1. Articles in category: Cardiology

    1-24 of 4340 1 2 3 4 ... 179 180 181 »
    1. Optical coherence tomography assessment of macrophages accumulation in non-ST-segment elevation acute coronary syndromes

      Optical coherence tomography assessment of macrophages accumulation in non-ST-segment elevation acute coronary syndromes

      Aims To investigate in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) the prevalence and the features of optical coherence tomography (OCT)-detected macrophages accumulation in culprit plaques as compared with nonculprit plaques (NCP). Methods The study is a post-hoc analysis of a prospective study aimed at evaluating the relationship between aortic inflammation as assessed by 18 F-fluorodeoxyglucose-PET and features of coronary plaque vulnerability as assessed by OCT. We enrolled 32 patients with first NSTE-ACS who successfully underwent three-vessel OCT. Results The median age was 65 (54–72) years and 27 patients (84%) were men. Culprit plaques were clinically defined ...

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    2. Circadian variations in pathogenesis of ST-segment elevation myocardial infarction: an optical coherence tomography study

      Circadian variations in pathogenesis of ST-segment elevation myocardial infarction: an optical coherence tomography study

      Previous studies have reported a circadian variation in the onset of ST-segment elevation myocardial infarction (STEMI). However, underlying mechanisms for the circadian variation have not been fully elucidated. We investigated the relationship between onset of STEMI and the underlying pathology using optical coherence tomography (OCT). Patients with a diagnosis of STEMI were selected from a multicenter OCT registry. Patients were divided into 4 groups based on the estimated time of onset (00:00–05:59, 06:00–11:59, 12:00–17:59, or 18:00–23:59). Underlying pathologies of MI (plaque rupture, plaque erosion, and calcified plaque) were ...

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    3. Nonculprit Lesion Plaque Morphology in Patients With ST-Segment–Elevation Myocardial Infarction: Results From the COMPLETE Trial Optical Coherence Tomography Substudys

      Nonculprit Lesion Plaque Morphology in Patients With ST-Segment–Elevation Myocardial Infarction: Results From the COMPLETE Trial Optical Coherence Tomography Substudys

      Background: Complete revascularization with routine percutaneous coronary intervention of nonculprit lesions after primary percutaneous coronary intervention improves outcomes in ST-segment–elevation myocardial infarction. Whether this benefit is associated with nonculprit lesion vulnerability is unknown. Methods: In a prospective substudy of the COMPLETEs trial (Complete vs Culprit-Only Revascularization to Treat Multi-Vessel Disease After Early PCI for STEMI), we performed optical coherence tomography of at least 2 coronary arteries before nonculprit lesion percutaneous coronary intervention in 93 patients with ST-segment–elevation myocardial infarction and multivessel disease; and the ST-segment–elevation myocardial infarction culprit vessel if there was unstented segment amenable to imaging ...

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    4. Early vascular response of ultra-thin bioresorbable polymer sirolimus-eluting stents assessed by optical frequency domain imaging: the EVALUATION study

      Early vascular response of ultra-thin bioresorbable polymer sirolimus-eluting stents assessed by optical frequency domain imaging: the EVALUATION study

      This study aimed to evaluate the early vascular response of ultra-thin strut bioresorbable polymer sirolimus-eluting stents (BP SES) using optical frequency domain imaging (OFDI). Ultra-thin strut BP SES have superior outcomes in terms of efficacy and safety endpoints when compared to other thin strut new-generation stents. However, the factors contributing to the superiority of BP SES over other thin strut new-generation stents are unclear. A total of 32 patients with multivessel disease requiring staged procedures at 1 month were enrolled from 3 cardiovascular institutions; of these, 31 were immediately assessed by OFDI ( n  = 31). All patients were assessed at 1 ...

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    5. Thromboembolic or atherosclerotic? Optical coherence tomography in determining the cause of myocardial infarction with ST-segment elevation

      Thromboembolic or atherosclerotic? Optical coherence tomography in determining the cause of myocardial infarction with ST-segment elevation

      In the last years, due to its high image resolution, Optical Coherence Tomography (OCT) has been largely exploited in the assessment of atherosclerotic plaque features. The results obtained in the OCT imaging may determine the choice of optimal treatment technique [1,2]. A 55-year-old man with no history of any cardiovascular disease was admitted to the hospital with typical severe retrosternal pain. Acute myocardial infarction with ST-segment elevation (STEMI) was diagnosed. Immediate coronary angiography showed large thrombus causing subtotal occlusion in the medial and distal segments of the right coronary artery (RCA) with TIMI flow 2 and the occlusion of ...

