1. 1-24 of 57 1 2 3 »
    1. Not all plaque ruptures are born equal: an optical coherence tomography study

      Not all plaque ruptures are born equal: an optical coherence tomography study

      Aims Plaque rupture (PR) represents the most common substrate of coronary thrombosis, in at least 50% of cases. Chronic low grade inflammation is a common background for atherosclerosis development; however, increased plaque inflammation may predispose by itself to PR. In the last decade, studies performed by optical coherence tomography (OCT) have allowed to establish the severity of plaque inflammation by assessing macrophage infiltration (MØI). Our retrospective study aimed at assessing the role of plaque inflammation in PR among patients with acute coronary syndrome (ACS) using OCT. Methods and results We enrolled 56 patients with ACS exhibiting PR at the ...

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      Mentions: Rocco Vergallo
    2. Utility of near-infrared spectroscopy for detection of thin-cap neoatherosclerosis

      Utility of near-infrared spectroscopy for detection of thin-cap neoatherosclerosis

      Aims Near-infrared spectroscopy (NIRS) has been employed to assess the composition of the atherosclerotic plaques in native coronary arteries. However, little is known about the detection of neoatherosclerosis by NIRS in in-stent restenosis (ISR). The aim of the study was to assess the relationship between the distribution of lipid determined by NIRS and morphology of ISR on optical coherence tomography (OCT). Methods and results We performed both NIRS and OCT in 39 drug-eluting stents with ISR. Values of lipid-core burden index (LCBI) derived by NIRS were compared with the OCT-derived thickness of the fibrous cap covering neoatherosclerotic lesions. A total ...

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    3. Optimization of coronary optical coherence tomography imaging using the attenuation-compensated technique: a validation study

      Optimization of coronary optical coherence tomography imaging using the attenuation-compensated technique: a validation study

      Purpose To optimize conventional coronary optical coherence tomography (OCT) images using the attenuation-compensated technique to improve identification of plaques and the external elastic lamina (EEL) contour. Method The attenuation-compensated technique was optimized via manipulating contrast exponent C, and compression exponent N, to achieve an optimal contrast and signal-to-noise ratio (SNR). This was applied to 60 human coronary lesions (38 native and 22 stented) ex vivo conventional coronary OCT images acquired from heart autopsies of 10 patients and matching histology was available as reference. Three independent reviewers assessed the conventional and attenuation-compensated OCT images blindly for plaque characteristics and EEL detection ...

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    4. Association of global and local low endothelial shear stress with high-risk plaque using intracoronary 3D optical coherence tomography: Introduction of ‘shear stress score’

      Association of global and local low endothelial shear stress with high-risk plaque using intracoronary 3D optical coherence tomography: Introduction of ‘shear stress score’

      Aims The association of low endothelial shear stress (ESS) with high-risk plaque (HRP) has not been thoroughly investigated in humans. We investigated the local ESS and lumen remodelling patterns in HRPs using optical coherence tomography (OCT), developed the shear stress score , and explored its association with the prevalence of HRPs and clinical outcomes. Methods and results A total of 35 coronary arteries from 30 patients with stable angina or acute coronary syndrome (ACS) were reconstructed with three dimensional (3D) OCT. ESS was calculated using computational fluid dynamics and classified into low, moderate, and high in 3-mm-long subsegments. In each subsegment ...

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    5. Left main artery compression by haematoma following acute aortic root dissection: identification by optical coherence tomography

      Left main artery compression by haematoma following acute aortic root dissection: identification by optical coherence tomography

      A 42-year-old woman with no previous history of cardiovascular disease was referred to our institution for a type A aortic dissection (A1), compressing the left main artery (LMA) ostium (arrow/ A2) and causing anterior ST elevation myocardial infarction with cardiogenic shock. The patient underwent emergent cardiac surgery: the ascending aorta was replaced, and a haematoma was removed from LMA …

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      Mentions: Nicolas Foin
    6. Optical coherence tomography evaluation of intermediate-term healing of different stent types: systemic review and meta-analysis

      Optical coherence tomography evaluation of intermediate-term healing of different stent types: systemic review and meta-analysis

      Aims The intermediate-term incidence of strut malapposition (SM) and uncovered struts (US), and the degree of neointimal thickness (NIT) according to stent type have not been characterized. Methods and results All studies of >50 patients in which optical coherence tomography was performed between 6 and 12 months after stent implantation were included. The incidences of SM and US were the co-primary end points, while NIT was the secondary end point. A total of 458 citations were initially appraised at the abstract level, and 11 full-text studies (280 652 analysed struts, 921 patients) were assessed. The 6–12 months incidences of ...

