1. Articles in category: Cardiology

    73-96 of 4327 « 1 2 3 4 5 6 7 ... 179 180 181 »
    1. Predictors for layered coronary plaques: an optical coherence tomography study

      Predictors for layered coronary plaques: an optical coherence tomography study

      Healed coronary plaques, morphologically characterized by a layered pattern, are signatures of previous plaque disruption and healing. Recent optical coherence tomography (OCT) studies showed that layered plaque is associated with vascular vulnerability. However, factors associated with layered plaques have not been studied. The aim of this study was to investigate predictors for layered plaque at the culprit plaques and at non-culprit plaques. Patients with coronary artery disease who underwent pre-intervention OCT imaging of the culprit lesion were included. Layered plaques were defined as plaques with one or more layers of different optical density and a clear demarcation from underlying components ...

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    2. Endothelial glycocalyx and severity and vulnerability of coronary plaque in patients with coronary artery disease

      Endothelial glycocalyx and severity and vulnerability of coronary plaque in patients with coronary artery disease

      Background and aims Endothelial glycocalyx covers the endothelium and maintains vascular integrity. However, its association with the severity and vulnerability of coronary artery disease (CAD) remains to be elucidated. Methods A total of 259 consecutive patients with stable CAD requiring percutaneous coronary intervention (PCI) were prospectively enrolled. Patients were classified into 2 groups according to the median value of serum syndecan-1, which is a core component of the endothelial glycocalyx (lower syndecan-1 group [syndecan-1 <99.0 ng/mL], n = 130; higher syndecan-1 group [syndecan-1 ≥99.0 ng/mL], n = 129). Severity of CAD and focal plaque vulnerability in culprit lesion ...

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    3. Effects of stent postdilatation during primary PCI for STEMI: Insights from coronary physiology and optical coherence tomography

      Effects of stent postdilatation during primary PCI for STEMI: Insights from coronary physiology and optical coherence tomography

      Objectives This study aimed to assess the impact of stent optimization by NC‐balloon postdilatation (PD) during primary‐PCI for STEMI with the use of coronary physiology and intracoronary imaging. Methods This was a prospective observational study ( ClinicalTrials.gov :NCT02788396). Optical coherence tomography (OCT) and physiological measurements were performed immediately before and after PD with the operators blinded to all measurements. The index of microcirculatory resistance (IMR), coronary flow reserve (CFR) and fractional flow reserve (FFR) were measured. OCT analysis was performed for assessment of stent expansion, malapposition, in‐stent plaque‐thrombus prolapse (PTP) and stent‐edge dissections (SED). The ...

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      Mentions: Francesco Prati
    4. Characteristic findings of acute spontaneous coronary artery dissection by cardiac computed tomography

      Characteristic findings of acute spontaneous coronary artery dissection by cardiac computed tomography

      Background: Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndrome (ACS); however, its detection carries relevant clinical implications. Cardiac computed tomography (CCT) has been found to be useful for follow-up, but data during the acute phase are scarce. Thus, our aim was to evaluate the early diagnostic ability of CCT to detect SCAD. Methods: We retrospectively analyzed all the in-hospital CCT performed in a prospective cohort of patients with SCAD from 2012 to 2016. An independent expert blindly evaluated the studies and described the radiologic characteristics of the lesions. These features were compared with the invasive ...

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    5. Detection of Cholesterol Crystals by Optical Coherence Tomography

      Detection of Cholesterol Crystals by Optical Coherence Tomography

      Aim: To determine the ability of optical frequency domain imaging (OFDI)/optical coherence tomography (OCT) imaging systems to visualize presence of cholesterol crystals (CCR) in human atherosclerotic coronary arteries. Methods and Results: We performed ex vivo imaging by OFDI/OCT of human coronary arteries. A total of 559 cross-sectional images from 45 autopsy cases were co-registered with histology and 117 histologic sections showed presence of necrotic core with cholesterol clefts (CC). We modified a previously used OFDI/OCT definition for identification of CCRs which we now define as a linear and discreet high intensity signal (bright area) within the plaque ...

