scholarly journals Mechanical performance and healing patterns of the novel sirolimus-eluting bioresorbable Fantom scaffold: 6-month and 9-month follow-up by optical coherence tomography in the FANTOM II study

Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e000941 ◽  
Author(s):  
Jo Krogsgaard Simonsen ◽  
Emil Nielsen Holck ◽  
Didier Carrié ◽  
Norbert Frey ◽  
Matthias Lutz ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Mechanical Performance ◽  
Optical Coherence ◽  
The Novel ◽  
Lumen Area ◽  
Stable Angina Pectoris ◽  
Bioresorbable Scaffold ◽  
Strut Thickness ◽  
Expansion Capacity

ObjectivesWe aimed to evaluate the mechanical properties and healing patterns 6 and 9 months after implantation of the sirolimus-eluting Fantom bioresorbable scaffold (BRS).BackgroundThe Fantom BRS (Reva Medical, San Diego, USA) has differentiating properties including radiopacity, strut thickness of 125 µm, high expansion capacity and has demonstrated favourable mid-term clinical and angiographic outcomes.Methods and resultsFANTOM II was a prospective, single arm study with implantation of the Fantom BRS in 240 patients with stable angina pectoris. Guidance by optical coherence tomography (OCT) was encouraged and was repeated at 6-month (cohort A) or 9-month follow-up (cohort B). Matched baseline and follow-up OCT recordings were available in 152 patients. In-scaffold mean lumen area in cohort A was 6.8±1.7 mm2 and 5.7±1.4 mm2 at baseline and follow-up (p<0.0001) and was 7.2±1.6 mm2 and 5.6±1.4 mm2 in cohort B (p<0.0001). Mean scaffold area remained stable from 7.1±1.5 mm2 at baseline to 7.2±1.4 mm2 at 6 months (p=0.12), and from 7.4±1.5 mm2 to 7.3±1.4 mm2 at 9 months. Strut malapposition was median 0.8 (IQR 0.0;3.5)% and 1.8 (IQR 0.3;6.0)% at baseline and was 0.0 (IQR 0.0;0.0)% in both groups at 6-month and 9-month follow-up. Strut tissue coverage was 98.1 (IQR 95.9;99.4)% at 6 months and 98.9 (IQR 98.3;100.0)% at 9 months.ConclusionsThe novel Fantom BRS had favourable healing patterns at 6-month and 9-month follow-up as malapposition was effectively resolved and strut coverage was almost complete. The scaffold remained stable through follow-up with no signs of systematic late recoil.

Abstract 13969: Effect of Endothelial Shear Stress on the Serial Changes of Vein Grafts Assessed by Optical Coherence Tomography during the First Year After Coronary Artery Bypass Graft Surgery: Analysis from the CABG-PRO Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Anna Kotsia ◽  
Michail Papafaklis ◽  
Tesfaldet Michael ◽  
Bavana Rangan ◽  
Matthias Pelz ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Shear Stress ◽  
Bypass Graft ◽  
Plaque Burden ◽  
Optical Coherence ◽  
Lumen Area ◽  
Vein Grafts ◽  
Late Failure ◽  
Endothelial Shear Stress

