupled with the distal end of the guidewire. The distal region of the guidewire can be relatively more flexible than the proximal region. The guidewire can also include a second, side looking imaging device, which can be coupled around a longitudinal portion of the guidewire in the radial ...

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    12. Incidence, Predictors, Morphological Characteristics, and Clinical Outcomes of Stent Edge Dissections Detected by Optical Coherence Tomography

      Incidence, Predictors, Morphological Characteristics, and Clinical Outcomes of Stent Edge Dissections Detected by Optical Coherence Tomography

      Objectives This study sought to investigate the frequency, predictors, and detailed qualitative and quantitative assessment of optical coherence tomography (OCT)-detected stent edge dissections. Its impact on subsequent management and clinical outcomes were also investigated. Background OCT is a high-resolution imaging modality that can lead to more frequent recognition and accurate assessment of vascular injuries during percutaneous coronary intervention (PCI). Methods From September 2010 to June 2011, all patients with OCT post-PCI were enrolled. Edge dissections were defined as disruptions of the arterial lumen surface in both the 5-mm distal and proximal stent edges. Qualitative and quantitative analyses of all ...

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    13. Optical Coherence Tomography – 15 Years in Cardiology –

      Optical Coherence Tomography – 15 Years in Cardiology –

      Since its invention in the late 1990s, intravascular optical coherence tomography (OCT) has been rapidly adopted in clinical research and, more recently, in clinical practice. Given its unprecedented resolution and high image contrast, OCT has been used to visualize plaque characteristics and to evaluate the vascular response to percutaneous coronary intervention. In particular, OCT is becoming the standard modality to evaluate in vivo plaque vulnerability, including the presence of lipid content, thin fibrous cap, or macrophage accumulation. Furthermore, OCT findings after stent implantation, such as strut apposition, neointimal hyperplasia, strut coverage, and neoatherosclerosis, are used as surrogate markers of the ...

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    14. Frequency-domain optical coherence tomography assessment of kissing-balloon effects in bifurcated coronary artery lesions undergoing provisional stenting - Corrected Proof

      Frequency-domain optical coherence tomography assessment of kissing-balloon effects in bifurcated coronary artery lesions undergoing provisional stenting - Corrected Proof

      Stenoses located at bifurcations represent a challenging subset of coronary lesions which may benefit from invasive imaging and optical coherence tomography (OCT) has been recognized to have a promising role in this setting . Provisional-T-stenting with drug-eluting stents (DES) represents the gold standard for percutaneous treatment of bifurcated lesions but the usefulness of final kissing balloon inflation (FKI) is not established. Indeed, in a dedicated trial, FKI has not been found to improve clinical outcome even if it provides better SB ostium angiographic results .

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    15. In vivo assessment of the three-dimensional haemodynamic micro-environment following drug-eluting bioresorbable vascular scaffold implantation in a human coronary artery: fusion of frequency domain optical coherence tomography and angiography

      In vivo assessment of the three-dimensional haemodynamic micro-environment following drug-eluting bioresorbable vascular scaffold implantation in a human coronary artery: fusion of frequency domain optical coherence tomography and angiography

      The biplane angiographic data, acquired after implantation of an everolimus-eluting bioresorbable vascular scaffold (Absorb™ BVS; Abbott Vascular, Santa Clara, CA, USA) in the right coronary artery of a 46-year-old patient, were separately fused with frequency domain optical coherence tomography (FD-OCT) and intravascular ultrasound (IVUS) data to reconstruct the three-dimensional (3-D) anatomy. The local shear stress (SS) distribution in the FD-OCT- and IVUS-based models was assessed using computational fluid dynamics. The FD-OCT-based reconstruction (Figure 1A) allowed imaging of the lumen irregularities in the scaffolded segment due to strut protrusion (Figure 1B), which caused recirculation zones around the struts (Figure 1C). In ...

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    16. Endovascular Imaging and 3-Dimensional Reconstruction of Spontaneous Coronary Artery Dissection

      Endovascular Imaging and 3-Dimensional Reconstruction of Spontaneous Coronary Artery Dissection

      A 57-year-old woman without coronary risk factors presented with non–ST-segment elevation myocardial infarction. Angiography revealed a normal anterior descending artery with lumen irregularities in the middle part (A, B, C) . Intravascular ultrasound (IVUS) (D, E, F) disclosed an intramural hematoma along the middle segment of the artery. Optical coherence tomography (OCT), resolution 15 μm, showed a proximal entry tear (G, H, arrow) , a large intramural hematoma (*) that compress the true lumen (TL) and a re-entry tear in the distal part (J) . The OCT 3-dimensional (3-D) reconstruction clearly visualize the spiral development of the dissection and the severe compression of ...

