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    1. 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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    2. 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
    3. 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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    4. 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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    5. 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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    6. 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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    7. 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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    8. 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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    9. 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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    10. Suboptimal agreement between optical coherence tomography and near-infrared spectroscopy for identification of lipid-laden plaque

      Suboptimal agreement between optical coherence tomography and near-infrared spectroscopy for identification of lipid-laden plaque

      Recently developed intracoronary imaging techniques allow real-time, in vivo identification of lipid in atherosclerotic plaques. Optical coherence tomography (OCT), a light-based imaging technique with high axial resolution (10-20 μm), identifies lipid-laden plaques as signal-poor regions with diffuse borders. A validation study performed versus histopathology confirmed the high sensitivity (90% to 94%) and specificity (90% to 92%) of OCT to identify lipid-laden plaques 1 . Near-infrared spectroscopy (NIRS) detects lipid-laden plaque by analysing light absorption that varies depending on the coronary tissue components and the wavelength of the incident near-infrared light. NIRS displays the probability of the presence of lipid-laden plaque on ...

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    11. Optical 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 chroni

      Optical 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 chroni

      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 ...

      Read Full Article
    12. Optical 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 chroni

      Optical 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 chroni

      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 ...

      Read Full Article
    13. Iatrogenic Coronary Artery Dissection Induced During Invasive Absolute Coronary Blood Flow Measurement: Optical Coherence Tomography Findings

      Iatrogenic Coronary Artery Dissection Induced During Invasive Absolute Coronary Blood Flow Measurement: Optical Coherence Tomography Findings

      A 65-year-old woman with previous history of hypertension was referred to our institution due to effort angina with a positive exercise stress test. Coronary angiography showed normal coronary arteries. A vasospasm provocation test with methylergonovine was negative. With the aim of assessing the state of microvasculature, absolute coronary blood flow by thermodilution was performed as previously described.

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      Mentions: Fernando Alfonso
    14. Characteristics of Early Versus Late In-Stent Restenosis in Second- Generation Drug-Eluting Stents: An Optical Coherence Tomography Study

      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 DES failure and target vessel revascularization. We evaluated differences between early and late-presenting restenosis in second-generation drug-eluting stents (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 <3.0mm2 were included; 33.3% of patients (n=57) had early ISR; and 67.7% (n=114) had late ISR (duration from stent implantation >1 year). Minimum stent area (MSA) <4.0mm2, neointimal thickness <100µm, and heterogeneous neointimal hyperplasia (NIH) were more prevalent in early ISR, whereas NIH ...

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    15. EuroIntervention Intravascular ultrasound and optical coherence tomography images for direct right coronary artery injury after tricuspid valve annuloplasty

      EuroIntervention Intravascular ultrasound and optical coherence tomography images for direct right coronary artery injury after tricuspid valve annuloplasty

      A 76-year-old female was admitted with dyspnoea and leg oedema. Echocardiography showed severe mitral and tricuspid valve regurgitation with marked right ventricular (RV) dilatation, and coronary angiography showed intact left and right coronary arteries (RCA) (Online Figure 1) . She was diagnosed with heart failure due to combined valvular disease and underwent tricuspid valve (the Kay bicuspidisation technique without ring) and mitral valve annuloplasty. After the operation, she suffered from myocardial infarction with ST-segment elevation in the inferior leads. Coronary angiography showed a total occlusion (arrow) at the middle portion of the RCA (Panel A, Moving image 1) . After passing a ...

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    16. Is quantitative coronary angiography reliable in assessing the late lumen loss of the everolimus eluting bioresorbable polylactide scaffold in comparison with the cobalt chromium metallic stent?

      Is quantitative coronary angiography reliable in assessing the late lumen loss of the everolimus eluting bioresorbable polylactide scaffold in comparison with the cobalt chromium metallic stent?

      Aims: Immediately after stent/scaffold implantation, quantitative coronary angiography (QCA) with respect to optical coherence tomography (OCT) more severely underestimates the lumen diameter (LD) in Absorb than in XIENCE. This OCT-QCA discrepancy has not been evaluated at long-term follow-up. The present study aimed to assess the accuracy of QCA with reference to OCT in Absorb as compared to XIENCE.

       

       

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    17. Comparing the vascular response in implantation of self-expanding, bare metal nitinol stents or paclitaxel-eluting nitinol stents in superficial femoral artery lesions: a serial optical frequency domain imaging study

      Comparing the vascular response in implantation of self-expanding, bare metal nitinol stents or paclitaxel-eluting nitinol stents in superficial femoral artery lesions: a serial optical frequency domain imaging study

      Aims: This study sought to investigate differences in vascular response between self-expanding bare metal nitinol stents (BMS) and paclitaxel-eluting nitinol stents (PES), in superficial femoral artery (SFA) disease, using optical frequency domain imaging (OFDI). Methods and results: Six months after stent implantation, follow-up quantitative vascular angiography (QVA) and OFDI assessment were scheduled to evaluate vascular response. Volume index (VI) was defined as volume divided by stent length. The primary endpoint was OFDI-derived late lumen area loss, defined as lumen VI post stent implantation minus lumen VI at follow-up. A total of 28 SFA lesions were analysed, with cases randomised to ...

