1. Articles from Journals

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    1. A case report of a coronary myocardial bridge with impaired full-cycle ratio during dobutamine challenge

      A case report of a coronary myocardial bridge with impaired full-cycle ratio during dobutamine challenge

      Background A myocardial bridge (MB) is a coronary variant in which an epicardial coronary artery tunnels through the myocardial band. Although MBs have been reported to cause ischaemia, physiological assessment of an MB has not been fully established. Case summary We encountered a case with exertional chest pain who underwent coronary angiography showing an MB at the mid-left anterior descending artery with systolic compression. Optical coherence tomography showed an MB defined as a homogeneous intermediate intensity surrounding the epicardial artery. The full-cycle ratio, defined as the lowest ratio of distal coronary pressure ( P d ) to aortic pressure ( P a ) during ...

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    2. Combining deep learning method with optical coherence tomography for ablation lesion assessment

      Combining deep learning method with optical coherence tomography for ablation lesion assessment

      Background The immediate effect of radio frequency catheter ablation (RFA) on the tissue is not directly visualized. Optical coherence tomography (OCT) is an imaging technique that uses light to capture histology-like images with a penetration depth of 1-3 mm in the cardiac tissue. There are two specific features of ablation lesions in the OCT images: the disappearance of birefringence artifacts in the lateral and sudden decrease of signal at the bottom (Figure panel A and D). These features can not only be used to recognize the ablation lesions from the OCT images by eye, but also be used to train ...

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    3. Longitudinal Monitoring of Flow-Diverting Stent Tissue Coverage After Implant in a Bifurcation Model Using Neurovascular High-Frequency Optical Coherence Tomography

      Longitudinal Monitoring of Flow-Diverting Stent Tissue Coverage After Implant in a Bifurcation Model Using Neurovascular High-Frequency Optical Coherence Tomography

      BACKGROUND Tissue growth over covered branches is a leading cause of delayed thrombotic complications after flow-diverter stenting (FDS). Due to insufficient resolution, no imaging modality is clinically available to monitor this phenomenon. OBJECTIVE To evaluate high-frequency optical coherence tomography (HF-OCT), a novel intravascular imaging modality designed for the cerebrovascular anatomy with a resolution approaching 10 microns, to monitor tissue growth over FDS in an arterial bifurcation model. METHODS FDS were deployed in a rabbit model (n = 6), covering the aortic bifurcation. The animals were divided in different groups, receiving dual antiplatelet therapy (DAPT) (n = 4), aspirin only (n = 1), and ...

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    4. Three-dimensional imaging of pulmonary arterial vasa vasorum using optical coherence tomography in patients after bidirectional Glenn and Fontan procedures

      Three-dimensional imaging of pulmonary arterial vasa vasorum using optical coherence tomography in patients after bidirectional Glenn and Fontan procedures

      Aims We evaluated pulmonary arterial (PA) vasa vasorum (VV) in Fontan candidate patients with a novel three-dimensional (3D) imaging technique using optical coherence tomography (OCT). Methods and results This prospective study assessed the development of adventitial VV in the distal PA of 10 patients with bidirectional Glenn circulation (BDG group, 1.6 ± 0.3 years) and Fontan circulation (Fontan group, 3.3 ± 0.3 years), and in 20 children with normal PA haemodynamics and morphology (Control group, 1.5 ± 0.3 years). We assessed the PA VV with two-dimensional (2D) cross-sectional, multi-planar reconstruction (MPR), and volume rendering (VR) imaging. VV ...

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    5. Assessment of Corneal Epithelial Thickness in Chronic Contact Lens Users Using Anterior Segment Optical Coherence Tomography

      Assessment of Corneal Epithelial Thickness in Chronic Contact Lens Users Using Anterior Segment Optical Coherence Tomography

      Introduction The corneal epithelium is stratified epithelium that is continuously renewed and provides the frontline of defence against invading ocular pathogens and a smooth refractive surface essential for vision. In the absence of a contact lens, pre-existing ocular trauma or disease, the epithelium maintains an inaccessible defence against attacks from pathogenic microorganisms, affording a high level of resistance against microbial invasion. Aim The aim of this study is to determine the effect of chronic use of contact lens on corneal epithelium thickness using anterior segment optical coherence topography as a non- invasive diagnostic accurate measure. Patients and Methods 30 eyes ...

