Background: Histologic experimental studies have reported incomplete neointimal healing in overlapping with respect to nonoverlapping segments in drug-eluting stents (DESs), but these observations have not been confirmed in human coronary arteries hitherto. On the contrary, angiographic and optical coherence tomography studies suggest that DES overlap elicits rather an exaggerated than an incomplete neointimal reaction.Methods: Optical coherence tomography studies from 2 randomized trials including sirolimus-eluting, biolimus-eluting, everolimus-eluting, and zotarolimus-eluting stents were analyzed at 9- to 13-month follow-up. Coverage in overlapping segments was compared versus the corresponding nonoverlapping segments of the same stents, using statistical pooled analysis.Results: Forty-two overlaps were ...

Aims Primary percutaneous coronary intervention (PPCI) with thrombectomy (TB) seems to reduce the thrombus burden, resulting in a larger flow area as measured with optical frequency domain imaging (OFDI). Methods and results In a multi-centre study, 141 patients with ST elevation myocardial infarction <12 h from onset were randomized to either PPCI with TB using an Eliminate catheter (TB: n = 71) or without TB (non-TB: n = 70), having operators blinded for the OFDI results. The primary endpoint was minimum flow area (MinFA) post-procedure assessed by OFDI, defined as: [stent area + incomplete stent apposition (ISA) area] − (intraluminal defect + tissue prolapse area ...

Critically evaluating the methodology of the adventitial delivery of stem cells, some specific options should be underlined. Adventitia as the most superficial layer, consisting of connective tissue has to be distinguished of perivascular tissues. By strict definition, an adventitia is the outermost connective tissue covering any organ, or vessel. The “adventitial” delivery of stem cells with a 1 mm micro-needle means a delivery to superficial so called pericardial myocardium, perivascular fat tissues, including a risk of perforation and injury of soft tissues. In fact, the mapping of the artery with visualization of the three-layer vessel structure and perivascular tissues as ...

The edge vascular response (EVR) has been previously evaluated with sound-based imaging modalities utilizing tissue characterization properties namely intravascular ultrasound (IVUS) and virtual histology IVUS (VH-IVUS) after implantation of metallic devices or bioresorbable drug-eluting platforms . The majority of these reports have shown lumen loss (LL) at the proximal edge, although in some studies the vascular response at the edges was diverse with proximal and distal lumen gain.

Objectives This study sought to assess stent strut coverage, malapposition, protrusion, and coronary evaginations as markers of healing 5 years after implantation of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES), by optical coherence tomography (OCT). Background Early-generation drug-eluting stents have been shown to delay vascular healing. Methods A total of 88 event-free patients with 1 randomly selected lesion were suitable for final OCT analysis 5 years after drug-eluting stent implantation. The analytical approach was based on a hierarchical Bayesian random-effects model. Results OCT analysis was performed at 5 years in 41 SES lesions with 6,380 struts, and in 47 ...

AIM: To assess the reproducibility of quantitative analysis of optical frequency domain imaging (OFDI) acquired at different pullback speeds (20, 30, 40 mm/sec), as well as the impact of cardiac motion artefact on three-dimensional (3D) reconstructions. METHODS AND RESULTS: A total of 36 OFDI pullbacks were obtained pre- and post-stent implantation at the pullback speeds of 20, 30 and 40 mm/sec in non-diseased swine coronary arteries. The amount of x-ray contrast needed for blood clearance during OFDI imaging was recorded. Three-dimensional images of stented segments were rendered and artefacts on 3D images were assessed. Lumen areas (LA) were ...

Aims: The aim of the pilot SECRITT trial was to evaluate the safety and feasibility of sealing the high risk IVUS and optical coherence tomography-derived thin cap fibroatheroma (TCFA), with a dedicated nitinol self-expanding vShield device. Methods and results: After screening with angiography, fractional flow reserve (FFR), intravascular ultrasound virtual histology (IVUS-VH) and optical coherence tomography (OCT), 23 patients met enrolment criteria (presence of non-obstructive VH-derived TCFA lesion with thin cap on OCT) and were randomised to vShield (n=13) versus medical therapy (n=10). In the shielded group, baseline percent diameter stenosis was 33.2±13.5%, FFR was ...