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    7. OCT imaging of aorto-coronary vein graft pathology modified by external stenting: 1-year post-surgery

      OCT imaging of aorto-coronary vein graft pathology modified by external stenting: 1-year post-surgery

      Aims The Venous External Support Trial (VEST) evaluated whether a novel external stent attenuated saphenous vein graft (SVG) disease assessed with intravascular ultrasound 1 year following coronary artery bypass graft (CABG) surgery. This sub-study assessed SVGs with and without external stenting using optical coherence tomography (OCT). The aim of this study was to accurately compare quantitative and qualitative features of SVGs with and without a novel external stent using OCT. Methods and results Twenty-four of 30 patients (65 ± 8 years) enrolled in VEST underwent coronary angiography with OCT imaging using a non-occlusive technique. Quantitative analysis of lumen area was performed ...

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    8. Prevalence and predictors of culprit plaque rupture at OCT in patients with coronary artery disease: a meta-analysis

      Prevalence and predictors of culprit plaque rupture at OCT in patients with coronary artery disease: a meta-analysis

      Aims The prevalence of plaque rupture at the culprit lesion identified by optical coherence tomography (OCT) in different clinical subset of patients undergoing coronary angiography and its clinical predictors remain to be defined. Methods All studies including patients with OCT evaluation of the culprit coronary plaque were included. The prevalence of culprit plaque rupture (CPR) and thin-cap fibro-atheroma (TCFA) were the primary endpoints. The factors associated with these findings were studied in a subset of patients with different clinical presentations [ST-elevation myocardial (STEMI) vs. nonST-elevation myocardial infarction (NSTEMI) vs. unstable angina (UA) vs. stable angina pectoris (SAP)]. Results One hundred ...

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    9. Coronary healing after stenting: wounds, faith, and the quest for the perfect stent

      Coronary healing after stenting: wounds, faith, and the quest for the perfect stent

      After coronary angioplasty, the arteries heal by a series of complex and dynamic mechanisms, which aim to restore vessel architecture and ensure laminar flow. With stent implantation, foreign material is introduced: an additional variable that significantly disturbs the healing process. Ideally, the stent struts should be covered by a perfectly functioning neo-endothelium, but this is not always the case. At different stages, peri-strut components induce inflammation with cell infiltration, fibrin, and clot formation. Patient and plaque factors play a role in healing, but we know from early-generation drug-eluting stents (DES) with permanent polymer (PP) that stent factors are crucial. The ...

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    10. Association between tissue characteristics assessed with optical coherence tomography and mid-term results after percutaneous coronary intervention for in-stent restenosis lesions: a comparison between balloon angioplasty, paclitaxel-coated balloon dilata

      Association between tissue characteristics assessed with optical coherence tomography and mid-term results after percutaneous coronary intervention for in-stent restenosis lesions: a comparison between balloon angioplasty, paclitaxel-coated balloon dilata

      Aims Morphological assessment of neointimal tissue using optical coherence tomography (OCT) is important for clarifying the pathophysiology of in-stent restenosis (ISR) lesions. The aim of this study was to determine the impact of OCT findings on recurrence of ISR after various types of percutaneous coronary intervention (PCI) including plain old balloon angioplasty (POBA), paclitaxel-coated balloon (PCB) dilatation, and drug-eluting stent (DES) implantation. Methods and results Between June 2008 and August 2013, we performed PCI for 428 ISR lesions in 379 patients using POBA (78 lesions, POBA group), PCB dilatation (202 lesions, PCB group), and DES implantation (148 lesions, DES group ...

