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    1. Bioresorbable Vascular Scaffolds in coronary chronic total occlusions. Clinical, vasomotor and optical coherence tomography findings at 3-year follow-up (ABSORB-CTO study)

      Bioresorbable Vascular Scaffolds in coronary chronic total occlusions. Clinical, vasomotor and optical coherence tomography findings at 3-year follow-up (ABSORB-CTO study)

      Aims: Percutaneous treatment of coronary chronic total occlusion (CTO) is associated with important arterial remodelling after successful recanalization. Bioresorbable vascular scaffold (BVS) implantation in CTO has been shown feasible and can be of interest when the scaffold achieves complete bioresorption. We sought to evaluate the 3-year results in terms of clinical events, serial imaging outcomes and the vasomotion response in CTO lesions successfully treated with BVS. Methods and results: A total of 33 patients (35 CTO lesions) successfully treated with BVS were included in ABSORB-CTO study. Clinical outcomes, quantitative coronary angiography (QCA) and optical coherence tomography (OCT) assessment were analysed ...

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      Mentions: Josep Gomez-Lara
    2. Pre-infarction Angina and Culprit Lesion Morphologies in Patients with a First ST-segment Elevation Acute Myocardial Infarction: Insights from In Vivo Optical Coherence Tomography

      Pre-infarction Angina and Culprit Lesion Morphologies in Patients with a First ST-segment Elevation Acute Myocardial Infarction: Insights from In Vivo Optical Coherence Tomography

      Aims: This study aimed to evaluate the relationship between pre-infarction angina (PIA) and in vivo culprit lesion characteristics as assessed by intravascular optical coherence tomography (OCT) in patients with a first ST-segment elevation myocardial infarction (STEMI). Methods and results: A total of 305 consecutive patients with a first STEMI who underwent OCT imaging of culprit lesions during primary percutaneous coronary intervention (PCI) were prospectively enrolled. OCT findings of the culprit plaque were compared between patients with (n=206) and without PIA (n=99). Patients with PIA showed lower rates of thin-cap fibroatheroma (TCFA) (62.6% vs. 80.8%, P=0 ...

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    3. Late clinical outcome of suboptimal stent implantation defined by intracoronary optical coherence tomography

      Late clinical outcome of suboptimal stent implantation defined by intracoronary optical coherence tomography

      Optical coherence tomography (OCT) is an intravascular imaging technique that provides high-resolution (10-20 μm) images. During percutaneous coronary intervention (PCI), OCT offers useful information to guide treatment strategies and assess optimal stent implantation (Figure 1) . However, OCT remains markedly underused in the real world. For further integration of OCT into clinical practice, it is necessary to accumulate evidence showing that OCT has a beneficial impact on the outcomes of PCI. In 2012 and 2015, Prati et al 1,2 reported the clinical benefits of OCT guidance in PCI using data

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    4. Delayed Appearance of Intramural Hematoma After Stent Implantation: Diagnosis by Optical Coherence Tomography

      Delayed Appearance of Intramural Hematoma After Stent Implantation: Diagnosis by Optical Coherence Tomography

      A 55-year-old man presented with an inferior myocardial infarction successfully treated with fibrinolysis. Elective coronary angiography revealed a tight lesion at the most proximal segment of the right coronary artery ( Video1 ). Following lesion predilation a drug-eluting stent (DES) was implanted and subsequently optimized using optical coherence tomography (OCT) guidance (Video 2). OCT confirmed an excellent final result. In particular, the distal edge of the stent was nicely expanded and apposed against the vessel wall and no edge-dissections were detected ( Figure 1A-D, Video 3 )

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      Mentions: Fernando Alfonso
    5. 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 1-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, 1149 consecutive patients were treated with atherectomy for moderately-severely calcified lesions (184 with OA, 965 with RA). Procedural complications were similarly observed in 2 groups except for higher dissection and perforation rates with OA. Major adverse cardiovascular events (MACE) were defined as the composite of death, myocardial infarction and target lesion revascularization ...

