The aim of the present study was to investigate the effects of glucose fluctuation on neointimal proliferation after stent implantation by optical coherence tomography (OCT) in a diabetic/hypercholesterolemic (DM/HC) swine model. A total of 24 everolimus-eluting stents (EES) were implanted in the right coronary artery (RCA) of the animals using a 20% overstretch ratio. The 24 swines were divided into a DM-high glucose fluctuation (HGF) group (n = 8), DMlow glucose fluctuation (LGF) group (n = 8), and a control group (n = 8). Percent diameter stenosis (%DS), late loss (LL), percent area stenosis (%AS), and neointimal thickness (NIT) were analyzed ...

Intravascular images of coronary stenosis by antiphospholipid syndrome (APS) would be beneficial to understand the mechanism of this disease. A 59-year-old woman with APS/systemic lupus erythematosis (SLE) underwent emergent coronary angiography which revealed stenosis with micro channels in the proximal left anterior descending artery. According to optical coherence tomography (OCT), the central lumen was surrounded by a thick septum with a homogenous and high intensity. Multiple small channels existed near the vessel wall with diffuse intimal hyperplasia. White thrombi were floating distal to the stenosis. Intravascular images obtained by optical coherence tomography (OCT) revealed the microstructure of complex coronary ...

Objective: Optical coherence tomography (OCT) has recently been applied for the characterization of carotid plaques, but few studies have compared OCT findings with findings from histopathologic examination of carotid plaques. We consider the accuracy, problems, and limitation of OCT findings by comparing OCT findings of carotid artery stenosis and pathological specimen of removed carotid plaque, and confirm that the interpretation of coronary artery findings of OCT can be applied to OCT findings of carotid artery plaque. Case Presentation: A 63-year-old man with asymptomatic left carotid stenosis underwent carotid endarterectomy (CEA). Findings for histopathologic assessment of excised plaque were compared with ...

The drug-coated balloon (DCB) is a device that is used to reduce the risk of stent re-implantation in patients with in-stent restenosis (ISR). However, imaging findings of the drug covering the neointimal plaque immediately after treatment of ISR by DCB, and during follow-up, have only been discussed in a few reports. Herein, we describe the use of optical coherence tomography (OCT) and angioscopy to evaluate ISR before and after treatment with DCB, and during the follow-up period in 3 patients. The patients developed critical ISR during the follow-up period after drug-eluting stent (DES) implantation. The patients included a 70-year-old woman ...

There has been increasing attention on neoatherosclerosis in coronary arteries following implantation of bare-metal and drug-eluting stents.1,2 Neoatherosclerosis might be a concern even in the field of peripheral artery disease (PAD). A 75-year-old man with hypertension, diabetes mellitus, dyslipidemia and a history of right iliac artery stenting with a Wallstent 12 years previously, was referred to hospital for treatment of recurrent/progressive intermittent claudication (Rutherford category 3) that had started 6 months earlier. Ankle brachial index (ABI) was 0.51 on the right. Diagnostic angiography showed significant in-stent restenosis in the right iliac artery stent (Figure A). Intravascular ...

Background and aims: The sweat glands and peripheral vessels beneath the skin surface act as minute organs governed by the skin sympathetic nerves and have important physiological functions for body temperature control and nutrition support along with maintenance of a peripheral organization. Dynamics of the mental sweating of sweat glands and the peripheral vessels reflect the activity of a sympathetic nerve. The purpose of this paper is to study the dynamic observation and analysis of sweat glands and a peripheral vessels by optical coherence tomography (OCT). Materials and Methods: In the dynamic analysis of mental sweating of sweat glands, after ...

Decision making on lesion preparation and stent/scaffold optimization are cornerstones of patient outcome. Intravascular imaging recently emerged as a critical modality to achieve better results of stent/scaffold implantation and superior clinical outcomes compared with coronary angiography alone. Optical coherence tomography (OCT), a light-based intravascular imaging modality with high frame rate in acquisition and very high speed pullback, can interrogate the target vessel in a couple of seconds, and immediately display a pristine longitudinal lumen contour with automatic detection of lesion severity, site and lumen/stent areas. Further, OCT provides pivotal information on sites of calcium, with accurate measurements ...

Background: The OCTOPUS registry prospectively evaluates the procedural and long-term outcomes of saphenous vein graft (SVG) PCI. The current study assessed the morphology of de novo lesions and in-stent restenosis (ISR) in patients undergoing PCI of SVG. Methods and Results: Optical coherence tomography (OCT) of SVG lesions in consecutive patients presenting with stable CAD and ACS was carried out. Thirty-nine patients (32 de novo and 10 ISR lesions) were included in the registry. ISR occurred in 5 BMS and 5 DES. There were no differences in the presence of plaque rupture and thrombus between de novo lesions and ISR. Lipid-rich ...

