1. Articles in category: Cardiology

    49-72 of 4327 « 1 2 3 4 5 6 ... 179 180 181 »
    1. Diagnostic accuracy and reproducibility of optical flow ratio for functional evaluation of coronary stenosis in a prospective series

      Diagnostic accuracy and reproducibility of optical flow ratio for functional evaluation of coronary stenosis in a prospective series

      Background: Evaluating prospectively the feasibility, accuracy and reproducibility of optical flow ratio (OFR), a novel method of computational physiology based on optical coherence tomography (OCT). Methods and results: Sixty consecutive patients (76 vessels) underwent prospectively OCT, angiography-based quantitative flow ratio (QFR) and fractional flow ratio (FFR). OFR was computed offline in a central core-lab by analysts blinded to FFR. OFR was feasible in 98.7% of the lesions and showed excellent agreement with FFR (ICCa = 0.83, r = 0.83, slope = 0.80, intercept = 0.17, kappa = 0.84). The area under curve to predict an FFR ≤ 0.80 was ...

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    2. Three-dimensional imaging of pulmonary arterial vasa vasorum using optical coherence tomography in patients after bidirectional Glenn and Fontan procedures

      Three-dimensional imaging of pulmonary arterial vasa vasorum using optical coherence tomography in patients after bidirectional Glenn and Fontan procedures

      Aims We evaluated pulmonary arterial (PA) vasa vasorum (VV) in Fontan candidate patients with a novel three-dimensional (3D) imaging technique using optical coherence tomography (OCT). Methods and results This prospective study assessed the development of adventitial VV in the distal PA of 10 patients with bidirectional Glenn circulation (BDG group, 1.6 ± 0.3 years) and Fontan circulation (Fontan group, 3.3 ± 0.3 years), and in 20 children with normal PA haemodynamics and morphology (Control group, 1.5 ± 0.3 years). We assessed the PA VV with two-dimensional (2D) cross-sectional, multi-planar reconstruction (MPR), and volume rendering (VR) imaging. VV ...

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    3. Does OCT Optimise Results of Stenting on the Left Main Stem

      Does OCT Optimise Results of Stenting on the Left Main Stem

      Angiographic evaluation of lesions of the left main stem presents particular challenges and high procedural complexity. The clinical sequelae of a suboptimal result in this context may be severe, and thus, it is recommended that patients with left-main lesions be considered for imaging-guided interventions by means of optimal coherence tomography (OCT) in non-ostial left main lesions. The investigators have previously demonstrated in a randomized trial of patients undergoing PCI for a lesion responsible for non ST elevation acute coronary syndromes that OCT provides useful clinical information beyond that obtained by angiography alone, and OCT-guidance for angioplasty in these patients yielded ...

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    4. SCAI Position Statement on Optimal Percutaneous Coronary Interventional Therapy for Complex Coronary Artery Disease

      SCAI Position Statement on Optimal Percutaneous Coronary Interventional Therapy for Complex Coronary Artery Disease

      The anatomic and clinical complexity of patients with coronary artery disease (CAD) is increasing in the United States. 1 - 3 While the terms “complex CAD” or “high‐risk CAD” have not been formally defined, they encompass both complex anatomic lesions and clinical parameters including advanced age, frailty, comorbidities, compromised hemodynamic status, depressed ventricular function and concomitant valvular disease. 4 - 6 Such features increase both the procedural complexity of percutaneous coronary intervention (PCI) and the risk of adverse patient outcomes. The direct relationship between CAD complexity and the appropriateness for coronary revascularization is also emphasized in current societal guidelines and appropriate ...

