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Coronary Optical Coherence Tomography

Nimit C Shah, Peter D O'Kane, Jehangir N Din
Very late stent recoil is a rare albeit recognized phenomenon leading to subsequent in-stent restenosis. Angiography alone may not be adequate in making the diagnosis, and intravascular imaging with optical coherence tomography (OCT) is far superior in confirming the diagnosis and guiding subsequent management. We describe a case with interesting coronary angiogram and OCT images demonstrating very rare diagnosis of the late stent collapse. These images provide a valuable insight into a novel mechanism responsible for late target lesion failure...
September 2016: Indian Heart Journal
Yibin Xie, Young-Jin Kim, Jianing Pang, Jung-Sun Kim, Qi Yang, Janet Wei, Christopher T Nguyen, Zixin Deng, Byoung Wook Choi, Zhaoyang Fan, C Noel Bairey Merz, Prediman K Shah, Daniel S Berman, Hyuk-Jae Chang, Debiao Li
OBJECTIVES: The aim of this work is the development of coronary atherosclerosis T1-weighted characterization with integrated anatomical reference (CATCH) technique and the validation by comparison with high-risk plaque features (HRPF) observed on intracoronary optical coherence tomography (OCT) and invasive coronary angiography. BACKGROUND: T1-weighted cardiac magnetic resonance with or without contrast media has been used for characterizing coronary atherosclerosis showing promising prognostic value...
October 6, 2016: JACC. Cardiovascular Imaging
Mitsuyasu Terashima, Hideaki Kaneda, Tetsuo Matsubara, Takahiko Suzuki
No abstract text is available yet for this article.
October 13, 2016: Acute Cardiac Care
Giovanni Teruzzi, Giuseppe Calligaris, Paolo Ravagnani, Daniela Trabattoni, Luca Grancini, Giovanni Monizzi, Alessandro Lualdi, Antonio L Bartorelli
Spontaneous coronary artery dissection (SCAD) accounts approximately for 0.2% of cases of acute coronary syndrome. It is defined "spontaneous" in absence of any coronary wall damage. This disease affects primarily young women in good health, with no risk factors for coronary artery disease, especially during the postpartum period. Since the clinical presentation varies widely from no symptoms to typical angina and sudden cardiac death, SCAD incidence is underestimated.A 40-year-old woman, in the 8th week after delivery, was admitted to our emergency department because of acute chest pain, and a diagnosis of inferior and posterior non-ST-elevation myocardial infarction was made...
October 2016: Giornale Italiano di Cardiologia
Yohei Sotomi, Yoshinobu Onuma, Jouke Dijkstra, Jeroen Eggermont, Shengnan Liu, Erhan Tenekecioglu, Yaping Zeng, Taku Asano, Robbert J de Winter, Jeffrey J Popma, Ken Kozuma, Kengo Tanabe, Patrick W Serruys, Takeshi Kimura
BACKGROUND: The optimal implantation technique for the bioresorbable scaffold (Absorb, Abbott Vascular) is still a matter of debate. The purpose of the present study was to evaluate the effect of implantation technique on strut embedment and scaffold expansion.Methods and Results:Strut embedment depth and scaffold expansion index assessed by optical coherence tomography (OCT) (minimum scaffold area/reference vessel area) were evaluated in the ABSORB Japan trial (OCT subgroup: 87 lesions) with respect to implantation technique using either quantitative coronary angiography (QCA) or OCT...
October 8, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Mark W Kennedy, Enrico Fabris, Alexander J Ijsselmuiden, Holger Nef, Sebastian Reith, Javier Escaned, Fernando Alfonso, Niels van Royen, Wojtek Wojakowski, Adam Witkowski, Ciro Indolfi, Jan Paul Ottervanger, Harry Suryapranata, Elvin Kedhi
BACKGROUND: Fractional flow reserve (FFR) is a widely used tool for the identification of ischaemia-generating stenoses and to guide decisions on coronary revascularisation. However, the safety of FFR-based decisions in high-risk subsets, such as patients with Diabetes Mellitus (DM) or vulnerable stenoses presenting thin-cap fibro-atheroma (TCFA), is unknown. This study will examine the impact of optical coherence tomography (OCT) plaque morphological assessment and the identification of TCFA, in combination with FFR to better predict clinical outcomes in DM patients...
October 10, 2016: Cardiovascular Diabetology
Yohei Sotomi, Yoshinobu Onuma, Pannipa Suwannasom, Hiroki Tateishi, Erhan Tenekecioglu, Yaping Zeng, Rafael Cavalcante, Hans Jonker, Jouke Dijkstra, Nicolas Foin, Jaryl Ng Chen Koon, Carlos Collet, Robbert J de Winter, Joanna J Wykrzykowska, Gregg W Stone, Jeffrey J Popma, Ken Kozuma, Kengo Tanabe, Patrick W Serruys, Takeshi Kimura
AIMS: The current study aimed to assess the difference in lumen dimension measurements between optical coherence tomography (OCT) and quantitative coronary angiography (QCA) in the polymeric bioresorbable scaffold and metallic stent. METHODS AND RESULTS: In the randomised ABSORB Japan trial, 87 lesions in the Absorb arm and 44 lesions in the XIENCE arm were analysed. Post-procedural OCT-QCA lumen dimensions were assessed in matched proximal/distal non-stented/non-scaffolded reference (n=199), scaffolded (n=145) and stented (n=75) cross-sections at the two device edges using the Bland-Altman method...