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    6. Optical coherence tomography versus intravascular ultrasound for culprit lesion assessment in patients with acute myocardial infarction

      Optical coherence tomography versus intravascular ultrasound for culprit lesion assessment in patients with acute myocardial infarction

      Introduction In patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) the implanted stent may not fully cover the whole intravascular ultrasound (IVUS)-derived thin-cap fibroatheroma (TCFA) related to the culprit lesion (CL). Aim Whether this phenomenon is more pronounced when optical coherence tomography (OCT) assessment of the CL is performed is not known. Material and methods Thus, we aimed to assess CLs in 40 patients with AMI treated with PCI, using VH (virtual histology)-IVUS and OCT before and after intervention. The results were blinded to the operator and PCI was done under angiography guidance. Results ...

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    7. Insulin-like growth factor-1 levels predict myocardial injury and infarction after elective percutaneous coronary intervention: an optical coherence tomography study

      Insulin-like growth factor-1 levels predict myocardial injury and infarction after elective percutaneous coronary intervention: an optical coherence tomography study

      Introduction Periprocedural myocardial necrosis, which can range from a low level elevation of cardiac biomarkers to a large myocardial infarction (MI), is a common complication after percutaneous coronary intervention (PCI). Aim We hypothesized that insulin-like growth factor-1 (IGF-1) levels may play a protective role in myocardial injury after coronary stent placement and aimed to investigate the relationship between IGF-1 levels and plaque characteristics assessed by optical coherence tomography (OCT). Material and methods Between May 2015 and December 2015 we prospectively enrolled 74 patients with stable angina pectoris in whom single de novo coronary artery stenosis was present. PCI was performed ...

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    8. Short-term healing response after implantation of the thin-strut, fast-releasing sirolimus-eluting biodegradable polymer-coated Alex Plus stent: optical coherence tomography study

      Short-term healing response after implantation of the thin-strut, fast-releasing sirolimus-eluting biodegradable polymer-coated Alex Plus stent: optical coherence tomography study

      Introduction Technological improvements in drug-eluting stents (DES) have led to drastic reductions in restenosis and acute stent thrombosis rates. However, chronic inflammation and late and very late stent thrombosis, particularly with the first generation durable polymer DES (DP-DES), prompted the development of new DES platforms that use biodegradable polymers. The advantage of biodegradable polymers relies on the resorbable property of these polymers, reducing in this way the polymer-induced chronic inflammation and related clinical events such as restenosis and stent thrombosis. Notwithstanding , despite the theoretical advantages of bioabsorbable polymer DES (BP-DES), there are limited data focused on its very early vascular ...

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    9. Connector sensors for permittivity-based thrombus monitoring in extracorporeal life support

      Connector sensors for permittivity-based thrombus monitoring in extracorporeal life support

      Extracorporeal circulation is vital in cardiovascular surgery, but thrombus formation at connector interface is a major threat. Optical coherence tomography (OCT) is presently used to monitor thrombogenesis at connectors, but it is expensive to install and complex to use. This study fabricated and evaluated a connector sensor for real-time permittivity-based thrombus monitoring at tube–connector interface. Computational simulations were initially done to pre-evaluate the applicability of connector sensor. The sensor was fabricated by incorporating two stainless steel electrodes on acrylic tube for measuring permittivity changes at the tube–connector interface. OCT images were also taken from the interface at intervals ...

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    10. Comparison of post-stent irregular protrusion and subsequent neointimal characteristics between second- and third-generation drug-eluting stent implantation

      Comparison of post-stent irregular protrusion and subsequent neointimal characteristics between second- and third-generation drug-eluting stent implantation

      Background Third-generation drug-eluting-stents (3rd DES) may improve coronary arterial healing and reduce neoatherosclerosis formation. We evaluated post-stent findings and subsequent vascular healing of 3rd DES by comparing to second-generation drug-eluting-stents (2nd DES) at intermediate-term follow-up using optical coherence tomography (OCT). Method We evaluated 170 patients with 170 lesions who underwent DES implantation (2nd DES, n = 98; 3rd DES, n = 72) and OCT-guided follow-up examination. After propensity score (PS) matching for baseline clinical characteristics, OCT findings from 56 pairs of patients with 2nd DES and 3rd DES implants were compared. Post-stent irregular protrusion (IP) was defined as the protrusion of material ...