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    5. Intravascular Imaging for Venous Interventions

      Intravascular Imaging for Venous Interventions

      Purpose of Review This review surveys the clinical landscape of intravascular imaging for endovenous interventions. Recent Findings Endovascular imaging has become increasingly important for diagnosing venous pathology and guiding venous interventions. In particular, intravascular ultrasound (IVUS) provides 3D high-resolution cross-sectional imaging of vessel and surrounding tissues, often in anatomic locations inaccessible to surface ultrasound, namely the superior vena cava, inferior vena cava, and caval-iliac veins. Summary Current well-established indications for venous IVUS include diagnostic studies, venoplasty, transjugular intrahepatic portosystemic shunt (TIPS) creation, inferior vena cava filter placement, and transjugular liver biopsy. In the future, optical coherence tomography may play an ...

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    6. Cutting-edge imaging may provide insight into the functional significance of a stenosis

      Cutting-edge imaging may provide insight into the functional significance of a stenosis

      A novel study aims to evaluate whether optical coherence tomography (OCT) parameters may predict fractional flow reserve (FFR) values and assess if OCT parameters may predict clinical outcome in patients with negative FFR. The study was presented as late-breaking science at the SCAI 2020 Scientific Sessions Virtual Conference. OCT imaging, a cutting-edge high-resolution intracoronary imaging technique generally used to characterize plaque morphology and to guide optimization of percutaneous coronary intervention, may also provide some insights into the functional significance of a stenosis. "The idea of predicting hemodynamic relevance of coronary lesions from imaging is extremely appealing. In this collaborative study ...

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      Mentions: Rocco Vergallo
    7. Tangential Signal Dropout Mimicking the Appearance of Lipid-rich Plaques and Macrophage Infiltration on Optical Frequency Domain Imaging

      Tangential Signal Dropout Mimicking the Appearance of Lipid-rich Plaques and Macrophage Infiltration on Optical Frequency Domain Imaging

      Aims: This study evaluated the optical frequency domain imaging (OFDI) artifact of tangential signal dropout (TSD), which mimics the appearance of lipid-rich plaque and macrophage (Mø) infiltration. Methods and results: A total of 1,019 histological cross-sections from 23 autopsy hearts were matched with the corresponding OFDI images. Of those, 232 OFDI cross-sections that contained signal-poor regions with diffuse borders were classified as lipid-rich plaques. The angle θ was calculated between the OFDI beam that strikes the edge of the luminal surface of the low-intensity region and that which strikes the surface line of the low-intensity region. On histological evaluation, 182 ...

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      Mentions: Kenichi Fujii
    8. Machine Leaning Model Comparison for Automatic Segmentation of Intracoronary Optical Coherence Tomography and Plaque Cap Thickness Quantification

      Machine Leaning Model Comparison for Automatic Segmentation of Intracoronary Optical Coherence Tomography and Plaque Cap Thickness Quantification

      Optical coherence tomography (OCT) is a new intravascular imaging technique with high resolution and could provide accurate morphological information for plaques in coronary arteries. However, its segmentation is still commonly performed manually by experts which is time consuming. The aim of this study was to develop automatic techniques to characterize plaque components and quantify plaque cap thickness using 3 machine learning methods including convolutional neural network (CNN) with U-Net architecture, CNN with Fully convolutional DenseNet (FC-DenseNet) architecture and support vector machine (SVM). In vivo OCT and intravascular ultrasound (IVUS) images were acquired from two patients at Emory University with informed ...

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    9. Intracardiac radiofrequency ablation in living swine guided by polarization-sensitive optical coherence tomography

      Intracardiac radiofrequency ablation in living swine guided by polarization-sensitive optical coherence tomography

      Significance: Pulmonary vein isolation with catheter-based radiofrequency ablation (RFA) is carried out frequently to treat atrial fibrillation. However, RFA lesion creation is only guided by indirect information (e.g., temperature, impedance, and contact force), which may result in poor lesion quality (e.g., nontransmural) and can lead to reoccurrence or complications. Aim: The feasibility of guiding intracardiac RFA with an integrated polarization-sensitive optical coherence tomography (PSOCT)-RFA catheter in the right atria (RA) of living swine is demonstrated. Approach : In total, 12 sparse lesions were created in the RA of three living swine using an integrated PSOCT-RFA catheter with standard ...

