scholarly journals The Return of the Vulnerable Plaque: Optical Coherence Tomography Imaging of a Case of a Late In-Stent Restenotic Chronic Total Occlusion

2016 ◽  
Vol 26 (03) ◽  
pp. 191-195
Author(s):  
Pranav Patel ◽  
Alisha Grewal ◽  
Prabhsimran Mohar ◽  
Morton Kern ◽  
Dilbahar Mohar
Keyword(s):  
Optical Coherence Tomography ◽  
Neointimal Hyperplasia ◽  
Optical Coherence ◽  
Vulnerable Atherosclerotic Plaque ◽  
Total Occlusion ◽  
Tomography Imaging ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
Optical Coherence Tomography Imaging ◽  
Oct Imaging

Although the use of drug-eluting stents (DES) has dramatically decreased the incidence of in-stent restenosis (ISR), concerns regarding the late manifestations of ISR remain. Optical coherence tomography (OCT) imaging provides unique insights into characteristics and patterns of ISR. We report a case of late DES ISR with unusual heterogeneous intracoronary luminal characteristics suggestive of vulnerable atherosclerotic plaque activity by OCT imaging. This case demonstrates that late ISR after DES may involve more than mere neointimal hyperplasia with lesion-associated craters, septae, and neoatherosclerosis. The use of OCT provides novel insights into the mechanisms and potential biology of the late DES ISR.

scholarly journals Visual and anatomical outcomes of central serous chorioretinopathy patients presenting to a tertiary unit: a prospective analysis

2020 ◽  
Vol 12 ◽  
pp. 251584142092319
Author(s):  
Andrew Walkden ◽  
Olivia Atkinson ◽  
Emma Linton ◽  
Adam Bull ◽  
Laina Abraham ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Central Serous Chorioretinopathy ◽  
Treatment Strategies ◽  
Optical Coherence ◽  
Prospective Data ◽  
Tomography Imaging ◽  
Visual Improvement ◽  
Optical Coherence Tomography Imaging ◽  
Oct Imaging ◽  
Anatomical Outcomes

Aim: The aim of this study was to prospectively define the characteristics and outcomes of a cohort of central serous chorioretinopathy patients using optical coherence tomography imaging to determine anatomical disease resolution. Much of the literature available on the characteristics of central serous chorioretinopathy patients pre date the advent of OCT imaging, with conclusive epidemiological evidence being scarce. We describe a cohort of patients presenting to a large centre over the course of a year. Methods: Prospective data collection was undertaken for all patients diagnosed with central serous chorioretinopathy at our unit over the course of 1 year. All patients underwent thorough history taking and optical coherence tomography imaging. Results: In total, 59 eyes from 51 patients were diagnosed with central serous chorioretinopathy between April 2017 and April 2018; 23 (45.1%) patients had optical coherence tomography evidence of complete anatomical resolution within a year, with three (5.88%) patients suffering a worse visual acuity compared with that at presentation at 1-year end point; and three patients developed secondary choroidal neovascular membranes. Conclusion: Our study reports much-needed prospective outcomes of patients with central serous chorioretinopathy, which helps to guide clinicians when deciding treatment strategies, as well as better informing patients of their prognosis for visual improvement.

scholarly journals Highly Selective PPARα (Peroxisome Proliferator‐Activated Receptor α) Agonist Pemafibrate Inhibits Stent Inflammation and Restenosis Assessed by Multimodality Molecular‐Microstructural Imaging

2021 ◽  
Author(s):  
Hiroshi Iwata ◽  
Eric A. Osborn ◽  
Giovanni J. Ughi ◽  
Kentaro Murakami ◽  
Claudia Goettsch ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Near Infrared ◽  
Neointimal Hyperplasia ◽  
Coronary Stent ◽  
Peroxisome Proliferator ◽  
Optical Coherence ◽  
Peroxisome Proliferator Activated Receptor ◽  
Near Infrared Fluorescence ◽  
Tomography Imaging ◽  
Optical Coherence Tomography Imaging

BACKGROUND New pharmacological approaches are needed to prevent stent restenosis. This study tested the hypothesis that pemafibrate, a novel clinical selective PPARα (peroxisome proliferator‐activated receptor α) agonist, suppresses coronary stent‐induced arterial inflammation and neointimal hyperplasia. METHODS AND RESULTS Yorkshire pigs randomly received either oral pemafibrate (30 mg/day; n=6) or control vehicle (n=7) for 7 days, followed by coronary arterial implantation of 3.5 × 12 mm bare metal stents (2–4 per animal; 44 stents total). On day 7, intracoronary molecular‐structural near‐infrared fluorescence and optical coherence tomography imaging was performed to assess the arterial inflammatory response, demonstrating that pemafibrate reduced stent‐induced inflammatory protease activity (near‐infrared fluorescence target‐to‐background ratio: pemafibrate, median [25th‐75th percentile]: 2.8 [2.5–3.3] versus control, 4.1 [3.3–4.3], P =0.02). At day 28, animals underwent repeat near‐infrared fluorescence–optical coherence tomography imaging and were euthanized, and coronary stent tissue molecular and histological analyses. Day 28 optical coherence tomography imaging showed that pemafibrate significantly reduced stent neointima volume (pemafibrate, 43.1 [33.7–54.1] mm 3 versus control, 54.2 [41.2–81.1] mm 3 ; P =0.03). In addition, pemafibrate suppressed day 28 stent‐induced cellular inflammation and neointima expression of the inflammatory mediators TNF‐α (tumor necrosis factor‐α) and MMP‐9 (matrix metalloproteinase 9) and enhanced the smooth muscle differentiation markers calponin and smoothelin. In vitro assays indicated that the STAT3 (signal transducer and activator of transcription 3)–myocardin axes mediated the inhibitory effects of pemafibrate on smooth muscle cell proliferation. CONCLUSIONS Pemafibrate reduces preclinical coronary stent inflammation and neointimal hyperplasia following bare metal stent deployment. These results motivate further trials evaluating pemafibrate as a new strategy to prevent clinical stent restenosis.

In vivo cellular optical coherence tomography imaging

1998 ◽  
Vol 4 (7) ◽  
pp. 861-865 ◽  
Author(s):  
Stephan A. Boppart ◽  
Brett E. Bouma ◽  
Costas Pitris ◽  
James F. Southern ◽  
Mark E. Brezinski ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence ◽  
Tomography Imaging ◽  
Optical Coherence Tomography Imaging
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