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Watanabe Y, Sakakura K, Taniguchi Y, Yamamoto K, Seguchi M, Tsukui T, Jinnouchi H, Wada H, Fujita H. Impact of intravascular ultrasound‐incomplete stent apposition on stent failure. Catheter Cardiovasc Interv 2022; 100:1000-1009. [DOI: 10.1002/ccd.30424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/04/2022] [Accepted: 10/02/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Yusuke Watanabe
- Division of Cardiovascular Medicine, Saitama Medical Center Jichi Medical University Saitama City Saitama Japan
| | - Kenichi Sakakura
- Division of Cardiovascular Medicine, Saitama Medical Center Jichi Medical University Saitama City Saitama Japan
| | - Yousuke Taniguchi
- Division of Cardiovascular Medicine, Saitama Medical Center Jichi Medical University Saitama City Saitama Japan
| | - Kei Yamamoto
- Division of Cardiovascular Medicine, Saitama Medical Center Jichi Medical University Saitama City Saitama Japan
| | - Masaru Seguchi
- Division of Cardiovascular Medicine, Saitama Medical Center Jichi Medical University Saitama City Saitama Japan
| | - Takunori Tsukui
- Division of Cardiovascular Medicine, Saitama Medical Center Jichi Medical University Saitama City Saitama Japan
| | - Hiroyuki Jinnouchi
- Division of Cardiovascular Medicine, Saitama Medical Center Jichi Medical University Saitama City Saitama Japan
| | - Hiroshi Wada
- Division of Cardiovascular Medicine, Saitama Medical Center Jichi Medical University Saitama City Saitama Japan
| | - Hideo Fujita
- Division of Cardiovascular Medicine, Saitama Medical Center Jichi Medical University Saitama City Saitama Japan
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Fujii K, Kubo T, Otake H, Nakazawa G, Sonoda S, Hibi K, Shinke T, Kobayashi Y, Ikari Y, Akasaka T. Expert consensus statement for quantitative measurement and morphological assessment of optical coherence tomography: update 2022. Cardiovasc Interv Ther 2022; 37:248-254. [PMID: 35167032 DOI: 10.1007/s12928-022-00845-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/21/2022] [Indexed: 12/16/2022]
Abstract
In this updated expert consensus document, the methods for the quantitative measurement and morphological assessment of optical coherence tomography (OCT)/optical frequency domain imaging images (OFDI) are briefly summarized. The focus is on the clinical application and the clinical evidence of OCT/OFDI to guide percutaneous coronary interventions.
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Affiliation(s)
- Kenichi Fujii
- Division of Cardiology, Department of Medicine II, Kansai Medical University, Hirakata-city, Osaka, 5731010, Japan.
| | - Takashi Kubo
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiromasa Otake
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Gaku Nakazawa
- Department of Cardiology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Shinjo Sonoda
- Department of Cardiovascular Failure Therapy, Saga University Faculty of Medicine, Saga, Japan
| | - Kiyoshi Hibi
- Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Toshiro Shinke
- Division of Cardiovascular Medicine, Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yuji Ikari
- Department of Cardiology, Tokai University School of Medicine, Kanagawa, Japan
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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Akutsu N, Hori K, Mizobuchi S, Ogaku A, Koyama Y, Fujito H, Arai R, Ebuchi Y, Migita S, Morikawa T, Tamaki T, Kojima K, Murata N, Nishida T, Kitano D, Fukamachi D, Okumura Y. Clinical Importance of the LDL-C/Apolipoprotein B Ratio for Neointimal Formation after Everolimus-Eluting Stent Implantations. J Atheroscler Thromb 2021; 29:536-550. [PMID: 33746158 PMCID: PMC9090476 DOI: 10.5551/jat.60954] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS Smaller low-density lipoprotein (LDL) particle size has been suggested to result in the development of endothelial dysfunction, atherosclerosis, and in-stent restenosis (ISR); however, little is known regarding the impact of the LDL particle size on the neointima formation leading to ISR after everolimus-eluting stent (EES) implantation. METHODS In this study, we have included 100 patients to examine the relationship between an LDL-C/apolipoprotein B (Apo B) ≤ 1.2, reportedly representing the LDL particle size, and the neointimal characteristics using optical coherence tomography (OCT) and coronary angioscopy (CAS) during the follow-up coronary angiography (CAG) period (8.8±2.5 months) after EES implantation. We divided them into two groups: LDL-C/Apo B ≤ 1.2 group (low LDL-C/Apo B group, n=53) and LDL-C/Apo B >1.2 group (high LDL-C/Apo B group, n=47). RESULTS The low LDL-C/Apo B group had a significantly larger neointimal volume (12.8±5.3 vs. 10.3±4.9 mm3, p=0.021) and lower incidence of a neointimal homogeneous pattern (71 vs. 89 %), higher incidence of a neointimal heterogeneous pattern (25 vs. 9 %) (p=0.006) and higher prevalence of macrophage accumulation (9 vs. 2 %) (p=0.030) as assessed via OCT, and, as per the CAS findings, a higher prevalence of yellow grade ≥ 2 (grade 2; adjusted residual: 2.94, grade 3; adjusted residual: 2.00, p=0.017) than the high LDL-C/Apo B group. CONCLUSIONS A low LDL-C/Apo B ratio was found to be strongly associated with neointimal proliferation and neointimal instability evidenced chronically by OCT and CAS. An LDL-C/Apo B ≤ 1.2 will be of aid in terms of identifying high-risk patients after EES implantation.
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Affiliation(s)
- Naotaka Akutsu
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Koichiro Hori
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Saki Mizobuchi
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Akihito Ogaku
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Yutaka Koyama
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Hidesato Fujito
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Riku Arai
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Yasunari Ebuchi
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Suguru Migita
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Tomoyuki Morikawa
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Takehiro Tamaki
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Keisuke Kojima
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Nobuhiro Murata
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Toshihiko Nishida
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Daisuke Kitano
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine.,Division of Advanced Cardiovascular Imaging, Department of Medicine, Nihon University School of Medicine
| | - Daisuke Fukamachi
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
| | - Yasuo Okumura
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine
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Treatment of In-Stent Restenosis Using Excimer Laser Coronary Atherectomy and Bioresorbable Vascular Scaffold Guided by Optical Coherence Tomography. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2020; 22:44-49. [PMID: 32448779 DOI: 10.1016/j.carrev.2020.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/27/2020] [Accepted: 05/11/2020] [Indexed: 11/23/2022]
Abstract
The rate of in-stent restenosis (ISR) has become increasingly prevalent with the exponential growth in stent implantation due to an aging population and a higher life expectancy, in addition to the high rates of obesity and diabetes. In this prospective, single operator, all-comer study, we sought to analyze the performance of ELCA followed by bioresorbable vascular scaffold (BVS) placement in patients undergoing percutaneous coronary intervention (PCI) for ISR. A total of 13 patients had ISR treated with a combination of ELCA and BVS, with 9 patients having matched OCT pre, post ELCA and post BVS. Mean age was 65 ± 11.22 and 83% of the patients were male. Hypertension and dyslipidemia were present in 100% of the patients and smoking and diabetes in 50%. After the procedure, we did not detect residual stenosis over 10% in any patient, resulting in a technical success of 100%. No patients had MACE during their hospital stay or within the next six months, resulting in a procedure success of 100%. The mean lumen area increased 0.35 mm2 from pre procedure to post ELCA and 3.58 mm2 from post ELCA to post BVS. The final difference, from pre procedure to post BVS, was a 3.93 mm2 lumen area gain. The mean lumen diameter increased 0.11 mm from baseline to ELCA, 0.95 mm from post laser to BVS implantation and 1.06 mm from pre procedure to post BVS. The NIH area reduced 0.48 mm2 from pre to post ELCA, 1.13mm2 from post ELCA to BVS implantation and 1.61 mm2 from baseline to post BVS implantation. We conclude that ELCA is a safe and feasible debulking method to approach ISR, with high rates of post-procedural BVS success, within six months follow-up.
