A 46-year-old man complained of chest pain at rest for the past three months. His symptoms gradually exacerbated and were suspected of being due to unstable angina. A coronary angiogram revealed focal tight stenosis at the proximal left anterior descending coronary artery with gross spastic coronary findings. Optical coherence tomography (OCT) revealed layered low-intensity structures with microvessels and the accumulation of macrophages, which indicated progressive stenosis with multiple-layered organized thrombus caused by coronary erosion. We treated the stenosis using a drug-coated balloon instead of drug-eluting stents. There was no restenosis, and OCT revealed good plaque healing at follow-up. This case ...

Background: High-resolution intravascular ultrasound (HR-IVUS) is the most recently developed IVUS technology, which allows the detailed assessment of intravascular structures. The aim of this study was to evaluate the diagnostic performance of HR-IVUS in the detection of abnormal post-stent findings. Methods and Results: Patients with acute coronary syndrome underwent both HR-IVUS and optical coherence tomography (OCT) for post-stent evaluations. Quantitative measurements for stented segments and qualitative assessments for abnormal post-stent findings (stent edge dissection, intrastent tissue protrusion, and incomplete stent apposition [ISA]) were performed. Forty-seven patients underwent both HR-IVUS and OCT after stent implantation. HR-IVUS identified a larger minimal lumen ...

Background: The association between unfavorable post-stent optical coherence tomography (OCT) findings and subsequent stent thrombosis (ST) remains unclear. This study investigated the ST-related characteristics of post-stent OCT findings at index percutaneous coronary intervention (PCI).Methods and Results:Fifteen patients with ST onset after OCT-guided PCI (ST group) were retrospectively enrolled. Post-stent OCT findings in the ST group were compared with those in 70 consecutive patients (reference group) without acute coronary syndrome onset for at least 5 years after OCT-guided PCI. The incidence of acute myocardial infarction (AMI) was higher in the ST than reference group (60.0% vs. 17.1 ...

Background: Smoking is an important risk factor of plaque erosion. This study aimed to investigate the predictors of plaque erosion in current and non-current smokers presenting with ST-segment elevation myocardial infarction (STEMI). Methods and Results: A total of 1,320 STEMI patients with culprit plaque rupture or plaque erosion detected by pre-intervention optical coherence tomography were divided into a current smoking group (n=715) and non-current smoking group (n=605). Plaque erosion accounted for 30.8% (220/715) of culprit lesions in the current smokers and 21.2% (128/605) in the non-current smokers. Multivariable analysis showed age <50 years ...

While embryo transfer (ET) is widely practiced, many of the transferred embryos fail to develop in cattle. To establish a more effective method for selecting bovine embryos for ET, here we quantified morphological parameters of living embryos using three-dimensional (3D) images non-invasively captured by optical coherence tomography (OCT). Seven Japanese Black embryos produced by in vitro fertilization that had reached the expanded blastocyst stage after 7 days of culture were transferred after imaged by OCT. Twenty-two parameters, including thickness and volumes of the inner cell mass, trophectoderm, and zona pellucida, and volumes of blastocoel and whole embryo, were quantified from ...

Background: Optical coherence tomography (OCT) provides valuable information to guide percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) regarding lesion preparation, stent sizing, and optimization. The aim of the present study was to compare lumen expansion of stent-treated lesions immediately after the procedure for ACS between OCT-guided PCI and angiography-guided PCI.Methods and Results:This study investigated stent-treated lesions immediately after PCI for ACS by using quantitative coronary angiography in 390 patients; 260 patients with OCT-guided PCI and 130 patients with angiography-guided PCI. Before stenting, the frequency of pre-dilatation and thrombus aspiration were not different between the OCT-guided and ...

Aims: Recent studies suggested plaque erosion with noncritical stenosis could be treated distinctly from that with critical stenosis, but their morphological features remained largely unknown. The present study aimed to investigate morphological features of eroded plaques with different lumen stenosis using optical coherence tomography (OCT). Methods: A total of 348 ST-segment elevated myocardial infarction patients with culprit OCT-defined plaque erosion (OCT-erosion) were analyzed. Based on the severity of lumen area stenosis, all patients with OCT-erosions were divided into the following three groups: Group A (area stenosis ＜50%, n=50); Group B (50% ≤area stenosis ＜75%, n=146); Group C (area ...

The present study aimed to evaluate choroidal changes and alternations within the structure of the retina prior to visible morphologic signs of diabetic retinopathy (DR) in pediatric type 1 diabetes (T1D) cases. Two hundred and six eyes of 103 pediatric patients with T1D without DR and 88 eyes of 44 healthy controls were enrolled. They underwent a comprehensive ophthalmic examination and optical coherence tomography evaluation. Choroidal thickness (ChT) measurements were performed manually on macular and peripapillary regions. There was no significant difference between the two groups in terms of age, intraocular pressure, and axial length (p > 0.05). ChT measurements ...

