1. Hiram G. Bezerra

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    1. Mentioned In 63 Articles

    2. Intravascular Frequency-Domain Optical Coherence Tomography Assessment of Carotid Artery Disease in Symptomatic and Asymptomatic Patients

      Intravascular Frequency-Domain Optical Coherence Tomography Assessment of Carotid Artery Disease in Symptomatic and Asymptomatic Patients

      Objectives The goal of this study was to investigate carotid plaque characteristics in symptomatic versus asymptomatic patients with the use of nonocclusive optical coherence tomography (OCT). Background The identification of asymptomatic patients with carotid disease who are at risk of stroke remains a challenge. There is an increasing awareness that plaque characteristics may best risk-stratify this population. We hypothesized that OCT, a new high-resolution (∼10 μm) imaging modality, might be useful for the identification of low-risk versus high-risk carotid plaque features and help us to understand the relationship between carotid diameter stenosis and plaque morphology to ischemic stroke. Methods Fifty-three ...

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    3. Segmentation and quantification for intravascular optical coherence tomography images

      Segmentation and quantification for intravascular optical coherence tomography images

      A system and related methods for automatic or semi-automatic segmentation and quantification of blood vessel structure and physiology, including segmentation and quantification of lumen, guide wire, vessel wall, calcified plaques, fibrous caps, macrophages, metallic and bioresorbable stents are described, and including visualization of results. Calcified plaque segmentation can be used to estimate the distribution of superficial calcification and inform strategies stenting. Volumetric segmentation and quantification of fibrous caps can provide more comprehensive information of the mechanisms behind plaque rupture. Quantification of macrophages can aid diagnosis and prediction of unstable plaque and associated acute coronary events. Automated detection and quantification of ...

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    4. Feasibility of Optical Coherence Tomography in Children with Kawasaki Disease and Pediatric Heart Transplant Recipients

      Feasibility of Optical Coherence Tomography in Children with Kawasaki Disease and Pediatric Heart Transplant Recipients

      Background —Optical Coherence Tomography (OCT) is a high-resolution intravascular imaging technique used in adults. We tested the hypothesis that OCT could identify coronary abnormalities not seen by angiography in children with a history of Kawasaki Disease (KD) and pediatric heart transplant (TX) recipients. Methods and Results —KD patients and TX recipients were evaluated between December 2012 and October 2013 with angiography and OCT (Ilumien System, LightLabs, St Jude Medical, Westford, MA). Modifications were made to the adult OCT protocol to adapt this technique for children. Serial cross sectional area (CSA) measurements of the lumen, intima and media were made. Entire ...

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    5. Optical coherence tomography and intravascular ultrasound of double kissing crush coronary bifurcation stenting

      Optical coherence tomography and intravascular ultrasound of double kissing crush coronary bifurcation stenting

      A 55-year-old male underwent percutaneous coronary intervention (PCI) of a Medina 1,1,1 circumflex (LCx) and a first obtuse marginal (OM1) bifurcation lesion. A double kissing crush technique was performed, utilising a 2.75×12 mm everolimus-eluting stent (EES) in OM1 and a XIENCE V 4.0×15 mm EES (Abbott Vascular, Santa Clara, CA, USA) in the LCx (Online Figure 1). Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) runs were performed (Online Figure 2, Online Figure 3, Moving image 1). 3D reconstruction of the OCT further clarified the reconstruction of the bifurcation carina and paving, in particular ...

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    6. Optical coherence tomography of the intracranial vasculature and Wingspan stent in a patient

      Optical coherence tomography of the intracranial vasculature and Wingspan stent in a patient

      A 67-year-old man with medically refractory vertebrobasilar insufficiency and short segment occlusions of the intracranial vertebral arteries was treated with angioplasty and stent placement. Fifteen hours after the procedure the patient developed symptoms of posterior fossa ischemia and repeat angiography showed thrombus formation within the stent which was treated with thrombolytic and aggressive antiplatelet therapy. Angiography revealed lysis of the clot, but concerns regarding the mechanism of the thrombotic phenomenon prompted frequency-domain optical coherence tomography (FDOCT) assessment. FDOCT provided excellent visualization of the stent and vessel wall interactions, as well as excluding residual flow-limiting stenosis, obviating the need for further ...

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    7. Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque

      Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque
      ...ons + New Tokyo Hospital, Chiba, Japan , * Kensuke Takagi Affiliations + New Tokyo Hospital, Chiba, Japan , * Hiram G. Bezerra Affiliations + University Hospitals, Case Medical Center, Cleveland, OH, United States , * Su...
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    8. Comprehensive overview of definitions for optical coherence tomography-based plaque and stent analyses

      Comprehensive overview of definitions for optical coherence tomography-based plaque and stent analyses

      Optical coherence tomography (OCT) is the current state-of-the-art intracoronary imaging modality that allows visualization of detailed morphological characteristics of both atherosclerotic plaque and stent. So far, three expert review documents have been released for standardization of OCT image analysis. In the real world, a variety of definitions are being used by different groups and by different core laboratories to analyze OCT findings because of different clinical/procedural contexts in which OCT research has been carried out. This comprehensive overview is aimed to summarize different applicable definitions used by different research groups in plaque and stent analysis using OCT. In addition ...