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    6. Relationship between elevated plasma ceramides and plaque rupture in patients with ST-segment elevation myocardial infarction

      Relationship between elevated plasma ceramides and plaque rupture in patients with ST-segment elevation myocardial infarction

      Background and aims Ceramides (Cer) is an atherogenic substance. However, the associations between specific plasma Cer levels and culprit plaque morphology in ST-segment elevation myocardial infarction (STEMI) patients are unclear. Methods The study consisted of two parallel cohorts. 100 consecutive patients with STEMI were screened as discovery cohort. In the validation cohort, we separately screened 30 normal donors, 30 stable angina pectoris (SAP) and 315 STEMI patients. All STEMI patients underwent emergency percutaneous intervention (PCI) and optical coherence tomography (OCT) examination for culprit plaque. Based on established diagnostic criteria, STEMI patients were classified into plaque rupture (PR) and plaque erosion ...

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      Mentions: Bo Yu
    7. Clinical considerations and recommendations for OCT-guided carotid artery stenting

      Clinical considerations and recommendations for OCT-guided carotid artery stenting

      Introduction : Optical Coherence Tomography (OCT) is an intravascular imaging providing high-resolution images of morphological features of arterial wall. Nowadays, OCT is an accepted intravascular modality to study coronary arteries, stent implantation and vessel injury. In the last decade, an increasing interest have been focused on the application of OCT in carotid arteries. Areas covered : Literature evidence in the application of OCT in carotid arteries still remains debated. So far, OCT has been used as a research tool, aiming to evaluate atherosclerotic plaques’ features and stents’ behavior after implantation. This paper is intended to summarize clinical evidences and practices in the ...

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    8. Optical Coherence Tomography Comparison of Percutaneous Coronary Intervention Among Plaque Rupture, Erosion, and Calcified Nodule in Acute Myocardial Infarction

      Optical Coherence Tomography Comparison of Percutaneous Coronary Intervention Among Plaque Rupture, Erosion, and Calcified Nodule in Acute Myocardial Infarction

      Background: Acute myocardial infarction (AMI) is caused by coronary plaque rupture (PR), plaque erosion (PE), or calcified nodule (CN). We used optical coherence tomography (OCT) to compare stent expansion immediately after primary percutaneous coronary intervention (PCI) in patients with AMI caused by PR, PE, or CN. Methods and Results: In all, 288 AMI patients were assessed by OCT before and immediately after PCI, performed with OCT guidance according to OPINION criteria for stent sizing and optimization. The frequency of OCT-identified PR (OCT-PR), OCT-PE, and OCT-CN was 172 (60%), 82 (28%), and 34 (12%), respectively. Minimum stent area was smallest in ...

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    9. Peri-strut low intensity areas and in-scaffold neointima growth after bioresorbable scaffold implantation in Stemi. A serial optical coherence tomography study

      Peri-strut low intensity areas and in-scaffold neointima growth after bioresorbable scaffold implantation in Stemi. A serial optical coherence tomography study

      Background Peri-strut low intensity areas (PLIA) visualized by optical coherence tomography (OCT) have been related to neointimal proliferation and increased incidence of target lesion revascularization in stable coronary artery disease. The aim of this study was to determine the association between PLIA by OCT and the long-term vascular healing response after bioresorbable scaffold (BRS) implantation in the setting of ST-segment elevation myocardial infarction (STEMI). Methods This is a single-centre, longitudinal, cohort study with a serial: baseline, 1, 2 and 5 years OCT evaluation of neointimal response (lumen area and neoatherosclerosis) after percutaneous coronary intervention (PCI) with BRS Absorb™ 1.0 ...

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    10. Saline-Optical Coherence Tomography-Percutaneous Coronary Intervention (SOCT-PCI Study)

      Saline-Optical Coherence Tomography-Percutaneous Coronary Intervention (SOCT-PCI Study)

      Aim The aim of this study was to evaluate the feasibility of heparinised saline as flushing media for Frequency-Domain optical coherence tomography (FD-OCT) image acquisition during percutaneous coronary intervention (PCI) optimisation. Methods and results Twenty-seven patients undergoing FD-OCT-guided PCI were enrolled. Heparinised saline was injected into the coronary during FD-OCT image acquisition. A total of 118 runs were analysed for image quality and diagnostic value. FD-OCT runs were categorised as: good runs (GR), clinically usable runs (CUR), and clinically not usable runs (NUR); GR and CUR were combined as clinically effective runs (ER). Saline FD-OCT enabled visualisation of all possible ...