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    10. Systems, methods and apparatus for determining a fractional flow reserve (FFR) based on the minimum lumen area (MLA) and the constant

      Systems, methods and apparatus for determining a fractional flow reserve (FFR) based on the minimum lumen area (MLA) and the constant

      n one aspect, the invention relates to system comprising: a processor configured to receive a first optical coherence tomography (OCT) data set obtained during a pullback of a data collection probe along a first length of a first blood vessel; determine a minimum lumen area disposed along the first length using the first OCT data set; and determine a first FFR value along the first length based on the minimum lumen area. In one embodiment, the first FFR value is an estimated FFR. In another aspect, the invention relates to a method that includes measuring, using OCT, the area of ...

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    11. Intravascular imaging and guide catheter detection methods and systems

      Intravascular imaging and guide catheter detection methods and systems

      In part, the disclosure relates to computer-based methods, devices, and systems suitable for detecting a delivery catheter using intravascular data. In one embodiment, the delivery catheter is used to position the intravascular data collection probe. The probe can collect data suitable for generating one or more representations of a blood vessel with respect to which the delivery catheter can be detected.

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      Mentions: Abbot
    12. Use of Optical Coherence Tomography in Coronary Artery Disease: Review Article

      Use of Optical Coherence Tomography in Coronary Artery Disease: Review Article

      Optical Coherence Tomography (OCT) is a catheter based imaging modality in heart catheterizations, which provides a significantly higher resolution of intravascular pathology by means of using light as opposed to ultrasound. The applications of this modality may include a detailed assessment of atherosclerotic plaques, stent evaluation including coverage and restenosis and percutaneous coronary intervention optimization. In this article, we provide a review of current literature highlighting the advantages and disadvantages of the use of OCT in the catheterization lab.

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    13. Short‐ and mid‐term influence of drug‐coated stent implantation on structural and functional vascular healing response: An optical coherence tomography and acetylcholine testing study

      Short‐ and mid‐term influence of drug‐coated stent implantation on structural and functional vascular healing response: An optical coherence tomography and acetylcholine testing study

      Objective This study investigated the effect of a drug‐coated stent (DCS) that has a novel microporous abluminal surface without a polymer on 1‐month and 1‐year functional and morphological healing response as assessed using acetylcholine (Ach) testing and optical coherence tomography (OCT). Background DCS is expected to induce favorable morphological and physiological arterial healing after its implantation. Methods A total of 11 patients who underwent vascular response examinations 1‐month and 1‐year after the index PCI with DCS implantation were enrolled. The vascular response was evaluated by the functional response test by acetylcholine infusion, the morphological response ...

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      Mentions: Kenichi Fujii
    14. ST-elevation myocardial infarction and pulmonary embolism in a patient with COVID-19 acute respiratory distress syndrome

      ST-elevation myocardial infarction and pulmonary embolism in a patient with COVID-19 acute respiratory distress syndrome

      The clinical course of an 82-year-old patient with acute respiratory distress syndrome due to SARS-CoV-2 infection was complicated by concomitant ST-elevation myocardial infarction and pulmonary embolism. An 82-year-old man was diagnosed with COVID-19 following a positive test for SARS-CoV-2 in the presence of symptoms of fever and mild dyspnoea. Following self-isolation at home for 1 week, the patient was hospitalized due to severe respiratory distress. Physical examination revealed a body temperature of 39.0°C, blood pressure of 152/113 mmHg, heart rate of 160 b.p.m., and an oxygen saturation of 78% on 10 L of oxygen. Laboratory ...

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    15. Multivessel coronary thrombosis in a patient with COVID-19 pneumonia

      Multivessel coronary thrombosis in a patient with COVID-19 pneumonia

      A 64-year-old male, with no known cardiovascular risk factors, was brought to the Emergency Room with an acute ST-elevation myocardial infarction (STEMI). One week before, he was admitted to the hospital because of a COVID-19 bilateral pneumonia treated with lopinavir–ritonavir and hydroxicloroquine, without any antithrombotic prophylaxis, and was discharged after 7 days without specific treatment, because he had made good clinical progress, just hours before he returned to the hospital. Coronary angiography showed a critical thrombotic stenosis of the proximal right coronary artery (RCA; Panel A ) as well as a non-occlusive filling defect compatible with thrombus at the middle ...

