1. 1-20 of 20
    1. The Curious Incident of Spotty Calcium (in Unstable Atherosclerotic Plaque)

      The Curious Incident of Spotty Calcium (in Unstable Atherosclerotic Plaque)

      Intravascular imaging studies – initially using intravascular ultrasound (IVUS) and more recently using optical coherence tomography (OCT) – as well an non-invasive imaging using multidetector computed tomography (CT) have reported spotty calcification – small calcium deposits within an atherosclerotic plaque – to be a distinct morphologic finding of both plaque instability in patients with acute coronary syndrome (ACS) and future atheroma progression even in patients with stable coronary artery disease.

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    2. Relation Between Superficial Calcifications and Plaque Rupture: An Optical Coherence Tomography Study

      Relation Between Superficial Calcifications and Plaque Rupture: An Optical Coherence Tomography Study

      Background There are several forms of calcium deposition, which play different roles in the stability of the coronary artery. It remains unknown whether certain calcification morphological characteristics determine rupture of lipid-rich lesions in the same plaque in acute coronary syndrome (ACS). Methods We retrospectively analyzed 550 patients with ACS between May 2008 and October 2014, who had undergone pre-intervention optical coherence tomography (OCT) imaging examination. A total of 78 patients with 78 culprit lipid-rich lesions having superficial calcifications on OCT images were included in this study, among which 45 were ruptured lesions with calcium (RC) and 33 were non-ruptured lipid-rich ...

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    3. Late self-apposition with one-year persisting uncoverage of malapposed bioresorbable polymeric struts

      Late self-apposition with one-year persisting uncoverage of malapposed bioresorbable polymeric struts

      This case reports the fate of a post-procedural incomplete struts apposition (ISA) of an Absorb bioresorbable scaffold. The 12-month optical coherence tomography showed the complete ISA resolution, apparently mediated by the passive reclining of struts from the lumen to the vessel wall. The lastly apposed struts appeared still uncovered, persisting a potential procedure-related mechanism of very late scaffold thrombosis.

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    4. Impact Of Optical Coherence Tomography On Management Of Pediatric Heart Transplant Recipients: Data From The International Pediatric OCT Registry

      Impact Of Optical Coherence Tomography On Management Of Pediatric Heart Transplant Recipients: Data From The International Pediatric OCT Registry

      Cardiac allograft vasculopathy (CAV) is a leading risk factor for graft failure and mortality in pediatric cardiac transplant recipients. Optical coherence tomography (OCT) is a high-resolution intravascular imaging technique that has shown promise at detecting early signs of CAV which are not yet detectable by conventional angiography. We established an International Pediatric OCT Registry to: 1) evaluate the impact of OCT on clinical care; and 2) document the safety profile of this technique across pediatric centres.

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    5. Quantitative Assessment Of Intimal Thickening Using Optical Coherence Tomography - Relationship To Cardiac Allograft Vasculopathy

      Quantitative Assessment Of Intimal Thickening Using Optical Coherence Tomography - Relationship To Cardiac Allograft Vasculopathy

      Cardiac allograft vasculopathy (CAV) is a cause of graft failure and mortality in pediatric heart transplant recipients. Optical coherence tomography (OCT) is an ultra high-resolution intravascular imaging technique that can detect angiographically silent coronary changes. We sought to characterize OCT-derived parameters indicative of evolving CAV in pediatric heart transplant patients.

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    6. Very Late Stent Thrombosis: The Value of Optical Coherence Tomography in Defining Etiology and Guiding Treatment

      Very Late Stent Thrombosis: The Value of Optical Coherence Tomography in Defining Etiology and Guiding Treatment

      A 60-year-old man had a history of percutaneous coronary intervention (PCI) with a single 2.75 × 32 mm drug-eluting stent (TAXUS Liberté; Boston Scientific, Marlborough, MA) to the proximal right coronary artery (RCA) after non–ST-elevation myocardial infarction in 2008. After 1 year of dual-antiplatelet therapy he was prescribed aspirin alone. In December 2013, he experienced chest pain after intense exercise. The electrocardiographic diagnosis was inferior ST-elevation myocardial infarction (STEMI).

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    7. Differences in Vessel Healing Between Sirolimus- and Everolimus-Eluting Stent Implantation for Bifurcation Lesions: The J-REVERSE Optical Coherence Tomography Substudy

      Differences in Vessel Healing Between Sirolimus- and Everolimus-Eluting Stent Implantation for Bifurcation Lesions: The J-REVERSE Optical Coherence Tomography Substudy

      Background We aimed to clarify the differences in vessel healing after stenting of bifurcation lesions using sirolimus-eluting stents (SESs) or everolimus-eluting stents (EESs). Methods J apanese R egistry Study in Comparison Between Ever olimus-Eluting Stent and S irolimus- E luting Stent for the Bifurcation Lesion (J-REVERSE) is a prospective multicentre registry of 303 bifurcation lesions that were treated with provisional SES or EES with or without final kissing inflation. The first 115 lesions at selected study sites were predefined for inclusion in the optical coherence tomography (OCT) substudy, and 9-month follow-up OCT was conducted in 64 lesions (SES, n = 18 ...

