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    1. Optical coherence tomography imaging of everolimus-eluting bioresorbable vascular scaffold implanted into coronary vein graft at 3-month follow-up

      Optical coherence tomography imaging of everolimus-eluting bioresorbable vascular scaffold implanted into coronary vein graft at 3-month follow-up

      A 54-year-old male with stable angina, hypertension, and dyslipidaemia, as well as a history of coronary artery bypass grafting with implantation of two saphenous vein grafts to left anterior descending artery (LAD) (Ao-LAD) and diagonal branch (Ao-D1) 23 years ago. Coronary angiography done because of recurrent angina revealed a chronic total occlusion of the right coronary artery, occlusion of Ao-LAD, and significant stenosis of Ao-D1. Quantitative coronary angiography (QCA) showed...

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    2. Coronary artery disease in systemic sclerosis not clinically apparent: findings from optical coherence tomography

      Coronary artery disease in systemic sclerosis not clinically apparent: findings from optical coherence tomography

      A 42-year-old female was referred for intermittent effort angina. She had low body mass index, no coronary risk factors and an unremarkable past medical history except for a Raynaud's phenomenon. Owing to a normal exercise stress test ( Panel A ), symptoms were initially attributed to anxiety. However, a 24h-EKG monitoring revealed diffuse ST-segment depression during …

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    3. Better Inflation time of stent balloon on stent expansion and apposition: an optical coherence tomography study

      Better Inflation time of stent balloon on stent expansion and apposition: an optical coherence tomography study

      Purpose: Adequate stent expansion and apposition are important for maintaining good clinical outcomes after coronary intervention. We determined the effect of inflation time of the stent balloon on stent expansion and apposition using optical coherence tomography. Methods: Subjects included 17 patients (18 de novo coronary artery lesions), in whom Resolute Integrity® (n=9) and Xience prime® (n=9) were deployed. The stents were inflated three times in all cases at the nominal inflation pressures (8.9±0.6 atm) by the stent delivery balloon with different inflation times of first, 15 seconds and 30 seconds. The first inflation time was ...

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    4. Association between prior aspirin use and optical coherence tomography findings in type II diabetes mellitus patients presenting with first acute coronary events

      Association between prior aspirin use and optical coherence tomography findings in type II diabetes mellitus patients presenting with first acute coronary events

      Aims: Aspirin has been shown to be beneficial in the primary prevention, secondary prevention, and treatment of acute coronary syndromes (ACS). However, it is less clear whether prior aspirin therapy affects lesion morphology in ACS. The aim of the present study is to investigate the association between prior aspirin use and the culprit lesion morphology examined by optical coherence tomography (OCT) in patients with the first ACS event. We further performed subgroup analysis on the basis of the presence or the absence of type 2 diabetes mellitus (DM). Methods and results: We studied 250 patients with the first ACS event ...

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      Mentions: Yoshito Iesaka
    5. Coronary evaginations are associated with positive vessel remodelling and are nearly absent following implantation of newer-generation drug-eluting stents: an optical coherence tomography and intravascular ultrasound study

      Coronary evaginations are associated with positive vessel remodelling and are nearly absent following implantation of newer-generation drug-eluting stents: an optical coherence tomography and intravascular ultrasound study

      Objectives The purpose of this study was to assess the occurrence, predictors, and mechanisms of optical coherence tomography (OCT)-detected coronary evaginations following drug-eluting stent (DES) implantation. Background Angiographic ectasias and aneurysms in stented segments have been associated with a risk of late stent thrombosis. Using OCT, some stented segments show coronary evaginations reminiscent of ectasias. Methods Evaginations were defined as outward bulges in the luminal contour between struts. They were considered major evaginations (MEs) when extending ≥3 mm along the vessel length, with a depth ≥10% of the stent diameter. A total of 228 patients who had sirolimus (SES ...

