1. Articles from Journals

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    1. Optical coherence tomography detection of vulnerable plaques at high risk of developing acute coronary syndrome

      Optical coherence tomography detection of vulnerable plaques at high risk of developing acute coronary syndrome

      Aims: The ability of optical coherence tomography (OCT) to detect plaques at high risk of developing acute coronary syndrome (ACS) remains unclear. The aim of this study was to evaluate the association between non-culprit plaques characterized as both lipid-rich plaque (LRP) and thin-cap fibroatheroma (TCFA) by OCT and the risk of subsequent ACS events at the lesion level. Methods and results: In 1378 patients who underwent OCT, 3533 non-culprit plaques were analysed for the presence of LRP (maximum lipid arc > 180°) and TCFA (minimum fibrous cap thickness < 65 μm). The median follow-up period was 6 years [interquartile range (IQR): 5-9 ...

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    2. Optical coherence tomography guidance: when one size does not fit all

      Optical coherence tomography guidance: when one size does not fit all

      This editorial refers to ‘External elastic lamina vs. luminal diameter measurement for determining stent diameter by optical coherence tomography: an ILUMIEN III substudy’ by E. Shlofmitz et al ., doi:10.1093/ehjci/jeaa276. The use of intravascular imaging is known to improve percutaneous coronary intervention (PCI) outcomes, especially in complex coronary anatomy and high-risk patients. While for intravascular ultrasound (IVUS) data from randomized clinical trials and meta-analysis are available, until now the evidence supporting optical coherence tomography (OCT) derives from large registries. 1 , 2 The journey of the ILUMIEN trial series has been pivotal for better understanding how to use ...

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    3. In vivo evaluation of coronary arteritis by serial optical coherence tomography in large vessel vasculitis

      In vivo evaluation of coronary arteritis by serial optical coherence tomography in large vessel vasculitis

      A 74-year-old man with acute coronary syndrome underwent emergency percutaneous coronary intervention with the implantation of everolimus-eluting stents for severe stenosis in proximal left ascending coronary artery (LAD) ( Panel A , red arrows). Coronary angiography (CAG) revealed mild stenosis in proximal right coronary artery (RCA) and severe stenosis in distal LAD ( Panel A , yellow arrows, Supplementary material online, Video S1 ). Optical coherence tomography (OCT) showed diffusely thickened homogenous intima in mid-LAD ( Panels a–d and Supplementary material online, Video S2 ). Four months later, the serum levels of high-sensitive C-reactive protein (hs-CRP) continued to be slightly high (1.52 mg/dL), and ...

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    4. Management of acute myocardial infarction in a patient with idiopathic thrombocytopenic purpura, the value of optical coherence tomography: a case report

      Management of acute myocardial infarction in a patient with idiopathic thrombocytopenic purpura, the value of optical coherence tomography: a case report

      Background  Treating myocardial infarction in the setting of immune thrombocytopenic purpura (ITP) is always a challenge especially if the platelet count is labile. Cardiologists dealing with such patients should keep a delicate balance between thrombotic and bleeding complications. Case summary  A 50-year-old gentleman with treatment-challenging ITP presented with acute inferior ST elevation myocardial infarction after receiving recent intravenous immunoglobulin. Using optical coherence tomography (OCT) guidance, it was decided to treat him with percutaneous old balloon angioplasty especially with the labile nature of his platelet count. Subsequently, dual antiplatelet therapy was a challenge and he remained on clopidogrel for a period ...

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    5. External elastic lamina vs. luminal diameter measurement for determining stent diameter by optical coherence tomography: an ILUMIEN III substudy

      External elastic lamina vs. luminal diameter measurement for determining stent diameter by optical coherence tomography: an ILUMIEN III substudy

      Aims Optical coherence tomography (OCT)-guided external elastic lamina (EEL)-based stent sizing is safe and as effective as intravascular ultrasound in achieving post-procedural lumen dimensions. However, when compared with automated lumen diameter (LD) measurements, this approach is time-consuming. We aimed to compare vessel diameter measurements and stent diameter selection using either of these approaches and examined whether applying a correction factor to automated LD measurements could result in selecting similar stent diameters to the EEL-based approach. Methods and results We retrospectively compared EEL-based measurements vs. automated LD in reference segments in 154 OCT acquisitions and derived a correction factor ...

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    6. Differential immunological signature at the culprit site distinguishes acute coronary syndrome with intact from acute coronary syndrome with ruptured fibrous cap: results from the prospective translational OPTICO-ACS study

      Differential immunological signature at the culprit site distinguishes acute coronary syndrome with intact from acute coronary syndrome with ruptured fibrous cap: results from the prospective translational OPTICO-ACS study

      Aims  Acute coronary syndromes with intact fibrous cap (IFC-ACS), i.e. caused by coronary plaque erosion, account for approximately one-third of ACS. However, the underlying pathophysiological mechanisms as compared with ACS caused by plaque rupture (RFC-ACS) remain largely undefined. The prospective translational OPTICO-ACS study programme investigates for the first time the microenvironment of ACS-causing culprit lesions (CL) with intact fibrous cap by molecular high-resolution intracoronary imaging and simultaneous local immunological phenotyping. Methods and results  The CL of 170 consecutive ACS patients were investigated by optical coherence tomography (OCT) and simultaneous immunophenotyping by flow cytometric analysis as well as by effector ...

