1. Articles from Journals

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    1. Using Optical Coherence Tomography to Make Needle Biopsies Safer

      Using Optical Coherence Tomography to Make Needle Biopsies Safer

      Stereotactic needle biopsy continues to be widely employed in the diagnosis of intracranial lesions. Despite an overall low complication rate, hemorrhage remains one the most common and potentially serious risks of the procedure. Previous series have reported a symptomatic hemorrhage rate of 3% to 6%, with a minority requiring craniotomy and hemorrhage evacuation. 1-4 Though certain factors inherent to the lesion or the patient have been known to increase hemorrhage risk, 2 , 3 up until this point there has been little that surgeons can do intraoperatively to avoid hemorrhage after a trajectory has been selected. A new report in Science ...

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    2. Refining the management of acute coronary and aortic syndromes

      Refining the management of acute coronary and aortic syndromes

      Stents have revolutionized the treatment of acute coronary syndromes (ACS) 1 . Although drug-coated devices and in particular biolimus-eluting stents with biodegradable polymer are increasingly used in this patient population, their long-term outcomes as compared with bare metal stents in patients with ST-segment elevation myocardial infarction (STEMI) remains unknown. 2 In their article entitled ‘ Five-year clinical outcomes and intracoronary imaging findings of the COMFORTABLE AMI trial: randomized comparison of biodegradable polymer-based biolimus-eluting stents with bare-metal stents in patients with acute ST-segment elevation myocardial infarction ’, 3 Lorenz Räber and colleagues from the Bern University Hospital in Switzerland report the 5-year follow-up ...

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    3. Functional assessment of tandem coronary artery stenosis by intracoronary optical coherence tomography-derived virtual fractional flow reserve: a case series

      Functional assessment of tandem coronary artery stenosis by intracoronary optical coherence tomography-derived virtual fractional flow reserve: a case series

      Background Optical coherence tomography (OCT)-derived fractional flow reserve (FFR)—which may be calculated using fluid dynamics—demonstrated an excellent correlation with the wire-based FFR. However, the applicability of the OCT-derived FFR in the assessment of tandem lesions is currently unclear. Case summary We present two cases of tandem lesions in the mid segment of the left anterior descending (LAD) artery which could have assessed accurately by OCT-derived FFR. The first patient underwent wire-based FFR at the far distal site of LAD, showed a value of 0.66. The OCT-derived FFR was calculated, yielding a value of 0.64. In ...

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    4. Optical coherence tomography in varying aetiologies of renal artery stenosis: a case series

      Optical coherence tomography in varying aetiologies of renal artery stenosis: a case series

      Background Renal artery stenosis (RAS) is a common cause of secondary hypertension. The most common aetiology is atherosclerosis; however, other causes like fibromuscular dysplasia (FMD) and Takayasu arteritis (TA) are also frequently encountered. The lesion characteristics and its response to percutaneous intervention depend upon the aetiology of RAS. Optical coherence tomography (OCT) is an excellent imaging modality to analyse coronary lesions during percutaneous coronary interventions. The data regarding the utility of OCT in renal artery imaging is limited, consisting of a few case reports. Case summary We hereby report four cases of RAS, each of different aetiology (atherosclerotic, FMD, post-transplant ...

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      Mentions: Takashi Akasaka
    5. Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Intervent

      Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision-making: an expert consensus document of the European Association of Percutaneous Cardiovascular Intervent

      This consensus document is the second of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near infrared spectroscopy (NIRS)-IVUS. Beyond guidance of stent selection and optimization of deployment, invasive imaging facilitates angiographic interpretation and may guide treatment in acute coronary syndrome. Intravascular imaging can provide additional important diagnostic information when confronted with angiographically ambiguous lesions and allows assessment of plaque morphology enabling identification of vulnerability characteristics. This second document focuses on useful ...

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    6. Volumetric laser endomicroscopy and its application to Barrett's esophagus: results from a 1,000 patient registry

      Volumetric laser endomicroscopy and its application to Barrett's esophagus: results from a 1,000 patient registry

      Volumetric laser endomicroscopy (VLE) uses optical coherence tomography (OCT) for real-time, microscopic cross-sectional imaging. A US-based multi-center registry was constructed to prospectively collect data on patients undergoing upper endoscopy during which a VLE scan was performed. The objective of this registry was to determine usage patterns of VLE in clinical practice and to estimate quantitative and qualitative performance metrics as they are applied to Barrett's esophagus (BE) management. All procedures utilized the NvisionVLE Imaging System (NinePoint Medical, Bedford, MA) which was used by investigators to identify the tissue types present, along with focal areas of concern. Following the VLE ...