Introduction: Saphenous vein grafts (SVGs) have high rates of both early (≤ 1 year) and late failure following coronary arterial bypass graft surgery (CABG). Hypothesis: Endothelial shear stress (ESS) is a critical determinant of the natural history of coronary atherosclerosis, but the influence on the structural changes of SVGs has not been studied. We evaluated the effect of ESS on the serial anatomic outcomes of SVGs assessed by optical coherence tomography (OCT) during the first postoperative year. Methods: We performed 3-dimensional SVG reconstruction in 8 SVGs using fusion of angiographic and OCT data 5-7 days after surgery (baseline) and at 12-month follow-up. Baseline ESS was assessed using computational fluid dynamics. The reconstructed SVGs were divided in consecutive 3-mm segments (n=181), and we assessed the association of baseline ESS with the anatomic outcomes in the corresponding segments at follow-up: change in lumen area and plaque burden, and neointimal area at follow-up. Baseline ESS was categorized according to the tertiles of the ESS frequency distribution. Results: Median baseline ESS in SVGs was 0.48 Pa [IQR: 0.37-0.61 Pa]). Baseline low ESS was associated with: (i) the largest decrease in lumen area (low ESS category: -8.72±0.95 mm2 vs. moderate ESS category: -5.67±0.95 mm2 vs. high ESS category: -3.64±0.95 mm2; p<0.001 low vs moderate and high ESS category), (ii) the largest increase in plaque burden (low ESS category: 24.3±3.4% vs. moderate ESS category: 22.6±3.4% vs. high ESS category: 20.9±3.4%; p=0.011 low vs high ESS category), and (iii) the largest neointimal area at 12 months (low ESS category: 4.02±0.45 mm2 vs. moderate ESS category: 3.65±0.45 mm2 vs. high ESS category: -3.57±0.45 mm2; p=0.020 low vs moderate ESS category, and p=0.009 low vs high ESS category). Conclusions: SVG areas with the lowest local ESS develop the largest lumen constriction, plaque burden increase and neointima formation. These findings provide important insights into the pathogenesis of early SVG failure.

Inner Retinal Morphology and Visual Outcomes in Idiopathic Epiretinal Membrane Surgery: A Retrospective Optical Coherence Tomography Study

2021 ◽  
pp. 247412642198961
Author(s):  
Ioannis S. Dimopoulos ◽  
Michael Dollin
Keyword(s):  
Optical Coherence Tomography ◽  
Epiretinal Membrane ◽  
Strong Predictor ◽  
Plexiform Layer ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
Visual Outcomes ◽  
Retinal Pathology

Purpose: Epiretinal membrane (ERM) is a common retinal finding for patients older than 50 years. Disorganization of the retinal inner layers (DRIL) has emerged as a novel predictor of poor visual acuity (VA) in eyes with inner retinal pathology. The aim of our study is to correlate preoperative DRIL with visual outcomes after ERM surgery. Methods: Medical records and optical coherence tomography (OCT) images of 81 pseudophakic patients who underwent treatment of idiopathic ERM were reviewed. Preoperative DRIL on OCT was correlated with VA at baseline and at 3 and 6 months after ERM surgery. DRIL was defined as the loss of distinction between the ganglion cell–inner plexiform layer complex, inner nuclear layer, and outer plexiform layer. DRIL severity was based on its extent within the central 2-mm region of a transfoveal B-scan (absent/mild: <one-third, severe: >one-third horizontal width). Results: Review of preoperative OCT showed severe DRIL in 41% and absent/mild DRIL in 59%. Severe DRIL was associated with worse baseline VA ( P < .001). Preoperative VA and DRIL status at baseline were both predictors of postoperative VA at follow-up time points ( P < .001). Severe DRIL was associated with significantly less improvement in VA at 6 months (–0.23 logMAR for absent/mild vs –0.14 for severe DRIL). Conclusions: Presence of severe preoperative DRIL correlates with worse baseline VA in patients with ERM and reduced VA improvement at 6 months. DRIL can be a strong predictor of long-term poor visual outcomes in ERM surgery.

scholarly journals The Use of Anterior-Segment Optical-Coherence Tomography for the Assessment of the Iridocorneal Angle and Its Alterations: Update and Current Evidence

2021 ◽  
Vol 10 (2) ◽  
pp. 231
Author(s):  
Giacinto Triolo ◽  
Piero Barboni ◽  
Giacomo Savini ◽  
Francesco De Gaetano ◽  
Gaspare Monaco ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Clinical Relevance ◽  
Anterior Segment ◽  
Angle Closure ◽  
Current Evidence ◽  
Optical Coherence ◽  
Iridocorneal Angle ◽  
Wide Range

The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with an extensive research in the field, have resulted in a wide range of possible parameters that may be used to diagnose and follow up on patients with this spectrum of diseases. However, the clinical relevance of such variables needs to be explored thoroughly. The aim of the present review is to summarize the current evidence supporting the use of AS-OCT for the diagnosis and follow-up of several iridocorneal-angle and anterior-chamber alterations, focusing on the advantages and downsides of this technology.

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