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    11. Longitudinal optical coherence tomography imaging of tissue repair and microvasculature regeneration and function after targeted cerebral ischemia

      Longitudinal optical coherence tomography imaging of tissue repair and microvasculature regeneration and function after targeted cerebral ischemia

      Significance: Understanding how the brain recovers from cerebral tissue and vascular damage after an ischemic event can help develop new therapeutic strategies for the treatment of stroke. Aim: We investigated cerebral tissue repair and microvasculature regeneration and function after a targeted ischemic stroke. Approach: Following photothrombosis occlusion of microvasculature, chronic optical coherence tomography (OCT)-based angiography was used to track ischemic tissue repair and microvasculature regeneration at three different cortical depths and up to 28 days in awake animals. Capillary network orientation analysis was performed to study the structural pattern of newly formed microvasculature. Based on the time-resolved OCT-angiography, we ...

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    12. Detecting and displaying stent expansion

      Detecting and displaying stent expansion

      A method for processing an intravascular image including a plurality of image frames acquired during a pullback of an imaging catheter inserted into a vessel. The method includes obtaining positions of lumen borders detected in the intravascular image and positions of stent-struts detected in the intravascular image. Determining, at different positions in a range, a stent expansion value of the stent implanted in the vessel, based on the first information and the second information, wherein each image frame from image frames in which stent-struts are detected corresponds to a different position along the range. The method may also include displaying ...

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    13. A Brief History of Intracoronary Imaging

      A Brief History of Intracoronary Imaging

      Purpose of Review The purpose of this paper is to review the history of intracoronary imaging as it pertains to the development of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) devices. Recent Findings Coronary angiography continues to maintain its stronghold as the diagnostic modality of choice in the diagnosis of coronary artery disease. Limitations in scope, however, have necessitated the development of adjunctive forms of imaging through IVUS and OCT in order to augment the comprehensive assessment and therapeutic management of angiographic findings. Summary IVUS and OCT have significantly enhanced current day percutaneous coronary intervention. Over the last 30 ...

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    14. Effect of neointimal tissue morphology on vascular response to balloon angioplasty in lesions with in-stent restenosis after drug-eluting stent deployment: an optical coherence tomography analysis

      Effect of neointimal tissue morphology on vascular response to balloon angioplasty in lesions with in-stent restenosis after drug-eluting stent deployment: an optical coherence tomography analysis

      This study aimed to evaluate the vascular response to balloon angioplasty for drug-eluting stent (DES) in-stent restenosis (ISR) lesions based on our novel optical coherence tomography (OCT) classification to establish the optimal treatment strategy for ISR lesions after DES implantation. A total of 104 ISR lesions after DES implantation were imaged by OCT and categorized into the following six patterns: type I—homogeneous high-intensity tissue, type II—heterogeneous tissue with signal attenuation, type III—speckled heterogeneous tissue, type IV—mixed tissue containing poorly delineated region with invisible strut, type V—mixed tissue containing sharply delineated low-intensity region, and type VI ...

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      Mentions: Kenichi Fujii
    15. Anatomical features and clinical outcome of a honeycomb-like structure in the coronary artery: reports from 16 consecutive patients

      Anatomical features and clinical outcome of a honeycomb-like structure in the coronary artery: reports from 16 consecutive patients

      Background: Recanalization of thrombus in coronary artery tree is defined as a honeycomb-like structure . However, the anatomic features and appropriate treatment of honeycomb-like structure still remain largely unclear. Methods and results: Between 2014 July and 2017 December, 17 honeycomb-like structure in 16 patients based on optical coherence tomography and intravascular ultrasound were included. Fractional flow reserve was measured for patients who had thrombolysis in myocardial infarction flow grade 3. Angiographic and optical coherence tomography /intravascular ultrasound-derived variables were studied. Clinical events (until to 2018 December) were collected. Honeycomb-like structures mostly involved left anterior descending artery (68.8%) and localized at ...

