1. Articles from Journals

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  2. 1-24 of 27 1 2 »
    1. 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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    2. 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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    3. 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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    4. 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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    5. 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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    6. 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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    7. 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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    8. 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
    9. 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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    10. 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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    11. Frontiers in cardiac imaging: diagnostic and prognostic validity and safety

      Frontiers in cardiac imaging: diagnostic and prognostic validity and safety

      The heart is a hidden organ and was not accessible for clinicians until the discovery of the stethoscope by René Laennec in 1821.1 Thereafter, there was little progress until the discovery of radiation by Wilhelm Röntgen in 18982 and its application for chest X-rays and later angiography. In the 1970s, echocardiography was developed followed by magnetic resonance imaging or MRI3,4 and computed tomography or CT.5 These imaging tools have revolutionized the diagnosis of cardiac conditions, and without them most cardiac procedures and interventions such as, for instance, TAVI (transcatheter aortic valve implantation) most recently ...

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    12. Serial changes in the side-branch ostial area after main-vessel stenting with kissing balloon inflation for coronary bifurcation lesions, assessed by 3D optical coherence tomography

      Serial changes in the side-branch ostial area after main-vessel stenting with kissing balloon inflation for coronary bifurcation lesions, assessed by 3D optical coherence tomography

      Aims We evaluated the influence of the jailing configuration and guidewire rewiring position in front of the side-branch (SB) ostium before kissing balloon inflation (KBI) against side-branch ostial area (SBOA) at follow-up using 3D optical coherence tomography (3D-OCT). Methods and results We retrospectively analysed the cases of the 37 consecutive patients who underwent main-vessel (MV) stenting with KBI for coronary bifurcation lesion under OCT guidance and the follow-up OCT 6–12 months. We divided the patients into two groups, considering both the jailing configuration and the rewiring position by 3D-OCT. We defined the cases that achieved both the distal rewiring ...

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      Mentions: Takayuki Okamura
    13. Coronary optical coherence tomography-derived virtual fractional flow reserve (FFR): anatomy and physiology all-in-one | European Heart Journal

      Coronary optical coherence tomography-derived virtual fractional flow reserve (FFR): anatomy and physiology all-in-one | European Heart Journal

      Most invasive coronary imaging modalities only provide anatomical information from which physiologic significance is inferred. Fractional flow reserve (FFR) and other physiologic indices of lesion severity are more reliable methods to identify physiologically significant lesions. Currently, accomplishing both anatomic and physiologic interrogation of an intermediate coronary stenosis requires the use of multiple devices within the coronary artery. Coronary angiography, optical coherence tomography (OCT), and FFR were performed in a left anterior descending artery harbouring an intermediate lesion. Quantitative coronary angiography (QAngio XA 7.3, Medis, the Netherlands) and OCT analysis were performed (QIvus 3.0, Medis, the Netherlands). Angiography and ...

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    14. Impact of coronary lumen reconstruction on the estimation of endothelial shear stress: in vivo comparison of three-dimensional quantitative coronary angiography and three-dimensional fusion combining optical coherent tomography

      Impact of coronary lumen reconstruction on the estimation of endothelial shear stress: in vivo comparison of three-dimensional quantitative coronary angiography and three-dimensional fusion combining optical coherent tomography

      Aims It is not clearly elucidated how the fusion technique improves the accuracy of endothelial shear stress (ESS) prediction, in comparison with that of three-dimensional (3D) quantitative coronary angiography (QCA) alone. We aimed to evaluate the difference in geometric measurements and haemodynamic estimation between 3D QCA and a 3D fusion model combining 3D QCA and optical coherence tomography (OCT). Methods and results Computational fluid dynamics was assessed in the coronary models of 20 patients. In the plane-per-plane comparison, the difference and agreement were assessed using a generalized linear mixed model and concordance correlation coefficient (CCC), respectively. The haemodynamic feature around ...