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    16. OCT Evaluation of Early Vascular Repair in Patients With Non ST Elevation Acute Coronary Syndrome (NSTE-ACS)

      OCT Evaluation of Early Vascular Repair in Patients With Non ST Elevation Acute Coronary Syndrome (NSTE-ACS)

      This is a prospective study of a new generation of drug-eluting stent in the treatment of non ST elevation acute coronary syndrome (NSTE-ACS). The purpose of this study was to evaluate the extent of early vascular repair in NSTE-ACS patients after receiving the new generation of drug-eluting stents, and the value of OCT guided optimal implantation in further improving the target vascular endothelial repair, so as to provide the basis for early discontinuation of dual antiplatelet drugs (dapt) in NSTE-ACS patients and later large-scale randomized clinical research.This study is a prospective, multicenter, randomized controlled clinical study. Sixty patients with ...

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    17. Optical Coherence Tomography-Guided Percutaneous Coronary Intervention With Low-Molecular-Weight Dextran ― Effect on Renal Function ―

      Optical Coherence Tomography-Guided Percutaneous Coronary Intervention With Low-Molecular-Weight Dextran ― Effect on Renal Function ―

      Background: The excessive volume of contrast needed is a significant limitation of optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI). Low-molecular-weight dextran (LMWD) has been used for OCT image acquisition instead of contrast media. This study compared the effects of OCT-guided PCI using LMWD on renal function and clinical outcomes to those of intravascular ultrasound (IVUS)-guided PCI. Methods and Results: In all, 1,183 consecutive patients who underwent intracoronary imaging-guided PCI were enrolled in this single-center, retrospective, observational study. After propensity score matching, 133 pairs of patients were assigned to undergo either OCT-guided PCI using LMWD or IVUS-guided ...

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    18. Very late stent thrombosis of a titanium-nitride-oxide-coated bioactive stent resulting from neoatherosclerosis: Optical coherence tomography insights

      Very late stent thrombosis of a titanium-nitride-oxide-coated bioactive stent resulting from neoatherosclerosis: Optical coherence tomography insights

      This is the first reported case of a BAS very late stent thrombosis resulting from ruptured neoatherosclerosis. • Optical Coherence Tomography provides unique insight to unravel the presence of neoatherosclerosis. • Very late stent thrombosis of BAS resulting from neoatherosclerosis is an uncommon but feared complication.

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    19. Chronic Total Occlusion 5 Years After Bioresorbable Vascular Scaffold Implantation: A Serial Optical Coherence Tomography Assessment

      Chronic Total Occlusion 5 Years After Bioresorbable Vascular Scaffold Implantation: A Serial Optical Coherence Tomography Assessment

      A 66-year-old man presented with ST-segment myocardial infarction. He underwent successful Absorb 1.0 bioresorbable vascular scaffold (Abbott Vascular) implantation. A prespecified 12-month and 24-month coronary angiography and optical coherence tomography showed preserved vessel patency with signs of peristrut low-intensity areas within the neointima and features of atherosclerosis progression at the distal edge of the scaffold (Figure 1). A prespecified angiography at 60 months revealed a total occlusion at the distal part of the scaffold. Within the proximal edge, optical coherence tomography showed a complete absorption of stent struts with a decreased mean scaffold area and diameter (Figure 1). First-generation ...