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    7. Optical coherence tomography: a window to the optic nerve in clinically isolated syndrome

      Optical coherence tomography: a window to the optic nerve in clinically isolated syndrome

      In this study, we aimed to evaluate the association of asymptomatic optic nerve demyelinating lesion in patients presenting a clinically isolated syndrome with the asymptomatic retinal neuro-axonal loss previously reported at clinically isolated syndrome. We prospectively recruited 66 patients presenting a clinically isolated syndrome and 66 healthy control subjects matched according to age and gender. All patients underwent brain magnetic resonance imaging including 3D-double inversion recovery (DIR) sequence, optical coherence tomography examination and visual function evaluation, at 2.5–4.5 months after CIS. Evaluation criteria were presence and length of optic nerve DIR hypersignal, retinal layers (including ganglion cell ...

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    8. Intimal lesions detected by optical coherence tomography herald intraluminal progression of cardiac allograft vasculopathy associated with humoral rejection

      Intimal lesions detected by optical coherence tomography herald intraluminal progression of cardiac allograft vasculopathy associated with humoral rejection

      This case illustrates humoral-rejection related cardiac graft vasculopathy (CAV) in a 44-year-old heart transplant recipient. In March 2018, at 3 years post-transplant de novo anti-HLA Class II donor-specific antibodies (DSA: DQ2 + DQ7 >25 000 MFI) were detected. The coronary angiogram (CA) in 2016 had been unsuspicious ( Panels A and B ; left), whereas optical coherence tomography (OCT) had noted a pathologic intima: media thickness ratio of 2:1 ( Panel C , left). The CA in March 2018, however, showed mild Type C CAV lesions in the distal LAD and RCA ( Panels A and B ; middle). Moreover, OCT marked intimal ‘opacity’ ( Panel C ,...

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    9. Impact of procedural characteristics on coronary vessel wall healing following implantation of second-generation drug-eluting absorbable metal scaffold in patients with de novo coronary artery lesions: an optical coherence tomography analysis

      Impact of procedural characteristics on coronary vessel wall healing following implantation of second-generation drug-eluting absorbable metal scaffold in patients with de novo coronary artery lesions: an optical coherence tomography analysis

      Aims Second-generation drug-eluting absorbable metal scaffold (DREAMS 2G) is an alternative novel device for treating coronary lesions. However, the relationship between in-scaffold dimensions after implantation of DREAMS 2G and vessel healing and luminal results at follow-up is unknown. The aim of this study is, therefore, to investigate whether the expansion index after implantation of DREAMS 2G as assessed by optical coherence tomography (OCT) impacts late luminal status and healing of the vessel wall. Methods and results This study comprises of a total 65 out of 123 patients who were enrolled in the BIOSOLVE-II trial. We assessed both qualitative and quantitative ...

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    10. ‘Full-plastic jacket’ with bioresorbable vascular scaffolds: 5-year optical coherence tomography follow-up

      ‘Full-plastic jacket’ with bioresorbable vascular scaffolds: 5-year optical coherence tomography follow-up

      A 54-year-old male patient with type 2 diabetes mellitus and dyslipidaemia was referred to our catheterization laboratory for unstable angina. Coronary angiography revealed severe diffuse and distal three-vessel coronary artery disease. The patient refused bypass surgery and was therefore scheduled for multivessel percutaneous coronary intervention. Following the PSP (pre-dilatation, vessel sizing, post-dilatation) strategy, three 3.0 × 28 mm everolimus-eluting bioresorbable scaffolds (BRS, Absorb, Abbott Vascular, USA) were implanted in the left anterior descending (LAD) artery, three 3.0 × 28 mm BRS in the right coronary artery (RCA) and one single 2.5 × 28 mm BRS was deployed in the obtuse ...

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    11. Multiple sclerosis: is it all black and white in optical coherence tomography?

      Multiple sclerosis: is it all black and white in optical coherence tomography?

      This scientific commentary refers to ‘Brain and retinal atrophy in African-Americans versus Caucasian-Americans with multiple sclerosis: a longitudinal study’, by Gonzalez Caldito et al. (doi: 10.1093/brain/awy245 ). ... Multiple sclerosis is an inflammatory demyelinating disease of the CNS. Histopathologically, degenerative processes have also been identified early in the disease course and independent of the demyelinating white matter disease. MRI of brain atrophy is currently the gold standard to assess neurodegeneration in vivo . However, longitudinal MRI of brain atrophy is difficult at the individual level owing to great interscan variability. Thus, alternative proxies for neurodegenerative processes that can predict future ...

