1. Marco A. Costa

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    1. Mentioned In 70 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. 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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    5. 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
      ...l Center, Cleveland, OH, United States , * Sunao Nakamura Affiliations + New Tokyo Hospital, Chiba, Japan , * Marco A. Costa Affiliations + University Hospitals, Case Medical Center, Cleveland, OH, United States + Corres...
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    6. 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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    7. 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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    8. 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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    9. 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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    10. 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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    11. 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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    12. Volumetric Characterization of Human Coronary Calcification by Frequency-Domain Optical Coherence Tomography.

      Volumetric Characterization of Human Coronary Calcification by Frequency-Domain Optical Coherence Tomography.

      Background: Coronary artery calcification (CAC) presents unique challenges for percutaneous coronary intervention. Calcium appears as a signal-poor region with well-defined borders by frequency-domain optical coherence tomography (FD-OCT). The objective of this study was to demonstrate the accuracy of intravascular FD-OCT to determine the distribution of CAC. Methods and Results: Cadaveric coronary arteries were imaged using FD-OCT at 100-μm frame interval. Arteries were subsequently frozen, sectioned and imaged at 20-μm intervals using the Case Cryo-Imaging automated system TM . Full volumetric co-registration between FD-OCT and cryo-imaging was performed. Calcium area, calcium-lumen distance (depth) and calcium angle were traced on every ...

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    13. Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention

      Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention
      ... MD^⁎, * Wei Wang, MS^⁎, * Sunao Nakamura, MD, PhD^‡, * Andrej Erglis, MD^§^, ^∥, * Giulio Guagliumi, MD^†, * Marco A. Costa, MD, PhD^⁎^, Corresponding author contact information ^, E-mail the corresponding author * ^⁎ H...
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    14. Optical coherence tomography for characterization of cardiac allograft vasculopathy after heart transplantation (OCTCAV study)

      Optical coherence tomography for characterization of cardiac allograft vasculopathy after heart transplantation (OCTCAV study)
      ... Yamamoto, MD^b, * Jeffrey J. Teuteberg, MD^a, * Michael A. Shullo, PharmD^c, * Hiram G. Bezerra, MD,PhD^b, * Marco A. Costa, MD,PhD^b, * Faith Selzer, PhD^d, * Joon S. Lee, MD^a, * Oscar C. Marroquin, MD^a, * Dennis M. ...
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    15. Very long-term follow-up of strut apposition and tissue coverage with Biolimus A9 stents analyzed by optical coherence tomography

      Very long-term follow-up of strut apposition and tissue coverage with Biolimus A9 stents analyzed by optical coherence tomography

      First generation drug-eluting stents (DES) are associated with reduced in-stent restenosis but significant increased risk of very late stent thrombosis (VLST). The absence of polymer in DES systems may reduce the occurrence of VLST. Optic coherence tomography (OCT) has been used for stent analysis as a surrogate safety endpoint. This study aimed to assess the long-term follow up of strut apposition and tissue coverage of BioMatrix™ DES by OCT. 20 patients undergoing BioMatrix™ DES (n = 15) or S-Stent™ BMS (n = 5) implantation were followed for at least 5 years and evaluated by quantitative coronary angiography, intravascular ultrasound, and OCT. The ...

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  2. About Marco A. Costa

    Marco A. Costa

    Marco Costa, MD, is Director of the Heart Vascular Institute University Hospitals Case Medical Center.

  3. Quotes

    1. I walk into hearts of people without much visualization...When I first saw this, I was like, ‘Oh my God, this is unbelievable. It's like walking into a different world.
      In New stent treatment shows doctors have a heart
    2. LightLab's C7-XR FD-OCT image resolution is extraordinary, but what is most fascinating about this technology is its ease of use and extremely fast image acquisition...These features will enable optimization of drug-eluting stent procedures with unprecedented accuracy, potentially reducing the number of stents placed per patient by ensuring appropriate disease assessment and targeting. The physician armed with OCT will have the ability to see the lumen vividly from the inside giving us incredible information and the ability to treat sub-optimal results while the patient is still in the cath lab.
      In LightLab Imaging Announces FDA Clearance of C7-XR™ Coronary OCT Products in the United States
    3. Cardiologists have long been searching for imaging tools to enhance our understanding of vascular disease and guide optimal PCI and other coronary therapeutic strategies...The LightLab's C7-XR™ imaging system is the first non-occlusive optical intravascular imaging system already available in Europe and Asia. Many have focused on the eye catching micron-level vascular images, but "ease-of-use" and speed at > 100 frames/sec are the key features of this imaging tool that will revolutionize the way real-world interventionalists approach coronary artery disease.
      In LightLab Highlights OCT Market Leadership at the Society for Cardiovascular Angiography and Interventions