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    6. Role of Optical Coherence Tomography Angiography in the Diagnosis and Management of Wet Age-Related Macular Degeneration

      Role of Optical Coherence Tomography Angiography in the Diagnosis and Management of Wet Age-Related Macular Degeneration

      Background Neo-vascular age-related macular degeneration (nAMD) (an advanced form of macular degeneration) is the main cause of visual impairment in older adults related to AMD. WHO has estimated that approximately 8 million people will be affected by AMD by the year 2020. Optical coherence tomography angiography (OCTA) is a novel imaging modality that permits direct visualization of the retinal and choroidal vasculature in vivo. In OCTA, high-frequency and dense volumetric scanning are made to detect blood flow by analyzing the signal decorrelation between scans. Compared with stationary areas of the retina, the movement of erythrocytes within a vessel makes a ...

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    7. Multivessel coronary thrombosis in a patient with COVID-19 pneumonia

      Multivessel coronary thrombosis in a patient with COVID-19 pneumonia

      A 64-year-old male, with no known cardiovascular risk factors, was brought to the Emergency Room with an acute ST-elevation myocardial infarction (STEMI). One week before, he was admitted to the hospital because of a COVID-19 bilateral pneumonia treated with lopinavir–ritonavir and hydroxicloroquine, without any antithrombotic prophylaxis, and was discharged after 7 days without specific treatment, because he had made good clinical progress, just hours before he returned to the hospital. Coronary angiography showed a critical thrombotic stenosis of the proximal right coronary artery (RCA; Panel A ) as well as a non-occlusive filling defect compatible with thrombus at the middle ...

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    8. ST-elevation myocardial infarction and pulmonary embolism in a patient with COVID-19 acute respiratory distress syndrome

      ST-elevation myocardial infarction and pulmonary embolism in a patient with COVID-19 acute respiratory distress syndrome

      The clinical course of an 82-year-old patient with acute respiratory distress syndrome due to SARS-CoV-2 infection was complicated by concomitant ST-elevation myocardial infarction and pulmonary embolism. An 82-year-old man was diagnosed with COVID-19 following a positive test for SARS-CoV-2 in the presence of symptoms of fever and mild dyspnoea. Following self-isolation at home for 1 week, the patient was hospitalized due to severe respiratory distress. Physical examination revealed a body temperature of 39.0°C, blood pressure of 152/113 mmHg, heart rate of 160 b.p.m., and an oxygen saturation of 78% on 10 L of oxygen. Laboratory ...

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    9. In-stent restenosis following third-generation sirolimus-eluting stent implantation: first report analysed from imaging modalities and histopathological findings

      In-stent restenosis following third-generation sirolimus-eluting stent implantation: first report analysed from imaging modalities and histopathological findings

      A 63-year-old man was hospitalized due to unstable angina and was subsequently implanted with a 4.0 × 28 mm third-generation sirolimus-eluting stent (SES) in the proximal left anterior descending artery ( Panels A and B ). Twelve months after implantation, he developed chest pain and underwent coronary angiography which revealed in-stent restenosis (ISR) ( Panels C – E ). Percutaneous coronary intervention was therefore performed. The ISR lesion showed iso and low echoic plaque on intravascular ultrasound (IVUS) ( Panel F ) and a layered pattern on optical coherence tomography (OCT) ( Panel G ). The lesion was resected using a novel directional coronary atherectomy (DCA) catheter (.

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    10. Primary percutaneous coronary intervention for a left main bifurcation lesion without stenting using excimer laser with optical coherence tomography guidance: a case report

      Primary percutaneous coronary intervention for a left main bifurcation lesion without stenting using excimer laser with optical coherence tomography guidance: a case report

      Background Optimal strategy for treating bifurcation lesions or lesions with large thrombus in left main disease remains elusive. Excimer laser coronary angioplasty (ELCA) is a therapeutic option for thrombotic lesions in acute coronary syndrome. Case summary A 68-year-old man with chest pain was transferred to our emergency department, and subsequently diagnosed as inferior ST-segment elevation myocardial infarction (STEMI). Emergent coronary angiography revealed a 75% stenosis in the left main trunk (LMT). Optical coherence tomography (OCT) showed massive thrombus at the distal LMT to the ostial left anterior descending artery (LAD) and left circumflex artery (LCx). ELCA was performed in the ...