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Expert consensus statement for quantitative measurement and morphological assessment of optical coherence tomography. Cardiovasc Interv Ther 2019; 35:13-18. [DOI: 10.1007/s12928-019-00626-5] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 08/09/2019] [Indexed: 11/25/2022]
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Nishino S, Sakuma M, Kanaya T, Nasuno T, Tokura M, Toyoda S, Abe S, Nakamura D, Tanaka K, Attizzani GF, Bezerra HG, Costa MA, Inoue T. Neointimal tissue characterization after implantation of drug-eluting stents by optical coherence tomography: quantitative analysis of optical density. Int J Cardiovasc Imaging 2019; 35:1971-1978. [PMID: 31218524 DOI: 10.1007/s10554-019-01651-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/13/2019] [Indexed: 11/24/2022]
Abstract
Normalized optical density (NOD) measured by optical coherence tomography represents neointimal maturity after coronary stent implantation and is correlated with morphologic information provided by both light and electron microscopy. We aimed to test the hypothesis that even second generation drug-eluting stents (DESs) are problematic in terms of neointimal maturity. We implanted bare-metal stents (BMS: n = 14), everolimus-eluting stents (EESs: n = 15) or zotarolimus-eluting stents (ZESs: n = 12) at 41 sites in 32 patients with stable coronary artery disease. OCT was performed at up to 12 months of follow-up, and the average optical density of neointima covering struts was evaluated. NOD was calculated as the optical density of stent-strut covering tissue divided by the optical density of the struts. We also measured circulating CD34+ /CD133+ /CD45low cells, and serum levels of stromal cell-derived factor (SDF)-1, interleukin (IL)-8 and matrix metalloproteinase (MMP)-9 at baseline and follow-up. NOD was lower in the EES (0.70 ± 0.06) group than in the BMS (0.76 ± 0.07, P < 0.05) and ZES (0.76 ± 0.06, P < 0.05) groups. The mean neointimal area (R = 0.33, P < 0.05) and mean neointimal thickness (R = 0.37, P < 0.05) were correlated with NOD. Although NOD was not correlated with percent changes in circulating endothelial progenitor cells, and the levels of SDF-1 and IL-8, it was negatively correlated with the change in MMP-9 level (R = - 0.51, P < 0.01). Neointimal maturity might be lower at EES sites than BMS or ZES sites. This might lead to impaired neointimal tissue growth and matrix degradation. These results suggest a specific pathophysiology after DES implantation.
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Affiliation(s)
- Setsu Nishino
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan. .,Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
| | - Masashi Sakuma
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Tomoaki Kanaya
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Takahisa Nasuno
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Michiaki Tokura
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Shichiro Abe
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Daisuke Nakamura
- Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Kentaro Tanaka
- Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Guiherme F Attizzani
- Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Hiram G Bezerra
- Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Marco A Costa
- Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
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Effect of drug-coated balloon angioplasty on in-stent restenotic coronary lesions analyzed with optical coherence tomography and serial coronary artery angioscopy. Heart Vessels 2019; 34:1925-1935. [DOI: 10.1007/s00380-019-01447-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 05/31/2019] [Indexed: 10/26/2022]
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Pereira GTR, La Manna A, Ichibori Y, Vergara-Martel A, Ramos Nascimento B, Samdani AJ, Capodanno D, D'Agosta G, Gravina G, Venuti G, Tamburino C, F Attizzani G. Optical coherence tomography evaluation of the absorb bioresorbable scaffold performance for overlap versus non-overlap segments in patients with coronary chronic total occlusion: insight from the GHOST-CTO registry. Int J Cardiovasc Imaging 2019; 35:1767-1776. [PMID: 31175527 DOI: 10.1007/s10554-019-01636-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/27/2019] [Indexed: 01/18/2023]
Abstract
The Absorb bioresorbable vascular scaffold (BVS) promised to avoid some of the disadvantages of its metal predecessors. Even though it has been taken off the market, limited data is available about its use in coronary chronic total occlusion (CTO) and its performance in overlap segments, which would be of special research interest due to its large thickness. This data is still pertinent since the platform of bioresorbable devices has not been abandoned, with several companies working on it. We aimed to compare healing and performance between overlap (OL) and non-overlap regions (NOL) of CTO lesions treated with BVS, using optical coherence tomography (OCT). Fourteen patients with overlapping BVS were included from the GHOST-CTO registry, resulting in 25 OL and 38 NOL regions. OCT based parameters were compared between OL and NOL groups at baseline (post-implantation) and 12-month follow-up. The mean age was 61.7 ± 7.2 years and 12 (86%) were males. Twelve (86%) patients underwent PCI for stable coronary artery disease and 2 (14%) had unstable angina. At 12-month follow-up, mean lumen area decreased in both NOL and OL regions, but the decrease was significantly larger in the OL region (NOL - 0.7 ± 1.33 vs. OL - 2.4 ± 1.54 mm2; p = 0.002). Mean scaffold area increased in both regions, but increased significantly more in NOL ( + 1.1 ± 1.54 vs. + 0.4 ± 1.16 mm2; p = 0.016). The percent of uncovered struts was lower in the OL group (5.0 ± 6.6% vs. 3.75 ± 8.7%, p = 0.043), whereas the percentage of malapposed struts was similar (0.3 ± 0.5% vs. 0.7 ± 2.3%, p = 0.441). Neointimal hyperplasia (NIH) was more pronounced in the OL region (0.13 ± 0.04 vs. 0.24 ± 0.10 mm2, p = 0.001). The OL and NOL segments showed comparable healing in terms of coverage and malapposition. However, NIH was more prominent in OL region. The long-term clinical implications of these findings needs further evaluation. The present study provides important insights for future development of BVS technology.
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Affiliation(s)
- Gabriel T R Pereira
- Case Western Reserve University and Harrington Heart and Vascular Institute, University Hospitals, Cleveland Medical Center, Cleveland, USA. .,Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside building, Room 3113, Mailstop Lakeside 5038, Cleveland, OH, 44106, USA.
| | - Alessio La Manna
- Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Yasuhiro Ichibori
- Case Western Reserve University and Harrington Heart and Vascular Institute, University Hospitals, Cleveland Medical Center, Cleveland, USA
| | - Armando Vergara-Martel
- Case Western Reserve University and Harrington Heart and Vascular Institute, University Hospitals, Cleveland Medical Center, Cleveland, USA
| | | | - Abdul Jawwad Samdani
- Case Western Reserve University and Harrington Heart and Vascular Institute, University Hospitals, Cleveland Medical Center, Cleveland, USA
| | - Davide Capodanno
- Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Guido D'Agosta
- Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Giacomo Gravina
- Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Giuseppe Venuti
- Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Corrado Tamburino
- Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Guilherme F Attizzani
- Case Western Reserve University and Harrington Heart and Vascular Institute, University Hospitals, Cleveland Medical Center, Cleveland, USA. .,Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Lakeside building, Room 3113, Mailstop Lakeside 5038, Cleveland, OH, 44106, USA.
