Yukio Ozaki, M Okumura, TF Ismail 2, S Motoyama, H. Naruse, K. Hattori, H. Kawai, M. Sarai, J. Ishii, Jagat Narula 3

Size: px
Start display at page:

Download "Yukio Ozaki, M Okumura, TF Ismail 2, S Motoyama, H. Naruse, K. Hattori, H. Kawai, M. Sarai, J. Ishii, Jagat Narula 3"

Transcription

1 Culprit Lesion Characteristics in Acute Coronary Syndrome and Stable Angina Assessed by Optical Coherence Tomography (OCT), Angioscopy, IVUS and Multidetector Computed Tomography (MDCT) Yukio Ozaki, M Okumura, TF Ismail 2, S Motoyama, H. Naruse, K. Hattori, H. Kawai, M. Sarai, J. Ishii, Jagat Narula 3 Fujita Health University Hospital, Toyoake, Japan Imperial College, National Heart & Lung Institute, London, UK University of California, Irvine, USA

2 Conflict of Interest: None Declared Background Pathological studies have indicated that ACS lesions have either rupturedfibrous (RFCACS) or intact (IFCACS) fibrous caps. Whereas CTangiographic characteristics of RFCACS include lowattenuation plaques and positive plaque remodelling, features associated with IFCACS have not been previously described. The aim of this study was to assess the CT characteristics of IFCACS lesions.

3 Background Pathological and clinical optical coherence tomography (OCT) studies have indicated that ACS lesions have either rupturedfibrous (RFCACS; Plaque Rupture) or intact (IFC ACS; Plaque Erosion) fibrous caps. Whereas CTangiographic characteristics of RFCACS include lowattenuation plaques and positive plaque remodelling, features associated with IFCACS have not been previously described. The aim of this study was to assess the CT characteristics of IFCACS lesions.

4 Inclusion and Exclusion Criteria Patients with nonstsegment elevation myocardial infarction (NSTEMI), unstable angina (UA) and stable angina were studied. Patients were excluded from the study when they had contraindications to antiplatelet therapy. CTO and LMT lesions were excluded from the study. The study was approved by local ethics committees and was carried out according to the guidelines of the Declaration of Helsinki. Written informed consent was obtained from all patients. Definitions of IFCACS IFCACS was defined as the presence of an intact fibrous cap (i.e., the absence of plaque rupture) by OCT associated with the presence of thrombus by angioscopy or OCT.

5 Patients Of the 74 patients 66 patients underwent 64slice MDCT prior to multiple intracoronary imagings, while the remaining 8 patients did not have 64slice MDCT prior to intracoronary imaging before PCI. All 66 underwent 64slice MDCT, OCT, IVUS, angioscopy and QCA before PCI. Intracoronary imaging and QCA were also performed after coronary stenting. Of these 66 patients, 57 demonstrated images of sufficient quality with all five modalities; 20 had NSTEMI, 15 had unstable angina and 22 stable.

6 Ozaki Y. et al. Eur Heart J. 2010;31: Optical Coherence Tomography (OCT) A inch OCT image wire (LightLab Imaging, MA). Following the careful passage of the inch OCT image wire through the lesion, the proximal occlusion balloon catheter was inflated and lactated Ringer s solution was continuously flushed. Motorized pullback was started at a rate of 1.0 mm/s. The images were saved in the OCT image system digitally. Optical Probe High resolution (14 nm) 2D/3D images Tissue Characteristics Doppler(CFR)

7 Angioscopy and IVUS Coronary angioscopy (Vecmova, Clinical Supply, Gifu, Japan) was performed after the OCT examination during the injection of low molecular dextran with and without balloon occlusion, while blood was cleared away from the view by this injection Following OCT and coronary angioscopy, a mechanical IVUS imaging catheter (40MHz, 2.5Fr, Boston Scientific, Natick, MA) was introduced over a 0.014inch guidewire and positioned distal to the lesion. Lesion geometry was then imaged by using a motorized pullback. ACS* SAP* *de Feyter PJ, Ozaki Y. et al, Circulation 1995;92:140813

8 64slice Multidetector Computed Tomography The 64slice MDCT was performed by Aquilion 64 system (Toshiba, Tokyo) with the ECG synchronization. To avoid motion artifact a heart rate was reduced less than 70 beats/min by oral betablocker before the examination. A bolus of 80 ml contrast medium was injected intravenously. The simultaneous helical scanning was done with a slice thickness of 0.5mm, gantry speed of 0.40 to 0.45 s/rotation and tube voltage of 135 kv at the current of 110 mas. Image reconstruction frames selected for analysis were middiastolic to minimize motion artifact using retrospective ECG gating. Images were estimated by M900 QUADRA (ZIOSoft, Tokyo) and the plaque density was expressed using Hunsfield unit (HU). Motoyama S, et al. J Am Coll Cardiol 2007;50:31926.

9 Statistical Analysis All continuous values are expressed as mean+sd for normally distributed data or median+interquartile range for nonparametric data. Differences between parametric continuous variables were assessed using unpaired or paired ttests as appropriate. Differences between nonparametric continuous variables were evaluated using the Mann Whitney Utest, and for paired variables, the Wilcoxon test. Differences in categorical variables were assessed using the chisquared and Fisher s exact tests as appropriate. The ANOVA test was used to assess differences in continuous variables between the three groups. Where a significant difference was detected, multiple comparison analysis was performed. Considering intracluster correlation (ICC), we only performed statistical estimations in single lesion in one patient based analysis. Twotailed values of p<0.05 were considered significant.