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    11. Multi-laboratory inter-institute reproducibility study of IVOCT and IVUS assessments using published consensus document definitions

      Multi-laboratory inter-institute reproducibility study of IVOCT and IVUS assessments using published consensus document definitions

      Aims The aim of this study was to investigate the reproducibility of intravascular optical coherence tomography (IVOCT) assessments, including a comparison to intravascular ultrasound (IVUS). Intra-observer and inter-observer variabilities of IVOCT have been previously described, whereas inter-institute reliability in multiple laboratories has never been systematically studied. Methods and results In 2 independent laboratories with intravascular imaging expertise, 100 randomized matched data sets of IVOCT and IVUS images were analysed by 4 independent observers according to published consensus document definitions. Intra-observer, inter-observer, and inter-institute variabilities of IVOCT qualitative and quantitative measurements vs. IVUS measurements were assessed. Minor inter- and intra-observer variability ...

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    12. Optical coherence tomography can visualize the pulmonary artery in Williams–Beuren syndrome

      Optical coherence tomography can visualize the pulmonary artery in Williams–Beuren syndrome

      Williams–Beuren syndrome (WBS) is caused by a microdeletion at the 7q11.23, including the ELN gene. In the absence of elastin, pervasive subendothelial migration and proliferation of smooth muscle cells cause occlusion of the vascular lumen. We assessed peripheral pathological findings of the pulmonary artery (PA) in …

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    13. Vascular response to bioresorbable polymer sirolimus-eluting stent vs. permanent polymer everolimus-eluting stent at 9-month follow-up: an optical coherence tomography sub-study from the CENTURY II trial

      Vascular response to bioresorbable polymer sirolimus-eluting stent vs. permanent polymer everolimus-eluting stent at 9-month follow-up: an optical coherence tomography sub-study from the CENTURY II trial

      Aims The Ultimaster bioresorbable polymer sirolimus-eluting stent (BP-SES) is a newly developed drug-eluting stent (DES) that consists of a thin-strut, cobalt chromium with bioresorbable polymer coated only albuminally. We sought to compare tissue coverage in coronary lesions treated with BP-SES with the XIENCE permanent polymer everolimus-eluting stent (PP-EES) using optical coherence tomography (OCT). Methods and results A total of 36 patients participated in the CENTURY II trial in our institution and were randomly assigned to BP-SES ( n = 15) and PP-EES ( n = 21). Of these, 27 patients (13 BP-SES and 14 PP-EES) underwent OCT at 9-month follow-up. Tissue coverage and apposition ...

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    14. Optical coherence tomography and intravascular ultrasound evaluation of cardiac allograft vasculopathy with and without intimal neovascularization

      Optical coherence tomography and intravascular ultrasound evaluation of cardiac allograft vasculopathy with and without intimal neovascularization

      Aims Neovascularization is closely associated with plaque progression in non-heart transplantation subjects; on the other hand, cardiac allograft vasculopathy causes unfavourable outcomes. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) can provide microscopic assessment in vivo . The aim of this study was to investigate the impact of neovascularization on intimal proliferation. Methods and results Both IVUS and OCT were attempted in 45 consecutive patients during annual catheterization after heart transplantation. There were 115 vessels [28 vessels were catheterized within 8 weeks of heart transplantation (baseline)]. IVUS analysis assessed vessel, luminal, and intimal (vessel-lumen) volume using Simpson's method. Qualitative parameters ...

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    15. Impacts of lesion angle on incidence and distribution of acute vessel wall injuries and strut malapposition after drug-eluting stent implantation assessed by optical coherence tomography

      Impacts of lesion angle on incidence and distribution of acute vessel wall injuries and strut malapposition after drug-eluting stent implantation assessed by optical coherence tomography

      Aims To investigate the impact of lesion angle on the incidence and distribution of acute vessel wall injuries and incomplete stent apposition (ISA) following second-generation drug-eluting stent (DES) implantation using optical coherence tomography (OCT). Several ex vivo studies demonstrated that angled arterial walls are exposed to imbalanced mechanical stress from deployed stents. Methods and results We included 243 lesions treated with a single DES (148 everolimus-eluting stent and 95 zotarolimus-eluting stent). Angled lesions were defined as lesions with angle ≥45° on an angiogram ( n = 58). The vessel wall injuries and ISA were evaluated by OCT. The results were compared with ...