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La Manna A, Miccichè E, D'Agosta G, Tensol Rodrigues Pereira G, Attizzani GF, Capranzano P, Capodanno D, Tamburino C. Vascular response and healing profile of everolimus-eluting bioresorbable vascular scaffolds for percutaneous treatment of chronic total coronary occlusions: A one-year optical coherence tomography analysis from the GHOST-CTO registry. Int J Cardiol 2018; 253:45-49. [PMID: 29137819 DOI: 10.1016/j.ijcard.2017.10.107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 08/30/2017] [Accepted: 10/25/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Bioresorbable vascular scaffolds (BVS) have been heralded with potential benefits that are especially desired in long lesions, including chronic total occlusions (CTOs). Procedural feasibility and mid-term outcomes of BVS in CTOs have been reported. However, there is still a paucity of data regarding the vascular and healing response to BVS in CTOs evaluated by optical coherence tomography (OCT). METHODS This study included prospectively 21 patients who had a CTO lesion treated with a BVS. Angiography and OCT scan were recorded at either post-implantation and 1-year follow-up. Quantitative coronary angiography and OCT analyses were performed by an independent core laboratory. RESULTS The angiographic analysis showed a significant increase in the percentage of in-segment diameter stenosis at 1year (11.89±9.5% vs. 21.84±11.7%; p=0.002). The OCT analysis showed a trend (p=0.07) towards increased mean scaffold area and significant reductions in mean lumen diameter (3.1±0.36mm vs. 2.85±0.47mm; p=0.0046), mean lumen area (7.8±1.73mm2 vs. 6.76±2mm2; p=0.0082) and minimal lumen area (5.26±1.86mm2 vs. 3.56±1.52mm2; p<0.0001). Malapposition area and volume decreased from 0.26±0.17mm2 to 0.08±0.1mm2 (p=0.0003) and from 14.17±12.92mm3 to 3.99±4.46mm3 (p=0.0014), respectively. The rate of uncovered or malapposed struts, measured at the frame level, was 5.29±6.48% at 1year. CONCLUSIONS In a small series of CTO patients treated with BVS implantation, OCT outcomes at 1year displayed an overall favorable vascular response and healing profile.
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Affiliation(s)
- Alessio La Manna
- Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Eligio Miccichè
- Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Guido D'Agosta
- Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Gabriel Tensol Rodrigues Pereira
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland Medical Center, 11100 Euclid Avenue Lakeside, 3113 Cleveland, OH, United States
| | - Guilherme Ferragut Attizzani
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland Medical Center, 11100 Euclid Avenue Lakeside, 3113 Cleveland, OH, United States
| | - Piera Capranzano
- Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Davide Capodanno
- Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy.
| | - Corrado Tamburino
- Cardio-Thoracic-Vascular Department, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
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Laimoud M, Nassar Y, Omar W, Abdelbarry A, Elghawaby H. Stent boost enhancement compared to intravascular ultrasound in the evaluation of stent expansion in elective percutaneous coronary interventions. Egypt Heart J 2017; 70:21-26. [PMID: 29622993 PMCID: PMC5883512 DOI: 10.1016/j.ehj.2017.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 09/26/2017] [Indexed: 12/16/2022] Open
Abstract
Background Stent underexpansion is a major risk factor for in-stent restenosis and acute in-stent thrombosis1Intravascular ultrasound (IVUS) is one of the standards for detection of stent underexpansion (de Feyter et al. 1999; Mintz et al., 2001). StentBoost (SB) enhancement allows an improved angiographic visualization of the stent (Koolen et al., 2005). Aim of work Comparison of stent expansion by IVUS and SB enhancement and detection of value of SB to guide dilatation post stent deployment. Methodology IVUS, SB enhancement and QCA were done in 30 patients admitted for elective stenting procedures .We compared measurements of mean ±standard deviations of (Max SD, Min SD, Mean SD, stent symmetry index) using IVUS, SB and QCA after stent deployment and after postdilatation whenever necessary to optimize stent deployment. The Stent symmetry index was calculated [(maximum stent diameter minus minimum stent diameter) divided by maximum stent diameter]. Results The Max SD was (3.45 ± 0.62 vs 3.55 ± 0.56 vs 2.97 ± 0.59) by IVUS vs SB vs QCA respectively. Max SD was significantly higher by IVUS vs QCA (p .009) and between SB vs QCA (p .001) while there was nonsignificant difference between IVUS vs SB (p .53). The Min SD was (2.77 ± 0.53 vs 2.58 ± 0.56 vs 1.88 ± 0.60) by IVUS vs SB vs QCA respectively. Min SD was significantly higher by IVUS vs QCA (p .001) and between SB vs QCA (p .001) while there was nonsignificant difference between IVUS vs SB (p .07). The stent symmetry index was (0.24 ±0.09 vs 0.34 ± 0.09 vs 0.14 ±0.27) by IVUS vs SB vs QCA respectively. It was significantly higher by IVUS vs QCA (p .001) and between SB vs QCA (p .001) while there was nonsignificant difference between IVUS vs SB (p .32). SB was positively correlated with IVUS measurements of Max SD (p < .0001 & r 0.74) and Min SD (p < .0001 & r 0.68). QCA was positively correlated with IVUS measurements of Max SD correlation (p < .0001 & r 0.69) and Min SD (p < .0001 & r 0.63). QCA was positively correlated with SB measurements of Max SD (p < .0001 & r 0.61) and Min SD (p .003 & r 0.49). Conclusions StentBoost enhancement has superior correlations for stent expansion measured by IVUS when compared with QCA. SB enhancement improved stent visualization and identification of stent underexpansion to guide stent postdilatation.
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Affiliation(s)
| | - Yasser Nassar
- Critical Care Medicine Department-Cairo University, Egypt
| | - Walid Omar
- Critical Care Medicine Department-Cairo University, Egypt
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Rodean I, Himcinschi E, Tirca A, Cernica D. Intracoronary Imaging in the Management of a Complex and Recurrent Acute Coronary Syndrome Associated With Multiple Comorbidities. A Case Report. JOURNAL OF CARDIOVASCULAR EMERGENCIES 2017. [DOI: 10.1515/jce-2017-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Coronary artery disease represents a major cause of morbidity and mortality around the world. Unstable angina pectoris is a serious manifestation of ischemic heart disease and represents an acute condition caused by the narrowing of the coronary lumen as the result of an atheromatous plaque formation. In most cases the trigger of this process is represented by the rupture of a plaque that has become vulnerable or unstable. The first-line intracoronary imaging technique for the evaluation of plaque vulnerability is optical coherence tomography, which can measure the thickness of the fibrous cap (a significant predictor of plaque vulnerability) and can also assess other characteristics of plaque vulnerability (macrophage infiltration, lipid pool, intracoronary thrombus, or neointimal rupture). We present the case of a 67-year-old male with symptoms suggestive of unstable angina pectoris, caused by the presence of a vulnerable plaque on the left main coronary artery, where optical coherence tomography had a significant contribution in identifying the etiology of chest pain.
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Affiliation(s)
- Ioana Rodean
- Department of Computational Imaging , Cardio Med Medical Center , Tîrgu Mureș , Romania
| | - Elisabeta Himcinschi
- Department of Computational Imaging , Cardio Med Medical Center , Tîrgu Mureș , Romania
| | - Alexandra Tirca
- Department of Computational Imaging , Cardio Med Medical Center , Tîrgu Mureș , Romania
| | - Daniel Cernica
- Department of Computational Imaging , Cardio Med Medical Center , Tîrgu Mureș , Romania
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Gora MJ, Suter MJ, Tearney GJ, Li X. Endoscopic optical coherence tomography: technologies and clinical applications [Invited]. BIOMEDICAL OPTICS EXPRESS 2017; 8:2405-2444. [PMID: 28663882 PMCID: PMC5480489 DOI: 10.1364/boe.8.002405] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/20/2017] [Accepted: 03/27/2017] [Indexed: 05/07/2023]
Abstract
In this paper, we review the current state of technology development and clinical applications of endoscopic optical coherence tomography (OCT). Key design and engineering considerations are discussed for most OCT endoscopes, including side-viewing and forward-viewing probes, along with different scanning mechanisms (proximal-scanning versus distal-scanning). Multi-modal endoscopes that integrate OCT with other imaging modalities are also discussed. The review of clinical applications of endoscopic OCT focuses heavily on diagnosis of diseases and guidance of interventions. Representative applications in several organ systems are presented, such as in the cardiovascular, digestive, respiratory, and reproductive systems. A brief outlook of the field of endoscopic OCT is also discussed.