10 Baseline Clinical and Angiographic Characteristics RFCACS IFCACS Stable Angina pvalue Patients (n) Age (years) Male (n, %) NSTEMI (n, %) UAP (n, %) Stable Angina (n, %) ± (100) 15 (60) 10 (40) ±8.2 8 (80) 4 (40) 6 (60) ± (100) 22 (100) Diabetes (n, %) 8 (32) 3 (30) 8 (36) Hypertension (%) 12 (48) 6 (60) 13 (59) Hypercholesterolemia(%) 12 (48) 6 (60) 10 (45) Smokers (n, %) Nonsmoker 10 (38) 1 (9) 7 (35) Exsmoker 9 (46) 2 (18) 12 (60) Current smoker 6 (17) 7 (73) 3 (5)

11 Baseline Angiographic Characteristics Culprit Lesions (n) RCA/LAD/LCX (n, %) Lesion type (A/B1/B2/C, n) QCA RD pre (mm) QCA MLD pre (mm) RFCACS IFCACS Stable Angina pvalue / 13/ 1 0/ 13/ 12/ ± ±0.20 4/ 5/ 1 1/ 4/ 5/ ± ±0.22 5/ 14/ 3 2/ 11/ 9/ ± ± Nonculprit lesions in nonculprit vessel by CTA RFCACS IFCACS Stable Angina pvalue NonCulprit Lesions (n) Average lesion severity (%) 42±19 32±12 46± NCP < 30 HU (n, %) 7 (37) 2 (25) 1 (8) Spotty calcification (n, %) 5 (26) 2 (25) 2 (16) Positive Remodeling (n, %) 10 (53) 1 (13) 2 (16) 0.044

12 Lesion (n) OCT RFCACS IFCACS Stable Angina pvalue 22 Fibrous cap thickness(μm) 45±12 * 131±57 * 321±146 * Lipid angle > 2quads (n, %) 23 (92) 4 (40) 5 (23) TCFA (n, %) 23 (92) 2 (20) 2 (9) Thrombus (n, %) 25 (100) 10 (100) 4 (18) Angioscopy RFCACS IFCACS Stable Angina pvalue Thrombus 22 (88) 10 (100) 3 (14) Mural thrombus 13 (52) 7 (70) 3 (14) Protruding thrombus 9 (36) 3 (30) 0 (0) Yellow plaque 21 (84) 7 (70) 12 (55) White plaque 4 (16) 3 (30) 10 (45) 0.088

13 Lesion (n) IVUS(mm 2 ) Vessel area pre Lumen area pre Plaque area pre Prox. ref. vessel area Distal. ref. vessel area Remodeling index IVUS RFCACS IFCACS Stable Angina ± ± ± ± ± ±0.12 * ± ± ± ± ± ±0.08 * ± ± ± ± ± ±0.11 * pvalue (ANOVA) * : p<0.05

14 64slice MDCT RFCACS IFCACS Stable Angina pvalue (ANOVA) Lesion (n) 64slice MDCT(n,%) NCP < 30 HU NCP from 30 to 150 HU Spotty calcification Large calcification Remodelling index Positive remodelling LAP & PR (88) 25 (100) 22 (80) 3 (12) 1.15±0.06 * 24 (96) 22 (88) 10 4 (40) 10 (100) 2 (20) 1 (10) 1.02±0.08 * 2 (20) 1 (10) 22 4 (18) 22 (100) 5 (23) 13 (59) 0.99±0.09 * 3 (14) 0 (0) * : p<0.05

15 Impact of IFC (Plaque Erosion) on ACS Approximately onethird of lesions responsible for major coronary thrombi on pathological analysis are secondary to plaque erosions. Shaar and colleagues reported that unlike ruptured plaques, eroded plaques showed constrictive remodelling, and did not necessarily demonstrate voluminous plaques nor necrotic cores. These lesions revealed a unique proteoglycan substrate, which facilitates endothelial sloughing and thrombogenecity. It is reasonable to presume that nondisrupted culprit lesions (IFCACS) in our study would represent plaque erosions.

16 Clinical Implications CT coronary angiography (CTA) has been employed as a useful modality to differentiate patients with or without significant coronary artery disease noninvasively and stratify the risk of subsequent events. CTA is able to successfully characterise ruptured plaques as low attenuation plaque with positive remodelling. However, this study has demonstrated that CTA fails to characterise lesions at risk of IFCACS which could be responsible for one third of ACS from common coronary atherosclerosis. Our findings suggest the need for future work to clarify the value of CTA for assessing risk in patients with IFCACS.

17 Conclusions The IFCACS lesions based on OCT and angioscopic characteristics demonstrated less low attenuation plaque and less positive remodelling than ruptured plaques by CTangiography. Since there are no unique CT features of nonruptured culprit lesions to enable their clear distinction from stable lesions, it will be difficult to develop CTbased noninvasive imaging techniques to allow the clear identification of subjects at high risk of developing ACS due to IFC.

18 Fujita Health University, Toyoake, Japan

Added Value of Invasive Coronary Imaging for Plaque Rupture and Erosion

Added Value of Invasive Coronary Imaging for Plaque Rupture and Erosion Assessment of Coronary Plaque Rupture and Erosion Added Value of Invasive Coronary Imaging for Plaque Rupture and Erosion Yukio Ozaki, MD, PhD, FACC, FESC Cardiology Dept., Fujita Health Univ. Toyoake,

More information

Assessment of plaque morphology by OCT in patients with ACS

Assessment of plaque morphology by OCT in patients with ACS Assessment of plaque morphology by OCT in patients with ACS Takashi Akasaka, M.D. Department of Cardiovascular Medicine Wakayama, Japan Unstable plaque Intima Lipid core Plaque rupture and coronary events

More information

1st Department of Cardiology, University of Athens, Hippokration Hospital, Athens, Greece

1st Department of Cardiology, University of Athens, Hippokration Hospital, Athens, Greece Konstantinos Toutouzas, Maria Riga, Antonios Karanasos, Eleftherios Tsiamis, Andreas Synetos, Maria Drakopoulou, Chrysoula Patsa, Georgia Triantafyllou, Aris Androulakis, Christodoulos Stefanadis 1st Department

More information

Failure of positive. Recanalization and CTO formation. TCFA rupture with (fatal) thrombotic occlusion. TCFA Lipid pool

Failure of positive. Recanalization and CTO formation. TCFA rupture with (fatal) thrombotic occlusion. TCFA Lipid pool Vulnerable Plaque features on coronary CT Jin Ho Choi, MD, PhD Department of Internal Medicine, Emergency Medicine Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea IPS /

More information

Assessment of vulnerable plaque by OCT

Assessment of vulnerable plaque by OCT Assessment of vulnerable plaque by OCT Comparison with histology and possible clinical applications Takashi Akasaka, M.D. Department of Cardiovascular Medicine Wakayama, Japan Identification of vulnerable

More information

Analysis of macrophage accumulation using optical coherence tomography one year after sirolimus, paclitaxel and zotarolimus-eluting stent

Analysis of macrophage accumulation using optical coherence tomography one year after sirolimus, paclitaxel and zotarolimus-eluting stent Analysis of macrophage accumulation using optical coherence tomography one year after sirolimus, paclitaxel and zotarolimus-eluting stent implantation. Department of Cardiology, Ehime Prefectural Imabari