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    15. Performance characteristics of optical coherence tomography in assessment of Barrett's esophagus and esophageal cancer: systematic review

      Performance characteristics of optical coherence tomography in assessment of Barrett's esophagus and esophageal cancer: systematic review

      Optical coherence tomography (OCT) can generate high-resolution images of the esophagus that allows cross-sectional visualization of esophageal wall layers. We conducted a systematic review to assess the utility of OCT for diagnosing of esophageal intestinal metaplasia (IM; Barrett's esophagus BE)), dysplasia, cancer and staging of early esophageal cancer. English language human observational studies and clinical trials published in PubMed and Embase were included if they assessed any of the following: (i) in-vivo features and accuracy of OCT at diagnosing esophageal IM, sub-squamous intestinal metaplasia (SSIM), dysplasia, or cancer, and (ii) accuracy of OCT in staging esophageal cancer. Twenty-one of ...

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    16. Report of an ESC-EAPCI Task Force on the evaluation and use of bioresorbable scaffolds for percutaneous coronary intervention: executive summary

      Report of an ESC-EAPCI Task Force on the evaluation and use of bioresorbable scaffolds for percutaneous coronary intervention: executive summary

      BRS require careful lesion assessment, to determine the need and extent of lesion preparation, as well as to select the appropriate size and length of the device. The use of pre-and post-procedural intracoronary imaging (Intravascular ultrasound, optical coherence tomography), as well as online quantitative coronary angiography, is encouraged to optimize device implantation. The use of BRS in heavily calcified vessels is strongly discouraged. Bioresorbable scaffolds should be avoided in stenoses with reference diameter smaller than 2.5 mm and in ostial lesions.

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    17. Optical coherence tomography or intravascular ultrasound to optimize coronary stent implantation

      Optical coherence tomography or intravascular ultrasound to optimize coronary stent implantation

      Optical coherence tomography (OCT) provides high-resolution tomographic images of the coronary arteries. 1 , 2 Spatial resolution of OCT (∼15 μm) is 10 times better than that of intravascular ultrasound (IVUS) (∼150 μm). 1 , 2 However, OCT needs complete blood clearance from the coronary lumen and, therefore, requires the use of contrast media. 1 , 2 OCT is unable to penetrate and see throughout red thrombus (that casts major dorsal shadowing) whereas IVUS is unable to see through heavily calcified plaques. IVUS has a deeper penetration on the vessel wall and, therefore, is better suited to detect...

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    18. Non-Newtonian pulsatile shear stress assessment: a method to differentiate bioresorbable scaffold platforms

      Non-Newtonian pulsatile shear stress assessment: a method to differentiate bioresorbable scaffold platforms

      In-vitro and in-sili co studies have shown that the implantation of coronary stent or scaffold induces changes in local haemodynamic microenvironment. Coronary angiography and optical coherence tomography (OCT) data were used to perform three-dimensional reconstruction of the right coronary of two healthy mini pigs after implantation of a 3.0 × 18 mm Absorb BVS with strut thickness of 157 µm (Abbott Vascular, USA) and 3.0 × 14 mm ArterioSorb with strut thickness of 95 µm (Arterius, UK) ( Figure ). Computational fluid dynamic (CFD) techniques were implemented to simulate pulsatile coronary blood flow. Quemada equation was implemented for shear-thinning blood rheology which ...

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    19. Cholangioport for optical coherence tomography imaging and photodynamic therapy of the cholangiocarcinoma

      Cholangioport for optical coherence tomography imaging and photodynamic therapy of the cholangiocarcinoma

      Introduction: Optical Coherence Tomography (OCT) is technology which can be used as criteria efficiency of Photodynamic Therapy (PDT) for cholangiocarcinoma. The prognosis of patients with cholangiocarcinomas is very poor and the first symptom is mechanical jaundice. The percutaneous transhepatic drainage is used in the first stage of treatment. It seemed to be an attractive idea to deliver light directly through the drainage. For doing that it was necessary to determine the possibility of tumor radiation by the semiconductor laser through the catheter wall. Methods: The aim of the first stage of research was to estimate the optimum transmission spectra and ...