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    6. Establishment of healing profile and neointimal transformation in the new polymer-free Biolimus A9-coated coronary stent by longitudinal sequential optical coherence tomography assessments: The EGO-BIOFREEDOM study

      Establishment of healing profile and neointimal transformation in the new polymer-free Biolimus A9-coated coronary stent by longitudinal sequential optical coherence tomography assessments: The EGO-BIOFREEDOM study

      Aims: In patients at high bleeding risk treated with 1 month of dual antiplatelet therapy, the polymer-free, biolimus A9-coated BioFreedom stent (BFS) was found safer and more efficacious than bare metal stents. We used sequential optical coherence tomography (OCT) to assess the time course of strut coverage and neointimal transformation from 1 to 9 months. Methods and results: We randomly assigned 104 BFS recipients to 1 of 5 groups with angiography and OCT follow-up at 1, 2, 3, 4, or 5 months, together with another follow-up for all at 9 months. The primary endpoint was the degree of OCT-detected strut ...

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    7. Optical Coherence Tomography Substudy of A Prospective Multicenter Randomized Post-Market Trial to Assess the Safety and Effectiveness of the Firehawk™ Rapamycin Target Eluting Cobalt Chromium Coronary Stent System for the Treatment of Atherosclerotic Les

      Optical Coherence Tomography Substudy of A Prospective Multicenter Randomized Post-Market Trial to Assess the Safety and Effectiveness of the Firehawk™ Rapamycin Target Eluting Cobalt Chromium Coronary Stent System for the Treatment of Atherosclerotic Les

      Aims: Durable polymer drug-eluting stents (DP DES) may contribute to persistent inflammation, delayed endothelial healing and subsequent late DES thrombosis. The aim of this Optical Coherence Tomography (OCT) sub-study was to compare healing and neointimal coverage of a novel bioabsorbable polymer sirolimus-eluting stent (FIREHAWK®) (BP DES) versus the DP DES (XIENCE) at 90 days in an all comers patient population. Methods and results: The TARGET All Comers study is a prospective multicenter randomised post-market trial of 1656 patients randomised 1:1 to FIREHAWK or XIENCE at 21 centers in 10 European countries. The TARGET OCT sub-study enrolled 36 consecutive patients ...

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    8. The Effectiveness of Excimer Laser Angioplasty to Treat Coronary In-Stent Restenosis With Peri-stent Calcium as Assessed by Optical Coherence Tomography

      The Effectiveness of Excimer Laser Angioplasty to Treat Coronary In-Stent Restenosis With Peri-stent Calcium as Assessed by Optical Coherence Tomography

      Aims: We evaluated the effectiveness of excimer laser coronary angioplasty (ELCA) to treat in-stent restenosis (ISR) due to peri-stent calcium-related stent under-expansion as assessed by optical coherence tomography (OCT). Methods and results: We studied 81 patients (81 lesions with ISR, stent under-expansion, and peri-stent calcium >90°) who underwent OCT imaging both pre- and post-percutaneous coronary intervention and compared lesions treated with ELCA (n=23) vs without ELCA (n=58). ELCA use was associated with more calcium fracture (ELCA: 61%, non-ELCA: 12%, p<0.01), . larger final minimum lumen area (ELCA: 4.76 mm2 [3.25, 5.57], non-ELCA: 3.46 ...

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    9. Long-term consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study

      Long-term consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study

      Aims: The role of intra-procedural Optical Coherence Tomography (OCT) on long-term clinical outcome of percutaneous coronary interventions (PCI) remains undefined. Methods and results: In the context of the multicenter Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) registry, we compared long-term PCI outcome of 1211 patients from 13 independent OCT-experienced centers according to end-procedural OCT findings. OCT assessment revealed suboptimal stent implantation in 30.9% of lesions, with increased prevalence in patients experiencing device-oriented cardiovascular events (DoCE) (52.8% vs. 28.0%, p<0.001). At median follow-up of 833 (quartiles 415-1447) days, in-stent minimum lumen ...

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    10. Lumen Boundaries Extracted from Coronary Computed Tomography Angiography on Computed Fractional Flow Reserve (FFRCT): Validation with Optical Coherence Tomography

      Lumen Boundaries Extracted from Coronary Computed Tomography Angiography on Computed Fractional Flow Reserve (FFRCT): Validation with Optical Coherence Tomography

      Aims: To evaluate the accuracy of minimal lumen area (MLA) by coronary computed tomography angiography (cCTA) and its impact on fractional flow reserve (FFRCT). Methods and results: Fifty-seven patients (118 lesions, 72 vessels) who underwent cCTA and optical coherence tomography (OCT) were enrolled. OCT and cCTA were co-registered and MLAs were measured with both modalities. FFROCT was calculated using OCT-updated models with cCTA-based lumen geometry replaced by OCT-derived geometry. Lesions were grouped by Agatston score (AS) and minimum lumen diameter (MLD) using the OCT catheter and guide wire size (1.0 mm) as a threshold. For all lesions, the average ...