More information

Imaging Overview for Vulnerable Plaque: Data from IVUS Trial and An Introduction to VH-IVUS Imgaging

Imaging Overview for Vulnerable Plaque: Data from IVUS Trial and An Introduction to VH-IVUS Imgaging Imaging Overview for Vulnerable Plaque: Data from IVUS Trial and An Introduction to VH-IVUS Imgaging Gary S. Mintz,, MD Cardiovascular Research Foundation New York, NY Today, in reality, almost everything

More information

Culprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome

Culprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome Culprit Lesion Remodeling and Long-term (> 5years) Prognosis in Patients with Acute Coronary Syndrome Hiroyuki Okura*, MD; Nobuya Matsushita**,MD Kenji Shimeno**, MD; Hiroyuki Yamaghishi**, MD Iku Toda**,

More information

Invasive Coronary Imaging Modalities for Vulnerable Plaque Detection

Invasive Coronary Imaging Modalities for Vulnerable Plaque Detection Invasive Coronary Imaging Modalities for Vulnerable Plaque Detection Gary S. Mintz, MD Cardiovascular Research Foundation New York, NY Greyscale IVUS studies have shown Plaque ruptures do not occur randomly

More information

Impact of Body Mass Index and Metabolic Syndrome on the Characteristics of Coronary Plaques Using Computed Tomography Angiography

Impact of Body Mass Index and Metabolic Syndrome on the Characteristics of Coronary Plaques Using Computed Tomography Angiography Impact of Body Mass Index and Metabolic Syndrome on the Characteristics of Coronary Plaques Using Computed Tomography Angiography Cardiovascular Division, Faculty of Medicine, University of Tsukuba Akira

More information

Imaging Atheroma The quest for the Vulnerable Plaque

Imaging Atheroma The quest for the Vulnerable Plaque Imaging Atheroma The quest for the Vulnerable Plaque P.J. de Feijter 1. Department of Cardiology 2. Department of Radiology Coronary Heart Disease Remains the Leading Cause of Death in the U.S, Causing

More information

OCT; Comparative Imaging Results with IVUS, VH and Angioscopy

OCT; Comparative Imaging Results with IVUS, VH and Angioscopy OCT; Comparative Imaging Results with IVUS, VH and Angioscopy Takashi Akasaka, M.D. Department of Cardiovascular Medicine Wakayama, Japan Comparison among coronary imaging techniques OCT IVUS MRI CAG Angioscopy

More information

OCT Findings: Lesson from Stable vs Unstable Plaques

OCT Findings: Lesson from Stable vs Unstable Plaques ANGIOPLASTY SUMMIT TCTAP 2010 Imaging Workshop OCT Findings: Lesson from Stable vs Unstable Plaques Giulio Guagliumi MD Ospedali Riuniti di Bergamo, Italy DISCLOSURE OF FINANCIAL INTERESTS Consultant Boston

More information

Usefulness of OCT during coronary intervention

Usefulness of OCT during coronary intervention Usefulness of OCT during coronary intervention Takashi Akasaka, M.D. Department of Cardiovascular Medicine Wakayama, Japan Predictors at 12 Months of Stent Thrombosis and Target Lesion Revascularization

More information

CLINICAL APPLICATIONS OF OPTICAL COHERENCE TOMOGRAPHY. Konstantina P. Bouki, FESC 2 nd Department of Cardiology General Hospital Of Nikea, Pireaus

CLINICAL APPLICATIONS OF OPTICAL COHERENCE TOMOGRAPHY. Konstantina P. Bouki, FESC 2 nd Department of Cardiology General Hospital Of Nikea, Pireaus CLINICAL APPLICATIONS OF OPTICAL COHERENCE TOMOGRAPHY Konstantina P. Bouki, FESC 2 nd Department of Cardiology General Hospital Of Nikea, Pireaus OPTICAL COHERENCE TOMOGRAPHY (OCT) IVUS and OCT IVUS OCT

More information

The PROSPECT Trial. A Natural History Study of Atherosclerosis Using Multimodality Intracoronary Imaging to Prospectively Identify Vulnerable Plaque

The PROSPECT Trial. A Natural History Study of Atherosclerosis Using Multimodality Intracoronary Imaging to Prospectively Identify Vulnerable Plaque The PROSPECT Trial Providing Regional Observations to Study Predictors of Events in the Coronary Tree A Natural History Study of Atherosclerosis Using Multimodality Intracoronary Imaging to Prospectively

More information

Chapter 43 Noninvasive Coronary Plaque Imaging

Chapter 43 Noninvasive Coronary Plaque Imaging hapter 43 Noninvasive oronary Plaque Imaging NIRUDH KOHLI The goal of coronary imaging is to define the extent of luminal narrowing as well as composition of an atherosclerotic plaque to facilitate appropriate

More information

OCT-Based Diagnosis and Management of STEMI Associated With Intact Fibrous Cap

OCT-Based Diagnosis and Management of STEMI Associated With Intact Fibrous Cap JACC: CARDIOVASCULAR IMAGING VOL. 6, NO. 3, 2013 2013 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-878X/$36.00 PUBLISHED BY ELSEVIER INC. http://dx.doi.org/10.1016/j.jcmg.2012.12.007 CONCEPTS

More information

CT Imaging of Atherosclerotic Plaque. William Stanford MD Professor-Emeritus Radiology University of Iowa College of Medicine Iowa City, IA

CT Imaging of Atherosclerotic Plaque. William Stanford MD Professor-Emeritus Radiology University of Iowa College of Medicine Iowa City, IA CT Imaging of Atherosclerotic Plaque William Stanford MD Professor-Emeritus Radiology University of Iowa College of Medicine Iowa City, IA PREVALENCE OF CARDIOVASCULAR DISEASE In 2006 there were 80 million

More information

Evaluation of Intermediate Coronary lesions: Can You Handle the Pressure? Jeffrey A Southard, MD May 4, 2013

Evaluation of Intermediate Coronary lesions: Can You Handle the Pressure? Jeffrey A Southard, MD May 4, 2013 Evaluation of Intermediate Coronary lesions: Can You Handle the Pressure? Jeffrey A Southard, MD May 4, 2013 Disclosures Consultant- St Jude Medical Boston Scientific Speaker- Volcano Corporation Heart

More information

Cardiovascular Research Foundation and Columbia University Medical Center, New York.