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    11. OCT (optical coherence tomography) contribution assessment in the revascularisation of long femoro-popliteal occlusive lesions (TASC C and D): a randomised trial

      OCT (optical coherence tomography) contribution assessment in the revascularisation of long femoro-popliteal occlusive lesions (TASC C and D): a randomised trial

      ackground Endovascular treatment has become the first-line revascularisation technique for femoropopliteal lesions. This technique lacks of reliable and accurate morphological control of the arterial segment treated. Intraoperative 2-D angiogram consumes iodinated contrast media and increases X-ray exposure; this subsequently provides none 3D information on the quality of the revascularisation completed, what could explain some of the early and late failures of the technique. Aim Our objective is to evaluate if intra-operative optical coherence tomography (OCT) control in addition to standard angiogram could improve the primary patency rate at 12 months in comparison to standard angiogram alone in patients with occlusive ...

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    12. The association between glucose-related variables and plaque morphology in patients with ST-segment elevated myocardial infarction

      The association between glucose-related variables and plaque morphology in patients with ST-segment elevated myocardial infarction

      Plaque rupture (PR) and plaque erosion (PE) are main causes of acute myocardial infarction with different demographic and histology characteristics and need different treatment strategy. PR and PE can be identified with optical coherence tomography (OCT) accurately, but convenient and effective noninvasive markers for them are rarely found. History of diabetes mellitus (DM) was reported to be a potential predictor of PR in ST-segment elevated myocardial infarction (STEMI) patients, but the predictive value of other glucose-related variables for it is still uncertain. Present study aimed to clear the relationship between some glucose-related variables and plaque morphology in patients with STEMI.

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    13. Association of systemic inflammatory biomarkers with morphological characteristics of the coronary atherosclerotic plaque by intravascular optical coherence tomography.

      Association of systemic inflammatory biomarkers with morphological characteristics of the coronary atherosclerotic plaque by intravascular optical coherence tomography.

      Despite significant advances in preventive, medical and interventional management, coronary artery disease remains the leading cause of death worldwide. We now know that in the majority of acute coronary syndromes, a thrombotic event is triggered either by the rupture or erosion of the so-called high-risk or ‘vulnerable’ plaque. However, accurately identifying the individual who is at significant risk of acute event remains the holy grail of preventive cardiology. To better stratify an individual’s risk of developing and suffering a cardiovascular event, biomarkers are needed that can accurately predict coronary events, and if possible monitor disease activity in response to ...

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    14. OCT angiography improves views of retina blood flow

      OCT angiography improves views of retina blood flow

      Projects from Boston and Portland could help translation of OCTA into clinics. Retina blood flow: vital for diagnosis Optical coherence tomography angiography (OCTA) is a promising technique for imaging of blood vessels, in which sequential OCT scans of the same tissue cross-section reveal the sites of blood flow within those tissues, and can allow the blood oxygen content to be calculated. Examination of the retina is one promising application area for OCTA, thanks partly to the widespread adoption of conventional OCT within ophthalmology and its established place in clinical workflows. Two recent projects have published findings that could assist the ...

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    15. UC Irvine Receives a 2020 NIH Grant for Phased Resolved ARF Optical Coherence Elastography for Intravascular Imaging

      UC Irvine Receives a 2020 NIH Grant for Phased Resolved ARF Optical Coherence Elastography for Intravascular Imaging

      University of California at Irvine Receives a 2020 NIH Grant for $698,188 for Phased Resolved ARF Optical Coherence Elastography for Intravascular Imaging. The principal investigator is Zhongping Chen. Below is a summary of the proposed work. Cardiovascular disease is responsible for 1 in 4 deaths, or 650,000 Americans, every year. It is the leading cause of death in the United States. Ruptured atherosclerotic plaques are the main cause of acute coronary events, and it is of lethal consequence. Clinically, early detection of the latent vulnerability of plaques is the first line of defense against such deadly circumstances, and ...

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    16. Three‐year outcome with drug‐coated balloon percutaneous coronary intervention in coronary Takayasu arteritis: A case review

      Three‐year outcome with drug‐coated balloon percutaneous coronary intervention in coronary Takayasu arteritis: A case review

      We describe the first long‐term follow‐up of a young patient with active Takayasu arteritis who presented with an acute coronary syndrome, treated endovascularly with percutaneous coronary intervention without stenting. A drug‐coated balloon was used with high‐resolution coronary imaging guidance in the form of optical coherence tomography on a critical ostial left anterior descending coronary artery lesion. A repeat procedure was undertaken after 4 months confirming a durable coronary angioplasty result and the patient remained symptom‐free beyond 3 years. Coronary stenting in this population is associated with early and aggressive stent failure. Hence, this is an ...