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      Mentions: Tsunekazu Kakuta
    11. In vivo relationship between near-infrared spectroscopy-detected lipid-rich plaques and morphological plaque characteristics by optical coherence tomography and intravascular ultrasound: a multimodality intravascular imaging study

      In vivo relationship between near-infrared spectroscopy-detected lipid-rich plaques and morphological plaque characteristics by optical coherence tomography and intravascular ultrasound: a multimodality intravascular imaging study

      Aims We assessed morphological features of near-infrared spectroscopy (NIRS)-detected lipid-rich plaques (LRPs) by using optical coherence tomography (OCT) and intravascular ultrasound (IVUS). Methods and results IVUS-NIRS and OCT were performed in the two non-infarct-related arteries (non-IRAs) in patients undergoing percutaneous coronary intervention for treatment of an acute coronary syndrome. A lesion was defined as the 4 mm segment with the maximum amount of lipid core burden index (maxLCBI 4mm ) of each LRP detected by NIRS. We divided the lesions into three groups based on the maxLCBI 4mm value: <250, 250–399, and ≥400. OCT analysis and IVUS analysis were ...

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    12. The year in cardiology: acute coronary syndromes: The year in cardiology 2019

      The year in cardiology: acute coronary syndromes: The year in cardiology 2019

      The mechanisms and the pathologic substrate of plaque erosion and plaque fissure are different. Indeed, plaques complicated by erosion tend to be matrix-rich, lipid-poor, and usually lack prominent macrophage collections, unlike plaques that rupture, which characteristically have thin fibrous caps, large lipid pools, and abundant foam cells. 9 In a prospective study in 211 patients with STEMI who underwent pre-intervention optical coherence tomography (OCT) examination for the culprit lesion, Tan et al . 10 found that trimethylamine N-oxide (TMAO) levels, a gut microbiota-dependent metabolite derived from dietary phosphatidylcholine and choline, were significantly and independently higher in patients with plaque fissure than ...

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    13. The year in cardiology 2019: Acute Coronary Syndromes

      The year in cardiology 2019: Acute Coronary Syndromes

      The management of acute coronary syndromes (ACS) has made enormous progress over the last five decades due to the introduction of defibrillation, beta blockers, thrombolytics, aspirin, primary percutaneous transluminal intervention (PCI), P 2 Y 12 inhibitors, statins, radial access, and eventually PCSK9 inhibitors, among others. 1 However, in spite of all these remedies, there is a remaining acute mortality risk, in particular, in those presenting in cardiogenic shock or after resuscitation and an accruing number of major cardiovascular events (MACE) over the following years. 2 Thus, there is an unmet need in the management of ACS. In 2019, there were ...

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    14. Fractional flow reserve in clinical practice: from wire-based invasive measurement to image-based computation

      Fractional flow reserve in clinical practice: from wire-based invasive measurement to image-based computation

      Fractional flow reserve (FFR) and instantaneous wave-free ratio are the present standard diagnostic methods for invasive assessment of the functional significance of epicardial coronary stenosis. Despite the overall trend towards more physiology-guided revascularization, there remains a gap between guideline recommendations and the clinical adoption of functional evaluation of stenosis severity. A number of image-based approaches have been proposed to compute FFR without the use of pressure wire and induced hyperaemia. In order to better understand these emerging technologies, we sought to highlight the principles, diagnostic performance, clinical applications, practical aspects, and current challenges of computational physiology in the catheterization laboratory ...

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    15. Cracking (the code of) coronary artery calcification to win the last battle of percutaneous coronary intervention: still in the middle of a rocky road

      Cracking (the code of) coronary artery calcification to win the last battle of percutaneous coronary intervention: still in the middle of a rocky road

      This editorial refers to ‘Vascular responses to coronary calcification following implantation of newer-generation drug-eluting stents in humans: impact on healing’, by S. Torii et al ., doi: 10.1093/eurheartj/ehz850 . Vascular calcification is classified into two categories according to its location. Calcification in the medial layer is called Monckeberg’s atherosclerosis and is seen mainly in the peripheral arteries. Intimal calcification is the dominant type of calcification seen in the coronary arteries. Coronary artery calcification (CAC) pathologically begins as microcalcification (0.5–15 μm) resulting from apoptosis of foam cells and/or smooth muscle cells. 1 Microcalcification may become calcified ...

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    16. Characteristics of non-culprit plaques in acute coronary syndrome patients with layered culprit plaque

      Characteristics of non-culprit plaques in acute coronary syndrome patients with layered culprit plaque

      Aims  Layered plaques represent signs of previous plaque destabilization. A recent study showed that acute coronary syndrome (ACS) patients with layered culprit plaque have more vulnerability at the culprit lesion and systemic inflammation. We aimed to compare the characteristics of non-culprit plaques between patients with or without layered plaque at the culprit lesion. We also evaluated the characteristics of layered non-culprit plaques, irrespective of culprit plaque phenotype. Methods and results We studied ACS patients who had undergone pre-intervention optical coherence tomography (OCT) imaging. The number of non-culprit lesions was evaluated on coronary angiogram and morphological characteristics of plaques were studied ...