Cardiovascular Research Foundation and Columbia University Medical Center, New York. Virtual Histology Intravascular Ultrasound Analysis of Non-culprit Attenuated Plaques Detected by Grayscale Intravascular Ultrasound in Patients with Acute Coronary Syndromes Xiaofan Wu, Akiko Maehara,

More information

Gary S. Mintz,, MD. IVUS Observations in Acute (vs Chronic) Coronary Artery Disease: Structure vs Function

Gary S. Mintz,, MD. IVUS Observations in Acute (vs Chronic) Coronary Artery Disease: Structure vs Function Gary S. Mintz,, MD IVUS Observations in Acute (vs Chronic) Coronary Artery Disease: Structure vs Function Important IVUS Observations: Remodeling Originally used (first by Glagov) ) to explain atherosclerosis

More information

Assessment of Culprit Lesion Morphology in Acute Myocardial Infarction

Assessment of Culprit Lesion Morphology in Acute Myocardial Infarction Journal of the American College of Cardiology Vol. 50, No. 10, 2007 2007 by the American College of Cardiology Foundation ISSN 0735-1097/07/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2007.04.082

More information

Le espressioni della placca che preoccupano il clinico: progressione o vulnerabilità? CardioLUCCA Marzo 2017

Le espressioni della placca che preoccupano il clinico: progressione o vulnerabilità? CardioLUCCA Marzo 2017 Le espressioni della placca che preoccupano il clinico: progressione o vulnerabilità? CardioLUCCA Marzo 2017 F Prati San Giovanni H. and CLI Foundation, Rome Euro Image Research Che cosa preoccupa il cardiologo

More information

Bifurcation stenting with BVS

Bifurcation stenting with BVS Bifurcation stenting with BVS Breaking the limits or just breaking the struts? Maciej Lesiak Department of Cardiology University Hospital in Poznan, Poland Disclosure Speaker s name: Maciej Lesiak I have

More information

Coronary Artery Imaging. Suvipaporn Siripornpitak, MD Inter-hospital Conference : Rajavithi Hospital

Coronary Artery Imaging. Suvipaporn Siripornpitak, MD Inter-hospital Conference : Rajavithi Hospital Coronary Artery Imaging Suvipaporn Siripornpitak, MD Inter-hospital Conference : Rajavithi Hospital Larger array : cover scan area Detector size : spatial resolution Rotation speed : scan time Retrospective

More information

Computed Tomographic Angiography Characteristics of Atherosclerotic Plaques Subsequently Resulting in Acute Coronary Syndrome

Computed Tomographic Angiography Characteristics of Atherosclerotic Plaques Subsequently Resulting in Acute Coronary Syndrome Journal of the American College of Cardiology Vol. 54, No. 1, 2009 2009 by the American College of Cardiology Foundation ISSN 0735-1097/09/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2009.02.068

More information

IVUS Analysis. Myeong-Ki. Hong, MD, PhD. Cardiac Center, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea

IVUS Analysis. Myeong-Ki. Hong, MD, PhD. Cardiac Center, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea IVUS Analysis Myeong-Ki Hong, MD, PhD Cardiac Center, Asan Medical Center University of Ulsan College of Medicine, Seoul, Korea Intimal disease (plaque) is dense and will appear white Media is made of

More information

Review Article Optical Coherence Tomography Imaging in Acute Coronary Syndromes

Review Article Optical Coherence Tomography Imaging in Acute Coronary Syndromes SAGE-Hindawi Access to Research Cardiology Research and Practice Volume 2011, Article ID 312978, 7 pages doi:10.4061/2011/312978 Review Article Optical Coherence Tomography Imaging in Acute Coronary Syndromes

More information

Intervention: How and to which extent is technology helping us?

Intervention: How and to which extent is technology helping us? Cardiological Society of India Congress 12th February 2016 Chennai, India Intervention: How and to which extent is technology helping us? SIMONE BISCAGLIA MD CARDIOVASCULAR INSTITUTE, FERRARA, ITALY Introduction

More information

Assessment of Vulnerable Plaque by IVUS and VH-IVUS

Assessment of Vulnerable Plaque by IVUS and VH-IVUS Assessment of Vulnerable Plaque by IVUS and VH-IVUS Akiko Maehara, MD Director of Intravascular Imaging & Physiology Core Laboratories Associate Director of MRI/MDCT Core Laboratory Cardiovascular Research

More information

Κλινική Χρήση IVUS και OCT PERIKLIS A. DAVLOUROS ASSOCIATE PROFESSOR OF CARDIOLOGY INVASIVE CARDIOLOGY & CONGENITAL HEART DISEASE

Κλινική Χρήση IVUS και OCT PERIKLIS A. DAVLOUROS ASSOCIATE PROFESSOR OF CARDIOLOGY INVASIVE CARDIOLOGY & CONGENITAL HEART DISEASE Κλινική Χρήση IVUS και OCT PERIKLIS A. DAVLOUROS ASSOCIATE PROFESSOR OF CARDIOLOGY INVASIVE CARDIOLOGY & CONGENITAL HEART DISEASE Conflict of interest None to declare While IVUS is the most used intravascular

More information

Multislice Computed Tomographic Characteristics of Coronary Lesions in Acute Coronary Syndromes

Multislice Computed Tomographic Characteristics of Coronary Lesions in Acute Coronary Syndromes Journal of the American College of Cardiology Vol. 50, No. 4, 2007 2007 by the American College of Cardiology Foundation ISSN 0735-1097/07/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2007.03.044

More information

Coronary plaque erosion: a clinical case. Dr. Giampaolo Niccoli, MD, PhD, FESC Institute of Cardiology Catholic University, Rome, Italy

Coronary plaque erosion: a clinical case. Dr. Giampaolo Niccoli, MD, PhD, FESC Institute of Cardiology Catholic University, Rome, Italy Coronary plaque erosion: a clinical case, MD, PhD, FESC Institute of Cardiology Catholic University, Rome, Italy Coronary plaque erosion: a clinical case B.M. Age: 59 years Sex: female. Cardiological risk

More information

Que nos puede aportar el OCT intracoronario

Que nos puede aportar el OCT intracoronario XXXI Jornadas SOLACI. 10ª Región CONOSUR LIIIº Congreso Chileno de Cardiología y Cirugía Cardiovascular Hotel Patagónico. Puerto Varas. Chile (30 Nov 1 Dic 2016) Que nos puede aportar el OCT intracoronario