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    8. Regressed Coronary Aneurysm After Kawasaki Disease: An Optical Coherence Tomography (OCT) Study From A Single Institution

      Regressed Coronary Aneurysm After Kawasaki Disease: An Optical Coherence Tomography (OCT) Study From A Single Institution

      Coronary artery aneurysms (CAA) are a serious complication of Kawasaki disease (KD). CAA size regresses in nearly 50% of the cases on follow up. Nevertheless, patients with regressed CAA have an increased risk of ischemic heart disease, myocardial infarction and sudden cardiac death on long-term follow-up. Actual imaging techniques often describe these segments as normal, whereas studies have shown significant endothelial and smooth muscle dysfunction. Optical Coherence Tomography (OCT) is a high-resolution intracoronary imaging modality that characterizes coronary artery wall structure. n.

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    9. In-Stent Restenosis Caused by a Calcified Nodule: A Novel Pattern of Neoatherosclerosis

      In-Stent Restenosis Caused by a Calcified Nodule: A Novel Pattern of Neoatherosclerosis

      Neoatherosclerosis has been described as a cause of in-stent restenosis particularly in patients treated with drug-eluting stents. Although neoatherosclerosis may present as calcified plaques the occurrence of a “calcified nodule” within the stent has not been previously reported. We describe optical coherence tomography findings in patient presenting with a calcified nodule causing “undilatable” in-stent restenosis 2 years after implantation of a drug-eluting stent. The clinical and technical implications of this novel pattern of neoatherosclerosis are discussed.

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      Mentions: Fernando Alfonso
    10. Role of Optical Coherence Tomography in the assessment of Stent Deformation

      Role of Optical Coherence Tomography in the assessment of Stent Deformation

      Longitudinal stent deformation (LSD) is a recognized complication of stenting procedure, characterized by stent distortion, affecting its length. LSD requires prompt recognition and treatment to avoid potential risk of stent thrombosis. Here we present a case of LSD, confirmed by optical coherence tomography. This case highlights importance of intravascular imaging in recognition of this complication.

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    11. Differences in Vessel Healing between Sirolimus- and Everolimus-eluting Stent Implantation for Bifurcation Lesions: The J-REVERSE OCT Sub-study

      Differences in Vessel Healing between Sirolimus- and Everolimus-eluting Stent Implantation for Bifurcation Lesions: The J-REVERSE OCT Sub-study

      Background We aimed to clarify the differences in vessel healing after stenting for bifurcation lesions using sirolimus-eluting stent (SES) or everolimus-eluting stent (EES). Methods J-REVERSE is a prospective multicenter registry of 303 bifurcation lesions that were treated with provisional SES or EES with or without final kissing inflation. The first 115 lesions at selected study sites were predefined for inclusion in the optical coherence tomography (OCT) sub-study and 9-month follow-up OCT was conducted in 64 lesions (SES: n = 18, EES: n = 46). In addition to standard OCT parameters, stent eccentricity index (SEI; minimum divided by the maximum stent diameter), neointimal ...

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    12. Three-dimensional optical coherence tomographic analysis of eccentric morphology of the jailed side-branch ostium in coronary bifurcation lesions

      Three-dimensional optical coherence tomographic analysis of eccentric morphology of the jailed side-branch ostium in coronary bifurcation lesions

      Background The severity of angiographic diameter stenosis of the jailed side-branch ostium is usually overestimated over the three-dimensional (3D) optical coherence tomography (OCT)-measured actual stenosis. Using the 3D-OCT, morphologic changes in the jailed side-branch ostium were evaluated before and after a single stent crossover at coronary bifurcation lesions. Methods In 109 patients who received a single stent crossover at coronary bifurcation lesions, the pre- and post-intervention minimal lumen area (MLA) and the eccentricity of the jailed side-branch ostium were measured with 3D-OCT. The eccentricity index was defined as the ratio of maximal diameter/minimal diameter of the jailed side-branch ...

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    13. One-year coverage by optical coherence tomography of a bioresorbable scaffold neocarina: is it safe to discontinue dual antiplatelet therapy?

      One-year coverage by optical coherence tomography of a bioresorbable scaffold neocarina: is it safe to discontinue dual antiplatelet therapy?

      This is a case reporting on the 1-year coverage status of side-branch bioresorbable vascular scaffold (BVS) struts protruding in main vessels. The 1-year optical coherence tomography demonstrated a tissue neocarina forming over protruding BVS struts, although the coverage was widely inhomogeneous and perhaps still incomplete in some portions, thus leading to cautious extension of dual antiplatelet therapy beyond one year.

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    14. Serial Optical Coherence Tomography Evaluation at 6, 12, and 24 months Following Biolimus A9-Eluting Biodegradable Polymer Coated Stent Implantation

      Serial Optical Coherence Tomography Evaluation at 6, 12, and 24 months Following Biolimus A9-Eluting Biodegradable Polymer Coated Stent Implantation

      Background Nobori is a biolimus A9-eluting stent (BES) featured with a biodegradable polymer coated on the abluminal side only. We previously reported that favorable vessel healing was achieved at 6-12 months after BES implantation. However, detailed long-term vessel reaction post-BES deployment is unclear. Methods Twenty-two BESs were serially evaluated by optical coherence tomography (OCT) at 6, 12, and 24 months post-stenting. Average neointimal thickness, uncovered struts and neointimal unevenness score (NUS: each cross section as maximum neointimal thickness in one cross section divided by the average neointimal thickness of the same cross-section) were manually measured. In addition, we evaluated the ...