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Affiliation(s)
- Michalina J Gora
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- ICube Laboratory, CNRS, Strasbourg University, 1 Place de l'Hopital, Strasbourg 67091, France
| | - Melissa J Suter
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Department of Medicine, Division of Pulmonary and Critical Care, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
- Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Xingde Li
- Department of Biomedical Engineering, Department of Electrical and Computer Engineering, and Department of Oncology, Johns Hopkins University, 720 Rutland Avenue, Traylor 710, Baltimore, MD 21205, USA
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Jaguszewski M, Aloysius R, Wang W, Bezerra HG, Hill J, De Winter RJ, Karjalainen PP, Verheye S, Wijns W, Lüscher TF, Joner M, Costa M, Landmesser U. The REMEDEE-OCT Study. JACC Cardiovasc Interv 2017; 10:489-499. [DOI: 10.1016/j.jcin.2016.11.040] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/11/2016] [Accepted: 11/17/2016] [Indexed: 12/24/2022]
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Miki K, Fujii K, Kawasaki D, Shibuya M, Fukunaga M, Imanaka T, Tamaru H, Sumiyoshi A, Nishimura M, Horimatsu T, Saita T, Kobayashi Y, Honda Y, Fitzgerald PJ, Masuyama T, Ishihara M. Impact of analysis interval size on the quality of optical frequency domain imaging assessments of stent implantation for lesions of the superficial femoral artery. Catheter Cardiovasc Interv 2017; 89:735-745. [PMID: 27515475 DOI: 10.1002/ccd.26673] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 07/03/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVES This study aimed to investigate the influence of analysis interval size on optical frequency domain imaging (OFDI) assessment of stent therapy for lesions of the superficial femoral artery (SFA). BACKGROUND No consensus or validating data are available with respect to the methodology of intravascular imaging analysis for the peripheral arteries. METHODS OFDI was performed for 30 SFA lesions, during endovascular therapy and at the 6-month follow-up. Initially, lumen and stent borders were traced at 1-mm axial intervals. Volumes were calculated using a PC-based software, and the volume index (VI) was defined as the volume divided by the stent length. Two additional OFDI analyses were performed using 2-mm and 5-mm intervals, thereby reducing the number of cross-sectional image frames analyzed. RESULTS The mean stent length was 89.7 ± 35.2 mm. The mean difference in baseline minimum lumen area (MLA) was 0.4 mm2 between MLA values from the 1-mm and 2-mm interval analyses, and 2.2 mm2 between MLA values from the 1-mm and 5-mm interval analyses. In volumetric analysis, there were excellent correlations and good agreements for stent, lumen, and neointimal VI measurements obtained on the basis of different analysis intervals. CONCLUSIONS Using large intervals in OFDI analyses of SFA lesions resulted in few differences in measurement variability of volumetric parameters. However, planar analysis for MLA assessment can be susceptible to high variability when large intervals are applied. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Kojiro Miki
- Division of Cardiovascular Medicine Stanford University School of Medicine, Stanford, California.,Division of Cardiovascular Medicine and Coronary Heart Disease Hyogo College of Medicine, Nishinomiya, Japan
| | - Kenichi Fujii
- Division of Cardiovascular Medicine and Coronary Heart Disease Hyogo College of Medicine, Nishinomiya, Japan
| | - Daizo Kawasaki
- Division of Cardiovascular Medicine, Morinomiya Hospital, Cardiovascular Center, Osaka, Japan
| | - Masahiko Shibuya
- Division of Cardiovascular Medicine and Coronary Heart Disease Hyogo College of Medicine, Nishinomiya, Japan
| | - Masashi Fukunaga
- Division of Cardiovascular Medicine, Morinomiya Hospital, Cardiovascular Center, Osaka, Japan
| | - Takahiro Imanaka
- Division of Cardiovascular Medicine and Coronary Heart Disease Hyogo College of Medicine, Nishinomiya, Japan
| | - Hiroto Tamaru
- Division of Cardiovascular Medicine and Coronary Heart Disease Hyogo College of Medicine, Nishinomiya, Japan
| | - Akinori Sumiyoshi
- Division of Cardiovascular Medicine and Coronary Heart Disease Hyogo College of Medicine, Nishinomiya, Japan
| | - Machiko Nishimura
- Division of Cardiovascular Medicine and Coronary Heart Disease Hyogo College of Medicine, Nishinomiya, Japan
| | - Tetsuo Horimatsu
- Division of Cardiovascular Medicine and Coronary Heart Disease Hyogo College of Medicine, Nishinomiya, Japan
| | - Ten Saita
- Division of Cardiovascular Medicine and Coronary Heart Disease Hyogo College of Medicine, Nishinomiya, Japan
| | - Yuhei Kobayashi
- Division of Cardiovascular Medicine Stanford University School of Medicine, Stanford, California
| | - Yasuhiro Honda
- Division of Cardiovascular Medicine Stanford University School of Medicine, Stanford, California
| | - Peter J Fitzgerald
- Division of Cardiovascular Medicine Stanford University School of Medicine, Stanford, California
| | - Tohru Masuyama
- Division of Cardiovascular Medicine and Coronary Heart Disease Hyogo College of Medicine, Nishinomiya, Japan
| | - Masaharu Ishihara
- Division of Cardiovascular Medicine and Coronary Heart Disease Hyogo College of Medicine, Nishinomiya, Japan
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Varho V, Nammas W, Kiviniemi TO, Sia J, Romppanen H, Pietilä M, Airaksinen JK, Karjalainen PP. Comparison of two different sampling intervals for optical coherence tomography evaluation of neointimal healing response after coronary stent implantation. Int J Cardiol 2017; 227:194-200. [PMID: 27839810 DOI: 10.1016/j.ijcard.2016.11.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 11/06/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND/OBJECTIVES Optical coherence tomography (OCT) is widely used for evaluation of healing response to stent implantation. We sought to test the agreement between the 1-mm and 0.6-mm sampling intervals for assessment of the percentage of uncovered and malapposed struts by OCT. METHODS Thirty-eight patients presenting with acute coronary syndrome were randomized to receive either a titanium-nitride-oxide-coated stent (n=19) or an everolimus-eluting stent (n=19). Neointimal strut coverage and strut apposition were evaluated by OCT at 2-month follow-up. Two independent investigators performed offline OCT image analysis at 1-mm intervals. One investigator repeated the measurements at 0.6-mm intervals and measurements were compared between the two sampling intervals. RESULTS At a median follow-up of 60 [8] days, 694 cross-sections (7603 struts) and 1138 cross-sections (12,331 struts) were analysed at 1-mm and at 0.6-mm intervals, respectively. The median [IQR] percentage of uncovered struts was 3.27% [11.1] versus 3.38% [9.76] (p=0.001), and the mean (±SD) percentage was 7.69±9.99% versus 6.27±8.14% (p=0.004), for the 1-mm sampling interval versus the 0.6-mm sampling interval analysis, respectively; the median percentage of malapposed struts was 0.42% [2.04] versus 0.12% [1.63], respectively, (p=0.003). The intraclass correlation coefficient between the two observers for the percentage of uncovered struts was 0.95. CONCLUSIONS The OCT-evaluated strut-level measurements of neointimal healing after stent implantation differ significantly between the 1-mm and the 0.6-mm sampling intervals.