More information

Basics of Angiographic Interpretation Analysis of Angiography

Basics of Angiographic Interpretation Analysis of Angiography Basics of Angiographic Interpretation Analysis of Angiography Young-Hak Kim, MD, PhD Cardiac Center, University of Ulsan College of Medicine, Seoul, Korea What made us nervous Supervisors Stent Contrast

More information

Optical Coherence Tomography (OCT): A New Imaging Tool During Carotid Artery Stenting

Optical Coherence Tomography (OCT): A New Imaging Tool During Carotid Artery Stenting Chapter 6 Optical Coherence Tomography (OCT): A New Imaging Tool During Carotid Artery Stenting Shinichi Yoshimura, Masanori Kawasaki, Kiyofumi Yamada, Arihiro Hattori, Kazuhiko Nishigaki, Shinya Minatoguchi

More information

Improvement of Image Quality with ß-Blocker Premedication on ECG-Gated 16-MDCT Coronary Angiography

Improvement of Image Quality with ß-Blocker Premedication on ECG-Gated 16-MDCT Coronary Angiography 16-MDCT Coronary Angiography Shim et al. 16-MDCT Coronary Angiography Sung Shine Shim 1 Yookyung Kim Soo Mee Lim Received December 1, 2003; accepted after revision June 1, 2004. 1 All authors: Department

More information

NUCLEAR CARDIOLOGY AND ADVANCED VASCULAR IMAGING. Joel Kahn, MD, FACC

NUCLEAR CARDIOLOGY AND ADVANCED VASCULAR IMAGING. Joel Kahn, MD, FACC NUCLEAR CARDIOLOGY AND ADVANCED VASCULAR IMAGING Joel Kahn, MD, FACC Short History Nuclear Cardiology Hermann blumgart-1927-injected radon to measure circulation time Hal Anger-1952-gamma camera-beginning

More information

Optical Coherence Tomography for Intracoronary Imaging

Optical Coherence Tomography for Intracoronary Imaging Optical Coherence Tomography for Intracoronary Imaging Lorenz Räber Stephan Windecker Department of Cardiology Swiss Cardiovascular Center and Clinical Trials Unit Bern Bern University Hospital, Switzerland

More information

DESolve NX Trial Clinical and Imaging Results

DESolve NX Trial Clinical and Imaging Results DESolve NX Trial Clinical and Imaging Results Alexandre Abizaid, MD, PhD, Instituto Dante Pazzanese, Sao Paulo, Brazil On behalf of the DESolve Nx Trial Investigators Please refer to the TCT2014 App or

More information

The PROSPECT Trial. A Natural History Study of Atherosclerosis Using Multimodality Intracoronary Imaging to Prospectively Identify Vulnerable Plaque

The PROSPECT Trial. A Natural History Study of Atherosclerosis Using Multimodality Intracoronary Imaging to Prospectively Identify Vulnerable Plaque The PROSPECT Trial Providing Regional Observations to Study Predictors of Events in the Coronary Tree A Natural History Study of Atherosclerosis Using Multimodality Intracoronary Imaging to Prospectively

More information

A Novel Low Pressure Self Expanding Nitinol Coronary Stent (vprotect): Device Design and FIH Experience

A Novel Low Pressure Self Expanding Nitinol Coronary Stent (vprotect): Device Design and FIH Experience A Novel Low Pressure Self Expanding Nitinol Coronary Stent (vprotect): Device Design and FIH Experience Juan F. Granada, MD Medical Director, Skirball Center for Cardiovascular Research The Cardiovascular

More information

Plaque Characteristics in Coronary Artery Disease. Chourmouzios Arampatzis MD, PhD, FESC

Plaque Characteristics in Coronary Artery Disease. Chourmouzios Arampatzis MD, PhD, FESC Plaque Characteristics in Coronary Artery Disease Chourmouzios Arampatzis MD, PhD, FESC Disclosure Statement of Financial Interest Regarding this Presentation NONE Atherosclerosis Model proposed by Stary

More information

High-risk vulnerable plaques. Kostis Raisakis G.Gennimatas General Hospital of Athens

High-risk vulnerable plaques. Kostis Raisakis G.Gennimatas General Hospital of Athens High-risk vulnerable plaques. Kostis Raisakis G.Gennimatas General Hospital of Athens Overview: 1 Definition-Pathology 2 3 Diagnostic Strategies Invasive Non Invasive Prognostic Value of Detection 4 Treatment

More information

Impact of Statin Therapy on Plaque Characteristics as Assessed by Serial OCT, Grayscale and Integrated Backscatter IVUS

Impact of Statin Therapy on Plaque Characteristics as Assessed by Serial OCT, Grayscale and Integrated Backscatter IVUS JACC: CARDIOVASCULAR IMAGING VOL. 5, NO. 2, 2012 2012 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-878X/$36.00 PUBLISHED BY ELSEVIER INC. DOI:10.1016/j.jcmg.2011.11.012 Impact of Statin Therapy

More information

FFR-guided Jailed Side Branch Intervention

FFR-guided Jailed Side Branch Intervention FFR-guided Jailed Side Branch Intervention - Pressure wire in Bifurcation lesions - Bon-Kwon Koo, MD, PhD Seoul National University Hospital, Seoul, Korea Bifurcation Lesions Bifurcation Lesions Still

More information

Between Coronary Angiography and Fractional Flow Reserve

Between Coronary Angiography and Fractional Flow Reserve Visual-Functional Mismatch Between Coronary Angiography and Fractional Flow Reserve Seung-Jung Park, MD., PhD. University of Ulsan, College of Medicine Asan Medical Center, Seoul, Korea Visual - Functional

More information

CPIS So-Yeon Choi, MD., PhD. Department of Cardiology Ajou University School of MedicineSuwon, Korea

CPIS So-Yeon Choi, MD., PhD. Department of Cardiology Ajou University School of MedicineSuwon, Korea So-Yeon Choi, MD., PhD. Department of Cardiology Ajou University School of MedicineSuwon, Korea Coronary Artery Imaging The ideal coronary imaging technology would be capable of identifying not only vessel

More information

Scientific Exhibit. Authors: D. Takenaka, Y. Ohno, Y. Onishi, K. Matsumoto, T.

Scientific Exhibit. Authors: D. Takenaka, Y. Ohno, Y. Onishi, K. Matsumoto, T. The feasibility of biphasic contrast-media-injection-protocol for chest imaging on 320-slice volume MDCT: Direct comparison of biphasic and bolus contrast-media injection protocols on 320-slice volume

More information

Can We Identify Vulnerable Patients & Vulnerable Plaque?