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    7. Atherosclerotic Plaque Disruption and Healing

      Atherosclerotic Plaque Disruption and Healing

      According to the United States Geologic Survey, there are approximately 1500 active volcanoes around the world. 1 By simplicity, volcanoes are considered as mountains where materials from within the earth come out. Yet each volcano is different. Their explosive force can create mountains as well as craters. Some volcanoes burst into life in explosive eruptions, while others slowly burp rivers of lava causing an effusive eruption. These differences can be explained by the physics and chemistry driving the molten activity. Effusive eruptions more frequently happen when the magma is less viscous, enabling gas to escape and the magma to flow ...

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    8. Retinal Vascular Density on Optical Coherence Tomography Angiography and Age-related Central and Peripheral Hearing Loss in a Southern Italian Older Population

      Retinal Vascular Density on Optical Coherence Tomography Angiography and Age-related Central and Peripheral Hearing Loss in a Southern Italian Older Population

      Background Age-related hearing loss (ARHL) and retinal vessel changes have both been associated to neurodegeneration/dementia, suggesting a possible link between these two conditions in older age. We aimed to determine whether superficial and deep vascular density (SVD and DVD) of the capillary plexi of macular vasculature can be associated with peripheral ARHL and age-related central auditory central processing (CAPD). Methods We analyzed data on 886 older participants (65 years+, age range:65-92 years) in the cross-sectional population-based Salus in Apulia Study. Optical coherence tomography angiography (OCT-A) was used to measure SVD and DVD of the capillary plexi of the ...

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    9. High Spatial Endothelial Shear Stress Gradient Independently Predicts Site of Acute Coronary Plaque Rupture and Erosion

      High Spatial Endothelial Shear Stress Gradient Independently Predicts Site of Acute Coronary Plaque Rupture and Erosion

      Aims To investigate local haemodynamics in the setting of acute coronary plaque rupture and erosion. Methods and Results Intracoronary optical coherence tomography performed in 37 patients with acute coronary syndromes caused by plaque rupture (n = 19) or plaque erosion (n = 18) was used for 3D reconstruction and computational fluid dynamic simulation. Endothelial shear stress (ESS), spatial ESS gradient (ESSG), and oscillatory shear index (OSI) were compared between plaque rupture and erosion through mixed-effects logistic regression. Lipid, calcium, macrophages, layered plaque, and cholesterol crystals were also analysed. By multivariable analysis, only high ESSG (odds ratio [OR] 5.29, 95% confidence interval ...

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    10. Optical Coherent Tomography Predicts Long-Term Visual Outcome of Pituitary Adenoma Surgery: New Perspectives From a 5-Year Follow-up Study

      Optical Coherent Tomography Predicts Long-Term Visual Outcome of Pituitary Adenoma Surgery: New Perspectives From a 5-Year Follow-up Study

      BACKGROUND Compressive optic neuropathy is the most common indication for transsphenoidal surgery for pituitary adenomas. Optical coherence tomography (OCT) is a useful visual assessment tool for predicting postoperative visual field recovery. OBJECTIVE To analyze visual parameters and their association based on long-term follow-up. METHODS Only pituitary adenoma patients with abnormal visual field defects were selected. A total of 188 eyes from 113 patients assessed by visual field index (VFI) and 262 eyes from 155 patients assessed by mean deviation (MD) were enrolled in this study. Postoperative VFI, MD, and retinal nerve fiber layer (RNFL) thickness were evaluated and followed up ...

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    11. https://doi.org/10.1093/eurheartj/ehaa632

      https://doi.org/10.1093/eurheartj/ehaa632

      A 56-year-old man with stable angina pectoris underwent implantation of a 3.5 mm × 28-mm Absorb bioresorbable vascular scaffold (BVS; Abbott Vascular, Santa Clara, CA, USA) in the left anterior descending coronary artery ( Panels A and B ). Optical coherence tomography (OCT) before ( Panel E ) and after implantation ( Panel F ) showed significant signal attenuation at the culprit site suggesting lipid-rich plaque, and fully apposed BVS struts ( Panel F and Supplementary material online , Video S1 ). Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel continued for a year, followed by aspirin monotherapy. Follow-up angiography after 2 years showed a patent, scaffolded segment...

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    12. Z-shape phenomenon of optical coherence tomography catheter: potential cause of coronary perforation

      Z-shape phenomenon of optical coherence tomography catheter: potential cause of coronary perforation

      A 75-year-old female underwent coronary intervention with rotational atherectomy (RA) due to severely calcified lesions in the left anterior descending artery (Panel A , yellow arrows). After RA with a 1.5 mm burr, multiple cracks were successfully created without any complications (Panel B ). To optimize stent deployment in the calcified lesion, we attempted to use optical coherence tomography (OCT). Despite effective lesion modification and support of a guide extension catheter, an OCT catheter (Dragonfly OPTIS, Abbott Vascular, Santa Clara, CA, USA) could not advance through the lesion with its lens part bent toward a side branch (Panel C , a white ...

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    13. 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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    14. 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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    15. 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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    16. 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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    17. 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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    18. 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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    19. 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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    20. 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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    21. 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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    22. 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
    23. 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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    24. 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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    1-24 of 73 1 2 3 »
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