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https://www.readbyqxmd.com/read/29226575/vulnerable-plaques-more-than-meets-the-i
#1
EDITORIAL
Emile Mehanna, J Dawn Abbott
Intravascular imaging plays a key role in the identification of mechanisms of acute coronary syndromes Post processing IVUS algorithms (IMAP-IVUS and VH-IVUS) for tissue characterization have not been widely adopted due to current limitations Future development will allow easier, faster, and more accurate identification of vulnerable plaques, ultimately allowing prognostication of various interventions.
December 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29222206/catastrophic-catheter-induced-coronary-artery-vasospasm-successfully-rescued-using-intravascular-ultrasound-imaging-guidance
#2
Masaki Kodaira, Ryota Tabei, Toshiki Kuno, Yohei Numasawa
A 46-year-old man underwent coronary angiography for stable angina. He developed inferior ST-segment myocardial infarction during the angiography. Intravascular ultrasound (IVUS) findings suggested coronary vasospasm. Intracoronary administration of isosorbide dinitrate restored the coronary flow. This case illustrates the essential role IVUS imaging played in establishing the diagnosis of catheter-induced coronary vasospasm.
December 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29216976/ivus-guided-versus-oct-guided-coronary%C3%A2-stent-implantation-a-critical-appraisal
#3
REVIEW
Akiko Maehara, Mitsuaki Matsumura, Ziad A Ali, Gary S Mintz, Gregg W Stone
Procedural guidance with intravascular ultrasound (IVUS) imaging improves the clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) by: 1) informing the necessity for lesion preparation; 2) directing appropriate stent sizing to maximize the final stent area and minimize geographic miss; 3) selecting the optimal stent length to cover residual disease adjacent to the lesion, thus minimizing geographic miss; 4) guiding optimal stent expansion; 5) identifying acute complications (edge dissection, stent malapposition, tissue protrusion); and 6) clarifying the mechanism of late stent failure (stent thrombosis, neointimal hyperplasia, stent underexpansion or fracture, or neoatherosclerosis)...
December 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29215469/multimodality-coronary-imaging-to-predict-periprocedural-myocardial-necrosis-after-an-elective-percutaneous-coronary-intervention
#4
Masahiro Hoshino, Taishi Yonetsu, Tadashi Murai, Yoshihisa Kanaji, Eisuke Usui, Masao Yamaguchi, Masahiro Hada, Rikuta Hamaya, Yoshinori Kanno, Tetsumin Lee, Tsunekazu Kakuta
BACKGROUND: Although multiple imaging modalities have been tested to predict periprocedural myocardial necrosis (PMN), the superior predictive efficacy of these imaging findings has not been established fully. We sought to evaluate which findings of the coronary imaging tools would best provide predictive efficacy of PMN among optical coherence tomography (OCT), intravascular ultrasound (IVUS), and coronary computed tomography (CCT) angiography. PATIENTS AND METHODS: A total of 130 patients with stable angina pectoris who underwent OCT, IVUS, and CCT examinations for a single de-novo preprocedural lesion were investigated...
December 5, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/29212965/effects-of-ezetimibe-statin-combination-therapy-on-coronary-atherosclerosis-in-acute-coronary-syndrome
#5
Kiyoshi Hibi, Shinjo Sonoda, Masanori Kawasaki, Yutaka Otsuji, Toyoaki Murohara, Hideki Ishii, Katsuhiko Sato, Ryoji Koshida, Yukio Ozaki, Masataka Sata, Yoshihiro Morino, Tadashi Miyamoto, Tetsuya Amano, Satoshi Morita, Ken Kozuma, Kazuo Kimura, Hisayoshi Fujiwara
BACKGROUND: The results of previous clinical trials on the effects of ezetimibe-statin combination therapy on atherosclerosis are inconsistent, and the anti-atherosclerotic effect of ezetimibe remains controversial.Methods and Results:We conducted a prospective, randomized open-label study at 10 centers. One hundred and twenty-eight statin-naïve patients with acute coronary syndrome (ACS) undergoing intravascular ultrasound (IVUS)-guided percutaneous coronary intervention were randomized to receive either 2 mg/day pitavastatin plus 10 mg/day ezetimibe, or 2 mg/day pitavastatin...