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    6. 2013 ESC guidelines on the management of stable coronary artery disease

      2013 ESC guidelines on the management of stable coronary artery disease

      Guidelines summarize and evaluate all evidence available, at the time of the writing process, on a particular issue with the aim of assisting physicians in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines are not substitutes but are complements for textbooks, and cover the ESC Core Curriculum topics. Guidelines and recommendations should help physicians to make decisions in their daily practice: however, the final decisions concerning an individual patient must be made by the ...

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    7. The bumpy road to evidence: why many research findings are lost in translation

      The bumpy road to evidence: why many research findings are lost in translation

      We have come a long way When, more than 2500 years ago, Thales of Milet (624–547 BC) claimed that nature was ruled by laws and not by gods, he changed the world. 1 Such a concept allowed for the discovery and mathematical proof of impersonal causation of what, until then, had been a mystery ruled by unpredictable gods. Indeed, ever since then the understanding of nature—today we would call it the natural sciences—has become a major activity of mankind. With this strategy, we have come a long way. Initially, it allowed us to use the position of ...

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    8. Near-infrared spectroscopy for cardiovascular risk assessment? Not ready for prime time

      Near-infrared spectroscopy for cardiovascular risk assessment? Not ready for prime time

      The rupture of an unstable atherosclerotic plaque precedes the majority of acute coronary syndromes, and considerable effort has been devoted to identifying patients at increased risk of future coronary ischaemic events. Atherosclerosis imaging is a potentially attractive strategy to detect vulnerable coronary plaques, with each modality having its own advantages and limitations. Different characteristics of the atherosclerotic plaque can be targeted with imaging, such as the number and severity of luminal narrowings with angiography, atheroma burden and remodelling with intravascular ultrasonography (IVUS), elastic properties with elastography, radiofrequency-determined plaque types with virtual histology, fibrous cap thickness and necrotic core with optical ...

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    9. Renal artery fibromuscular dysplasia: in vivo optical coherence tomography insights

      Renal artery fibromuscular dysplasia: in vivo optical coherence tomography insights

      A 66-year-old woman with long-term essential hypertension presented with poorly controlled blood pressure in spite of six antihypertensive drugs. Percutaneous renal denervation was indicated as a treatment of resistant arterial hypertension. Renal angiography showed ‘strings of beads’ appearance characteristic of fibromuscular dysplasia (FMD) in the mid-segment of the right …

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    10. Pathological insights of a woven coronary artery with optical coherence tomography

      Pathological insights of a woven coronary artery with optical coherence tomography

      A 78-year-old male was admitted to our centre because of III/IV CCS stable angina despite optimal medical treatment. Stress-induced myocardial ischaemia was demonstrated by SPECT in the inferior wall ( Panel A ), and a coronary angiography was performed. Severe coronary stenosis was observed in the first diagonal and in the circumflex. The right coronary artery (RC A )

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    11. View point: what should the future design of clinical imaging studies be?

      View point: what should the future design of clinical imaging studies be?

      Coronary artery disease (CAD) is primarily a structural disease characterized by the build-up of atherosclerotic plaques in the coronary arteries. With progressive impingement on coronary blood flow, a given coronary stenosis will elicit functional consequences that are described by the ‘ischaemic cascade’ and emerge progressively as inducible changes of perfusion, wall motion, and electrocardiogram, and finally manifest as chest pain ( Figure 1 ). Thus, definitions for clinically significant CAD may vary considerably based on whether rather anatomical vs. functional criteria are used ( Table 1 ).