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    17. Optical coherence tomography allows 3D reconstruction of ablation lesions

      Optical coherence tomography allows 3D reconstruction of ablation lesions

      Radiofrequency catheter ablation (RFA) is an effective interventional treatment for atrial fibrillation. However, the immediate effect of RFA on the tissue is not directly visualized. This is a key limitation as only acute electrical measurements are taken into account and the atrial wall structure or ablation lesion form are neglected. Optical coherence tomography (OCT) is an imaging technique that uses light to capture histology-like images with a moderate penetration depth of 1–3 mm in the cardiac tissue. It is well-established to characterize plaques in patients with coronary artery disease. Therefore, it might also be used for high-precision imaging of ...

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    18. Diagnosis of malignant coronary vasospasm by 12-lead Holter electrocardiogram and optical coherence tomography

      Diagnosis of malignant coronary vasospasm by 12-lead Holter electrocardiogram and optical coherence tomography

      A 73-year-old man presented with recurrent syncopes preceded by angina. Three years earlier, the patient had a pacemaker implanted due to symptomatic sick sinus syndrome. Device interrogation showed several torsade-like ventricular tachycardias (VTs) corresponding with the symptoms. Left ventricular ejection fraction was normal. Coronary angiography revealed diffuse coronary sclerosis and a hazy 50% lesion in the mid left anterior descending artery (LAD), which was treated with a drug-eluting stent. Three days later, the patient experienced another syncope with documentation of ventricular fibrillation by the provided life-vest ( Panel A ). The pacemaker was upgraded to an implantable cardioverter-defibrillator. During subsequent workup, a ...

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    19. Refining percutaneous coronary intervention: intracoronary imaging, haemodynamics, P2Y12 antagonists, and public outcomes reporting

      Refining percutaneous coronary intervention: intracoronary imaging, haemodynamics, P2Y12 antagonists, and public outcomes reporting

      Podcast: Percutaneous coronary intervention (PCI) is a remarkable success story and a lesson to sceptics as well. Although Andreas Grüntzig’s seminal first procedure went smoothly with an amazing and longstanding result after two balloon inflations, PCI remained a risky and complication-prone procedure initially. 1 Had it not have been for its elegance and vision, PCI would have been abandoned due to the risk of acute occlusions and its high rate of restenosis. 2 However, against all odds, step by step, the procedure was improved and refined, thanks to guidewires, stents, 3 , 4 antithrombotic medication 5 , 6 , secondary prevention ...

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    20. Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: the CLIMA study

      Relationship between coronary plaque morphology of the left anterior descending artery and 12 months clinical outcome: the CLIMA study

      Aims The CLIMA study, on the relationship between c oronary p l aque morphology of the left anter i or descending artery and twelve m onths clinic a l outcome, was designed to explore the predictive value of multiple high-risk plaque features in the same coronary lesion [minimum lumen area (MLA), fibrous cap thickness (FCT), lipid arc circumferential extension, and presence of optical coherence tomography (OCT)-defined macrophages] as detected by OCT. Composite of cardiac death and target segment myocardial infarction was the primary clinical endpoint. Methods and results From January 2013 to December 2016, 1003 patients undergoing OCT evaluation ...

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    21. Plaque burden can be assessed using intravascular optical coherence tomography and a dedicated automated processing algorithm: a comparison study with intravascular ultrasound

      Plaque burden can be assessed using intravascular optical coherence tomography and a dedicated automated processing algorithm: a comparison study with intravascular ultrasound

      Aims Plaque burden (PB) measurement using intravascular optical coherence tomography (IVOCT) is currently thought to be inferior to intravascular ultrasound (IVUS). We developed an automated IVOCT image processing algorithm to enhance the external elastic lamina (EEL) contour. Thus, we investigated the accuracies of standard IVOCT and an IVOCT enhancement algorithm for measuring PB using IVUS as the reference standard. Methods and results The EEL-enhancement algorithm combined adaptive attenuation compensation, exponentiation, angular registration, and image averaging using three sequential frames. In two different laboratories with intravascular imaging expertise, PB was quantified on 200 randomized, matched IVOCT and IVUS images by four ...

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    22. 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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    23. 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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    24. 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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    1-24 of 61 1 2 3 »
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