Unstable Angina Caused by Honeycomb-Like Coronary Lesion Identified with Use of Optical Coherence Tomography.
Ontology highlight
ABSTRACT:
SUBMITTER: Ober MC
PROVIDER: S-EPMC7046345 | biostudies-literature | 2020 Feb
REPOSITORIES: biostudies-literature
Publications
Unstable Angina Caused by Honeycomb-Like Coronary Lesion Identified with Use of Optical Coherence Tomography.
Ober Mihai Claudiu MC Homorodean Calin C Bindea Dan D Spinu Mihail M Olinic Dan Mircea DM
Texas Heart Institute journal 20200201 1
Similar Datasets
Project description:Intimal tear is a rare cause of ACS and is angiographically indistinguishable. OCT provides unprecendented insight to the mechanism of ACS with its near tissue level definition. This is a case of unstable angina with non-significant RCA lesion. OCT showed intimal tear/flaps with evidence of thrombi, thus clinching the diagnosis.
| S-EPMC5079200 | biostudies-literature
Project description:We present a scheme for correction of x-y-separable aberrations in optical coherence tomography (OCT) designed to work with phase unstable systems with no hardware modifications. Our approach, termed SHARP, is based on computational adaptive optics and numerical phase correction and follows from the fact that local phase stability is sufficient for the deconvolution of optical aberrations. We demonstrate its applicability in a raster-scan polygon-laser OCT system with strong phase-jitter noise, achieving successful refocusing at depths up to 4 times the Rayleigh range. We also present in vivo endoscopic and ex vivo anterior segment OCT data, showing significant enhancement of image quality, particularly when combining SHARP results with a resolution-preserving despeckling technique like TNode.
| S-EPMC8384075 | biostudies-literature
Project description: Not available
| S-EPMC8114643 | biostudies-literature
Project description:Intravascular imaging, particularly optical coherence tomography, has brought significant improvement in diagnostic and therapeutical approaches to coronary artery disease and has offered superior high-resolution visualization of coronary arteries. The ability to obtain images of intramural and transmural coronary structures allows the study of the process of atherosclerosis, effect of therapies, mechanism of acute coronary syndrome and stent failure, and performance of new devices and enables the interventional cardiologist to optimize the effect of percutaneous coronary intervention. In this review, we provide the summary of the latest published data on clinical use of optical coherence tomography as well as practical algorithm for optical coherence tomography-guided percutaneous coronary intervention for daily interventional practice.
| S-EPMC8141373 | biostudies-literature
Project description:BackgroundPrevious studies reported the cardiac protection effect of preinfarction angina (PIA) in patients with acute myocardial infarction (AMI). We sought to identify culprit-plaque morphology and clinical outcomes associated with PIA in patients with ST-segment elevation myocardial infarction (STEMI) using optical coherence tomography (OCT).Methods and resultsA total of 279 patients with STEMI between March 2017 and March 2019 who underwent intravascular OCT of the culprit lesion were prospectively included. Of them, 153 (54.8%) patients were presented with PIA. No differences were observed in clinical and angiographic data between the two groups, except STEMI onset with exertion was significantly less common in the PIA group (24.2 vs. 40.5%, p = 0.004). Patients with PIA exhibited a significantly lower incidence of plaque rupture (40.5 vs. 61.9%, p < 0.001) and lipid-rich plaques (48.4 vs. 69.0%, p = 0.001). The thin-cap fibroatheroma (TCFA) prevalence was lower in the PIA group, presenting a thicker fibrous cap thickness, although statistically significant differences were not observed (20.3 vs. 30.2%, p = 0.070; 129.1 ± 92.0 vs. 111.4 ± 78.1 μm, p = 0.088; respectively). The multivariate logistic regression analysis indicated that PIA was an independent negative predictor of plaque rupture (odds ratio: 0.44, 95% CI: 0.268-0.725, p = 0.001). No significant differences in clinical outcomes were observed besides unplanned revascularization.ConclusionCompared with the non-PIA group, STEMI patients with PIA showed a significantly lower prevalence of plaque rupture and lipid-rich plaques in culprit lesion, implying different mechanisms of STEMI attack in these two groups.
| S-EPMC8804379 | biostudies-literature
Project description:BackgroundDirectional coronary atherectomy (DCA) was revived in Japan in 2014. DCA is a special procedure to remove the atherosclerotic plaque of coronary artery during percutaneous coronary intervention. We present the case of a 91-year-old woman with symptoms of angina. Coronary angiography revealed significant stenosis with a slit lesion of the proximal left anterior descending artery. Because she had a high risk of bleeding, we did not want to implant a stent to prevent bleeding events. Then, we performed optical coherence tomography (OCT) and intravascular ultrasound to evaluate the morphology of the slit lesion in more detail. OCT showed clearly that the direction of the flap was counterclockwise and the edge of the flap was located in the epicardium. Since we could understand the localization of plaque distribution fully by OCT examination, we successfully removed the flap by DCA based on information from OCT. After that, we performed balloon dilatation with a 3.0-mm drug-coated balloon and finished without implanting the stent successfully. Her symptoms completely disappeared and postoperative course was good. DCA supported with OCT might be one of the options in high bleeding risk patients, suggesting a potential stent-less therapeutic option. <Learning objective: There may be hesitation about implantation of stents in patients with high risk of bleeding, such as the elderly. Stent-less percutaneous coronary intervention using directional coronary atherectomy followed by drug-coated balloon under optical coherence tomography (OCT) guidance may be the one of the option for patients with a high risk of bleeding, because OCT can more clearly show the feature of the lesion and the effect of treatment compared to intravascular ultrasound.>.
| S-EPMC8766346 | biostudies-literature
Project description: Not available
| S-EPMC7596210 | biostudies-literature
Project description: Not available
| S-EPMC8343469 | biostudies-literature
Project description:Compared to the luminogram obtained by angiography, intravascular modalities produce cross-sectional images of coronary arteries with a far greater spatial resolution. It is capable of accurately determining the vessel size and plaque morphology. It also eliminates some disadvantages such as contrast streaming, foreshortening, vessel overlap, and angle dependency inherent to angiography. Currently, the development of its system and the visualization of coronary arteries has shown significant advancement. Of those, optical coherence tomography (OCT) makes it possible to obtain high-resolution images of intraluminal and transmural coronary structures leading to navigation of the treatment strategy before and after stent implantations. The aim of this review is to summarize the published data on the clinical utility of OCT, focusing on the use of OCT in interventional cardiology practice to optimize percutaneous coronary intervention.
| S-EPMC6713825 | biostudies-literature
Project description:Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in the management of patients with acute coronary syndromes. Detection by OCT of healed coronary plaque has been important in our understanding of the mechanisms involved in plaque destabilization and healing with the rapid progression of atherosclerosis. Accurate detection by OCT of sequelae from percutaneous coronary interventions that might be missed by angiography could improve clinical outcomes. In addition, OCT has become an essential diagnostic modality for myocardial infarction with non-obstructive coronary arteries. Insight into neoatherosclerosis from OCT could improve our understanding of the mechanisms of very late stent thrombosis. The appropriate use of OCT depends on accurate interpretation and understanding of the clinical significance of OCT findings. In this Review, we summarize the state of the art in cardiac OCT and facilitate the uniform use of this modality in coronary atherosclerosis. Contributions have been made by clinicians and investigators worldwide with extensive experience in OCT, with the aim that this document will serve as a standard reference for future research and clinical application.
| S-EPMC9982688 | biostudies-literature