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    12. Geometrically correct three-dimensional optical coherence tomography: first self-expanding bifurcation stent evaluation

      Geometrically correct three-dimensional optical coherence tomography: first self-expanding bifurcation stent evaluation

      A 78-year-old female was referred to the Andreas Gruentzig Catheterization Laboratories suffering from angina pain CCS II. Coronary angiography demonstrated a bifurcation lesion in the middle left anterior descending and the first diagonal branch ( Panel A ). Based on these findings, percutaneous coronary intervention (PCI) was performed with implantation of a

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    13. Coronary atherosclerosis with vulnerable plaque and complicated lesions in transplant recipients: new insight into cardiac allograft vasculopathy by optical coherence tomography

      Coronary atherosclerosis with vulnerable plaque and complicated lesions in transplant recipients: new insight into cardiac allograft vasculopathy by optical coherence tomography

      Aims Cardiac allograft vasculopathy (CAV) is a major limitation to long-term survival following cardiac transplantation. Conventional imaging modalities such as angiography and intravascular ultrasound fail to characterize CAV plaque morphology. Our aim was to characterize CAV in vivo using the high spatial resolution of intracoronary optical coherence tomography (OCT). Methods and results We prospectively enrolled 53 cardiac transplant patients to undergo OCT of the left anterior descending coronary artery (LAD) in addition to annual CAV screening by coronary angiography and intravascular ultrasound (IVUS). The proximal 30 mm of the LAD was divided into three segments of 10 mm each ( n ...

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      Mentions: Yoshiki Matsuo
    14. Vascular lesions induced by renal nerve ablation as assessed by optical coherence tomography: pre- and post-procedural comparison with the Simplicity® catheter system and the EnligHTN™ multi-electrode renal denervation catheter

      Vascular lesions induced by renal nerve ablation as assessed by optical coherence tomography: pre- and post-procedural comparison with the Simplicity® catheter system and the EnligHTN™ multi-electrode renal denervation catheter

      Aims Catheter-based renal nerve ablation (RNA) using radiofrequency energy is a novel treatment for drug-resistant essential hypertension. However, the local endothelial and vascular injury induced by RNA has not been characterized, although this importantly determines the long-term safety of the procedure. Optical coherence tomography (OCT) enables in vivo visualization of morphologic features with a high resolution of 10–15 µm. The objective of this study was to assess the morphological features of the endothelial and vascular injury induced by RNA using OCT. Methods and results In a prospective observational study, 32 renal arteries of patients with treatment-resistant hypertension underwent OCT ...

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    15. Update on acute coronary syndromes: the pathologists' view

      Update on acute coronary syndromes: the pathologists' view

      Although mortality rates from coronary heart disease in the western countries have declined in the last few decades, morbidity caused by this disease is increasing and a substantial number of patients still suffer acute coronary syndrome (ACS) and sudden cardiac death. Acute coronary syndrome occurs as a result of myocardial ischaemia and its manifestations include acute myocardial infarction and unstable angina. Culprit plaque morphology in these patients varies from thrombosis with or without coronary occlusion to sudden narrowing of the lumen from intraplaque haemorrhage. The coronary artery plaque morphologies primarily responsible for thrombosis are plaque rupture, and plaque erosion, with ...

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    16. Severity of coronary atherosclerosis in patients with a first acute coronary event: a diabetes paradox

      Severity of coronary atherosclerosis in patients with a first acute coronary event: a diabetes paradox

      Aims We aimed to compare coronary artery disease (CAD) at the time of a first acute coronary syndrome (ACS) in type II diabetic and non-diabetic patients by coronary angiography and by optical coherence tomography (OCT). Methods and results Two different patient populations with a first ACS were enrolled for the angiographic (167 patients) and the OCT (72 patients) substudy. Angiographic CAD severity was assessed by Bogaty, Gensini, and Sullivan scores, whereas collateral development towards the culprit vessel was assessed by the Rentrop score. Optical coherence tomography plaque features were evaluated at the site of the minimum lumen area (MLA) and ...