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Affiliation(s)
- Ville Varho
- Heart Center, Turku University Hospital, University of Turku, Turku, Finland.
| | - Wail Nammas
- Heart Centre, Satakunta Central Hospital, Pori, Finland
| | - Tuomas O Kiviniemi
- Heart Center, Turku University Hospital, University of Turku, Turku, Finland; Heart Centre, Satakunta Central Hospital, Pori, Finland
| | - Jussi Sia
- Department of Cardiology, Central Ostrobothnia Central Hospital, Kokkola, Finland
| | - Hannu Romppanen
- Cardiology Unit, Kuopio University Hospital, Kuopio, Finland
| | - Mikko Pietilä
- Heart Center, Turku University Hospital, University of Turku, Turku, Finland
| | - Juhani K Airaksinen
- Heart Center, Turku University Hospital, University of Turku, Turku, Finland
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16
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Fujino Y, Attizzani GF, Tahara S, Naganuma T, Takagi K, Yabushita H, Wang W, Tanaka K, Matsumoto T, Kawamoto H, Yamada Y, Amano S, Watanabe Y, Warisawa T, Sato T, Mitomo S, Kurita N, Ishiguro H, Hozawa K, Tsukahara T, Motosuke M, Bezerra HG, Nakamura S, Nakamura S. Difference in vascular response between sirolimus-eluting- and everolimus-eluting stents in ostial left circumflex artery after unprotected left main as observed by optical coherence tomography. Int J Cardiol 2016; 230:284-292. [PMID: 28065691 DOI: 10.1016/j.ijcard.2016.12.122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 12/01/2016] [Accepted: 12/17/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Kissing-balloon technique (KBT) is commonly performed during percutaneous coronary intervention of distal unprotected left main coronary artery (ULM) aiming at obtaining optimal opening of the side branch (left circumflex artery; LCX) ostium. Nonetheless, detailed evaluation of vascular response to stents in LCX ostium is lacking. We therefore evaluated the vascular response to different drug-eluting stents (DES) in ostial LCX after ULM by means of optical coherence tomography (OCT). METHODS We prospectively enrolled 38 consecutive patients with ULM disease, who were treated with single-stent procedure using DES, crossover the ULM-left anterior descending artery (LAD) followed by KBT. Twelve patients were treated with sirolimus-eluting stents (SES) and 26 patients were treated with everolimus-eluting stents (EES). OCT was conducted at post-PCI and 9-month follow-up. We evaluated the DES-vessel interactions and number of stent struts at the side branch (LCX) ostium (SO) at post-PCI, and compared the narrowing of ostial area at LCX between SES and EES. RESULTS Post-procedure, the number of stent struts at SO was significantly higher in SES compared to EES (median 14.47% vs 0.19%, p<0.001). The narrowing of LCX ostial area at follow-up was more pronounced in SES compared with EES (29.16% vs 2.46%, respectively, p<0.001). Linear regression analysis showed a high correlation between the number of stent struts in LCX ostium and ostial area narrowing (r=0.771, p<0.001). CONCLUSIONS OCT showed differences between EES- and SES-vessel interactions at ULM bifurcation PCI. Number of LCX ostium struts at post-PCI impacted the narrowing of ostial area at 9-month follow-up.
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Affiliation(s)
- Yusuke Fujino
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan.
| | - Guilherme F Attizzani
- Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, United States
| | - Satoko Tahara
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
| | - Toru Naganuma
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
| | - Kensuke Takagi
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
| | | | - Wei Wang
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS, United States
| | - Kentaro Tanaka
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
| | | | | | - Yuya Yamada
- Department of Mechanical Engineering, Tokyo University of Science, Chiba, Japan
| | - Shinnosuke Amano
- Department of Mechanical Engineering, Tokyo University of Science, Chiba, Japan
| | | | | | - Tomohiko Sato
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
| | - Satoru Mitomo
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
| | - Naoyuki Kurita
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
| | | | - Koji Hozawa
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
| | - Takahiro Tsukahara
- Department of Mechanical Engineering, Tokyo University of Science, Chiba, Japan
| | - Masahiro Motosuke
- Department of Mechanical Engineering, Tokyo University of Science, Chiba, Japan
| | - Hiram G Bezerra
- Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, United States
| | | | - Sunao Nakamura
- Department of Cardiology, New Tokyo Hospital, Chiba, Japan
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Fujino Y, Attizzani GF, Tahara S, Naganuma T, Takagi K, Yabushita H, Wang W, Warisawa T, Watanabe Y, Mitomo S, Sato T, Kurita N, Ishiguro H, Hozawa K, Nakamura S, Bezerra HG, Nakamura S. Optical coherence tomography assessment of in-stent restenosis after percutaneous coronary intervention with two-stent technique in unprotected left main. Int J Cardiol 2016; 219:285-92. [DOI: 10.1016/j.ijcard.2016.05.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 05/10/2016] [Accepted: 05/12/2016] [Indexed: 11/28/2022]
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Han Z, Feng L, Du H, Sun Z, Hu S, Dai J, Sun M, Xing L, Hou J, Zhang S, Yu B. Impact of Age on Stent Strut Coverage and Neointimal Remodeling as Assessed by Optical Coherence Tomography. Medicine (Baltimore) 2015; 94:e2246. [PMID: 26683940 PMCID: PMC5058912 DOI: 10.1097/md.0000000000002246] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
While older age associates with adverse percutaneous coronary intervention (PCI) outcomes, detailed information relating age to stent strut coverage and neointimal characteristics is lacking. One hundred nineteen patients with 123 sirolimus-eluting stents (SESs) were divided into 3 groups: group A (≤55 years), group B (56-65 years), and group C (>65 years). At 6 and 12 months of follow-up, optical coherence tomography was performed to assess strut coverage and neointimal remodeling. At 6 months, the proportion of uncovered struts increased with age: 6.1% in group A versus 7.3% in group B versus 11.7% in group C (P < 0.001) while the proportion of embedded struts decreased: 72.1% versus 57.0% vs. 55.0%, respectively (P < 0.001). Mean neointimal thicknesses were 90 μm versus 60 μm versus 60 μm, respectively (P < 0.001), and neointimal areas were 0.82 mm2 versus 0.52 mm2 versus 0.57 mm2 (P < 0.001). At 12 months, the proportion of uncovered struts increased with age (3.9% vs. 3.3% vs. 4.9 %; P < 0.001), while mean neointimal thicknesses were 100 versus 70 versus 80 μm (P < 0.001) and neointimal areas were 0.87 versus 0.60 versus 0.67 mm2 (P < 0.001). Patients ≤55 years receiving SES showed highest strut coverage and neointimal repair rate compared with the other 2 groups. A "catch-up phenomenon" appeared to occur in the oldest patients, as in the first 6 months the neointima showed lowest endothelial cell coverage and lowest neointimal proliferation rate, whereas from 6 to 12 months, the highest neointimal proliferation rate was seen in the oldest patients.