December 7, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29212544/plaque-volume-and-plaque-risk-profile-in-diabetic-vs-non-diabetic-patients-undergoing-lipid-lowering-therapy-a-study-based-on-3d-intravascular-ultrasound-and-virtual-histology
#6
Tomas Kovarnik, Zhi Chen, Gary S Mintz, Andreas Wahle, Kristyna Bayerova, Ales Kral, Martin Chval, Karel Kopriva, John Lopez, Milan Sonka, Ales Linhart
BACKGROUND: Coronary atherosclerosis progresses faster in patients with diabetes mellitus (DM) and causes higher morbidity and mortality in such patients compared to non-diabetics ones (non-DM). We quantify changes in plaque volume and plaque phenotype during lipid-lowering therapy in DM versus non-DM patients using advanced intracoronary imaging. METHODS: We analyzed data from 61 patients with stable angina pectoris included to the PREDICT trial searching for prediction of plaque changes during intensive lipid-lowering therapy (40 mg rosuvastatin daily)...
December 7, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29194769/intravascular-ultrasound-of-the-proximal-left-anterior-descending-artery-is-sufficient-to-detect-early-cardiac-allograft-vasculopathy
#7
Vincent Floré, Adam J Brown, Stephen J Pettit, Nick Ej West, Clive Lewis, Jayan Parameshwar, Stephen P Hoole
MAIN PROBLEM: Cardiac allograft vasculopathy (CAV) can be detected early with intravascular ultrasound (IVUS) but there is limited information on the most efficient imaging protocol. METHODS: Coronary angiography and IVUS of the 3 coronary arteries were performed. Volumetric IVUS analysis was performed and a Stanford grade determined for each vessel. RESULTS: 18 patients were included 18 (range 12-24) months after transplantation. Angiographic CAV severity ranged from none (CAV0) to mild (CAV1) whereas IVUS CAV severity ranged from none (Stanford grade I) to severe (grade IV)...
November 30, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29191043/what-does-the-future-hold-for-novel-intravascular-imaging-devices-a-focus-on-morphological-and-physiological-assessment-of-plaque
#8
Yuki Katagiri, Erhan Tenekecioglu, Patrick W Serruys, Carlos Collet, Athanasios Katsikis, Taku Asano, Yosuke Miyazaki, Jan J Piek, Joanna J Wykrzykowska, Christos Bourantas, Yoshinobu Onuma
It is well recognized that a lesion that does not cause a hemodynamically significant stenosis can trigger a sudden cardiac event through plaque rupture. As a diagnostic tool, intravascular imaging was developed to circumvent limitations of coronary angiography; however, none of the intravascular imaging devices are individually able to provide complete assessment of the plaque morphology, geometry, physiology and biology. Therefore, over the past few years an effort was made to develop hybrid intravascular imaging catheters to provide more complete evaluation of coronary plaque pathobiology...
December 1, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29189397/patterns-of-coronary-calcification-and-their-impact-on-the-diagnostic-accuracy-of-computed-tomography-coronary-angiography
#9
Dariusz Noll, Mariusz Kruk, Marcin Demkow, Jerzy Pręgowski, Edyta Kaczmarska, Karolina Kryczka, Radosław Pracoń, Zofia Dzielińska, Justyna Śleszycka, Adam Witkowski, Witold Rużyłło, Cezary Kępka
OBJECTIVE: Despite coronary calcifications being a major factor affecting the diagnostic accuracy of coronary computed tomography angiography (CTA), there is a lack of established criteria for categorizing calcifications. We aimed to evaluate patterns of coronary calcification based on quantitative radiodensity and size parameters to provide coronary calcium categories and assess their impact on the accuracy of coronary CTA. METHODS AND RESULTS: We analyzed length, maximum thickness, volume, mean density, and maximum density of coronary calcium and divided each of these parameters into tertiles...
November 16, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/29180327/-a-probability-model-for-analyzing-speckles-in-intravascular-ultrasound-images-to-facilitate-image-segmentation
#10
Wu-Yi Chai, Feng Yang, Shao-Feng Yuan, Shu-Jun Liang, Jing Huang
Ultrasonic image speckles result from the interference of the reflected signals by the scatters in the detected tissue. The physical characteristics of the speckles are closely correlated with the structures of the biological tissues, and the probability distribution of these speckles differs across different tissues. Based on the probability characteristics of intravascular ultrasound (IVUS) speckles, a Gamma mixture model and Gaussian mixture model are proposed to describe the calcified plaque, soft plaque and normal vascular regions on IVUS images...