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    20. Ticagrelor versus clopidogrel for prevention of subclinical stent thrombosis detected by optical coherence tomography in patients with drug-eluting stent implantation—a multicenter and randomized study

      Ticagrelor versus clopidogrel for prevention of subclinical stent thrombosis detected by optical coherence tomography in patients with drug-eluting stent implantation—a multicenter and randomized study

      Introduction : This prospective, multicenter, randomized study was designed to analyze the benefits of ticagrelor over clopidogrel in reducing subclinical stent thrombosis (ST) in patients with coronary artery disease who underwent implantation of a second-generation drug-eluting stent (DES). Methods : About 352 patients with single de novo coronary stenosis were randomly assigne`d to either clopidogrel group (aspirin plus clopidogrel) or ticagrelor group (aspirin plus ticagrelor) after DES implantation for 1 year. Baseline clinical characteristics, blood chemistry markers, coronary artery angiography (CAG), and optical coherence tomography (OCT) were obtained during the index procedure. Data about clinic, CAG and OCT were also collected ...

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    21. Multi-parameter characterization of atherosclerotic plaques based on optical coherence tomography, photoacoustic and viscoelasticity imaging

      Multi-parameter characterization of atherosclerotic plaques based on optical coherence tomography, photoacoustic and viscoelasticity imaging

      Detection of atherosclerotic plaque vulnerability is the critical step in prevention of acute coronary events. Fibrous cap thickness, lipid core size, and inflammation extent are three key parameters for assessing plaque vulnerability. Here, we report on multimodality imaging of mice aortic plaques using a system that integrates optical coherence tomography (OCT), photoacoustic imaging (PAI), and photoacoustic viscoelasticity imaging (PAVEI). The thickness of fibrous cap is accurately evaluated by OCT, and PAI helps to determine the distribution and size of lipid core. The mechanical properties of plaques are closely related to the plaque compositions and the content and distribution of macrophages ...

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    22. Supporting evidence from optical coherence tomography for shortening dual antiplatelet therapy after drug-eluting stents implantation

      Supporting evidence from optical coherence tomography for shortening dual antiplatelet therapy after drug-eluting stents implantation

      Introduction : Dual antiplatelet therapy (DAPT) is required for coronary artery disease treated with drug-eluting stents (DES) implantation. Shortening DAPT duration would be beneficial for patients with high bleeding risk. Areas covered : Early healing patterns, especially stent strut coverage, assessed by optical coherence tomography (OCT) as a surrogate of neointima have been investigated to make decisions on whether short DAPT would be a safe alternative. This review evaluates the OCT evidence (i.e., neointimal coverage of stent struts within 3 months) for shortening DAPT duration after DES implantation. Expert commentary : Shortening DAPT (i.e., within 3 months) duration after DES implantation ...

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    23. Imaging system includes imaging probe and delivery devices

      Imaging system includes imaging probe and delivery devices

      An imaging system is provided comprising an imaging probe and at least one delivery device. The imaging probe comprises an elongate shaft, a rotatable optical core and an optical assembly. The elongate shaft comprises a proximal end, a distal portion, and a lumen extending between the proximal end and the distal portion. The rotatable optical core is positioned within the lumen of the elongate shaft and comprises a proximal end and a distal end. The rotatable optical core is configured to optically and mechanically connect with an interface unit. The optical assembly is positioned in the elongate shaft distal portion ...

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    24. Comparison of post‐stent optical coherence tomography findings: Layered versus non‐layered culprit lesions

      Comparison of post‐stent optical coherence tomography findings: Layered versus non‐layered culprit lesions

      Objectives This study aimed to investigate the vascular response of lesions with a layered phenotype. Background Recent studies have shown that layered plaques at culprit lesions detected by optical coherence tomography (OCT) have greater plaque burden and more inflammatory features than non‐layered plaques. Methods This is a retrospective observational study. A total of 193 target lesions from 193 patients [100 patients with acute coronary syndromes (ACS) and 93 with stable angina pectoris (SAP)] who had undergone OCT imaging of the culprit lesion both before and after stenting were included. Layered plaques were identified by OCT as plaques with layers ...

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    49-72 of 4327 « 1 2 3 4 5 6 ... 179 180 181 »
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