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    17. A case report of a coronary myocardial bridge with impaired full-cycle ratio during dobutamine challenge

      A case report of a coronary myocardial bridge with impaired full-cycle ratio during dobutamine challenge

      Background A myocardial bridge (MB) is a coronary variant in which an epicardial coronary artery tunnels through the myocardial band. Although MBs have been reported to cause ischaemia, physiological assessment of an MB has not been fully established. Case summary We encountered a case with exertional chest pain who underwent coronary angiography showing an MB at the mid-left anterior descending artery with systolic compression. Optical coherence tomography showed an MB defined as a homogeneous intermediate intensity surrounding the epicardial artery. The full-cycle ratio, defined as the lowest ratio of distal coronary pressure ( P d ) to aortic pressure ( P a ) during ...

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    18. Optical Coherence Tomography Imaging in Acute Myocardial Infarction: Calcified Nodule as a Culprit Lesion

      Optical Coherence Tomography Imaging in Acute Myocardial Infarction: Calcified Nodule as a Culprit Lesion

      A 72-year-old male had acute inferior-wall myocardial infarction, for which he was subjected to primary angioplasty at another institute. Coronary angiography revealed a thrombotic 95% occlusion of the proximal right coronary artery (RCA) (Figure 1A). Percutaneous coronary intervention (PCI) was attempted but failed, as the coronary guidewire could not cross the lesion. There was TIMI 0 flow across the RCA at the end of the abandoned procedure (Figure 1B; Video 1). He was referred to our institute for a repeat PCI. Repeat coronary angiography revealed 95% eccentric calcified stenosis of the mid RCA with TIMI 3 flow (Figure 1C). The ...

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    19. Invasive Coronary Artery Imaging Using Optical Coherence Tomography: A Cost-effectiveness and Implementation Process Analysis (Thesis)

      Invasive Coronary Artery Imaging Using Optical Coherence Tomography: A Cost-effectiveness and Implementation Process Analysis (Thesis)

      The aim of this project was the implementation of optical coherence tomography (OCT), an invasive intracoronary imaging (ICI) tool used for the visualization of coronary arteries. The implementation was performed in a structured manner by: (1) A literature review into the current applications of OCT in relation to current standards; (2) A thesis feasibility study into clinical practices, professional views and other processes regarding ICI; (3) A Master’s thesis including a cost-effectiveness analysis (CEA) and the actual implementation of OCT at the department. The project started with a literature review about the current applications of OCT in relation to ...

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    20. Case Western Reserve University Receives NIH Grant for Computer Assisted Coronary Artery Stent Interventions

      Case Western Reserve University Receives NIH Grant for Computer Assisted Coronary Artery Stent Interventions

      Case Western Reserve University Receives a 2020 NIH Grant for $727,994 for Computer Assisted Coronary Artery Stent Interventions The principal investigator is David Wilson. Below is a summary of the proposed work. Computer assisted coronary artery stent interventions Summary When treating highly calcified coronary artery lesions with stents, interventional cardiologists, with limited information, make stressful treatment decisions, which can lead to inadequate stent deployment and poor outcomes, or even rare calamitous events. When calcification is present, a cardiologist must choose to use a normal sized angioplasty balloon; a larger angioplasty balloon with increasingly high, prolonged pressures to fracture the ...

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    21. In vivo based biomechanics of right and left coronary arteries

      In vivo based biomechanics of right and left coronary arteries

      A realistic/comprehensive biomechanical model of right/left coronary arteries is developed using the in vivo geometric and haemodynamic properties obtained from optical coherence tomography (OCT), angiography, and electrocardiography (ECG). The developed biomechanical model is constructed with the help of an image processing technique and simulated via the finite element method (FEM) for determination of regions with highest shear/von Mises stresses (which determine the potential areas for plaque rupture and initiation of myocardial infarction). A set of simulation results is compared to clinically obtained data to assess the validity of modelling/simulations. The model comprehensively incorporates information relating to ...

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    22. Association between Admission Hyperglycemia and Culprit Lesion Characteristics in Nondiabetic Patients with Acute Myocardial Infarction: An Intravascular Optical Coherence Tomography Study

      Association between Admission Hyperglycemia and Culprit Lesion Characteristics in Nondiabetic Patients with Acute Myocardial Infarction: An Intravascular Optical Coherence Tomography Study

      Background . Hyperglycemia is frequently observed in acute myocardial infarction (AMI). Diabetes mellitus (DM) patients and non-DM patients have different culprit lesion phenotypes and few data are available on non-DM patients with admission hyperglycemia. Therefore, we aimed to investigate the association between admission hyperglycemia and culprit lesion characteristics using optical coherence tomography (OCT) in AMI patients. Methods and Results . We consecutively enrolled 434 patients with AMI, and 277 patients were included in analysis: 65.7% ( ) non-DM patients and 34.3% ( ) DM patients. We measured acute blood glucose (ABG) and hemoglobin A 1c to calculate the acute-to-chronic glycemic ratio (A/C). Then ...

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