1. Articles from radcliffecardiology.com

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    1. Optical Coherence Tomography For the Detection of the Vulnerable Plaque

      Optical Coherence Tomography For the Detection of the Vulnerable Plaque

      Morphological characteristics of the atheromatous plaque have been associated with the development of plaque rupture and the pathogenesis of acute coronary syndromes (ACS). Plaques with a specific morphological phenotype that are at high risk of causing ACS are called vulnerable plaques, and can be identified in vivo through the use of intracoronary imaging. Optical coherence tomography (OCT) is a high-resolution intravascular imaging modality that enables detailed visualization of atheromatous plaques. Consequently, OCT is a valuable research tool for examining the role of morphological characteristics of atheromatous plaques in the progression of coronary artery disease and plaque destabilisation, which leads to ...

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    2. Optical Coherence Tomography For the Detection of the Vulnerable Plaque

      Optical Coherence Tomography For the Detection of the Vulnerable Plaque

      Morphological characteristics of the atheromatous plaque have been associated with the development of plaque rupture and the pathogenesis of acute coronary syndromes (ACS). Plaques with a specific morphological phenotype that are at high risk of causing ACS are called vulnerable plaques, and can be identified in vivo through the use of intracoronary imaging. Optical coherence tomography (OCT) is a high-resolution intravascular imaging modality that enables detailed visualization of atheromatous plaques. Consequently, OCT is a valuable research tool for examining the role of morphological characteristics of atheromatous plaques in the progression of coronary artery disease and plaque destabilisation, which leads to ...

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    3. Choice of Intracoronary Imaging: When to Use Intravascular Ultrasound or Optical Coherence Tomography

      Choice of Intracoronary Imaging: When to Use Intravascular Ultrasound or Optical Coherence Tomography

      Intracoronary imaging has the capability of accurately measuring vessel and stenosis dimensions, assessing vessel integrity, characterising lesion morphology and guiding optimal percutaneous coronary intervention (PCI). Coronary angiography used to detect and assess coronary stenosis severity has limitations. The 2D nature of fluoroscopic imaging provides lumen profile only and the assessment of coronary stenosis by visual estimation is subjective and prone to error. Performing PCI based on coronary angiography alone is inadequate for determining key metrics of the vessel such as dimension, extent of disease, and plaque distribution and composition. The advent of intracoronary imaging has offset the limitations of angiography ...

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    4. Utility of Optical Coherence Tomography Imaging with Angiographic Co-registration for the Guidance of Percutaneous Coronary Intervention

      Utility of Optical Coherence Tomography Imaging with Angiographic Co-registration for the Guidance of Percutaneous Coronary Intervention

      Intracoronary optical coherence tomography (OCT) is a light-based imaging modality able to visualise with high resolution (~10 μm) the vascular morphology and the acute and chronic effects of intervention with intracoronary devices. 1,2 OCT could therefore find application in the guidance of percutaneous coronary intervention (PCI), allowing a thorough preprocedural lesion assessment, which enables accurate device sizing, selection of the vessel segment requiring treatment, and, thus, efficient planning of the implantation strategy (see Table 1 ). 3 Moreover, it can be used for the assessment of the acute procedural result, allowing the estimation of stent expansion and vessel injury. Consequently ...

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    5. Application and Practical Use of Optical Coherence Tomography to Guide Percutaneous Coronary Intervention in Clinical Practice

      Application and Practical Use of Optical Coherence Tomography to Guide Percutaneous Coronary Intervention in Clinical Practice

      Background While many hundreds of studies have been published utilising coronary artery optical coherence tomography (OCT), very few have focused on the application of OCT in daily clinical practice. The following case studies are intended to help guide physicians on specific clinical situations in which OCT can help optimise physician treatment strategies. The cardiac cath lab at Mount Sinai Hospital, New York, New York, is a leader in sharing best practices for improving outcomes in complex coronary cases. Mount Sinai has established guidelines to help drive best practices among interventional cardiologists and fellows in the cath lab. OCT has been ...