October 10, 2016: EuroIntervention
Maria D Radu, Kyohei Yamaji, Hector M García-García, Serge Zaugg, Masanori Taniwaki, Konstantinos C Koskinas, Patrick W Serruys, Stephan Windecker, Jouke Dijkstra, Lorenz Räber
AIMS: The minimum fibrous cap thickness (FCT) is considered a major criterion of coronary plaque vulnerability according to autopsy studies. We aimed to assess the reproducibility in the measurement of the optical coherence tomography (OCT)-detected minimum FCT and the agreement in the classification of thin-cap fibroatheroma (TCFA), by a software-based semi-automatic method compared with the manual method. METHODS AND RESULTS: A total of 50 frames with fibroatheromas (FA) were randomly selected from the Integrated Biomarker Imaging Study-4 (IBIS-4)...
October 10, 2016: EuroIntervention
H M Nef, O Dörr, H Möllmann, A Elsässer
Bifurcation lesions are a therapeutic challenge in the interventional treatment of coronary artery disease. Thus, consideration of anatomical aspects and selection of the most appropriate strategy for an individual bifurcation have an impact on the interventional outcome. Accordingly, assessment of the type of bifurcation stenosis, including the relevance of the side branches, vessel diameter and the angle between the two branches are critical for the optimal choice of interventional strategy. The fractional flow reserve (FFR) is a parameter that provides a measure of the severity of coronary stenosis and despite some limitations, FFR can be applied to bifurcation lesions...
October 7, 2016: Herz
Muhammad Muzaffar Mahmood, David Austin
Spontaneous coronary artery dissection (SCAD) is an uncommon but important cause of acute coronary syndrome. The diagnosis of SCAD by an angiogram alone can be challenging and the increasing use of intracoronary imaging has proven an invaluable diagnostic adjunct in this regard. The appropriate initial management of SCAD has been a matter of significant debate. Owing to frequent spontaneous healing of coronary dissection and a higher risk of complications with percutaneous coronary intervention (PCI) in the setting of SCAD, a default approach of mechanical revascularization is not recommended...
September 18, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Wan Qin, Meredith A Roberts, Xiaoli Qi, Charles E Murry, Ying Zheng, Ruikang K Wang
In this study, we propose a novel implementation of optical coherence tomography-based angiography combined with ex vivo perfusion of fixed hearts to visualize coronary microvascular structure and function. The extracorporeal perfusion of Intralipid solution allows depth-resolved angiographic imaging, control of perfusion pressure, and high-resolution optical microangiography. The imaging technique offers new opportunities for microcirculation research in the heart, which has been challenging due to motion artifacts and the lack of independent control of pressure and flow...
October 7, 2016: Physics in Medicine and Biology
Takumi Higuma, Tsunenari Soeda, Masahiro Yamada, Takashi Yokota, Hiroaki Yokoyama, Kei Izumiyama, Fumie Nishizaki, Yoshiyasu Minami, Lei Xing, Erika Yamamoto, Hang Lee, Ken Okumura, Ik-Kyung Jang
OBJECTIVES: The aim of this study was to evaluate if residual thrombus burden after aspiration thrombectomy affects the outcomes of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Recent studies failed to show clinical benefit of aspiration thrombectomy in STEMI patients. This might be due to insufficient removal of thrombus at the culprit lesion. METHODS: A total of 109 STEMI patients who underwent aspiration thrombectomy followed by stenting within 24 h from symptom onset were included...
October 10, 2016: JACC. Cardiovascular Interventions
Antonio Enrique Gómez Menchero, Santiago Jesús Camacho Freire, José Francisco Díaz Fernández, Jessica Roa Garrido, Javier León Jiménez, Rosa Cardenal Piris
A patient presented with an inferior non-ST segment elevation myocardial infarction and a tight lesion on the distal right coronary artery. After stent implantation, a large scaffold malapposition was observed by optical coherence tomography. This case emphasizes the importance of not expanding a bioresorbable vascular scaffold more than 0.5 mm over its nominal size.
October 2016: Journal of Invasive Cardiology
Josep Gomez-Lara, Salvatore Brugaletta, Francisco Jacobi, Luis Ortega-Paz, Marcos Ñato, Gerard Roura, Rafael Romaguera, Jose-Luis Ferreiro, Luis Teruel, Montserrat Gracida, Victoria Martin-Yuste, Xavier Freixa, Monica Masotti, Joan-Antoni Gomez-Hospital, Manel Sabate, Angel Cequier
BACKGROUND: The main causes of late (>1 month) stent thrombosis (ST) are stent uncoverage, malapposition, and neoatherosclerosis. First-generation drug-eluting stents were associated with higher rate of late ST compared with bare-metal stents (BMS), especially in patients with ST-segment-elevation myocardial infarction. Second-generation everolimus-eluting stents (EES) have shown similar rate of late ST than BMS. The aims of the study are to compare the ratio of uncovered to total struts per cross-section ≥30% and other optical coherence tomographic findings associated with ST between EES and BMS in patients with ST-segment-elevation myocardial infarction at 5 years...