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    20. Optical frequency domain imaging vs. intravascular ultrasound in percutaneous coronary intervention (OPINION trial): one-year angiographic and clinical results

      Optical frequency domain imaging vs. intravascular ultrasound in percutaneous coronary intervention (OPINION trial): one-year angiographic and clinical results

      Aims Optical frequency domain imaging (OFDI) is a recently developed, light-based, high-resolution intravascular imaging technique. Intravascular ultrasound (IVUS) is a widely used, conventional imaging technique for guiding percutaneous coronary intervention (PCI). We aimed to demonstrate the non-inferiority of OFDI-guided PCI compared with IVUS-guided PCI in terms of clinical outcomes. Methods and results We did a prospective, multicentre, randomized (ratio 1:1), active-controlled, non-inferiority study to compare head-to-head OFDI vs. IVUS in patients undergoing PCI with a second generation drug-eluting stent. The primary endpoint was target vessel failure defined as a composite of cardiac death, target-vessel related myocardial infarction, and ischaemia-driven ...

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    21. Effects of statins on plaque rupture assessed by optical coherence tomography in patients presenting with acute coronary syndromes: insights from the optical coherence tomography (OCT)-FORMIDABLE registry

      Effects of statins on plaque rupture assessed by optical coherence tomography in patients presenting with acute coronary syndromes: insights from the optical coherence tomography (OCT)-FORMIDABLE registry

      Aims Chronic pre-treatment with statins may reduce mortality and morbidity in patients experiencing acute coronary syndromes (ACS), but mechanisms accounting for these findings are not completely understood. Methods and results The optical coherence tomography (OCT)-Formidable registry retrospectively enrolled 285 consecutive patients with ACS undergoing OCT in 9 European centres. Mean age was 60.4 ± 12.8 years, 148 (51.9%) patients had hyperlipemia, 45 (15.8%) diabetes mellitus and 142 (49.8%) presented with ST Segment Elevation Myocardial Infarction (STEMI). Patients were stratified according to statin prescription: 150 (52.6%) were on chronic pre-treatment with statins before ACS and ...

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    22. Optical coherence tomography for strategy planning and staged optimization of spontaneous coronary artery dissection

      Optical coherence tomography for strategy planning and staged optimization of spontaneous coronary artery dissection

      A 49-year-old non-pregnant female, taking no hormonal replacement therapy, smoker, and with a family history of myocardial infarction, was admitted with inferior ST-segment elevation myocardial infarction. Angiography of the right coronary artery demonstrated a diffuse tubular narrowing in the proximal segment ( A ). A spontaneous coronary artery dissection (SCAD), type 2A, was suspected. Optical coherence tomography (OCT) demonstrated a large dissection, with the presence of a false double lumen and an associated diffuse circular haematoma, resulting in the compression of the true lumen ( B – C – D ). Because of ongoing ischaemia (ST-elevation and severe chest pain), the decision to stent the dissection ...

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    23. You can’t judge a book by its cover: a trivial angiographic image, an optical coherence tomography run and a surprising ending

      You can’t judge a book by its cover: a trivial angiographic image, an optical coherence tomography run and a surprising ending

      A 75 year-old man was hospitalized for recent onset of low-threshold effort dyspnoea and moderate reduction of the left ventricular ejection fraction (39%, 2 weeks before it measured 55%) with infero-postero-lateral ipokinesia and severe mitral regurgitation. His medical history included three-vessel coronary artery disease treated by percutaneous coronary intervention (PCI) and implantation of drug eluting stents (DES) on the mid left anterior descending coronary artery, the mid left circumflex coronary artery and the distal right coronary artery (RCA).

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    1-24 of 27 1 2 »
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