Can We Identify Vulnerable Patients & Vulnerable Plaque? Can We Identify Vulnerable Patients & Vulnerable Plaque? We Know Enough to Treat High-Risk Lesions? Takashi Akasaka, MD, PhD Department of Cardiovascular Medicine, Japan Disclosure Statement of Financial

More information

Analysis of neointimal coverage after silolimus-eluting stent implantation using optical coherence tomography.

Analysis of neointimal coverage after silolimus-eluting stent implantation using optical coherence tomography. Analysis of neointimal coverage after silolimus-eluting stent implantation using optical coherence tomography. Division of Cardiology, Department of Internal Medicine, Fasculty of Medicine, Kinki University,

More information

Fractional Flow Reserve: Basics, FAME 1, FAME 2. William F. Fearon, MD Associate Professor Stanford University Medical Center

Fractional Flow Reserve: Basics, FAME 1, FAME 2. William F. Fearon, MD Associate Professor Stanford University Medical Center Fractional Flow Reserve: Basics, FAME 1, FAME 2 William F. Fearon, MD Associate Professor Stanford University Medical Center Conflict of Interest Advisory Board for HeartFlow Research grant from St. Jude

More information

RAMA-EGAT Risk Score for Predicting Coronary Artery Disease Evaluated by 64- Slice CT Angiography

RAMA-EGAT Risk Score for Predicting Coronary Artery Disease Evaluated by 64- Slice CT Angiography RAMA-EGAT Risk Score for Predicting Coronary Artery Disease Evaluated by 64- Slice CT Angiography Supalerk Pattanaprichakul, MD 1, Sutipong Jongjirasiri, MD 2, Sukit Yamwong, MD 1, Jiraporn Laothammatas,

More information

Optical Coherence Tomography

Optical Coherence Tomography Optical Coherence Tomography Disclosure Information Demetrius Lopes MD The following relationships exist related to this presentation: University Grant/Research Support: Rush University Industry Grant

More information

EBC London 2013 Provisional SB stenting strategy with kissing balloon with Absorb

EBC London 2013 Provisional SB stenting strategy with kissing balloon with Absorb EBC London 2013 Provisional SB stenting strategy with kissing balloon with Absorb A. Medina Servicio de Cardiología Hospital Universitario de Gran Canaria Dr. Negrín Islas Canarias (Spain) Provisional

More information

Coronary Artery Thermography

Coronary Artery Thermography Coronary Artery Thermography The 10th Anniversary, Interventional Vascular Therapeutics Angioplasty Summit 2005 TCT Asia Pacific Christodoulos Stefanadis Professor of Cardiology Athens Medical School In

More information

2yrs 2-6yrs >6yrs BMS 0% 22% 42% DES 29% 41% Nakazawa et al. J Am Coll Cardiol 2011;57:

2yrs 2-6yrs >6yrs BMS 0% 22% 42% DES 29% 41% Nakazawa et al. J Am Coll Cardiol 2011;57: Pathology of In-stent Neoatherosclerosis in BMS and DES 197 BMS, 103 SES, and 106 PES with implant duration >30 days The incidence of neoatherosclerosis was significantly greater in DES (31%) than BMS

More information

Spotty Calcification Typifies the Culprit Plaque in Patients With Acute Myocardial Infarction An Intravascular Ultrasound Study

Spotty Calcification Typifies the Culprit Plaque in Patients With Acute Myocardial Infarction An Intravascular Ultrasound Study Spotty Calcification Typifies the Culprit Plaque in Patients With Acute Myocardial Infarction An Intravascular Ultrasound Study Shoichi Ehara, MD; Yoshiki Kobayashi, MD; Minoru Yoshiyama, MD; Kenei Shimada,

More information

Plaque Imaging: What It Can Tell Us. Kenneth Snyder, MD, PhD L Nelson Hopkins MD FACS Elad Levy MD MBA FAHA FACS Adnan Siddiqui MD PhD

Plaque Imaging: What It Can Tell Us. Kenneth Snyder, MD, PhD L Nelson Hopkins MD FACS Elad Levy MD MBA FAHA FACS Adnan Siddiqui MD PhD Plaque Imaging: What It Can Tell Us Kenneth Snyder, MD, PhD L Nelson Hopkins MD FACS Elad Levy MD MBA FAHA FACS Adnan Siddiqui MD PhD Buffalo Disclosure Information FINANCIAL DISCLOSURE: Research and consultant

More information

Prediction of Acute Coronary Syndrome by Using Multislice Computed Tomography

Prediction of Acute Coronary Syndrome by Using Multislice Computed Tomography Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp CONTROVERSIES IN CARDIOVASCULAR MEDICINE Prediction of Acute Coronary Syndrome by Using Multislice Computed

More information

The Site of Plaque Rupture in Native Coronary Arteries

The Site of Plaque Rupture in Native Coronary Arteries Journal of the American College of Cardiology Vol. 46, No. 2, 2005 2005 by the American College of Cardiology Foundation ISSN 0735-1097/05/$30.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2005.03.067

More information

J Am Coll Cardiol 1995; 25: 1479

J Am Coll Cardiol 1995; 25: 1479 Complex PCI: IVUS-Guided PCI Junko Honye Fuchu Keijinkai Hospital, Tokyo Gifu Heart Center, Gifu Japan Roles of IVUS during PCI 1. IVUS before PCI (automatic pullback) Device selection: direct stenting?

More information

Catch-up Phenomenon: Insights from Pathology

Catch-up Phenomenon: Insights from Pathology Catch-up Phenomenon: Insights from Pathology Michael Joner, MD CVPath Institute Inc. Gaithersburg, MD USA Path Lessons learned from the BMS and DES (1 st Gen) era Neointimal Thickness [mm] In Stent Re

More information

Can IVUS Define Plaque Features that Impact Patient Care?