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    18. EuroIntervention Automated characterisation of lipid core plaques in vivo by quantitative optical coherence tomography tissue type imaging

      EuroIntervention Automated characterisation of lipid core plaques in vivo by quantitative optical coherence tomography tissue type imaging

      Aims: Qualitative criteria for plaque tissue characterisation by OCT are well established, but quantitative methods lack systematic validation in vivo . High optical attenuation coefficient µ t has been associated with unstable plaque features, such as lipid core. The purpose of this study was to validate optical coherence tomography (OCT) attenuation imaging for tissue characterisation in vivo , specifically to detect lipid core in coronary atherosclerotic plaques, and to evaluate quantitatively the ability of OCT attenuation imaging to differentiate thin-cap (TCFA) and thick-cap fibroatheroma (FA). Methods and results: We prospectively enrolled 85 patients undergoing imaging of a native coronary segment by both OCT ...

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    19. Variability in the measurement of minimum fibrous cap thickness and reproducibility of fibroatheroma classification by optical coherence tomography using manual versus semi-automatic assessment

      Variability in the measurement of minimum fibrous cap thickness and reproducibility of fibroatheroma classification by optical coherence tomography using manual versus semi-automatic assessment

      Aims: The minimum fibrous cap thickness (FCT) is considered a major criterion of coronary plaque vulnerability according to autopsy studies. We aimed to assess the reproducibility in the measurement of the optical coherence tomography (OCT)-detected minimum FCT and the agreement in the classification of thin-cap fibroatheroma (TCFA), by a software-based semi-automatic method compared with the manual method. Methods and results: A total of 50 frames with fibroatheromas (FA) were randomly selected from the Integrated Biomarker Imaging Study-4 (IBIS-4). Two experienced OCT analysts independently measured the minimum FCT at two different time points, manually and by three different semi-automatic software-based ...

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    20. The OPTIS Integrated System: real-time, co-registration of angiography and optical coherence tomography

      The OPTIS Integrated System: real-time, co-registration of angiography and optical coherence tomography

      The efficacy of an IVUS-guided stent implantation strategy to improve acute results and clinical outcome has been described previously. OCT is another technique which allows high-resolution intracoronary imaging. However, the use of invasive imaging modalities to guide PCI has, as yet, played a limited role in current clinical practice. This may be partly explained by the expertise required for interpretation and clinical decision making. We present a novel technology which enables real-time co-registration of OCT images with angiography. This will simplify matching cross-sectional images to their geographic position on the angiogram, thereby facilitating imaging-guided PCI.

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    21. Two-year clinical, angiographic, and serial optical coherence tomographic follow-up after implantation of an everolimus-eluting bioresorbable scaffold and an everolimus-eluting metallic stent: insights from the randomised ABSORB Japan trial

      Two-year clinical, angiographic, and serial optical coherence tomographic follow-up after implantation of an everolimus-eluting bioresorbable scaffold and an everolimus-eluting metallic stent: insights from the randomised ABSORB Japan trial

      Aims: We sought to investigate two-year clinical and serial optical coherence tomography (OCT) outcomes after implantation of a fully bioresorbable vascular scaffold (BVS) or a cobalt-chromium everolimus-eluting stent (CoCr-EES). Methods and results: In the ABSORB Japan trial, 400 patients were randomised in a 2:1 ratio to BVS (N=266) or CoCr-EES (N=134). A pre-specified OCT subgroup (N=125, OCT-1 group) underwent angiography and OCT post procedure and at two years. Overall, the two-year TLF rates were 7.3% and 3.8% in the BVS and CoCr-EES arms (p=0.18), respectively. Very late scaffold thrombosis (VLST) beyond one ...

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    22. Culprit plaque morphology in STEMI – an optical coherence tomography study: insights from the TOTAL-OCT substudy

      Culprit plaque morphology in STEMI – an optical coherence tomography study: insights from the TOTAL-OCT substudy

      Aims: Our aim was to compare stenosis severity and plaque content between STEMI culprit lesions with intact fibrous cap (IFC) and those with plaque rupture (PR) in a prospective study. Methods and results: We evaluated 93 patients undergoing OCT and thrombectomy as part of a prospective substudy of the TOTAL (ThrOmbecTomy versus PCI ALone) trial. Culprit lesion morphology was assessable by OCT in 70/93 (75.3%). IFC was found in 31 (44.3%), PR in 34 (48.6%) and calcified nodule in five (7.1%) patients. Following thrombectomy, OCT demonstrated similar lumen area stenosis in IFC (79.3%) and ...

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    23. Optical coherence tomography visualisation of burst balloon catheter trapped by coronary stent

      Optical coherence tomography visualisation of burst balloon catheter trapped by coronary stent

      A 69-year-old man with prior anterior myocardial infarction underwent percutaneous coronary intervention for significant stenosis of the left anterior descending (LAD) artery. High-pressure inflation by non-compliant balloon was required because of severe calcification in the culprit lesion. The balloon ruptured during inflation and an angiographic filling defect appeared in the LAD. The balloon catheter was pulled out of the body and the tip and membranous part of the catheter was lost ( Panel A , black arrowhead). Although we attempted to retrieve…

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    24. Evaluation of vascular healing of polymer-free sirolimus-eluting stents in native coronary artery stenosis: a serial follow-up at three and six months with optical coherence tomography imaging

      Evaluation of vascular healing of polymer-free sirolimus-eluting stents in native coronary artery stenosis: a serial follow-up at three and six months with optical coherence tomography imaging

      Aims: Our aim was to assess vascular response after polymer-free sirolimus-eluting stent (SES) implantation by using an optical coherence tomography (OCT)-derived vascular healing score (HS), quantifying the deficiency of healing. Methods and results: In a prospective, multicentre, single-arm, open-label study, OCT examinations were performed at three months in 45 patients (47 lesions). Per protocol, 24 lesions which had not reached adequate vascular healing according to study criteria were scheduled for OCT examination at six months. The HS was calculated at two time points. Serial OCT imaging demonstrated that the proportion of covered stent struts increased from a median of ...

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