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      Mentions: Francesco Prati
    17. Optical coherence tomography to reveal strut malapposition due to thrombus resolution 3 weeks after acute coronary syndrome

      Optical coherence tomography to reveal strut malapposition due to thrombus resolution 3 weeks after acute coronary syndrome

      A 37-year-old male was admitted with a non-ST-elevation myocardial infarction. Coronary angiography and optical coherence tomography (OCT) revealed a 70% stenosis of the ostial left artery descending (LAD) with little thrombotic material but without obvious signs for rupture/dissection ( Panels A and B , Supplementary material online, Video S1 ). After direct stenting with a biolimus-eluting stent (BES, 3.5 × 18 mm, 10 atmospheres), OCT revealed suboptimal strut apposition with

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    18. Randomized study to assess the effect of thrombus aspiration on flow area in patients with ST-elevation myocardial infarction: an optical frequency domain imaging study—TROFI trial

      Randomized study to assess the effect of thrombus aspiration on flow area in patients with ST-elevation myocardial infarction: an optical frequency domain imaging study—TROFI trial

      Aims Primary percutaneous coronary intervention (PPCI) with thrombectomy (TB) seems to reduce the thrombus burden, resulting in a larger flow area as measured with optical frequency domain imaging (OFDI). Methods and results In a multi-centre study, 141 patients with ST elevation myocardial infarction <12 h from onset were randomized to either PPCI with TB using an Eliminate catheter (TB: n = 71) or without TB (non-TB: n = 70), having operators blinded for the OFDI results. The primary endpoint was minimum flow area (MinFA) post-procedure assessed by OFDI, defined as: [stent area + incomplete stent apposition (ISA) area] − (intraluminal defect + tissue prolapse area ...

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    19. The diabetes conundrum: despite increasing incidences of coronary disease in diabetic type II patients, their first cathlab presentation is later than expected. Observations from an angiographic and optical coherence tomography study

      The diabetes conundrum: despite increasing incidences of coronary disease in diabetic type II patients, their first cathlab presentation is later than expected.  Observations from an angiographic and optical coherence tomography study

      Niccoli et al . assessed the severity of coronary artery disease (CAD) in the culprit vessels of diabetic type II as well as non-diabetic patients ( n = 167) at the time of their first coronary event employing standard coronary angiography and intracoronary optical coherence tomography (OCT) imaging ( n = 72). 1 To assess the severity of CAD, they applied the Bogarty, Gensini, and Sullivan scores, and to evaluate the development of collaterals they used the Rentrop score, all based on coronary angiography. Intracoronary imaging by OCT was performed to study coronary plaque morphology, more particularly to quantify the amount of lipids and calcification ...

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    20. Optical coherence tomography findings in renal denervation

      Optical coherence tomography findings in renal denervation

      Percutaneous catheter-based renal denervation is an emerging technique to treat severe and ‘resistant’ arterial hypertension. We report the case of a 56-year-old woman who was considered as ‘resistant’ hypertensive despite being treated with four antihypertensive drugs (including one diuretic) and was referred for percutaneous catheter-based renal denervation to our institution. The procedure was performed in accordance with the manufacturer'

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    21. Thrombotic arch in ST-segment elevation myocardial infarction: comparison between two-dimensional and three-dimensional optical frequency domain imaging

      Thrombotic arch in ST-segment elevation myocardial infarction: comparison between two-dimensional and three-dimensional optical frequency domain imaging
      A 54-year-old female presented with inferoposterior ST-segment elevation myocardial infarction. Coronary angiogram revealed total occlusion of the proximal left circumflex artery. Following a thrombus aspiration, without administration of glycoprotein IIb/IIIa inhibitor, direct stenting with a drug-eluting metallic stent was performed. After stent implantation, angiogram showed thrombolysis in myocardial infarction (TIMI) grade III flow, without any evidence of intraluminal defect
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    22. Allograft vasculopathy vs. coronary artery disease: comparison by optical coherence tomography

      Allograft vasculopathy vs. coronary artery disease: comparison by optical coherence tomography

      Optical coherence tomography (OCT) is a novel high-resolution intravascular imaging technique allowing characterization of coronary artery plaques and evaluation of stent strut coverage. As a new application, OCT can be also used in allograft vasculopathy as demonstrated by the following images. Comparison of OCT and coronary angiography...

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    1-24 of 54 1 2 3 »
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