November 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/29179695/nonlocal-total-variation-based-on-symmetric-kullback-leibler-divergence-for-the-ultrasound-image-despeckling
#11
Shujun Liang, Feng Yang, Tiexiang Wen, Zhewei Yao, Qinghua Huang, Chengke Ye
BACKGROUND: Ultrasound imaging is safer than other imaging modalities, because it is noninvasive and nonradiative. Speckle noise degrades the quality of ultrasound images and has negative effects on visual perception and diagnostic operations. METHODS: In this paper, a nonlocal total variation (NLTV) method for ultrasonic speckle reduction is proposed. A spatiogram similarity measurement is introduced for the similarity calculation between image patches. It is based on symmetric Kullback-Leibler (KL) divergence and signal-dependent speckle model for log-compressed ultrasound images...
November 28, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/29174595/impact-of-everolimus-eluting-stent-length-on-long-term-clinical-outcomes-of-percutaneous-coronary-intervention
#12
Hideki Yano, Shigeo Horinaka, Toshihiko Ishimitsu
BACKGROUND: Even though longer stented lengths may increase the risk of restenosis, full coverage of diffuse long lesions with longer stents seems to be the optimal strategy for percutaneous coronary intervention (PCI) in the new drug-eluting stent (DES) era. However, it remains unclear whether this strategy will indicate favorable outcome or not. This study evaluated the impact of stent length on two-year clinical outcomes after PCI with the XIENCE Alpine everolimus-eluting stent. METHODS: This was a retrospective, non-randomized, observational study...
November 22, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29171212/plaque-characteristics-and-ruptured-plaque-location-according-to-lesion-geometry-in-culprit-lesions-of-st-segment-elevation-myocardial-infarction
#13
Ju Hyun Chung, Joo Myung Lee, Ae Young Her, Heeyoun Cho, Joon Hyung Doh, Chang Wook Nam, Hyung Il Kim, Bon Kwon Koo, Eun Seok Shin
BACKGROUND AND OBJECTIVES: The correlations between plaque characteristics and plaque rupture location according to segmental lesion analysis have not been well defined. The aim of this study was to assess those characteristics of ST-segment elevation myocardial infarction (STEMI) culprit lesions according to segmental lesion geometry using virtual histology intravascular ultrasound (VH-IVUS). METHODS: Sixty single discrete lesions found in the left anterior descending (LAD) coronary arteries of 60 patients with STEMI were included...
October 26, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29171202/advances-in-intravascular-imaging-new-insights-into-the-vulnerable-plaque-from-imaging-studies
#14
REVIEW
Taishi Yonetsu, Ik Kyung Jang
The term "vulnerable plaque" denotes the plaque characteristics that are susceptible to coronary thrombosis. Previous post-mortem studies proposed 3 major mechanisms of coronary thrombosis: plaque rupture, plaque erosion, and calcified nodules. Of those, characteristics of rupture-prone plaque have been extensively studied. Pathology studies have identified the features of rupture-prone plaque including thin fibrous cap, large necrotic core, expansive vessel remodeling, inflammation, and neovascularization...
November 9, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29169759/abnormal-coronary-vasoreactivity-in-transient-left-ventricular-apical-ballooning-tako-tsubo-syndrome
#15
Edoardo Verna, Stefano Provasoli, Sergio Ghiringhelli, Fabrizio Morandi, Jorge Salerno-Uriarte
BACKGROUND: The exact etiology and pathophysiologic mechanisms of tako-tsubo syndrome (TTS) remain controversial. OBJECTIVE: To further evaluate the abnormal coronary vasoreactivity and its possible anatomical substrate in TTS. METHODS: We studied 47 patients (46 women; age 67±12years) who underwent diagnostic cardiac catheterization and evaluation of coronary vasoreactivity by sequential acetylcholine (Ach), nitroglycerine and adenosine testing with angiographic and intracoronary pressure-Doppler flow monitoring...
January 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29160047/neoatherosclerosis-from-basic-principles-to-intravascular-imaging
#16
Philipp Nicol, Erion Xhepa, Dmitry Bozhko, Michael Joner
Development of new atherosclerotic lesions within the neointima of stented vessels has been recognized as a novel disease manifestation of atherosclerosis (neoatherosclerosis), often manifesting as in-stent restenosis (ISR) or in-stent thrombosis (ST). The pathobiology of this entity is still not fully understood and definite diagnosis is challenging owing to limitations in resolution of contemporary intravascular imaging modalities and lack of consequent histopathology correlation studies. Yet, intravascular imaging has emerged as the gold standard for the diagnosis of in-stent pathologies, the most routinely used modalities being intravascular ultrasound (IVUS) and optical coherence tomography (OCT)...