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    15. Spontaneous coronary artery dissection associated with ascending aorta dystrophy : a tear for fear

      Spontaneous coronary artery dissection associated with ascending aorta dystrophy : a tear for fear

      A 36-year old man with a recent history of aortic valve surgery for ascending aorta aneurysm was admitted for a non-ST elevation myocardial infarction. Cardiac MRI depicted a limited necrotic lesion in the anterior wall. Coronary angiography showed no significant stenosis, but a mild distal dynamic tortuosity on left anterior descending artery. Optical coherence tomography analysis confirmed the absence of any significant atherosclerotic infiltration but revealed the presence of a localized short arterial dissection within the kinked zone. The patient was managed with a conservative medical approach. The subsequent evolution was uneventful.

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    16. Optical coherence tomography evidence of a spontaneous healing of an intramural coronary hematoma

      Optical coherence tomography evidence of a spontaneous healing of an intramural coronary hematoma

      A 57 year old, woman without cardiovascular risk factors was admitted for non ST-elevation myocardial infarction with a non-significant lesion of mid left anterior descending artery reveled by the coronarography. An Optical Coherence Tomography confirmed an extensive left anterior descending intramural hematoma, managed with medical treatment. An OCT control was performed at one year showing the complete healing of coronary hematoma.

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    17. Serial randomized comparison of strut coverage between everolimus- vs. 1-generation sirolimus-eluting stents

      Serial randomized comparison of strut coverage between everolimus- vs. 1-generation sirolimus-eluting stents

      Background There has not been sufficient data to evaluate the serial vascular healing pattern after everolimus-eluting stent (EES) implantation. Using optical coherence tomography (OCT), serial changes in strut coverage were compared between EES and 1 st -generation sirolimus-eluting stents (SES). Methods Sixty patients were randomly assigned to receive either EES (n=30) or 1 st -generation SES (n=30) for coronary artery disease. Serial OCT evaluation at post-procedure, and 3- and 12-month follow-ups were performed in 50 patients with 54 stents (25 patients with 28 EES vs. 25 patients with 26 SES). The percentage of uncovered struts was defined as ...

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    18. Proximal optimization technique and kissing balloon inflations with the bioresorbable vascular scaffold for coronary bifurcation percutaneous coronary intervention

      Proximal optimization technique and kissing balloon inflations with the bioresorbable vascular scaffold for coronary bifurcation percutaneous coronary intervention

      Proximal optimization technique and final kissing balloon inflations with noncompliant balloons facilitate success with coronary bifurcation intervention. The use of bioresorbable vascular scaffolds has been postulated to reduce the risk of in-stent restenosis, a particular problem with bifurcation intervention. We present a case of bifurcation intervention in a 49-year-old woman, using for the first time, proximal optimization and kissing balloon inflation within bioresorbable vascular scaffolds, using optical coherence tomography guidance.

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    19. Treatment of In-Stent Restenosis With Bioresorbable Vascular Scaffolds: Optical Coherence Tomography Insights

      Treatment of In-Stent Restenosis With Bioresorbable Vascular Scaffolds: Optical Coherence Tomography Insights

      The role of bioresorbable vascular scaffolds (BVS) in patients with in-stent restenosis (ISR) remains unsettled. We present optical coherence tomography (OCT) findings in a series of 15 consecutive patients undergoing treatment of ISR with BVS under systematic OCT guidance. OCT disclosed severe ISR in all patients (minimal lumen area (MLA) 1.3±0.6 mm 2 ; stent obstruction 80±10%). After the procedure OCT MLA was 6.4±2 mm 2 with a final BVS expansion of 79±19%. “ Angiographically silent” edge-dissections (n=6), intra-device-dissections (n=3), tissue prolapse (n=3) and malapposition (n=3) were also readily visualized. These ...

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      Mentions: Fernando Alfonso
    20. Recanalized Image of Thrombotic Occlusion With Coronary Plaque Rupture: A Lotus Root-Like Appearance by Optical Coherence Tomography

      Recanalized Image of Thrombotic Occlusion With Coronary Plaque Rupture: A Lotus Root-Like Appearance by Optical Coherence Tomography
      A 60-year-old man with essential hypertension, type 2 diabetes mellitus, and dyslipidemia was admitted to our hospital with anterior acute myocardial infarction. Coronary angiography revealed total occlusion of the proximal left anterior descending artery just proximal to the site-implanted bare metal stent 8 years ago. Simultaneously, coronary angiography revealed a braid-like appearance at the middle segment of the right coronary artery (, white arrow). Optical coherence tomography showed that this segment was composed of multiple channels (, A) communicating with each other and converged into a single lumen in the proximal and distal site. Optical coherence tomography could also detect the lumen ...
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    1-20 of 20
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