Can IVUS Define Plaque Features that Impact Patient Care? Can IVUS Define Plaque Features that Impact Patient Care? A Pichard L Satler, K Kent, R Waksman, W Suddath, N Bernardo, N Weissman, M Angelo, D Harrington, J Lindsay, J Panza. Washington Hospital Center

More information

Cover Page. Author: Wang, Ancong Title: Automatic quantification of intravascular optical coherence tomography Issue Date:

Cover Page. Author: Wang, Ancong Title: Automatic quantification of intravascular optical coherence tomography Issue Date: Cover Page The handle http://hdl.handle.net/1887/29690 holds various files of this Leiden University dissertation Author: Wang, Ancong Title: Automatic quantification of intravascular optical coherence

More information

Assessment of Non-Calcified Coronary Plaques Using 64-Slice Computed Tomography: Comparison With Intravascular Ultrasound

Assessment of Non-Calcified Coronary Plaques Using 64-Slice Computed Tomography: Comparison With Intravascular Ultrasound ORIGINAL ARTICLE DOI 10.4070 / kcj.2009.39.3.95 Print ISSN 1738-5520 / On-line ISSN 1738-5555 Copyright c 2009 The Korean Society of Cardiology Assessment of Non-Calcified Coronary Plaques Using 64-Slice

More information

Intravascular Ultrasound (IVUS) and Optical Coherence Tomography (OCT)

Intravascular Ultrasound (IVUS) and Optical Coherence Tomography (OCT) Intravascular Ultrasound (IVUS) and Optical Coherence Tomography (OCT) Clare McLaren Great Ormond Street Hospital London Introduction IVUS and OCT supplementary techniques to angiography provide information

More information

State of the Art. Advances in Cardiovascular Imaging. ESC Congres Stockholm September 1, 2010 Frank E. Rademakers, MD, PhD, FESC

State of the Art. Advances in Cardiovascular Imaging. ESC Congres Stockholm September 1, 2010 Frank E. Rademakers, MD, PhD, FESC State of the Art Advances in Cardiovascular Imaging ESC Congres Stockholm September 1, 2010 Frank E. Rademakers, MD, PhD, FESC Coronary Artery Disease Content Patho Physiology Imaging requirements Economical

More information

CASE from South Korea

CASE from South Korea CASE from South Korea Bon-Kwon Koo, MD, PhD, Seoul, Korea Outpatient clinic of a non-interventional cardiologist F/56 Chief complaint: Angina with recent aggravation, CCS II~III Brief history: # Stroke

More information

Clinical Value of OCT. Guidance for Coronary Stenting. Giulio Guagliumi, MD

Clinical Value of OCT. Guidance for Coronary Stenting. Giulio Guagliumi, MD Clinical Value of OCT Guidance for Coronary Stenting Giulio Guagliumi, MD 100 % Endovascular Imaging Indications of use 87.5 % 75 % 57.5 % 50 % 45 % 25 % 15 % 0 Lesion morphology Stent optimization Lesion

More information

Soft and Intermediate Plaques in Coronary Arteries: How Accurately Can We Measure CT Attenuation Using 64-MDCT?

Soft and Intermediate Plaques in Coronary Arteries: How Accurately Can We Measure CT Attenuation Using 64-MDCT? 64-MDCT Measurement of Coronary Artery Plaques Cardiac Imaging Original Research Jun Horiguchi 1 Chikako Fujioka 1 Masao Kiguchi 1 Yun Shen 2 Christian E. Althoff 3,4 Hideya Yamamoto 5 Katsuhide Ito 3

More information

Vulnerable Plaque Pathophysiology, Detection, and Intervention. VP: A Local Problem or Systemic Disease. Erling Falk, Denmark

Vulnerable Plaque Pathophysiology, Detection, and Intervention. VP: A Local Problem or Systemic Disease. Erling Falk, Denmark Vulnerable Plaque Pathophysiology, Detection, and Intervention VP: A Local Problem or Systemic Disease Erling Falk, Denmark Vulnerable Plaque Pathophysiology, Detection, and Intervention VP: A Local Problem

More information

Cardiac Computed Tomography

Cardiac Computed Tomography Cardiac Computed Tomography Authored and approved by Koen Nieman Stephan Achenbach Francesca Pugliese Bernard Cosyns Patrizio Lancellotti Anastasia Kitsiou Contents CARDIAC COMPUTED TOMOGRAPHY Page 1.

More information

Effect of Intravascular Ultrasound- Guided vs. Angiography-Guided Everolimus-Eluting Stent Implantation: the IVUS-XPL Randomized Clinical Trial

Effect of Intravascular Ultrasound- Guided vs. Angiography-Guided Everolimus-Eluting Stent Implantation: the IVUS-XPL Randomized Clinical Trial Effect of Intravascular Ultrasound- Guided vs. Angiography-Guided Everolimus-Eluting Stent Implantation: the IVUS-XPL Randomized Clinical Trial Myeong-Ki Hong, MD. PhD on behalf of the IVUS-XPL trial investigators

More information

Cardiac Imaging Tests

Cardiac Imaging Tests Cardiac Imaging Tests http://www.medpagetoday.com/upload/2010/11/15/23347.jpg Standard imaging tests include echocardiography, chest x-ray, CT, MRI, and various radionuclide techniques. Standard CT and

More information

Evaluation of a new micromesh carotid stent with Optical Coherence Tomography.

Evaluation of a new micromesh carotid stent with Optical Coherence Tomography. Evaluation of a new micromesh carotid stent with Optical Coherence Tomography. Technical case report. J. Lemoine,S. Myla,Z. Chati,R.Aslam, M.Amor Clinic Louis Pasteur,Essey les Nancy.France Disclosure

More information

Impact of Metabolic Syndrome on Tissue Characteristics of Angiographically Mild to Moderate Coronary Lesions

Impact of Metabolic Syndrome on Tissue Characteristics of Angiographically Mild to Moderate Coronary Lesions Journal of the American College of Cardiology Vol. 49, No. 11, 2007 2007 by the American College of Cardiology Foundation ISSN 0735-1097/07/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2006.12.028

More information

Plaque Shift vs. Carina Shift Prevalence and Implication

Plaque Shift vs. Carina Shift Prevalence and Implication TCTAP 2013 Fellowship Course Left Main and Bifurcation PCI: Bifurcation PCI Plaque Shift vs. Carina Shift Prevalence and Implication Soo-Jin Kang, MD., PhD. Department of Cardiology, University of Ulsan

More information

Post PCI functional testing and imaging: case based lessons from FFR React

Post PCI functional testing and imaging: case based lessons from FFR React Post PCI functional testing and imaging: case based lessons from FFR React Joost Daemen, MD, PhD, FESC Optics in Cardiology 2018 April 21st, 2018 10.15 10.30h Disclosure Statement of Financial Interest

More information

Coronary angiography and PCI

Coronary angiography and PCI Coronary arteries Coronary angiography and PCI Samo Granda, Franjo Naji Department of Cardiology Clinical department of internal medicine University clinical centre Maribor Coronary arteries Atherosclerosis

