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Intravascular 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
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
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
Anne Willerslev, Mathias M Hansen, Oliver Niels Klefter, Ole Weis Bjerrum, Hans C Hasselbalch, Stine N Clemmensen, Michael Larsen, Inger Christine Munch
PURPOSE: To study the circulation in the retinal vessels in patients with blood dyscrasia due to myeloproliferative neoplasms using non-invasive retinal imaging. METHODS: Prospective consecutive case series of seven treatment-naïve patients with chronic myeloid leukaemia (n = 2), polycythemia vera (n = 4), essential thrombocytosis (n = 1) examined before and after cytoreductive treatment. We investigated retinal circulation with motion-contrast imaging, retinal oximetry and spectral-domain optical coherence tomography...
September 29, 2016: Acta Ophthalmologica
Sebastian Kufner, Erion Xhepa, Christoph Lutter, Salvatore Cassese, Michael Joner
Despite the high anti-restenotic efficacy of contemporary percutaneous interventional techniques, a substantial number of patients who undergo percutaneous coronary intervention (PCI) still present with restenosis. Despite iterations of devices- from plain balloon angioplasty to bare metal stenting (BMS) to drug-eluting stent (DES) therapy - have granted a progressive decline in the rate of this complication, in-stent restenosis remains a critical issue encountered in clinical practice. Owing to the overall increase in the use of DES, the number of patients presenting with DES restenosis is not insignificant in absolute terms...
September 27, 2016: Minerva Cardioangiologica
Tereza Novakova, Jan Kanovsky, Roman Miklik, Otakar Bocek, Martin Poloczek, Petr Jerabek, Lenka Privarova, Tomas Ondrus, Jiri Jarkovsky, Klara Benesova, Jindrich Spinar, Petr Kala
BACKGROUND AND AIMS: Transradial catheterization is the predominant access site for coronary catheterization and percutaneous coronary interventions (PCI). Previous studies have reported a high incidence of radial artery (RA) injury. The aim of this investigation was to evaluate the incidence of RA injury using last generation optical coherence tomography (OCT) intravascular imaging in a serial manner. METHODS: 100 patients with a diagnosis of non-ST-elevation myocardial infarction (nSTEMI) treated by PCI were enrolled...
September 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Eduardo A Novais, Luiz Roisman, Paulo Ricardo Chaves de Oliveira, Ricardo N Louzada, Emily D Cole, Mark Lane, Marco Bonini Filho, André Romano, João Rafael de Oliveira Dias, Caio V Regatieri, David Chow, Rubens Belfort, Philip Rosenfeld, Nadia K Waheed, Daniela Ferrara, Jay S Duker
Fluorescein angiography (FA) and indocyanine green angiography (ICGA) have been the gold standard for the evaluation of retinal and choroidal vasculature in the last three decades and have revolutionized the diagnosis of retinal and choroidal vascular diseases. The advantage of these imaging modalities lies in their ability to document retinal and choroidal vasculature through the dynamic assessment of contrast transit over time in the intravascular and extravascular spaces. However, disadvantages include the absence of depth resolution, blurring of details by contrast leakage, and the inability to selectively evaluate different levels of the retinal and choroidal microvasculature...
September 1, 2016: Ophthalmic Surgery, Lasers & Imaging Retina
I V Buzaev, V V Plechev, I E Nikolaeva, I G Zagitov, B A Oleĭnik
A series of studies demonstrated comparability of the incidence rate of major adverse cardiac events (MACE) in the middle-term postoperative period following implantation of last-generation drug-coated stents and biodegradable intravascular scaffolds. It was noted observed that these complications may be associated with malposition and inadequate inappropriate preparation of the lesion. We carried out a total of 16 percutaneous coronary interventions (PCI) with implantation of absorbable vascular scaffolds (Absorb, Abbott Vascular) under the guidance of optical coherent tomography...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Muthukaruppan Gnanadesigan, Ali S Hussain, Stephen White, Simon Scoltock, Andreas Baumbach, Antonius F W van der Steen, Evelyn Regar, Thomas W Johnson, Gijs van Soest
Lipid-core atherosclerotic plaques are associated with disease progression, procedural complications, and cardiac events. Coronary plaque lipid can be quantified in optical coherence tomography (OCT) pullbacks by measurement of lipid arcs and lipid lengths; parameters frequently used in clinical research, but labor intensive and subjective to analyse. In this study, we investigated the ability of quantitative attenuation, derived from intravascular OCT, to detect plaque lipid. Lipid cores are associated with a high attenuation coefficient...