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      Mentions: St. Jude Medical
    6. Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

      Intravascular Ultrasound Versus Optical Coherence Tomography for Coronary Artery Imaging – Apples and Oranges?

      Intravascular imaging has advanced our understanding of coronary artery disease and facilitated decision-making in percutaneous coronary intervention (PCI). In particular, intravascular ultrasound (IVUS) has contributed significantly to modern PCI techniques. The recent introduction of optical coherence tomography (OCT) has further expanded this field due to its higher resolution and rapid image acquisition as compared with IVUS. Furthermore, OCT allows detailed planning of interventional strategies and optimisation before stent deployment, particularly with complex lesions. However, to date it is unclear whether OCT is superior to IVUS as an intracoronary imaging modality with limited data supporting OCT use in routine clinical practice ...

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      Mentions: Daniel A. Jones
    7. Left Main Coronary Artery Lesions and Optical Coherence Tomography

      Left Main Coronary Artery Lesions and Optical Coherence Tomography

      Optimal treatment of left main coronary artery (LMCA) lesions requires a highly tailored approach that incorporates patient comorbidities, clinical presentation, the extent of coronary artery disease (CAD), lesion characteristics and local expertise. 1,2 Coronary artery bypass grafting (CABG) is the treatment for LMCA lesions that has the highest evidence level in guideline recommendations. 2,3 However, the evidence for percutaneous coronary intervention (PCI) has increased in recent years and is now class IIa for ostial and trunk LMCA lesions and IIb for distal LMCA bifurcation treatment in stable patients suited for PCI. 2,3 However, these lesion-specific recommendations cannot ...

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      Mentions: St. Jude Medical
    8. Fractional Flow Reserve and Optical Coherence Tomography

      Fractional Flow Reserve and Optical Coherence Tomography

      Angiography has long been considered the gold standard in guiding coronary interventional therapies. However, well-documented limitations of angiography necessitate the use of more advanced imaging and functional hemodynamic evaluation to arrive at optimal decisions regarding revascularization.1 Contemporary guideline-driven practice dictates revascularization only for ischemia-causing lesions and medical therapy for other lesions.2,3 For this reason, accurate assessment of the functional significance of a lesion (ischemic vs. nonischemic) using noninvasive or invasive techniques is very important.

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    9. Clinical Utilisation of Optical Coherence Tomography in Acute Coronary Syndromes

      Clinical Utilisation of Optical Coherence Tomography in Acute Coronary Syndromes

      In recent years, the development and widespread clinical utilisation of optical coherence tomography (OCT) has redefined the standard of intracoronary imaging. OCT is a unique, high-resolution, light-based imaging modality for application in the coronary circulation. OCT offers visualisation of coronary arteries at a resolution up to 10 times higher than that of intravascular ultrasound. 1 As a result, OCT is useful for assessing atherosclerotic plaque, stent apposition, stent thrombosis and stent bifurcations. The high resolution of OCT enables visualisation of various atherosclerotic plaque rupture (see Figure 1 ), including thin-cap fibroatheroma (TCFA), fibrous cap thickness and thrombus formation (see Figure 2 ).

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    10. Bifurcated Lesions and Optical Coherence Tomography

      Bifurcated Lesions and Optical Coherence Tomography

      Coronary artery bifurcation lesions constitute a complex subgroup that are encountered in 15–20 % of all percutaneous coronary interventions (PCI). 1–5 Compared with simple lesions, bifurcations have been associated with lower procedural success rates, higher adverse event rates, longer procedures, and worse angiographic and clinical outcomes. 1,3,5–12 The less favourable outcomes associated with bifurcation treatment compared with non-bifurcation lesions may in part result from the inability of current devices and techniques to adequately scaffold and preserve the side branch (SB) ostium, which is a common location of restenosis. 1,3,5–13

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    1-10 of 10
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