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    16. Optical coherence tomography can visualize the pulmonary artery in Williams-Beuren syndrome

      Optical coherence tomography can visualize the pulmonary artery in Williams-Beuren syndrome

      Williams–Beuren syndrome (WBS) is caused by a microdeletion at the 7q11.23, including the ELN gene. In the absence of elastin, pervasive subendothelial migration and proliferation of smooth muscle cells cause occlusion of the vascular lumen. We assessed peripheral pathological findings of the pulmonary artery (PA) in …

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    17. Variable underlying morphology of culprit plaques associated with ST-elevation myocardial infarction: an optical coherence tomography analysis from the SMART trial

      Variable underlying morphology of culprit plaques associated with ST-elevation myocardial infarction: an optical coherence tomography analysis from the SMART trial

      Aims The objective was to assess in vivo culprit lesion morphologies that caused ST-segment elevation myocardial infarction (STEMI) using optical coherence tomography (OCT). Methods and results Culprit lesions in 80 patients presenting within 6 h of STEMI onset from the CompariSon of Manual Aspiration with Rheolytic Thrombectomy in patients undergoing primary PCI (SMART) trial were evaluated. Underlying morphology of 64 culprit lesions was identifiable by OCT and included 37 lesions with plaque rupture, 25 lesions without plaque rupture, and 2 lesions with calcified nodules. Patients with plaque rupture tended to be younger (64 ± 12 versus 70 ± 10 years, P = 0 ...

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    18. Comparison of optical coherence tomography and intravascular ultrasound for evaluation of coronary lipid-rich atherosclerotic plaque progression and regression

      Comparison of optical coherence tomography and intravascular ultrasound for evaluation of coronary lipid-rich atherosclerotic plaque progression and regression

      Aims Compared with intravascular ultrasound (IVUS), optical coherence tomography (OCT) has relative merits and demerits for detecting plaque characteristics. It remains unknown whether the IVUS and OCT evaluations of plaque progression/regression are consistent. We sought to analyse the correlations between IVUS and OCT evaluations of plaques at single time points, and compare temporal changes in the IVUS and OCT data. Methods and results Eighty-eight lipid-rich plaques from 65 patients with coronary artery disease were analysed with IVUS and OCT at baseline and 12-month follow-up. Fibrous cap thickness on OCT was negatively correlated with total atheroma volume on IVUS ( r ...

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    19. Association between tissue characteristics assessed with optical coherence tomography and mid-term results after percutaneous coronary intervention for in-stent restenosis lesions: a comparison between balloon angioplasty, paclitaxel-coated balloon dilata

      Association between tissue characteristics assessed with optical coherence tomography and mid-term results after percutaneous coronary intervention for in-stent restenosis lesions: a comparison between balloon angioplasty, paclitaxel-coated balloon dilata

      Aims Morphological assessment of neointimal tissue using optical coherence tomography (OCT) is important for clarifying the pathophysiology of in-stent restenosis (ISR) lesions. The aim of this study was to determine the impact of OCT findings on recurrence of ISR after paclitaxel-coated balloon (PCB) dilatation compared with plain old balloon angioplasty (POBA). Methods and results Between July 2008 and May 2012, we performed percutaneous coronary intervention for 214 ISR lesions using POBA + PCB (146 lesions, PCB group) or POBA only (68 lesions, POBA group). Morphological assessment of neointimal tissue using OCT, including assessment of restenotic tissue structure and restenotic tissue backscatter ...