A 44-year-old man who had undergone paroxysmal atrial fibrillation (AF) ablation 3 times at another hospital underwent endovascular treatment (EVT) for left superior pulmonary vein occlusion (LSPVO) due to hemoptysis following the administration of dabigatran (300 mg/day). At the initial EVT, dilatations using a 6-mm×20-mm balloon restored blood flow in the LSPV ( Figure A ). However, at the 3-month follow-up, enhanced computed tomography (CT) showed the recurrence of LSPVO, so secondary EVT was performed to prevent recurrent hemoptysis. Serial optical coherence tomography (OCT) images after dilatation with a 2-mm balloon ( Figure B–E ) revealed a hyperplastic neointima, mimicking a ...

Both optical coherence tomography (OCT) and coronary angioscopy (CAS) are excellent modalities to observe intracoronary structures. Although most coronary artery structures are identifiable by both modalities, some difficulty to assess structures may be present. We report a case of a 76-year-old male who presented with effort angina. Coronary angiography revealed a severe stenotic lesion in the distal right coronary artery (RCA), and hence, percutaneous coronary intervention (PCI) to the lesion was performed. We additionally performed post-dilatation with a noncompliant balloon after stenting, resulting in the balloon rupturing at only 4 atm. When observing the balloon, a pinhole rupture was confirmed ...

Background: Optical flow ratio (OFR) is a recently developed method for functional assessment of coronary artery disease based on computational fluid dynamics of vascular anatomical data from intravascular optical coherence tomography (OCT). The purpose of this study was to investigate the relationship between OFR and fractional flow reserve (FFR) in stent-treated arteries immediately after percutaneous coronary intervention (PCI). Methods and Results: The OFR and FFR were measured in 103 coronary arteries immediately after successful PCI with a stent. An increase in the OFR and FFR values within the stent was defined as in-stent ∆OFR and ∆FFR, respectively. The values of ...

Background: The relationship between the characteristics of tissue protrusion detected by using optical coherence tomography (OCT) and the findings of coronary angioscopy (CAS) immediately after stent implantation were evaluated. Methods and Results: A total of 186 patients (192 stents) underwent OCT before and after stenting and were observed by using CAS immediately after stenting and at the chronic phase. Patients were assigned to irregular protrusion, smooth protrusion, and disrupted fibrous tissue protrusion groups according to OCT findings. Serum high-sensitivity C-reactive protein (hs-CRP) levels were measured before and after stent implantation. The grade of yellow color (YC) and neointimal coverage (NC ...

Very late stent thrombosis (VLST) is a potentially life-threatening complication in coronary angioplasty patients. The patient was a 95-year-old man who had been implanted with a durable polymer everolimus-eluting stent (DP-EES, 3.5 × 23 mm) at the restenosis site in the proximal part of the left descending artery using only plain balloon angioplasty for acute coronary syndrome (ACS) 27 months earlier. Final intravascular ultrasound (IVUS) evaluation had shown no stent malapposition and adequate stent expansion. However, he presented to our hospital due to vomiting and fatigue 89 months after the implantation. An electrocardiogram showed ST-elevation in V2-6 leads, we therefore ...

Purpose: To investigate fatigue damage over time, monolithic posterior computer-aided-designed/computer-aided-manufactured (CAD/CAM) crowns were artificially aged in a mouth-motion-simulator, and damage was monitored with optical coherence tomography (OCT). Methods: Forty-eight crowns were milled of six different CAD/CAM-materials (n=8), including 3Y-TZP (Lava Plus,‘3Y’), 4Y-PSZ (Pritidentamultidisc,‘4Y’), 5Y-PSZ (Prettauanterior,‘5Y’), zirconia-reinforced lithium silicate (CeltraDuo,‘ZLS’), hybrid ceramic (Vita Enamic,‘VE’),and resin composite (BrilliantCrios,‘COM’), and were adhesively luted on CAD/CAM-milled human molars. Specimens were artificially aged in a mouth-motion-simulator (50-500N, 2Hz, 37°C) for a period of 1 million cycles. Before loading and every 250,000 ...

Summary In-stent restenosis (ISR) still exists after drug-eluting stent (DES) implantation, even up to one year. The incidence and risk factors for neoatherosclerosis in patients with early ISR have not yet been elucidated. Here, we used optical coherence tomography (OCT) to evaluate the incidence and predictors of neoatherosclerosis in patients with early ISRs. OCT was performed on ISR lesions in 185 patients in order to detect neoatherosclerosis. The median follow-up was 180 days, and neoatherosclerosis was detected in 37% of early ISR lesions. According to the presence of neoatherosclerosis, patients with ISR were divided into two groups: neoatherosclerosis (group A ...