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    12. Intravascular optical coherence tomography

      Intravascular optical coherence tomography

      Intravascular optical coherence tomography (IVOCT) began at MIT in the early 1990’s with the recognition that OCT could be used for clinical applications other than ophthalmology. Initial steps made there towards IVOCT feasibility included the acquisition of cadaver arterial images demonstrating the capacity of OCT to visualize depth-resolved architectural detail of plaque 5 and the development of the first mechanical scanning catheter. 6 Early histopathologic correlation studies from cadaver arteries demonstrated that IVOCT was capable of distinguishing the major fibrous, fibrocalcific, and lipid-rich plaque types and also potentially identifying inflammation as manifested by macrophage accumulations. 7, 8 Data from ...

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    13. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions

      Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions

      his Consensus Document is the first of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The first document appraises the role of intracoronary imaging to guide percutaneous coronary interventions (PCIs) in clinical practice. Current evidence regarding the impact of intracoronary imaging guidance on cardiovascular outcomes is summarized, and patients or lesions most likely to derive clinical benefit from an imaging-guided intervention are identified. The relevance of the use of IVUS or OCT prior ...

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    14. Assessing coronary plaques: non-invasive and intracoronary imaging and haemodynamic measurements

      Assessing coronary plaques: non-invasive and intracoronary imaging and haemodynamic measurements

      Atherosclerotic plaque is the hidden culprit of angina and infarction. Commonly, we assume that a coronary plaque that causes ischaemia and/or angina is clinically relevant, although we have learned that even non-obstructive plaques can cause acute coronary syndromes. 1–3 The assessment of haemodynamically relevant plaques is challenging. The so-called gold standard, i.e. coronary angiography, only provides an estimate of the significance of luminal narrowing as it provides only a two-dimensional pictures of the lumen and, unless it is analysed quantitatively, also involves a lot of subjectivity. Intracoronary imaging with intravascular ultrasound (IVUS) and optical coherence tomography (OCT ...

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    15. Intraoperative Imaging Modalities and the Potential Role of Speckle Modulating Optical Coherence Tomography

      Intraoperative Imaging Modalities and the Potential Role of Speckle Modulating Optical Coherence Tomography

      Maximizing extent of resection has been correlated with improved outcomes in a variety of pediatric and adult brain tumors. 1-11 While gross total resections are often achieved without the use of intraoperative adjuncts, difficulty in distinguishing tumor from normal brain can at times prevent the complete resection of brain tumors. Intraoperative imaging tools have increasingly been embraced with the goal of improving rates of gross total resection. In this review, we will discuss several currently used intraoperative imaging modalities, including intraoperative magnetic resonance imaging (iMRI), wide-field fluorescence, high-resolution fluorescence microscopy, and optical coherence tomography (OCT). 12-17 We will also discuss ...

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    16. Performance of modern stents in stable and acute coronary disease

      Performance of modern stents in stable and acute coronary disease

      Since Grüntzig’s seminal first procedure in 1977, 1 percutaneous coronary intervention or PCI has made impressive progress. Most importantly, the introduction of stents has markedly improved the acute and long-term results. 2–4 The first stent implantations were performed in patients with dissection and acute occlusions, 5 but their long-term follow-up also showed that restenosis rates were lower in those receiving a stent. A major breakthrough was the introduction of drug-eluting stents 6–9 which over time brought restenosis and stent thrombosis to an all-time low. With drug-eluting stents, delayed healing and endothelial dysfunction may occur, which favours ...

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    17. Healing by design: in vivo insights following contemporary coronary stent deployment

      Healing by design: in vivo insights following contemporary coronary stent deployment

      The evolution of coronary stenting from bare metal to first- and second-generation drug-eluting stents (DES) has been accompanied by a progressive reduction in major adverse cardiovascular events (MACE) including stent thrombosis, with the greatest differential between these devices occurring during the first year after deployment. 1 Beyond 1 year, clinical events (MACE, target lesion, or vessel failure) occur at a consistent 2–4%/year rate regardless of device. 2 , 3 The pathogenesis of very late events may relate to the common...

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    18. Optical coherence tomography in autosomal recessive spastic ataxia of Charlevoix-Saguenay

      Optical coherence tomography in autosomal recessive spastic ataxia of Charlevoix-Saguenay

      Autosomal recessive spastic ataxia of Charlevoix-Saguenay is a rare neurodegenerative disorder caused by mutations in the SACS gene. Thickened retinal nerve fibres visible on fundoscopy have previously been described in these patients; however, thickening of the retinal nerve fibre layer as demonstrated by optical coherence tomography appears to be a more sensitive and specific feature. To test this observation, we assessed 292 individuals (191 patients with ataxia and 101 control subjects) by peripapillary time-domain optical coherence tomography. The patients included 146 with a genetic diagnosis of ataxia (17 autosomal spastic ataxia of Charlevoix-Saguenay, 59 Friedreich’s ataxia, 53 spinocerebellar ataxias ...