Swept source optical coherence tomography (SS-OCT) is an interferometric imaging technique. This study aimed to assess SS-OCT as a diagnostic tool for the evaluation of occlusal fissure depth and sealant penetration into fissure. Seventy investigation sites of occlusal fissures without visible evidence of caries were categorized into four groups (smooth, shallow, intermediate, and deep fissures). Categorization utilized two methods: 1) visually, using a computer screen, and 2) using SS-OCT images. After sealant placement, penetration was observed in SS-OCT. The results obtained from SS-OCT and visual inspections were compared with those of confocal laser scanning microscope (CLSM). The diagnostic power of ...

Background: Target lesion calcification is known to influence percutaneous coronary intervention. We evaluated the effects of rotational atherectomy (RA) and subsequent balloon angioplasty on calcified coronary lesions using optical coherence tomography (OCT). Methods and Results: Thirty-seven calcified lesions in 36 patients were treated with RA followed by balloon angioplasty and stent implantation. In all patients, serial OCT images obtained after RA, after balloon angioplasty, and after stent implantation were analyzed at 1-mm intervals. The arc and thickness of the calcium component were measured after RA. The formation of calcium cracks was assessed after balloon angioplasty. A total of 625 segments ...

Endolymphatic hydrops is a disorder in which an excessive amount of endolymph fluid causes an increase in the pressure of the endolymphatic system of the inner ear. In cochlea, endolymphatic hydrops can cause stretching in the scala media , a tubular construction that, along with two other similar structures, the scala vestibuli and scala tympani , runs through the cochlea from the base to the top. Visualizing the enlargement of the scala media has traditionally been done by histological study of tissue sections, and the degree can be calculated by comparing the ratio of the area of the scala media to the ...

Background: The edge vascular response (EVR) has been linked to important prognostic implications in patients treated with permanent metallic stents. We aimed to investigate the relationship of EVR with the geometric changes in the everolimus-eluting bioresorbable scaffold using serial optical coherence tomography (OCT) analysis. Methods and Results: In the first-in-man ABSORB trial, 28 patients (29 lesions) underwent serial OCT at 4 different time points (Cohort B1: post-procedure, 6, 24, and 60 months [n=13]; Cohort B2: post-procedure, 12, 36, and 60 months [n=15]) following implantation of the scaffold. In Cohort B1, there was no significant luminal change at the ...

Background: The role of culprit plaque and related atherothrombotic components on incomplete stent apposition (ISA) occurrence after primary percutaneous coronary intervention (p-PCI) is unknown. Methods and Results: ST-segment elevation myocardial infarction (STEMI) patients undergoing p-PCI with an everolimus-eluting stent were prospectively investigated with optical coherence tomography (OCT) of the infarct-related artery before, after stenting and at 9 months. OCT data, aspirated thrombus and serum inflammatory biomarkers were analyzed. 114 patients with 114 lesions were evaluated. Acute ISA occurred in 82 lesions (71.9%), preferentially in larger vessels with a median area of 0.2 mm 2 . The presence of thrombus ...

The role of pentraxin 3 (PTX3) has been implicated in the process of plaque vulnerability. However, few studies have addressed the direct relationship between plaque morphology and plasma PTX3. We evaluated the relationship between coronary vulnerable plaque, assessed by optical coherence tomography (OCT), and plasma PTX3 in patients with coronary artery disease (CAD). OCT was used to determine plaque vulnerability in 51 patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS; n = 17) and stable angina (SA; n = 34). Both highly-sensitive C-reactive protein and systemic plasma PTX3 were measured. Based on the OCT findings, patients were divided into 3 groups ...

A 46-year-old woman on hemodialysis due to end-stage renal disease was admitted for repeated thrombus formation in previously implanted drug-eluting stents in the right coronary artery. We could successfully aspirate this thrombus, and histopathology revealed a calcified thrombus comprising multiple microcalcifications and fibrinous materials. This is the first report showing how a calcified thrombus is visualized in vivo by intracoronary imaging modalities including intravascular ultrasound, optical coherence tomography, and angioscopy.

Background: Glycemic variability (GV) is associated with coronary plaque rupture at the culprit lesion in acute myocardial infarction (AMI). The present study determined the relationship between GV and coronary plaque vulnerability in the non-culprit vessel. Methods and Results: The present prospective study involved 46 patients with first-episode acute coronary syndrome (ACS) who underwent optical coherence tomography in the non-culprit vessel. The relationship between GV, assessed with continuous glucose monitoring system, and the presence of thin-cap fibroatheroma (TCFA) at the non-culprit plaque with mild-to-moderate stenosis in the non-culprit vessel, was assessed. GV was quantified using mean amplitude of glycemic excursion (MAGE ...