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    16. Comparison of neointimal coverage between ultrathin biodegradable polymer‐coated sirolimus‐eluting stents and durable polymer‐coated everolimus‐eluting stents: 6 months optical coherence tomography follow‐up from the TAXCO study

      Comparison of neointimal coverage between ultrathin biodegradable polymer‐coated sirolimus‐eluting stents and durable polymer‐coated everolimus‐eluting stents: 6 months optical coherence tomography follow‐up from the TAXCO study

      Aim The TAXCO study was designed to compare the degree of neointimal coverage and the prevalence of malapposition at 6 months subsequent to implantation of ultrathin biodegradable polymer‐coated sirolimus‐eluting stents (SES) and durable polymer‐coated everolimus‐eluting stents (EES) of thin strut thickness using optical coherence tomography (OCT). Methods The TAXCO study included a total of 42 patients who gave consent and underwent OCT examination between August 2017 and September 2017. Of 42, five patients' OCT examinations were of insufficient quality for quantitative analysis. Thus, the OCT analysis group consisted of 37 patients. Among them, 16 patients were ...

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    17. Radial Artery Spiral Dissection Confirmed by OCT Without Guidewire Shadow

      Radial Artery Spiral Dissection Confirmed by OCT Without Guidewire Shadow

      A 75-year-old man underwent right transradial coronary angiography because of acute myocardial infarction. Postprocedural radial angiography revealed a dissection with a spiral luminal filling defect in the proximal radial artery corresponding to a National Heart, Lung, and Blood Institute type D dissection (Figure 1A; Video 1). In order to acquire a full, 360° optical coherence tomography (OCT) image, we withdrew the guidewire out of the sheath ahead of pullback and left the OCT imaging wire in the vessel alone. However, subsequent pullbacks were performed without any difficulties. Without the guidewire shadow, it was clear that the dissection started from a ...

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    18. Procedural and one-year outcomes of patients treated with orbital and rotational atherectomy with mechanistic insights from optical coherence tomography

      Procedural and one-year outcomes of patients treated with orbital and rotational atherectomy with mechanistic insights from optical coherence tomography

      Aims: We sought to evaluate procedural complications and one-year clinical outcomes for patients who underwent percutaneous coronary intervention (PCI) with orbital (OA) and rotational atherectomy (RA). Methods and results: From a total of 13,467 patients who underwent PCI in our hospital between January 2013 and June 2016, 1,149 consecutive patients were treated with atherectomy for moderately-severely calcified lesions (184 with OA, 965 with RA). Procedural complications were similarly observed in the two groups except for higher dissection and perforation rates with OA. Major adverse cardiovascular events (MACE) were defined as the composite of death, myocardial infarction or target ...

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    19. Myocardial Infarction Complicating Vasospastic Angina in a Female Patient—Case Report

      Myocardial Infarction Complicating Vasospastic Angina in a Female Patient—Case Report

      Coronary artery vasospasm is an infrequent cause of acute coronary syndrome (ACS). A 50-year-old female developed persistent chest discomfort related to anterior STEMI. After an unsuccessful thrombolysis attempt, due to delay concern, the patient was then sent to the catheterization laboratory for rescue PCI. The coronary angiogram revealed a TIMI 3 flow proximal LAD significant stenosis with spastic appearance of the coronary arteries which has improved after intracoronary nitrates administration. Optical Coherence Tomography (OCT) excluded coronary artery dissection and haematoma also revealed thrombus on moderate atherosclerotic plaque. The patient was then pain-free; she was managed medically and discharged after few ...

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    20. Quantitative Coronary Angiography Can Predict Cardiac Allograft Vasculopathy in Pediatric Heart Transplant Recipients

      Quantitative Coronary Angiography Can Predict Cardiac Allograft Vasculopathy in Pediatric Heart Transplant Recipients

      Purpose Cardiac allograft vasculopathy (CAV) is a leading cause of death and re-transplantation (tx). Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are increasingly used for earlier detection, but lengthen procedure time and cost, and are unsuitable in small children. Coronary angiography is routine in all age groups but may be subjectively interpreted. We hypothesized that serial analysis of quantitative coronary angiography (QCA) is possible in infants and children and may also predict disease progression. Methods Pediatric recipients between Feb 1999 - July 2012 were studied. QCA was performed in two projections of the same region of the right (RCA), left ...

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