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    9. Frequency-Domain Optical Coherence Tomography Assessment of Unfavorable Kissing-Balloon Result in Unprotected Left Main Intervention

      Frequency-Domain Optical Coherence Tomography Assessment of Unfavorable Kissing-Balloon Result in Unprotected Left Main Intervention

      A 67-year-old man with a history of hypertension and dyslipidemia was admitted because of angina symptoms. Coronary angiography (CAG) showed an eccentric lesion of the distal unprotected left main coronary artery (ULMCA) involving the ostium of the left anterior descending coronary artery (LAD) (Figure 1 A). ULMCA/LAD crossover stent implantation was conducted with a 3.5 × 18-mm everolimus-eluting stent (EES) (XIENCE PRIME, Abbott Vascular, Santa Clara, California) at 12 atm, followed by the kissing-balloon technique (KBT). Despite a favorable CAG result (Figure 2 A), frequency-domain optical coherence tomography (FD-OCT) revealed stent strut deformation towards the LAD, leading to a ...

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    10. Serial assessment of vessel interactions after drug-eluting stent implantation in unprotected distal left main coronary artery disease using frequency-domain optical coherence tomography

      Serial assessment of vessel interactions after drug-eluting stent implantation in unprotected distal left main coronary artery disease using frequency-domain optical coherence tomography

      Objectives This study sought to assess stent-vessel interactions after drug-eluting stent (DES) implantation in unprotected left main coronary artery (ULM) by frequency-domain optical coherence tomography (FD-OCT). Background Percutaneous coronary intervention using DES in ULM has been increasingly performed in routine practice. Recently, FD-OCT assessments of DES-vessel interactions have been used as surrogates for DES safety; however, there are no FD-OCT studies in ULM. Methods We prospectively enrolled 33 consecutive patients with ULM disease treated with sirolimus- (n = 11) and everolimus-eluting stents (n = 22). FD-OCT assessments were performed post-percutaneous coronary intervention and at 9-month follow-up. Three different segments of ULM were ...

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    11. Novel use of optical coherence tomography

      Novel use of optical coherence tomography

      Currently in use by interventional cardiology for the intravascular evaluation of coronary arteries, optical coherence tomography (OCT) has proven to be effective in the evaluation of atherosclerotic disease and further therapeutic management. We report a novel use of OCT technology in the case of a 46-year-old man with sudden onset blurred vision and greater than 70% stenosis of his left vertebral artery. To date, no detailed descriptions or case reports have previously been reported regarding the use of neuroendovascular OCT in diseased arteries.

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    12. Serial Assessment by Optical Coherence Tomography of Early and Late Vascular Responses After Implantation of an Absorbable-Coating Sirolimus-Eluting Stent (from the First-in-Human DESSOLVE I Trial)

      Serial Assessment by Optical Coherence Tomography of Early and Late Vascular Responses After Implantation of an Absorbable-Coating Sirolimus-Eluting Stent (from the First-in-Human DESSOLVE I Trial)

      The initial enthusiasm caused by the potent antirestenotic effect of early generation drug-eluting stents was recently plagued by concerns regarding their safety profile. Investigators worldwide were stimulated, therefore, to seek for improvement in drug-eluting stent technology, such as eliminating their permanent polymer blamed for vascular inflammation and delayed healing. Optical coherence tomography (OCT) assessments of stent-vessel interactions are used as a surrogate for vessel healing after DES implantation. Herewith, we report serial OCT assessments of vascular reactions to the implantation of a novel absorbable polymer sirolimus-eluting stent (MiStent). In total, 30 patients were included. At 4-, 6-, and 8-month follow-up ...

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    13. Incidence, Predictors, Morphological Characteristics, and Clinical Outcomes of Stent Edge Dissections Detected by Optical Coherence Tomography

      Incidence, Predictors, Morphological Characteristics, and Clinical Outcomes of Stent Edge Dissections Detected by Optical Coherence Tomography

      Objectives This study sought to investigate the frequency, predictors, and detailed qualitative and quantitative assessment of optical coherence tomography (OCT)-detected stent edge dissections. Its impact on subsequent management and clinical outcomes were also investigated. Background OCT is a high-resolution imaging modality that can lead to more frequent recognition and accurate assessment of vascular injuries during percutaneous coronary intervention (PCI). Methods From September 2010 to June 2011, all patients with OCT post-PCI were enrolled. Edge dissections were defined as disruptions of the arterial lumen surface in both the 5-mm distal and proximal stent edges. Qualitative and quantitative analyses of all ...

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  2. About Hiram G. Bezerra

    Hiram G. Bezerra, M.D., is with the University Hospitals Case Medical Center-Interventional Cardiovascular Center and Research & Innovation Center.