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Affiliation(s)
- Zhigang Han
- From the Department of Cardiology, 2nd Affiliated Hospital of Harbin Medical University, Harbin, P.R. China (SZ); and the Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, P.R. China (ZH, LF, HD, ZS, SH, JD, MS, LX, JH, BY)
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In vitro study of sirolimus release from a drug-eluting stent: Comparison of the release profiles obtained using different test setups. Eur J Pharm Biopharm 2015; 93:328-38. [DOI: 10.1016/j.ejpb.2015.04.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 04/11/2015] [Accepted: 04/26/2015] [Indexed: 11/21/2022]
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Silva GV, Gahremanpour A, Attizzani GF, Zeng Y, Wang W, Yamamoto H, Kanaya T, Rippy MK, Bezerra HG, Costa MA, Perin E. Comparison of scanning electron microscopy and optical coherence tomography for imaging of coronary bifurcation stents. Catheter Cardiovasc Interv 2015; 85:1141-9. [DOI: 10.1002/ccd.25612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 07/14/2014] [Indexed: 11/06/2022]
Affiliation(s)
| | | | | | - Yi Zeng
- Texas Heart Institute; Houston Texas
| | - Wei Wang
- Harrington Heart and Vascular Institute, Case Medical Center; Cleveland Ohio
| | - Hirosada Yamamoto
- Harrington Heart and Vascular Institute, Case Medical Center; Cleveland Ohio
| | - Tomoaki Kanaya
- Harrington Heart and Vascular Institute, Case Medical Center; Cleveland Ohio
| | | | - Hiram G. Bezerra
- Harrington Heart and Vascular Institute, Case Medical Center; Cleveland Ohio
| | - Marco A. Costa
- Harrington Heart and Vascular Institute, Case Medical Center; Cleveland Ohio
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Wijns W, Vrolix M, Verheye S, Schoors D, Slagboom T, Gosselink M, Benit E, Donohoe D, Knape C, Attizzani GF, Lansky AJ, Ormiston J. Randomised study of a bioabsorbable polymer-coated sirolimus-eluting stent: results of the DESSOLVE II trial. EUROINTERVENTION 2015; 10:1383-90. [DOI: 10.4244/eijy14m05_03] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Mancuso JJ, Halaney DL, Elahi S, Ho D, Wang T, Ouyang Y, Dijkstra J, Milner TE, Feldman MD. Intravascular optical coherence tomography light scattering artifacts: merry-go-rounding, blooming, and ghost struts. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:126017. [PMID: 25545341 PMCID: PMC4659478 DOI: 10.1117/1.jbo.19.12.126017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 12/04/2014] [Indexed: 06/04/2023]
Abstract
We sought to elucidate the mechanisms underlying two common intravascular optical coherence tomography (IV-OCT) artifacts that occur when imaging metallic stents: “merry-go-rounding” (MGR), which is an increase in strut arc length (SAL), and “blooming,” which is an increase in the strut reflection thickness (blooming thickness). Due to uncontrollable variables that occur in vivo, we performed an in vitro assessment of MGR and blooming in stented vessel phantoms. Using Xience V and Driver stents, we examined the effects of catheter offset, intimal strut coverage, and residual blood on SAL and blooming thickness in IV-OCT images. Catheter offset and strut coverage both caused minor MGR, while the greatest MGR effect resulted from light scattering by residual blood in the vessel lumen, with 1% hematocrit (Hct) causing a more than fourfold increase in SAL compared with saline (p<0.001 ). Residual blood also resulted in blooming, with blooming thickness more than doubling when imaged in 0.5% Hct compared with saline (p<0.001 ). We demonstrate that a previously undescribed mechanism, light scattering by residual blood in the imaging field, is the predominant cause of MGR. Light scattering also results in blooming, and a newly described artifact, three-dimensional-MGR, which results in “ghost struts” in B-scans.
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Affiliation(s)
- J. Jacob Mancuso
- The University of Texas Health Science Center at San Antonio, Division of Cardiology, Department of Medicine, 7703 Floyd Curl Drive, San Antonio, Texas 78229, United States
- South Texas Veterans Health Care System, The Department of Veterans Affairs, San Antonio, Texas 78229, United States
| | - David L. Halaney
- The University of Texas Health Science Center at San Antonio, Division of Cardiology, Department of Medicine, 7703 Floyd Curl Drive, San Antonio, Texas 78229, United States
- South Texas Veterans Health Care System, The Department of Veterans Affairs, San Antonio, Texas 78229, United States
| | - Sahar Elahi
- The University of Texas at Austin, Department of Biomedical Engineering, 1 University Station C0800, Austin, Texas 78712, United States
| | - Derek Ho
- The University of Texas at Austin, Department of Biomedical Engineering, 1 University Station C0800, Austin, Texas 78712, United States
| | - Tianyi Wang
- The University of Texas at Austin, Department of Biomedical Engineering, 1 University Station C0800, Austin, Texas 78712, United States
| | - Yongjian Ouyang
- The University of Texas Health Science Center at San Antonio, Division of Cardiology, Department of Medicine, 7703 Floyd Curl Drive, San Antonio, Texas 78229, United States
| | - Jouke Dijkstra
- Leiden University Medical Center, Division of Image Processing, Department of Radiology, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Thomas E. Milner
- The University of Texas at Austin, Department of Biomedical Engineering, 1 University Station C0800, Austin, Texas 78712, United States
| | - Marc D. Feldman
- The University of Texas Health Science Center at San Antonio, Division of Cardiology, Department of Medicine, 7703 Floyd Curl Drive, San Antonio, Texas 78229, United States
- South Texas Veterans Health Care System, The Department of Veterans Affairs, San Antonio, Texas 78229, United States
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23
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Attizzani GF, Ohno Y, Capodanno D, Francaviglia B, Grasso C, Sgroi C, Wang W, Fujino Y, Ganocy SJ, Longo G, Tamburino CI, Di Salvo M, La Manna A, Capranzano P, Tamburino C. New insights on acute expansion and longitudinal elongation of bioresorbable vascular scaffolds in vivo and at bench test: A note of caution on reliance to compliance charts and nominal length. Catheter Cardiovasc Interv 2014; 85:E99-E107. [DOI: 10.1002/ccd.25645] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 08/17/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Guilherme F. Attizzani
- Division of Cardiology; Ferrarotto Hospital, University of Catania; Catania Italy
- Department of Interventional Cardiology; Pitangueiras Hospital; Jundiai Sao Paulo Brazil
- Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center; Cleveland Ohio
| | - Yohei Ohno
- Division of Cardiology; Ferrarotto Hospital, University of Catania; Catania Italy
| | - Davide Capodanno
- Division of Cardiology; Ferrarotto Hospital, University of Catania; Catania Italy
- Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center; Cleveland Ohio
| | - Bruno Francaviglia
- Division of Cardiology; Ferrarotto Hospital, University of Catania; Catania Italy
| | - Carmelo Grasso
- Division of Cardiology; Ferrarotto Hospital, University of Catania; Catania Italy
| | - Carmelo Sgroi
- Division of Cardiology; Ferrarotto Hospital, University of Catania; Catania Italy
| | - Wei Wang
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center; Jackson Mississippi
| | | | - Stephen J. Ganocy
- Department of Biostatistics; Case Western Reserve University; Cleveland Ohio
| | - Giovanni Longo
- Division of Cardiology; Ferrarotto Hospital, University of Catania; Catania Italy
| | - Claudia I. Tamburino
- Division of Cardiology; Ferrarotto Hospital, University of Catania; Catania Italy
| | - Marilena Di Salvo
- Division of Cardiology; Ferrarotto Hospital, University of Catania; Catania Italy
| | - Alessio La Manna
- Division of Cardiology; Ferrarotto Hospital, University of Catania; Catania Italy
| | - Piera Capranzano
- Division of Cardiology; Ferrarotto Hospital, University of Catania; Catania Italy
| | - Corrado Tamburino
- Division of Cardiology; Ferrarotto Hospital, University of Catania; Catania Italy
- Excellence Through Newest Advances (ETNA) Foundation; Catania Italy