November 20, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29157464/characterization-of-coronary-plaque-regions-in-intravascular-ultrasound-images-using-a-hybrid-ensemble-classifier
#17
Yoo Na Hwang, Ju Hwan Lee, Ga Young Kim, Eun Seok Shin, Sung Min Kim
BACKGROUND AND OBJECTIVES: The purpose of this study was to propose a hybrid ensemble classifier to characterize coronary plaque regions in intravascular ultrasound (IVUS) images. METHODS: Pixels were allocated to one of four tissues (fibrous tissue (FT), fibro-fatty tissue (FFT), necrotic core (NC), and dense calcium (DC)) through processes of border segmentation, feature extraction, feature selection, and classification. Grayscale IVUS images and their corresponding virtual histology images were acquired from 11 patients with known or suspected coronary artery disease using 20 MHz catheter...
January 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29155383/efficacy-of-optical-coherence-tomography-derived-morphometric-assessment-in-predicting-the-physiological-significance-of-coronary-stenosis-head-to-head-comparison-with-intravascular-ultrasound
#18
Eisuke Usui, Taishi Yonetsu, Yoshihisa Kanaji, Masahiro Hoshino, Masao Yamaguchi, Masahiro Hada, Rikuta Hamaya, Yoshinori Kanno, Tadashi Murai, Tetsumin Lee, Tsunekazu Kakuta
AIMS: This study aimed to investigate the diagnostic efficacy of optical coherence tomography (OCT) in identifying functional significance via fractional flow reserve (FFR) compared with that of intravascular ultrasound (IVUS). METHODS AND RESULTS: We investigated 203 de novo intermediate coronary lesions of 186 patients who underwent frequency-domain OCT, IVUS and FFR measurements. Diagnostic efficacy of the minimal lumen area (MLA) obtained by OCT (OCT-MLA) and IVUS (IVUS-MLA) in predicting an FFR<0...
November 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29153502/clinical-outcomes-following-intravascular%C3%A2-imaging-guided-versus-coronary-angiography-guided-percutaneous-coronary-intervention-with%C3%A2-stent-implantation-a%C3%A2-systematic-review-and-bayesian-network-meta-analysis-of%C3%A2-31%C3%A2-studies-and-17-882-patients
#19
Sergio Buccheri, Gabriele Franchina, Sara Romano, Sebastiano Puglisi, Giuseppe Venuti, Paolo D'Arrigo, Bruno Francaviglia, Matteo Scalia, Antonio Condorelli, Marco Barbanti, Piera Capranzano, Corrado Tamburino, Davide Capodanno
OBJECTIVES: The authors sought to explore the comparative clinical efficacy of different imaging modalities for guiding percutaneous coronary interventions (PCI). BACKGROUND: Coronary angiography (CA) is the standard imaging modality for intraprocedural guidance of PCI. Intracoronary imaging techniques, including intravascular ultrasound (IVUS) and optical coherence tomography (OCT), can overcome some limitations of CA. METHODS: Comprehensive hierarchical Bayesian network meta-analysis of randomized clinical trials and adjusted observational studies comparing clinical outcomes of PCI with stent implantation guided by CA, IVUS, or OCT...
November 8, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29151488/impact-of-coronary-stent-fracture-on-restenotic-neointimal-tissue-characterization-after-drug-eluting-stent-implantation
#20
Yasuhiro Uchida, Satoshi Ichimiya, Hideki Ishii, Hideo Oishi, Toshijiro Aoki, Yusuke Miki, Toshiki Kawamiya, Hitoshi Ichimiya, Junji Watanabe, Masaaki Kanashiro, Shinji Hayano, Susumu Suzuki, Tetsuya Amano, Tatsuaki Matsubara, Toyoaki Murohara
Although drug-eluting stents (DESs) reduce the rates of in-stent restenosis (ISR) and subsequent target lesion revascularization, stent fracture (SF) after DES implantation has become an important concern because of its potential association with restenosis and stent thrombosis. We aimed to assess the pathogenic impact of SF on in-stent restenotic neointimal tissue components after DES implantation. We analyzed 43 consecutive patients (14 with SF and 29 without SF) with ISR requiring revascularization after DES implantation between January 2008 and March 2014...
November 17, 2017: International Heart Journal
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