Background: The excessive volume of contrast needed is a significant limitation of optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI). Low-molecular-weight dextran (LMWD) has been used for OCT image acquisition instead of contrast media. This study compared the effects of OCT-guided PCI using LMWD on renal function and clinical outcomes to those of intravascular ultrasound (IVUS)-guided PCI. Methods and Results: In all, 1,183 consecutive patients who underwent intracoronary imaging-guided PCI were enrolled in this single-center, retrospective, observational study. After propensity score matching, 133 pairs of patients were assigned to undergo either OCT-guided PCI using LMWD or IVUS-guided ...

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 ...

No abstract provided.

Background: We previously reported that ST-segment elevation myocardial infarction （STEMI） patients with large residual thrombus burden after thrombectomy before stent implantation had more severe microvascular dysfunction, and greater myocardial damage compared with those with small residual thrombus. However, clinical significance of residual thrombus after stent implantation in STEMI patients is unclear. Aims: This study aimed to evaluate the incidence of thrombus by optical coherence tomography （OCT） after stent implantation, and to investigate its clinical impact in STEMI patients. Methods and Results: A total of 180 STEMI patients within 12 hours after onset of symptoms were studied. Patients were divided into ...

Long-term patency of saphenous vein graft (SVG) remains challenging.1 A 75-year-old man on hemodialysis had undergone coronary artery bypass grafting (CABG) 11 years earlier. At the current presentation he underwent percutaneous coronary intervention (PCI) for SVG failure to the diagonal branch (Figure A). Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) showed convex calcifications at the severe proximal anastomotic stenosis (Figure B,C) and tandem stenotic sites (Figure D,E). In addition, coronary angioscopy (CAS) indicated punctate red thrombus on a protruding mass (Figure F). These findings were suggestive of calcified nodules (CN). A 3.5×48-mm stent was ...

Abstract Background: The risks of ventricular fibrillation (Vfib) associated with frequency-domain optical coherence tomography (OCT)/optical frequency domain imaging (OFDI) remain undetermined. Methods and Results: We retrospectively studied the occurrence of Vfib during OCT/OFDI for unselected indications. The frequency of Vfib and patient and procedural characteristics were investigated. A total of 4,467 OCT/OFDI pullback examinations were performed in 1,754 patients (median of 2.0 [2.0–3.0] pullbacks for 1.0 [1.0–1.3] vessels). OCT/OFDI was performed during PCI in 899 patients (51.3%). The contrast injection volume per pullback was 14 ...

Although metallic stents improved the safety and efficacy of percutaneous coronary intervention (PCI), even the latest generation of drug-eluting stents (DES) is still limited by several factors. The limitations of DES are mainly related to the permanent metallic caging in vessel, chronic inflammatory response to the polymer and adverse effects of antiproliferative drug on endothelial tissue, leading to impaired physiological vasomotor response and late stent-related adverse events such as stent thrombosis and neoatherosclerosis. Bioresorbable vascular scaffold (Absorb BVS; Abbott Vascular) was designed to overcome these drawbacks of DES by disappearing from the vessel wall. Absorb BVS, however, was withdrawn from ...

The microscopic tissue structure and organization influence the polarization of light. Intravascular polarimetry leverages this compelling intrinsic contrast mechanism by using polarization-sensitive optical frequency domain imaging to measure the polarization properties of the coronary arterial wall. Tissues rich in collagen and smooth muscle cells appear birefringent, while the presence of lipid causes depolarization, offering quantitative metrics related to the presence of important components of coronary atherosclerosis. Here, we review the basic principles, the interpretation of polarization signatures, and first clinical investigations of intravascular polarimetry and discuss how this extension of contemporary intravascular imaging may advance our knowledge and improve clinical ...

Background: Attenuation-compensated (AC) technique was recently introduced to improve the plaque characterization of optical coherence tomography (OCT). Histological validation demonstrated promising results but the efficacy and reproducibility of this technique for assessing in-vivo tissue composition remains unclear. Methods and Results: OCT images portraying native (n=200) and stented (n=200) segments and 31 histological cross-sections were analyzed. AC-OCT appeared superior to conventional (C)-OCT in detecting the external elastic lamina (EEM) borders (76% vs. 65.5%); AC-OCT enabled larger EEM arc detection compared with C-OCT (174.2±58.7° vs. 137.5±57.9°; P<0.001). There was poor ...