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    11. Plaque Burden Influences Accurate Classification of Fibrous Cap Atheroma by In-Vivo Optical Coherence Tomography in a Porcine Model of Advanced Coronary Atherosclerosis

      Plaque Burden Influences Accurate Classification of Fibrous Cap Atheroma by In-Vivo Optical Coherence Tomography in a Porcine Model of Advanced Coronary Atherosclerosis

      Aims: In-vivo validation of coronary optical coherence tomography (OCT) against histology and the effects of plaque burden (PB) on plaque classification remain unreported. We investigated this in a porcine model with human-like coronary atherosclerosis. Methods and results: Five female Yucatan D374Y-PCSK9 transgenic hypercholesterolemic mini-pigs were implanted with a coronary shear-modifying stent to induce advanced atherosclerosis. OCT frames (n=201) were obtained 34 weeks after implantation. Coronary arteries were perfusion-fixed, serially sectioned and co-registered with OCT using a validated algorithm. Lesions were adjudicated using the Virmani classification and PB assessed from histology. OCT had a high sensitivity, but modest specificity (92 ...

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    12. Very late scaffold thrombosis: insights from optical coherence tomography and histopathology

      Very late scaffold thrombosis: insights from optical coherence tomography and histopathology

      A 79-year-old male patient had a 2.5×12 mm bioresorbable vascular scaffold (Absorb™ BVS; Abbott Vascular, Santa Clara, CA, USA) implanted in the setting of the RIBS VI study protocol for in-stent restenosis of a 3×9 mm bare metal stent (AVE S670; Medtronic, Minneapolis, MN, USA) in January 2015, at which time point the patient presented with stable angina and positive exercise stress test (index procedure). The Absorb BVS was implanted with predilatation at 20 atmospheres (atm) accompanied by post-dilatation with a non-compliant balloon (2.5×10 mm) at 26 atm. The patient was maintained on dual antiplatelet ...

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    13. Long-tem consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study

      Long-tem consequences of optical coherence tomography findings during percutaneous coronary intervention: the centro per la lotta contro l\'infarto - optimization of percutaneous coronary intervention (cli-opci) late study

      Aims: The role of intra-procedural Optical Coherence Tomography (OCT) on long-term clinical outcome of percutaneous coronary interventions (PCI) remains undefined. Methods and results: In the context of the multicenter Centro per la Lotta contro l’Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) registry, we compared long-term PCI outcome of 1211 patients from 13 independent OCT-experienced centers according to end-procedural OCT findings. OCT assessment revealed suboptimal stent implantation in 30.9% of lesions, with increased prevalence in patients experiencing device-oriented cardiovascular events (DoCE) (52.8% vs. 28.0%, p<0.001). At median follow-up of 833 (quartiles 415-1447) days, in-stent minimum lumen ...

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    14. Quality difference of neointima following the implantation of bioresorbable scaffold and metallic stent in patients with ST elevation myocardial infarction: quantitative assessments by light intensity, light attenuation, and backscatter on optical coheren

      Quality difference of neointima following the implantation of bioresorbable scaffold and metallic stent in patients with ST elevation myocardial infarction: quantitative assessments by light intensity, light attenuation, and backscatter on optical coheren

      Aims: We aimed to assess possible difference of the neointimal quality after everolimus-eluting bioresorbable scaffold (BVS) implantation in comparison with cobalt chromium everolimus-eluting scaffold (CoCr-EES) by optical frequency domain imaging (OFDI). Methods and results: This study is a post-hoc analysis of TROFI II trial assessing neointimal quality 6-month after the implantation of BVS(N=82) and CoCr-EES(N=87) in STEMI patients. Neointimal light property analysis by OFDI full-automatically computed light attenuation, backscatter and light intensity for superficial and deep neointima. High light attenuation/backscatter and high light intensity are reportedly associated with lipidic change and tissue maturation, respectively. Superficial ...