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van Ditzhuijzen NS, Karanasos A, Bruining N, van den Heuvel M, Sorop O, Ligthart J, Witberg K, Garcia-Garcia HM, Zijlstra F, Duncker DJ, van Beusekom HMM, Regar E. The impact of Fourier-Domain optical coherence tomography catheter induced motion artefacts on quantitative measurements of a PLLA-based bioresorbable scaffold. Int J Cardiovasc Imaging 2014; 30:1013-26. [DOI: 10.1007/s10554-014-0447-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 05/09/2014] [Indexed: 11/24/2022]
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Attizzani GF, Capodanno D, Ohno Y, Tamburino C. Mechanisms, pathophysiology, and clinical aspects of incomplete stent apposition. J Am Coll Cardiol 2014; 63:1355-67. [PMID: 24530675 DOI: 10.1016/j.jacc.2014.01.019] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 12/12/2013] [Accepted: 01/07/2014] [Indexed: 11/25/2022]
Abstract
Incomplete stent apposition (ISA) is characterized by the lack of contact of at least 1 stent strut with the vessel wall in a segment not overlying a side branch; it is more commonly found in drug-eluting stents than bare-metal stents. The accurate diagnosis of ISA, initially only possible with intravascular ultrasound, can currently be performed with higher accuracy by optical coherence tomography, which also enables strut-level assessment due to its higher axial resolution. Different circumstances related both to the index procedure and to vascular healing might influence ISA occurrence. Although several histopathology and clinical studies linked ISA to stent thrombosis, potential selection bias precluded definitive conclusions. Initial studies usually performed single time point assessments comparing overall ISA percentage and magnitude in different groups (i.e., stent type), thus hampering a comprehensive understanding of its relationship with vascular healing. Serial intravascular imaging studies that evaluated vascular response heterogeneity recently helped fill this gap. Some particular clinical scenarios such as acute coronary syndromes, bifurcations, tapered vessels, overlapping stents, and chronic total occlusions might predispose to ISA. Interventional cardiologists should be committed to optimal stent choices and techniques of implantation and use intravascular imaging guidance when appropriate to aim at minimizing acute ISA. In addition, the active search for new stent platforms that could accommodate vessel remodeling over time (i.e., self-expandable stents) and for new polymers and/or eluting drugs that could induce less inflammation (hence, less positive remodeling) could ultimately reduce the occurrence of ISA and its potentially harmful consequences.
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Affiliation(s)
- Guilherme F Attizzani
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy; Division of Interventional Cardiology, Pitangueiras Hospital, Jundiaí, SP, Brazil; Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio
| | - Davide Capodanno
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy; Excellence Through Newest Advances (ETNA) Foundation, Catania, Italy.
| | - Yohei Ohno
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Corrado Tamburino
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy; Excellence Through Newest Advances (ETNA) Foundation, Catania, Italy
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Reiber JHC, Tu S, Tuinenburg JC, Koning G, Janssen JP, Dijkstra J. QCA, IVUS and OCT in interventional cardiology in 2011. Cardiovasc Diagn Ther 2013; 1:57-70. [PMID: 24282685 DOI: 10.3978/j.issn.2223-3652.2011.09.03] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 09/24/2011] [Indexed: 12/21/2022]
Abstract
Over the past 30 years, quantitative coronary arteriography (QCA) has been used extensively as an objective and reproducible tool in clinical research to assess changes in vessel dimensions as a result of interventions, but also as a tool to provide evidence to the interventionalist prior to and after an intervention and at follow-up when necessary. With the increasing complexities of bifurcation stenting, corresponding analytical tools for bifurcation analysis have been developed with extensive reporting schemes. Although intravascular ultrasound (IVUS) has been around for a long time as well, more recent radiofrequency analysis provides additional information about the vessel wall composition; likewise optical coherence tomography (OCT) provides detailed information about the positions of the stent struts and the quality of the stent placement. Combining the information from the X-ray lumenogram and the intravascular imaging devices is mentally a challenging task for the interventionalist. To support the registration of these intravascular images with the X-ray images, 3D QCA has been developed and registered with the IVUS or OCT images, so that at every position along the vessel of interest the luminal data and the vessel wall data by IVUS or the stent strut data by OCT can be combined. From the 3D QCA the selection of the optimal angiographic views can also be facilitated. It is the intention of this overview paper to provide an extensive description of the techniques that we have developed and validated over the past 30 years.
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Affiliation(s)
- Johan H C Reiber
- Division of Image Processing (LKEB), Department of Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
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Fujino Y, Attizzani GF, Bezerra HG, Wang W, Tahara S, Yamamoto H, Chamie D, Kanaya T, Mehanna E, Takagi K, Nakamura S, Costa MA. Serial Assessment of Vessel Interactions After Drug-Eluting Stent Implantation in Unprotected Distal Left Main Coronary Artery Disease Using Frequency-Domain Optical Coherence Tomography. JACC Cardiovasc Interv 2013; 6:1035-45. [DOI: 10.1016/j.jcin.2013.05.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 05/20/2013] [Accepted: 05/24/2013] [Indexed: 11/26/2022]
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Belkacemi A, Stella PR, Ali DS, Novianti PW, Doevendans PA, van Belle E, Agostoni P. Diagnostic accuracy of optical coherence tomography parameters in predicting in-stent hemodynamic severe coronary lesions: Validation against fractional flow reserve. Int J Cardiol 2013; 168:4209-13. [DOI: 10.1016/j.ijcard.2013.07.178] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 07/06/2013] [Accepted: 07/15/2013] [Indexed: 01/11/2023]
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Bezerra HG, Attizzani GF, Sirbu V, Musumeci G, Lortkipanidze N, Fujino Y, Wang W, Nakamura S, Erglis A, Guagliumi G, Costa MA. Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention. JACC Cardiovasc Interv 2013; 6:228-36. [PMID: 23517833 DOI: 10.1016/j.jcin.2012.09.017] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 09/06/2012] [Accepted: 09/27/2012] [Indexed: 12/26/2022]
Abstract
OBJECTIVES We compared intravascular ultrasound (IVUS) and 2 different generations of optical coherence tomography (OCT)-time-domain OCT (TD-OCT) and frequency-domain OCT (FD-OCT)-for the assessment of coronary disease and percutaneous coronary intervention (PCI) using stents. BACKGROUND OCT is a promising light-based intravascular imaging modality with higher resolution than IVUS. However, the paucity of data on OCT image quantification has limited its application in clinical practice. METHODS A total of 227 matched OCT and IVUS pull backs were studied. One hundred FD-OCT and IVUS pull backs in nonstented (n = 56) and stented (n = 44) vessels were compared. Additionally, 127 matched TD-OCT and IVUS images were compared in stented vessels. RESULTS FD-OCT depicted more severe native coronary disease than IVUS; minimal lumen area (MLA) was 2.33 ± 1.56 mm(2) versus 3.32 ± 1.92 mm(2), respectively (p < 0.001). Reference vessel dimensions were equivalent between FD-OCT and IVUS in both native and stented coronaries, but TD-OCT detected smaller reference lumen size compared with IVUS. Immediately post-PCI, in-stent MLAs were similar between FD-OCT and IVUS, but at follow-up, both FD-OCT and TD-OCT detected smaller MLAs than did IVUS, likely due to better detection of neointimal hyperplasia (NIH). Post-PCI malapposition and tissue prolapse were more frequently identified by FD-OCT. CONCLUSIONS FD-OCT generates similar reference lumen dimensions but higher degrees of disease severity and NIH, as well as better detection of malapposition and tissue prolapse compared with IVUS. First-generation TD-OCT was associated with smaller reference vessel dimensions compared with IVUS.