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    19. In vivo predictors of plaque erosion in patients with ST-segment elevation myocardial infarction: a clinical, angiographical, and intravascular optical coherence tomography study

      In vivo predictors of plaque erosion in patients with ST-segment elevation myocardial infarction: a clinical, angiographical, and intravascular optical coherence tomography study

      Aims Plaque erosion is a significant substrate of acute coronary thrombosis. This study sought to determine in vivo predictors of plaque erosion in patients with ST-segment elevation myocardial infarction (STEMI). Methods and results A prospective series of 822 STEMI patients underwent pre-intervention optical coherence tomography. Using established diagnostic criteria, 209 had plaque erosion (25.4%) and 564 had plaque rupture (68.6%). Plaque erosion was more frequent in women <50 years when compared with those ≥50 years of age ( P  = 0.009). There was a similar, but less striking, trend in men ( P  = 0.011). Patients with plaque erosion were ...

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    20. Are characteristics of plaque erosion defined by optical coherence tomography similar to true erosion in pathology?

      Are characteristics of plaque erosion defined by optical coherence tomography similar to true erosion in pathology?

      Plaque erosion occurs without cap disruption where flowing blood comes into direct contact with intimal surface lacking endothelial cells. 1 In both clinical studies using intravascular imaging and autopsy data from subjects dying suddenly, plaque erosion is the second most common cause of coronary thrombus. In our recent pathological analysis of autopsies from subjects dying suddenly, plaque rupture was the most frequent causes of coronary thrombus (60%), the second most frequent was...

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    21. Optical coherence tomography-verified morphological correlates of high-intensity coronary plaques on non-contrast T1-weighted magnetic resonance imaging in patients with stable coronary artery disease

      Optical coherence tomography-verified morphological correlates of high-intensity coronary plaques on non-contrast T1-weighted magnetic resonance imaging in patients with stable coronary artery disease

      Aims Coronary high-intensity plaques (HIPs) with a high plaque-to-myocardial signal intensity ratio (PMR) on non-contrast T1-weighted imaging in patients with stable coronary artery disease (CAD) are associated with future coronary events. To characterize the morphological substrate of HIP, we performed a correlative optical coherence tomography (OCT) study. Methods and results We examined 137 lesions in 105 patients with stable angina pectoris or silent myocardial ischaemia scheduled for percutaneous coronary intervention (PCI) using a 3 T magnetic resonance scanner. Pre-interventional OCT was performed for PCI target lesions. HIP was defined as PMR ≥ 1.4. Of the 137 lesions, 34% were HIP ...

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      Mentions: Jagat Narula
    22. Quantification of the Effect of Toxicants on the Intracellular Kinetic Energy and Cross-Sectional Area of Mammary Epithelial Organoids by OCT Fluctuation Spectroscopy

      Quantification of the Effect of Toxicants on the Intracellular Kinetic Energy and Cross-Sectional Area of Mammary Epithelial Organoids by OCT Fluctuation Spectroscopy

      The ability to assess toxicant exposures of 3D in vitro mammary models that recapitulate the tissue microenvironment can aid in our understanding of environmental exposure risk over time. Longitudinal studies of 3D model systems, however, are cumbersome and suffer from a lack of high-throughput toxicological assays. In this study, we establish a noninvasive and label-free optical coherence tomography (OCT)-based imaging platform for tracking exposure-response relationships in 3D human mammary epithelial organoid models. The OCT-based assay includes metrics that quantify organoid intracellular kinetic energy and cross-sectional area (CSA). We compare the results to those obtained using the 3-(4,5-dimethylthiazol-2-yl ...

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    23. Utility of intracoronary imaging in the cardiac catheterization laboratory: comprehensive evaluation with intravascular ultrasound and optical coherence tomography

      Utility of intracoronary imaging in the cardiac catheterization laboratory: comprehensive evaluation with intravascular ultrasound and optical coherence tomography

      Background Intracoronary imaging is an important tool for guiding decision making in the cardiac catheterization laboratory. Sources of data We have reviewed the latest available evidence in the field to highlight the various potential benefits of intravascular imaging. Areas of agreement Coronary angiography has been considered the gold standard test to appropriately diagnose and manage patients with coronary artery disease, but it has the inherent limitation of being a 2-dimensional x-ray lumenogram of a complex 3-dimensional vascular structure. Areas of controversy There is well-established inter- and intra-observer variability in reporting coronary angiograms leading to potential variability in various management strategies ...

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    1-24 of 40 1 2 »
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