Background: The ability of iMap-intravascular ultrasound (IVUS) tissue characterization to detect thin-cap fibroatheroma (TCFA) identified on optical coherence tomography (OCT) has not yet been fully elucidated. Methods and Results: We evaluated 86 coronary lesions from 73 patients with stable angina pectoris using iMap-IVUS and OCT. We defined OCT-derived TCFA (OCT-TCFA) as lipid-rich plaque with a <65-μm-thick fibrous cap. The external elastic membrane (EEM) cross-sectional area (CSA), lumen CSA, plaque plus media (P+M) CSA, plaque burden and remodeling index were measured on gray-scale IVUS. Plaque components categorized on iMap-IVUS as fibrotic, lipidic, necrotic or calcified are presented as absolute ...

Percutaneous coronary intervention (PCI) is an established treatment strategy for acute coronary syndrome. However, periprocedural myocardial infarction (PMI), which occurs in 5–50% of PCI procedures, has prognostic implications for long-term clinical outcomes. Coronary imaging modalities such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are expected to predict PMI. IVUS is widely used to safely and reliably guide PCI. Several studies suggest that IVUS-derived coronary plaque characteristics, such as a large plaque burden (positive remodeling), echo-attenuated plaque (EA), or plaque with necrotic core, are associated with the risk of PMI.1,2 However, IVUS has an axial resolution ...

This study aimed to assess swept source optical coherence tomography (SS-OCT) for in vitro and in vivo detection of enamel white spot lesion (WSL). WSLs without surface breakdown on 33 extracted human posterior teeth were non-invasively scanned using SSOCT. The teeth were then cross-sectioned and imaged under confocal laser scanning microscope (CLSM) and light microscopy (LM). SS-OCT cross-sectional images were compared with CLSM and LM. WSL shapes in SS-OCT images closely corresponded to those of LM. There were significant correlations ( p <0.001) in WSLs depth between SS-OCT and LM (r=0.92), SS-OCT and CLSM (r=0.80) and ...

Background: We performed an ex vivo study to investigate optical coherence tomography (OCT) imaging for differentiating several types of neointimal tissue during the later phases after bare-metal stent (BMS) implantation as compared with histologic results. Methods and Results: OCT imaging was performed in 6 autopsy hearts for 10 BMS with implant duration >4 years. OCT qualitative neointimal tissue characterization was based on tissue structure and classified as homogeneous pattern, heterogeneous pattern with visible struts, or heterogeneous pattern with invisible struts. Corresponding histological analyses of each 2-mm cross-section of the entire BMS were performed. Of 81 cross-sections, histological analysis revealed that ...

The early phase arterial reaction after implantation of second-generation drug-eluting stents (2nd DES) and baremetal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. The MECHANISM pilot study is a multi-center prospective registry that enrolled 24 STEMI patients (from 11 centers) who had undergone implantation of everolimus-eluting ( n = 6), biolimus A9-eluting ( n = 6) or zotarolimus-eluting stents ( n = 6), or BMS ( n = 6). Scheduled optical coherence tomography (OCT) was performed 2 weeks after implantation, and images were independently analyzed at a core laboratory in a blinded fashion. Intra-stent thrombus was quantitatively analyzed in terms of the maximal area ...

Background: Periprocedural myocardial injury (PMI) is not an uncommon complication and is related to adverse cardiac events after percutaneous coronary intervention (PCI). We investigated the predictors of PMI in patients with stable angina pectoris (SAP) on intravascular imaging. Methods and Results: We enrolled 193 SAP patients who underwent pre-PCI intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Clinical characteristics, lesion morphology, and long-term follow-up data were compared between patients with and without PMI, defined as post-PCI elevation of high-sensitivity cardiac troponin-T. PMI were observed in 79 patients (40.9%). Estimated glomerular filtration rate (odds ratio [OR], 0.973; 95% confidence ...

The purpose of the present study was to develop an alternative transdermal formulation containing sumatriptan succinate (SS) for the treatment of migraine. Novel self-dissolving SS-loaded microneedle arrays (MNs) were fabricated from sodium hyaluronate and their efficacy for transdermal delivery of SS was characterized. The resulting MNs maintained their skin piercing abilities for at least 30 min after being placed at a high relative humidity of 75%. Rapid release of SS from the MNs was also observed in vitro . Optical coherence tomography images demonstrated that MNs were able to successfully pierce into rat skin without any bending or cracking, and needles ...

Background:This study evaluated the ability of a newly developed integrated backscatter intravascular ultrasound (IB-IVUS) system (VISIWAVE, Terumo, Tokyo, Japan) to detect optical coherence tomography (OCT)-verified thin cap fibroatheroma (TCFA) and assessed the correlation with peri-procedural myocardial infarction (PMI) after percutaneous coronary intervention (PCI).Methods and Results:One hundred culprit lesions in 100 consecutive patients with ischemic heart disease who consented to repeated IVUS and OCT prior to PCI were studied. Of 100 lesions, 48 had OCT-verified TCFA with a cap thickness <65 µm. Such lesions had larger percentage lipid area and lipid angle >2 quadrants on IB-IVUS. A ...