Intracoronary Imaging

Heart ◽  
2017 ◽  
Vol 103 (9) ◽  
pp. 708-725 ◽  
Author(s):  
Alessandra Giavarini ◽  
Ismail Dogu Kilic ◽  
Alfredo Redondo Diéguez ◽  
Giovanni Longo ◽  
Isabelle Vandormael ◽  
...  
2016 ◽  
Vol 11 (1) ◽  
pp. 11
Author(s):  
Sudheer Koganti ◽  
◽  
◽  
◽  
Tushar Kotecha ◽  
...  

Intracoronary imaging has the capability of accurately measuring vessel and stenosis dimensions, assessing vessel integrity, characterising lesion morphology and guiding optimal percutaneous coronary intervention (PCI). Coronary angiography used to detect and assess coronary stenosis severity has limitations. The 2D nature of fluoroscopic imaging provides lumen profile only and the assessment of coronary stenosis by visual estimation is subjective and prone to error. Performing PCI based on coronary angiography alone is inadequate for determining key metrics of the vessel such as dimension, extent of disease, and plaque distribution and composition. The advent of intracoronary imaging has offset the limitations of angiography and has shifted the paradigm to allow a detailed, objective appreciation of disease extent and morphology, vessel diameter, stent size and deployment and healing after PCI. It has become an essential tool in complex PCI, including rotational atherectomy, in follow-up of novel drug-eluting stent platforms and understanding the pathophysiology of stent failure after PCI (e.g. following stent thrombosis or in-stent restenosis). In this review we look at the two currently available and commonly used intracoronary imaging tools – intravascular ultrasound and optical coherence tomography – and the merits of each.


2014 ◽  
pp. 36-39
Author(s):  
Kalpa De Silva Ashford ◽  
Philippa Howlett ◽  
Fiona Hatch ◽  
Michael Mahmoudi

2021 ◽  
Vol 10 ◽  
pp. 204800402199219
Author(s):  
Claire E Raphael ◽  
Peter D O’Kane

Bifurcation lesions are common and associated with higher risks of major cardiac events and restenosis after percutaneous coronary intervention (PCI). Treatment requires understanding of lesion characteristics, stent design and therapeutic options. We review the evidence for provisional vs 2-stent techniques. We conclude that provisional stenting is suitable for most bifurcation lesions. We detail situations where a 2-stent technique should be considered and the steps for performing each of the 2-step techniques. We review the importance of lesion preparation, intracoronary imaging, proximal optimization (POT) and kissing balloon inflation


2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Mohammad Abdallah Eltahlawi ◽  
Abdel-Aziz Fouad Abdel-Aziz ◽  
Abdel-Salam Sherif ◽  
Khalid Abdel-Azeem Shokry ◽  
Islam Elsayed Shehata

Abstract Background We hypothesized that 1st generation everolimus-eluting bioresorbable vascular scaffold (BVS) stent associated with less complication and less restenosis rate than everolimus-eluting stent (EES) in chronic total occlusion (CTO) recanalization guided by intracoronary imaging. Therefore, we aimed to assess the safety and performance of BVS stent in CTO revascularization in comparison to EES guided by intracoronary imaging. Our prospective comparative cross-sectional study was conducted on 60 CTO patients divided into two groups according to type of stent revascularization: group I (EES group): 40 (66.7%) patients and group II (BVS group): 20 (33.3%) patients. All patients were subjected to history taking, electrocardiogram (ECG), echocardiography, laboratory investigation, stress thallium study to assess viability before revascularization. Revascularization of viable CTO lesion guided by intracoronary imaging using optical coherence tomography (OCT). Then, long-term follow-up over 1 year clinically and by multi-slice CT coronary angiography (MSCT). Our clinical and angiographic endpoints were to detect any clinical or angiographic complications during the follow-up period. Results At 6 months angiographic follow-up, BVS group had not inferior angiographic parameters but without statistically significant difference (p = 0.566). At 12 months follow-up, there was no difference at end points between the two groups (p = 0.476). No differences were found at angiographic or clinical follow-up between BVS and EES. Conclusion This study shows that 1st generation everolimus-eluting BVS is non-inferior to EES for CTO revascularization. Further studies are needed to clearly state which new smaller footprint BVS, faster reabsorption, magnesium-based less thrombogenicity, and advanced mechanical properties is under development. We cannot dismiss the efficacy and safety of new BVS technology. Trial registration ZU-IRB#2498/3-12-2016 Registered 3 December 2016, email: [email protected]


Author(s):  
Tatsunori Takahashi ◽  
Kleanthis Theodoropoulos ◽  
Azeem Latib ◽  
Hiroyuki Okura ◽  
Yuhei Kobayashi

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
R M Mori ◽  
I N G Nunez

Abstract Background Recent publications suggest that bioabsorbable vascular scaffolds (BVS) carry an excess of thrombotic complications. Our goal was to describe the results in real life and in the long term, in a series of patients who received a BVS which is currently off the market. Methods Two hundred and thirteen consecutive patients who received at least 1 BVS between May 2012 and December 2016 were analyzed. The primary objective was the incidence of the compound event “target vessel failure” that included infarction or target vessel revascularization and cardiac death. Results Seventy-five percent of patients were men with a mean age of 61.4 years. They had a high prevalence of dyslipidemia (62.44%) and smoking (65.26%). The most common cause of admission was myocardial infarction without ST elevation (53.52%). A total of 233 coronary lesions were treated, with an average of 1.3±0.3 lesions per patient. The implant was successful in 99.5% of cases. Predilatation was performed in 89.3% and post dilation in 33.5% of cases. The use of intracoronary imaging (Optical Coherence Tomography OCT and/or Intravascular ultrasonography IVUS) to optimize the BVS implant was performed in 86 patients (40.38%). With a mean follow-up of 42.5 months, the incidence of target vessel failure was 6.57% during the first 24 months and 7.98% at the end of the follow-up. Regarding the device, this included 6 cases (2.81%) of thrombosis (definitive, probable or possible) and 10 cases (4.69%) of restenosis. Patients with a history of diabetes mellitus (HR 1.72 95% CI 1.01–2.95 P=0,05) and/or chronic oral anticoagulation (HR 5.71 95% CI 1.12–28.94 P=0.04) had a higher risk of target vessel failure. The use of intracoronary imaging (OCT and/or IVUS) during the BVS implantation had a considerable trend toward significance as a protective factor (HR 0.32 95% CI 0.11–1.03 P=0.06). Conclusions In this series of patients; in real life conditions, the incidence of target vessel failure was comparable to that previously described in randomized clinical trials. The events were more frequent during the first 2 years of follow-up, in the presence of greater cardiovascular comorbidity and in the absence of intracoronary imaging during the implantation. FUNDunding Acknowledgement Type of funding sources: Other. Main funding source(s): European Society of Cardiology KM curve for target vessel failure (TVF) Predictor analysis for TVF


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