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    15. Characteristics of stent thrombosis in bifurcation lesions analyzed by optical coherence tomography

      Characteristics of stent thrombosis in bifurcation lesions analyzed by optical coherence tomography

      Aims: This work aimed to investigate a cohort of patients presenting with stent thrombosis (ST) explored by optical coherence tomography (OCT) to identify the underlying mechanical abnormalities in case of bifurcation lesions. Methods and results: The PESTO study was a prospective national registry involving 29 French catheterization facilities. Patients with acute coronary syndromes were prospectively screened for presence of definite ST and analyzed by OCT after culprit lesion reopening.The cohort involved n=120 subjects, including n=21 patients (17.5% of the global PESTO group; median age: 62.6 y; 76% male) with bifurcation lesions. The clinical presentation was ...

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    16. First serial optical coherence tomography assessment at baseline, 12 and 24 months in STEMI patients treated with the second generation ABSORB™ bioresorbable vascular scaffold

      First serial optical coherence tomography assessment at baseline, 12 and 24 months in STEMI patients treated with the second generation ABSORB™ bioresorbable vascular scaffold

      Aims: The aim of the study was to assess the vascular healing response after Absorb bioresorbable vascular scaffold (BVS) implantation in patients with ST segment elevation myocardial infarction (STEMI) utilizing truly serial optical coherence tomography (OCT) examination at baseline, 12- and 24-months. Methods and results: This is the single-centre, prospective, longitudinal study with baseline, 12- and 24-month OCT evaluation of 18 STEMI patients treated with 22 Absorb BVS implantation. The healing pattern was evaluated based upon lumen area, neointimal hyperplasia, strut coverage and apposition. The lumen area decreased at 12 months compared to baseline (8.52± 1.69 mm2 vs ...

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    17. Efficacy of Optical Coherence Tomography-derived Morphometric Assessment in Predicting the Physiological Significance of Coronary Stenosis: Head-to-Head Comparison with Intravascular Ultrasound

      Efficacy of Optical Coherence Tomography-derived Morphometric Assessment in Predicting the Physiological Significance of Coronary Stenosis: Head-to-Head Comparison with Intravascular Ultrasound

      Aims: This study aimed to investigate the diagnostic efficacy of optical coherence tomography (OCT) in identifying functional significance via fractional flow reserve (FFR) compared with that of intravascular ultrasound (IVUS). Methods and results: We investigated 203 de novo intermediate coronary lesions of 186 patients who underwent frequency-domain OCT, IVUS and FFR measurements. Diagnostic efficacy of the minimal lumen area (MLA) obtained by OCT (OCT-MLA) and IVUS (IVUS-MLA) in predicting an FFR<0.75 was evaluated. Receiver operating characteristic curve analysis showed that OCT-MLA had significantly better diagnostic efficacy than IVUS-MLA in identifying functional ischemia. OCT analysis revealed that the incidence ...

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      Mentions: Taishi Yonetsu
    18. Very Late Scaffold Thrombosis: Insights from Optical Coherence Tomography and Histopathology

      Very Late Scaffold Thrombosis: Insights from Optical Coherence Tomography and Histopathology

      Aims: to investigate and understand the mechanisms of very late scaffold thrombosis 13 months following implantation in the setting of bare metal in-stent restenosis. Methods and results: we collected consecutive angiography, optical coherence tomography and full autopsy evaluation in a 79-year old patients presenting with cardiogenic shock and undergoing rescue PCI after suffering very late scaffold thrombosis. Combined assessment of angiography, optical coherence tomography and histopathology revealed heterogenous vascular healing 13 months following implantation of a bioresorbable vascular scaffold with presence of scaffold struts fully integrated into neointimal tissue while others remained uncovered and malapposed. Furthermore, plaque rupture within the ...

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    19. Impact of Guidewire Recrossing Point into Stent Jailed Side Branch for Optimal Kissing Balloon Dilatation - Corelab 3D Optical Coherence Tomography Analysis

      Impact of Guidewire Recrossing Point into Stent Jailed Side Branch for Optimal Kissing Balloon Dilatation - Corelab 3D Optical Coherence Tomography Analysis

      AIMS: We investigated the influence of the guidewire recrossing point on the incidence of incomplete stent apposition (ISA) after kissing balloon dilatation (KBD), and clinical and angiographic outcome at 9 months in a prospective multicenter registry. METHODS AND RESULTS: One hundred five patients underwent single crossover stenting across the side branch (SB) and subsequent KBD. Jailing configuration of the SB orifice and the guidewire recrossing position were assessed by off-line 3D-OCT in the corelab. We defined the cases that achieved both Link-Free carina configuration and the distal recrossing as the LFD group (54 cases), and the other cases were defined ...