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    17. Ultrahigh speed endoscopic optical coherence tomography using micromotor imaging catheter and VCSEL technology

      Ultrahigh speed endoscopic optical coherence tomography using micromotor imaging catheter and VCSEL technology

      We developed a micromotor based miniature catheter with an outer diameter of 3.2 mm for ultrahigh speed endoscopic swept source optical coherence tomography (OCT) using a vertical cavity surface-emitting laser (VCSEL) at a 1 MHz axial scan rate. The micromotor can rotate a micro-prism at several hundred frames per second with less than 5 V drive voltage to provide fast and stable scanning, which is not sensitive to the bending of the catheter. The side-viewing probe can be pulled back to acquire a three-dimensional (3D) data set covering a large area on the specimen. The VCSEL provides a high ...

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    18. Automated tissue characterization of in vivo atherosclerotic plaques by intravascular optical coherence tomography images

      Automated tissue characterization of in vivo atherosclerotic plaques by intravascular optical coherence tomography images

      Intravascular optical coherence tomography (IVOCT) is rapidly becoming the method of choice for the in vivo investigation of coronary artery disease. While IVOCT visualizes atherosclerotic plaques with a resolution <20µm, image analysis in terms of tissue composition is currently performed by a time-consuming manual procedure based on the qualitative interpretation of image features. We illustrate an algorithm for the automated and systematic characterization of IVOCT atherosclerotic tissue. The proposed method consists in a supervised classification of image pixels according to textural features combined with the estimated value of the optical attenuation coefficient. IVOCT images of 64 plaques, from 49 ...

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    19. Plaque vulnerability of coronary artery lesions is related to left ventricular dilatation as determined by optical coherence tomography and cardiac magnetic resonance imaging in patients with type 2 diabetes

      Plaque vulnerability of coronary artery lesions is related to left ventricular dilatation as determined by optical coherence tomography and cardiac magnetic resonance imaging in patients with type 2 diabetes

      Background Patients with type 2 diabetes are at increased risk for both, left ventricular (LV)-dilatation and myocardial infarction (MI) following the rupture of a vulnerable plaque. This study investigated the to date incompletely understood relationship between plaque vulnerability and LV-dilatation using optical coherence tomography (OCT) and cardiac magnetic resonance imaging (CMR) in patients with type 2 diabetes and stable coronary artery disease. Methods CMR was performed in 58 patients with type 2 diabetes, in which 81 coronary lesions were investigated using OCT. Results A decreased minimal fibrous cap thickness (FCT) of coronary lesions was associated with an increase of ...

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    20. Excimer laser for a highly stenotic saphenous vein graft: evidence of debulking by optical coherence tomography

      Excimer laser for a highly stenotic saphenous vein graft: evidence of debulking by optical coherence tomography

      A 73-year-old woman with a history of coronary artery bypass (saphenous vein graft [SVG] for left anterior descending artery [LAD] and right coronary artery) was admitted for non-ST-elevation acute coronary syndrome. Coronary angiography showed a proximal severe stenosis of the SVG for LAD that was the culprit lesion of the acute coronary syndrome (Figure 1A). Frequency-domain optical coherence tomography (FD-OCT) was performed using a non-occlusive technique and showed a highly fibrous stenosis of the SVG (MLA 0.7 mm) (Figure 1B-E) that was debulked with excimer laser coronary atherectomy (ELCA) (Figure 1-A’,B’). However, a thrombus occurred at the lesion ...

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    21. South Texas Veterans Health Care System Receives NIH Grant for Detection of Plaque Based Macrophases With Light

      South Texas Veterans Health Care System Receives NIH Grant for Detection of Plaque Based Macrophases With Light

      South Texas Veterans Health Care System received a 2013 NIH Grant for Detection of Plaque Based Macrophases With Light. The principal investigator is Marc Feldman. The program started in 2010 and ends in 2014. A summary of the program is given below. The pathologic features that predict atherosclerotic plaque rupture are large lipid collections, thinning of the fibrous cap, and infiltration of macrophages. Optical Coherence Tomography (OCT) has already been demonstrated to accurately image thin fibrous caps and large lipid cores. We now propose an approach which will detect macrophages in vulnerable plaque with OCT in patients at the time ...

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      Mentions: Marc D. Feldman
    481-504 of 2375 « 1 2 ... 18 19 20 21 22 23 24 ... 97 98 99 »
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