October 2016: Circulation. Cardiovascular Interventions
Sebina Shrestha, Michael J Serafino, Jesus Rico-Jimenez, Jesung Park, Xi Chen, Siqin Zhaorigetu, Brian L Walton, Javier A Jo, Brian E Applegate
Multimodal imaging probes a variety of tissue properties in a single image acquisition by merging complimentary imaging technologies. Exploiting synergies amongst the data, algorithms can be developed that lead to better tissue characterization than could be accomplished by the constituent imaging modalities taken alone. The combination of optical coherence tomography (OCT) with fluorescence lifetime imaging microscopy (FLIM) provides access to detailed tissue morphology and local biochemistry. The optical system described here merges 1310 nm swept-source OCT with time-domain FLIM having excitation at 355 and 532 nm...
September 1, 2016: Biomedical Optics Express
Yanping Cheng, Pawel Gasior, Masahiko Shibuya, Kamal Ramzipoor, Chang Lee, Edward A Estrada, Daniell Dokko, Jenn C McGregor, Gerard B Conditt, Greg L Kaluza, Juan F Granada
BACKGROUND: Clinically available bioresorbable scaffolds (BRS) rely on polymer crystallinity to achieve mechanical strength resulting in limited overexpansion capabilities and structural integrity when exposed to high-loading conditions. We aimed to evaluate the biomechanical behavior and vascular healing profile of a novel, sirolimus-eluting, high-molecular-weight, amorphous poly-l-lactic acid-based BRS (Amaranth BRS). METHODS AND RESULTS: In vitro biomechanical testing was performed under static and cyclic conditions...
October 2016: Circulation. Cardiovascular Interventions
J Kikoïne, M Lebon, G Gouffran, D Millischer, S Cattan, O Nallet
A 54-year-old woman was hospitalized for an acute pulmonary oedema revealing a severe aortic stenosis (AS) associated with an aortic aneurysm and a left ventricular hypertrophy (LVH). The coronary angiography found an equivocal left main lesion. Fractional flow reserve (FFR) showed hemodynamic significance (FFR=0.78) and optical coherence tomography confirmed this result with a minimal lumen area of 4.9mm(2). FFR-guided percutaneous intervention is reported to improve outcome in patients with stable coronary disease...
September 28, 2016: Annales de Cardiologie et D'angéiologie
José A Páramo, Fernando Civeira
As it is well-known, a thrombus evolving into a disrupted/eroded atherosclerotic plaque causes most acute coronary syndromes. Plaque stabilization via reduction of the lipid core and/or thickening of the fibrous cap is one of the possible mechanisms accounted for the clinical benefits displayed by different anti-atherosclerotic strategies. The concept of plaque stabilization was developed to explain how lipid-lowering agents could decrease adverse coronary events without substantial modifications of the atherosclerotic lesion ('angiographic paradox')...
September 27, 2016: Clínica e Investigación en Arteriosclerosis
Pasi P Karjalainen, Wail Nammas
Coating of stent surface with a biocompatible material is suggested to improve stent safety profile. A proprietary process was developed to coat titanium-nitride-oxide on the stent surface, based on plasma technology that uses the nano-synthesis of gas and metal. Preclinical in vitro and in vivo investigation confirmed blood compatibility of titanium (nitride-) oxide films. Titanium-nitride-oxide-coated stents demonstrated a better angiographic outcome, compared with bare-metal stents at mid-term follow-up; however, they failed to achieve non-inferiority for angiographic outcome versus second-generation drug-eluting stents...
October 3, 2016: Annals of Medicine
Tsuyoshi Nishiguchi, Atsushi Tanaka, Akira Taruya, Hiroki Emori, Yuichi Ozaki, Makoto Orii, Yasutsugu Shiono, Kunihiro Shimamura, Takeyoshi Kameyama, Takashi Yamano, Tomoyuki Yamaguchi, Yoshiki Matsuo, Yasushi Ino, Takashi Kubo, Takeshi Hozumi, Yasushi Hayashi, Takashi Akasaka
OBJECTIVE: Early clinical presentation of ST-segment-elevation myocardial infarction (STEMI) and non-ST-segment-elevation myocardial infarction affects patient management. Although local inflammatory activities are involved in the onset of MI, little is known about their impact on early clinical presentation. This study aimed to investigate whether local inflammatory activities affect early clinical presentation. APPROACH AND RESULTS: This study comprised 94 and 17 patients with MI (STEMI, 69; non-STEMI, 25) and stable angina pectoris, respectively...
September 29, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
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