September 12, 2016: International Journal of Cardiovascular Imaging
Kunihiro Shimamura, Giulio Guagliumi
Decision making on lesion preparation and stent/scaffold optimization are cornerstones of patient outcome. Intravascular imaging recently emerged as a critical modality to achieve better results of stent/scaffold implantation and superior clinical outcomes compared with coronary angiography alone. Optical coherence tomography (OCT), a light-based intravascular imaging modality with high frame rate in acquisition and very high speed pullback, can interrogate the target vessel in a couple of seconds, and immediately display a pristine longitudinal lumen contour with automatic detection of lesion severity, site and lumen/stent areas...
September 23, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Takumi Higuma, Tsunenari Soeda, Masahiro Yamada, Takashi Yokota, Hiroaki Yokoyama, Fumie Nishizaki, Lei Xing, Erika Yamamoto, Krzysztof Bryniarski, Jiannan Dai, Hang Lee, Ken Okumura, Ik-Kyung Jang
BACKGROUND: Previous studies reported that reduced TIMI (Thrombolysis in Myocardial Infarction) flow grade before procedure was associated with worse clinical outcomes in patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention. The aim of this study was to identify specific morphological characteristics of the culprit plaque associated with poor TIMI flow grade at baseline in patients with ST-segment-elevation myocardial infarction using both optical coherence tomography and intravascular ultrasound...
September 2016: Circulation. Cardiovascular Interventions
Zulong Xie, Jingbo Hou, Huai Yu, Haibo Jia, Hongwei Du, Hang Lee, Bo Yu, Jinwei Tian, Ik-Kyung Jang
OBJECTIVE: Some plaques grow slowly in a linear manner, whereas others undergo a rapid phasic progression. However, the detailed in-vivo relationship between plaque characteristics and plaque progression pattern has not been reported. The current study aimed to investigate the plaque progression patterns with serial intravascular ultrasound (IVUS) examinations, and to correlate baseline plaque characteristics assessed by optical coherence tomography and IVUS with plaque progression patterns...
August 30, 2016: Coronary Artery Disease
Haibo Jia, Jiannan Dai, Jingbo Hou, Lei Xing, Lijia Ma, Huimin Liu, Maoen Xu, Yuan Yao, Sining Hu, Erika Yamamoto, Hang Lee, Shaosong Zhang, Bo Yu, Ik-Kyung Jang
AIMS: Plaque erosion, compared with plaque rupture, has distinctly different underlying pathology and therefore may merit tailored therapy. In this study, we aimed to assess whether patients with acute coronary syndrome (ACS) caused by plaque erosion might be stabilized by anti-thrombotic therapy without stent implantation. METHODS AND RESULTS: This was a single-centre, uncontrolled, prospective, proof-of concept study. Patients with ACS including ST-segment elevation myocardial infarction were prospectively enrolled...
August 30, 2016: European Heart Journal
Abdel Rahman A Al Emam, Ahmed Almomani, Syed A Gilani, Wissam I Khalife
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome. It occurs predominantly among younger females, typically in the absence of atherosclerotic coronary artery disease. Presentations vary greatly and this condition can be fatal. Given its rarity, there are no management guidelines. We present six patients with SCAD with different presentations and treatment approaches as examples in our literature review. Two patients presented with ST elevation myocardial infarction (STEMI), two with non-STEMI (NSTEMI), and two with cardiac arrest...