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    20. Simultaneous morphological and biochemical endogenous optical imaging of atherosclerosis

      Simultaneous morphological and biochemical endogenous optical imaging of atherosclerosis

      Aims The aim of this study was to validate novel imaging technology for simultaneous morphological and biochemical endogenous optical imaging of coronary atherosclerotic plaque. Methods and results Optical coherence tomography (OCT) generates high-resolution 3D images of plaque morphology and endogenous fluorescence lifetime imaging microscopy (FLIM) characterizes biochemical composition. Both imaging modalities rely on plaque's intrinsic optical characteristics, making contrast agents unnecessary. A multimodal OCT/FLIM system was utilized to generate luminal biochemical maps superimposed on high-resolution (7 µm axial and 13 µm lateral) structural volumetric images. Forty-seven fresh postmortem human coronary segments were imaged: pathological intimal thickening (PIT, n ...

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    21. Identification and quantification of macrophage presence in coronary atherosclerotic plaques by optical coherence tomography

      Identification and quantification of macrophage presence in coronary atherosclerotic plaques by optical coherence tomography

      Aims Vulnerable plaques are characterized by a high macrophage content. We investigated the optical coherence tomography (OCT) capability of identifying coronary plaque macrophage presence using tissue property indexes. Methods and results Fifteen epicardial coronary arteries were imaged by OCT and subsequently analysed by histology. Correlating OCT–histological sections were identified and regions of interest (ROIs) were selected on both atherosclerotic plaques and normal appearing vessel tracts. OCT-derived tissue property indexes named normalized standard deviation (NSD), signal attenuation, and granulometry index were applied on ROIs to identify inflamed ROIs defined as a macrophage percentage >10 by histology. Forty-three paired samples (OCT ...

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      Mentions: Francesco Prati
    22. Pulmonary vein stenosis after radiofrequency ablation: in vivo optical coherence tomography insights

      Pulmonary vein stenosis after radiofrequency ablation: in vivo optical coherence tomography insights

      A 56-year-old woman with paroxysmal atrial fibrillation refractory to medical treatment developed left inferior pulmonary vein (LIPV) stenosis 3 months after catheter ablation. Radiofrequency was delivered at the antrum of the vein, but some ostial applications were needed to achieve vein disconnection at the carina between both the left PV. She complained of cough and effort dyspnoea. Computed tomography angiography showed severe proximal stenosis in the LIPV, and percutaneous intervention for stent implantation was planned. Vein pulmonary angiography showed an ostial stenosis of the LIPV ( Panel A ). Optical coherence tomography (OCT) is an imaging technique that provides high-resolution (up to ...

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    23. Comparison of vascular response between everolimus-eluting stent and bare metal stent implantation in ST-segment elevation myocardial infarction assessed by optical coherence tomography

      Comparison of vascular response between everolimus-eluting stent and bare metal stent implantation in ST-segment elevation myocardial infarction assessed by optical coherence tomography

      Aims The long-term safety of second-generation everolimus-eluting stents (EESs) in ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of this study was to evaluate the late vascular response after stent implantation in STEMI between EES and bare-metal stent (BMS) by using optical coherence tomography (OCT). Methods and results A prospective OCT examination was performed in 102 patients at 10 months after stent implantation for treatment of STEMI. A total of 1253 frames with 12 772 struts in 61 EESs and 776 frames with 8594 struts in 41 BMSs were analysed. There were no significant differences in the percentage of ...

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    24. Intra-coronary thrombus evolution during acute coronary syndrome: regression assessment by serial optical coherence tomography analyses

      Intra-coronary thrombus evolution during acute coronary syndrome: regression assessment by serial optical coherence tomography analyses

      Aims We investigated the feasibility of thrombus quantification by frequency-domain optical coherence tomography (FD-OCT) methods in patients with highly thrombotic acute coronary syndrome (ACS) treated by deferred stenting strategy. Methods and results Patients were suitable for inclusion if they presented (i) an ACS that was successfully revascularized by manual thrombo-aspiration and (ii) a large residual thrombus on coronary angiography and initial FD-OCT analysis. These patients underwent a second procedure including FD-OCT analysis after several days of optimal antithrombotic therapy. Serial area measurements within the athero-thrombotic culprit lesion were performed to evaluate the OCT-thrombus score, volume, and length. Sixteen patients (88 ...

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    1-24 of 57 1 2 3 »
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