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Affiliation(s)
- Hiram G Bezerra
- Harrington Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH 44106, USA
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Fujino Y, Bezerra HG, Attizzani GF, Wang W, Yamamoto H, Chamié D, Kanaya T, Mehanna E, Tahara S, Nakamura S, Costa MA. Frequency-domain optical coherence tomography assessment of unprotected left main coronary artery disease-a comparison with intravascular ultrasound. Catheter Cardiovasc Interv 2013; 82:E173-83. [DOI: 10.1002/ccd.24843] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 11/14/2012] [Accepted: 01/21/2013] [Indexed: 11/12/2022]
Affiliation(s)
| | - Hiram G. Bezerra
- Harrington Heart and Vascular Institute; University Hospitals Case Medical Center; Case Western Reserve University; Cleveland; Ohio
| | - Guilherme F. Attizzani
- Harrington Heart and Vascular Institute; University Hospitals Case Medical Center; Case Western Reserve University; Cleveland; Ohio
| | - Wei Wang
- Harrington Heart and Vascular Institute; University Hospitals Case Medical Center; Case Western Reserve University; Cleveland; Ohio
| | - Hirosada Yamamoto
- Harrington Heart and Vascular Institute; University Hospitals Case Medical Center; Case Western Reserve University; Cleveland; Ohio
| | - Daniel Chamié
- Harrington Heart and Vascular Institute; University Hospitals Case Medical Center; Case Western Reserve University; Cleveland; Ohio
| | - Tomoaki Kanaya
- Harrington Heart and Vascular Institute; University Hospitals Case Medical Center; Case Western Reserve University; Cleveland; Ohio
| | - Emile Mehanna
- Harrington Heart and Vascular Institute; University Hospitals Case Medical Center; Case Western Reserve University; Cleveland; Ohio
| | - Satoko Tahara
- Department of Cardiology; New Tokyo Hospital; Chiba; Japan
| | - Sunao Nakamura
- Department of Cardiology; New Tokyo Hospital; Chiba; Japan
| | - Marco A. Costa
- Harrington Heart and Vascular Institute; University Hospitals Case Medical Center; Case Western Reserve University; Cleveland; Ohio
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Belkacemi A, Agostoni P, Nathoe HM, Voskuil M, Shao C, Van Belle E, Wildbergh T, Politi L, Doevendans PA, Sangiorgi GM, Stella PR. First Results of the DEB-AMI (Drug Eluting Balloon in Acute ST-Segment Elevation Myocardial Infarction) Trial. J Am Coll Cardiol 2012; 59:2327-37. [DOI: 10.1016/j.jacc.2012.02.027] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 02/06/2012] [Accepted: 02/07/2012] [Indexed: 11/28/2022]
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Nakatani S, Nishino M, Taniike M, Makino N, Kato H, Egami Y, Shutta R, Tanouchi J, Yamada Y. Initial findings of impact of strut width on stent coverage and apposition of sirolimus-eluting stents assessed by optical coherence tomography. Catheter Cardiovasc Interv 2012; 81:776-81. [PMID: 22517601 DOI: 10.1002/ccd.24401] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Accepted: 03/02/2012] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We investigate the influence of stent design on stent coverage at 6-9 months after sirolimus eluting stent (SES) implantation using optical coherence tomography (OCT). BACKGROUND Although some reports suggest that stent design may correlate with stent coverage of stent struts, there were few detailed data whether stent design impact on stent coverage in the same drug-eluting stent. METHODS A total of 21 SESs (15 patients), who had implanted 2.5, 2.75, and 3.0 mm stents, underwent OCT at 6-9 months after stent implantation. SES is constructed by two different strut width-components; narrow strut width parts (59 μm) and wide strut width parts (115 μm). Thus, we divided stent struts of SESs into two groups: narrow strut width parts (narrow group) and wide ones (wide group). We compared the incidence of incomplete apposed struts, uncovered struts, and neointimal hyperplasia (NIH) thickness between the two groups. RESULTS We could detect 2,948 struts (narrow group consisted of 1,132 struts and wide group consisted of 1,816 struts). Incidence of uncovered struts in the narrow group was significantly lower than in the wide group (30.2% vs. 40.8%, P < 0.001), and NIH thickness in the narrow group was significantly greater than in the wide group (127.5 ± 93.4 μm vs. 118.6 ± 81.4 μm, P = 0.03). CONCLUSIONS Stent design, especially strut width, affects stent coverage of SES. The narrow strut may avoid the absence of stent coverage in SES, which correlates with stent thrombosis.
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Kaňovský J, Boček O, Červinka P, Ondrúš T, Kala P. Optical coherence tomography in interventional cardiology - research field or future daily routine? COR ET VASA 2012. [DOI: 10.1016/j.crvasa.2012.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Attizzani GF, Bezerra HG. Contemporary assessment of stent strut coverage by OCT. Int J Cardiovasc Imaging 2012; 29:23-7. [DOI: 10.1007/s10554-012-0046-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 03/26/2012] [Indexed: 10/28/2022]
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Kim BK, Shin DH, Kim JS, Ko YG, Choi D, Jang Y, Hong MK. Optical coherence tomography-based evaluation of malapposed strut coverage after drug-eluting stent implantation. Int J Cardiovasc Imaging 2012; 28:1887-94. [DOI: 10.1007/s10554-012-0039-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 03/13/2012] [Indexed: 12/17/2022]
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Cardiovascular imaging 2011 in the International Journal of Cardiovascular Imaging. Int J Cardiovasc Imaging 2012; 28:439-51. [PMID: 22476909 PMCID: PMC3326368 DOI: 10.1007/s10554-012-0040-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Seidlitz A, Weitschies W. In-vitro dissolution methods for controlled release parenterals and their applicability to drug-eluting stent testing. J Pharm Pharmacol 2012; 64:969-85. [DOI: 10.1111/j.2042-7158.2011.01439.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Abstract
Objectives
Dissolution testing is a powerful tool for the characterization of dosage form performance in vitro under standardized conditions. In spite of the increasing number of parenterally administered medicinal products, currently there are no compendial dissolution test methods designed especially for these types of dosage forms. In addition to classical drug delivery systems, drug/device combination products, such as drug-eluting stents, are being used increasingly.
Key findings
This review describes the current methods that are used most often for in-vitro dissolution testing of parenteral dosage forms, i.e. the ‘sample and separate’ methods, the ‘dialysis’ methods, and the ‘flow-through’ methods, with a special emphasis on whether these methods can be used for drug-eluting stent testing. In the light of current regulatory requirements and with the exploding costs of preclinical and clinical development, test systems that include biorelevant parameters and are predictive of in-vivo performance are increasingly important. Published attempts to take biorelevant conditions into consideration in the design of dissolution test apparatus developed for parenteral dosage forms, including a method that was designed to emulate the embedding and flow-conditions at the site of stent implantation, have been outlined in this review.
Summary
In spite of the large quantity of highly potent controlled release parenteral products marketed today, there is still a lack of suitable methods for in vitro dissolution testing for these dosage forms especially with regard to biorelevant testing conditions. For dosage forms implanted into tissues it seems of major importance to reproduce the transport forces which are predominant in vivo (diffusive versus convective) in the in-vitro experimental setup.
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Affiliation(s)
- Anne Seidlitz
- Institute of Pharmacy, Biopharmaceutics and Pharmaceutical Technology, Ernst Moritz Arndt University of Greifswald, Greifswald, Germany
| | - Werner Weitschies
- Institute of Pharmacy, Biopharmaceutics and Pharmaceutical Technology, Ernst Moritz Arndt University of Greifswald, Greifswald, Germany
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