September 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Andrew Kei-Yan Ng, Man-Hong Jim
In the era of drug-eluting stents, the provisional stenting strategy has been established as the default strategy in percutaneous coronary intervention for bifurcation lesions. However, emerging evidence shows that, in selected situations, the complex strategy of stenting both vessels regardless could reduce side-branch restenosis without penalty. In particular, the double kissing crush technique has been proven to outperform the provisional strategy and other complex strategies in randomized trials. In this review, we present the evidence comparing the 2 strategies and individual stenting techniques and discuss the roles of other optimization techniques such as final kissing balloon inflation, proximal optimization technique, intravascular ultrasonography, and optical coherence tomography...
August 24, 2016: Clinical Cardiology
Vijay Kunadian, R Dermot G Neely, Hannah Sinclair, Jonathan A Batty, Murugapathy Veerasamy, Gary A Ford, Weiliang Qiu
INTRODUCTION: The ICON1 study (a study to Improve Cardiovascular Outcomes in high-risk older patieNts with acute coronary syndrome) is a prospective observational study of older patients (≥75 years old) with non-ST-elevation acute coronary syndrome managed by contemporary treatment (pharmacological and invasive). The aim of the study was to determine the predictors of poor cardiovascular outcomes in this age group and to generate a risk prediction tool. METHODS AND ANALYSIS: Participants are recruited from 2 tertiary hospitals in the UK...
2016: BMJ Open
Johan W Verjans, Eric A Osborn, Giovanni J Ughi, Marcella A Calfon Press, Ehsan Hamidi, Antonios P Antoniadis, Michail I Papafaklis, Mark F Conrad, Peter Libby, Peter H Stone, Richard P Cambria, Guillermo J Tearney, Farouc A Jaffer
OBJECTIVES: This study sought to determine whether indocyanine green (ICG)-enhanced near-infrared fluorescence (NIRF) imaging can illuminate high-risk histologic plaque features of human carotid atherosclerosis, and in coronary atheroma of living swine, using intravascular NIRF-optical coherence tomography (OCT) imaging. BACKGROUND: New translatable imaging approaches are needed to identify high-risk biological signatures of atheroma. ICG is a U.S. Food and Drug Administration-approved NIRF imaging agent that experimentally targets plaque macrophages and lipid in areas of enhanced endothelial permeability...
September 2016: JACC. Cardiovascular Imaging
Lisbeth Antonsen, Per Thayssen, Henrik Steen Hansen, Anders Junker, Karsten Tange Veien, Knud Nørregaard Hansen, Mikkel Hougaard, Lisette Okkels Jensen
BACKGROUND: Stenting-induced edge dissections (ED) can be assessed in detail by optical coherence tomography (OCT). This study sought to investigate the incidence, morphological characteristics, and spontaneous healing course of OCT-identified EDs following drug-eluting stent (DES) implantation in a non-ST segment elevation myocardial infarction (NSTEMI) patient-population. METHODS: Acute vessel wall injury at the 5-mm stent adjacent distal and proximal reference segments was assessed by post-procedure OCT and intravascular ultrasound (IVUS) in n=97 NSTEMI-patients (n=97 lesions)...
November 15, 2016: International Journal of Cardiology
Judit Karacsonyi, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, John Bahadorani, Aris Karatasakis, Barbara A Danek, Anthony Doing, J Aaron Grantham, Dimitri Karmpaliotis, Jeffrey W Moses, Ajay Kirtane, Manish Parikh, Ziad Ali, William L Lombardi, David E Kandzari, Nicholas Lembo, Santiago Garcia, Michael R Wyman, Aya Alame, Phuong-Khanh J Nguyen-Trong, Erica Resendes, Pratik Kalsaria, Bavana V Rangan, Imre Ungi, Craig A Thompson, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: Intravascular imaging can facilitate chronic total occlusion (CTO) percutaneous coronary intervention. METHODS AND RESULTS: We examined the frequency of use and outcomes of intravascular imaging among 619 CTO percutaneous coronary interventions performed between 2012 and 2015 at 7 US centers. Mean age was 65.4±10 years and 85% of the patients were men. Intravascular imaging was used in 38%: intravascular ultrasound in 36%, optical coherence tomography in 3%, and both in 1...
2016: Journal of the American Heart Association
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