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    20. EuroIntervention Near infrared spectroscopy, optical coherence tomography and angioscopy to unravel the mechanism of very late metallic drug-eluting stent thrombosis

      EuroIntervention Near infrared spectroscopy, optical coherence tomography and angioscopy to unravel the mechanism of very late metallic drug-eluting stent thrombosis

      The incidence of very late stent thrombosis (VLST) after second-generation drug-eluting stent (DES) implantation has decreased compared to that previously seen after first-generation DES implantation. However, VLST remains a major concern and its mechanism has not been fully elucidated yet. A 69-year-old man with angina pectoris was implanted with a durable-polymer everolimuseluting stent (EES, Xience, 3.25x33mm) in left circumflex artery. At 1-year follow-up, coronary angiography (CAG) demonstrated the patency of the EES. Dual-antiplatelet therapy was switched to single-antiplatelet therapy using clopidogrel. However, he had sudden onset of chest pain

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    21. EuOptical coherence tomography findings: insights from the “randomised multicentre trial investigating angiographic outcomes of hybrid sirolimus-eluting stents with biodegradable polymer compared with everolimus-eluting stents with durable polymer in chro

      EuOptical coherence tomography findings: insights from the “randomised multicentre trial investigating angiographic outcomes of hybrid sirolimus-eluting stents with biodegradable polymer compared with everolimus-eluting stents with durable polymer in chro

      Aims: The PRISON IV trial investigated the next-generation sirolimus-eluting stent (SES) with ultra-thin struts and biodegradable polymer against the second-generation everolimus-eluting stent (EES) with thin struts and durable polymer in patients with successfully recanalised chronic total occlusions (CTO). In this study, we examined the secondary optical coherence tomography endpoints. Methods and results: The main PRISON IV trial randomised 330 patients to either SES or EES. At nine months, 281 (85%) patients underwent repeat angiography. Of these, 60 consecutive patients received optical coherence tomography divided over both stent groups. The mean number of struts analysed was 750±337 and 633±358 ...

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    22. EuroIntervention Optical Coherence Tomography Assessment of New Generation Mesh-Covered Stents after Carotid Stenting

      EuroIntervention Optical Coherence Tomography Assessment of New Generation Mesh-Covered Stents after Carotid Stenting

      As a public service to our readership, this article - peer reviewed by the Editors of EuroIntervention - has been published immediately upon acceptance as it was received. The content of this article is the sole responsibility of the authors, and not that of the journal or its publishers. As a public service to our readership, this article - peer reviewed by the Editors of EuroIntervention - has been published immediately upon acceptance as it was received.

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    23. EuroIntervention Characteristics of early versus late in-stent restenosis in second-generation drug-eluting stents: an optical coherence tomography study

      EuroIntervention Characteristics of early versus late in-stent restenosis in second-generation drug-eluting stents: an optical coherence tomography study

      Aims: In-stent restenosis (ISR) is an important cause of drug-eluting stent (DES) failure and target vessel revascularisation. In this study we aimed to evaluate differences between early and late-presenting restenosis in second-generation DES using optical coherence tomography (OCT). Methods and results: Overall, 171 cases of second-generation DES ISR with a follow-up OCT minimum lumen area <3.0 mm 2 were included: 33.3% of patients (n=57) had early ISR, and 66.7% (n=114) had late ISR (duration from stent implantation >1 year). Minimum stent area (MSA) <4.0 mm 2 , neointimal thickness <100 µm, and heterogeneous neointimal hyperplasia ...

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    24. OCT Atlas app – Second edition upcoming release (Textbook)

      OCT Atlas app – Second edition upcoming release (Textbook)

      Developed specifically for the iPad, The Clinical Atlas of OCT offers a rapid and interactive guidance to a systematic and scientifically critical interpretation of OCT images for interventional cardiologists, pathologists, and other physicians, technicians, trainees and research staff. The Clinical Atlas of Intravascular Optical Coherence Tomography (OCT) is the first comprehensive educational tool devoted exclusively to intravascular OCT. The iPad Atlas of OCT provides high-quality images in agreement with international consensus presented in an interactive and educative manner covering all emerging topics in the field. Conducted by Professor Patrick W. Serruys, Dr. Maria Radu, Dr. Lorenz Räber and Dr ...

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