More information

Fielder XT: Initial and. Department of Cardiology, Asan Medical Center, Ulsan University of college of medicine

Fielder XT: Initial and. Department of Cardiology, Asan Medical Center, Ulsan University of college of medicine Fielder XT: Initial and Professional Use for CTO Seung-Whan Lee, MD, PhD D t t f C di l A M di l C t Department of Cardiology, Asan Medical Center, Ulsan University of college of medicine Plastic-Jacket

More information

Neointimal coverage of bare-metal and sirolimuseluting stents evaluated with optical coherence tomography

Neointimal coverage of bare-metal and sirolimuseluting stents evaluated with optical coherence tomography Neointimal coverage of bare-metal and sirolimuseluting stents evaluated with optical coherence tomography B X Chen, F Y Ma, W Luo, J H Ruan, W L Xie, X Z Zhao, S H Sun, X M Guo, F Wang, T Tian, X W Chu

More information

Characterization of coronary plaques with combined use of intravascular ultrasound, virtual histology and optical coherence tomography

Characterization of coronary plaques with combined use of intravascular ultrasound, virtual histology and optical coherence tomography Heart International 2010; volume 5:e12 Characterization of coronary plaques with combined use of intravascular ultrasound, virtual histology and optical coherence tomography Guillermo Sánchez-Elvira, 1

More information

Carotid Intravascular Imaging Technique and Indication

Carotid Intravascular Imaging Technique and Indication Nurse and Technician Forum Carotid Intravascular Imaging Technique and Indication Gianmarco de Donato Assistant Professor Vascular and Endovascular Surgery University of Siena - Italy Disclosure Speaker

More information

PCI for Chronic Total Occlusions

PCI for Chronic Total Occlusions PCI for Chronic Total Occlusions Chronic Total Occlusions Why not Medical Treatment? Medical Treatment CTO in 891 pts over 24 years High 10% Mortality Low 2 % 1 year 10 years Puma JA, et al. JACC 1994;23:390A

More information

Shockwave Intravascular Lithotripsy System treatment of calcified lesions: Intravascular OCT analysis

Shockwave Intravascular Lithotripsy System treatment of calcified lesions: Intravascular OCT analysis Shockwave Intravascular Lithotripsy System treatment of calcified lesions: Intravascular OCT analysis Andrew Holden, MBChB, FRANZCR, EBIR Director of Interventional Radiology Auckland, New Zealand LINC

More information

Integrated Use of IVUS and FFR for LM Stenting

Integrated Use of IVUS and FFR for LM Stenting Integrated Use of IVUS and FFR for LM Stenting Gary S. Mintz, MD Cardiovascular Research Foundation Four studies have highlighted the inaccuracy of angiography in the assessment of LMCA disease Fisher

More information

Non-invasive Imaging of Carotid Artery Atherosclerosis

Non-invasive Imaging of Carotid Artery Atherosclerosis Non-invasive Imaging of Carotid Artery Atherosclerosis 최연현 성균관의대삼성서울병원영상의학과 Noninvasive Techniques US with Doppler CT MRI Ultrasonography Techniques of Carotid US US Anatomy (ICA vs ECA) Gray scale and

More information

Objectives. Acute Coronary Syndromes; The Nuts and Bolts. Overview. Quick quiz.. How dose the plaque start?

Objectives. Acute Coronary Syndromes; The Nuts and Bolts. Overview. Quick quiz.. How dose the plaque start? Objectives Acute Coronary Syndromes; The Nuts and Bolts Michael P. Gulseth, Pharm. D., BCPS Pharmacotherapy II Spring 2006 Compare and contrast pathophysiology of unstable angina (UA), non-st segment elevation

More information

Quick guide. Core. precision guided therapy system

Quick guide. Core. precision guided therapy system Quick guide Core precision guided therapy system The Philips Volcano imaging system should only be operated by trained personnel. The following information is presented for your convenience and is not

More information

The Egyptian Journal of Hospital Medicine (Apr. 2017) Vol. 67(1), Page

The Egyptian Journal of Hospital Medicine (Apr. 2017) Vol. 67(1), Page The Egyptian Journal of Hospital Medicine (Apr. 2017) Vol. 67(1), Page 425-435 Comparison of Usefulness of Percutaneous Coronary Intervention Guided by Angiography plus Computed Tomography versus Angiography

More information

New Insight about FFR and IVUS MLA

New Insight about FFR and IVUS MLA New Insight about FFR and IVUS MLA Can IVUS MLA Predict FFR

More information

Noninvasive Coronary Imaging: Plaque Imaging by MDCT

Noninvasive Coronary Imaging: Plaque Imaging by MDCT Coronary Physiology & Imaging Summit 2007 Noninvasive Coronary Imaging: Plaque Imaging by MDCT Byoung Wook Choi Department of Radiology Yonsei University, Seoul, Korea Stary, H. C. et al. Circulation

More information

CT or PET/CT for coronary artery disease

CT or PET/CT for coronary artery disease CT or PET/CT for coronary artery disease Rotterdam 2012 Juhani Knuuti, MD, PhD, FESC Turku PET Centre University of Turku Turku, Finland Juhani.knuuti@utu.fi Turku PET Centre University of Turku Åbo Akademi

More information

Challenging of contrast agent-free endovascular treatment using 3D imaging

Challenging of contrast agent-free endovascular treatment using 3D imaging AC17-0010 Challenging of contrast agent-free endovascular treatment using 3D imaging Amane Kozuki Department of Cardiology, Osaka Saiseikai Nakatsu Hospital Introduction With advances in devices and techniques,

More information

Chapter 4. Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. Department of Radiology,

Chapter 4. Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands. Department of Radiology, Chapter 4 Impact of Coronary Calcium Score on Diagnostic Accuracy of Multislice Computed Tomography Coronary Angiography for Detection of Coronary Artery Disease Gabija Pundziute, 1,3 Joanne D. Schuijf,

More information

Calcified nodule as a cause of myocardial infarction with nonobstructive

Calcified nodule as a cause of myocardial infarction with nonobstructive www.edoriumjournals.com CASE REPORT PEER REVIEWED OPEN ACCESS Calcified nodule as a cause of myocardial infarction with nonobstructive coronary artery disease Kaitlyn E. Dugan, Akiko Maehara, Raymond Y.

More information

Optical coherence tomography evaluation of zotarolimus-eluting stents at 9-month follow-up: comparison with sirolimus-eluting stents

Optical coherence tomography evaluation of zotarolimus-eluting stents at 9-month follow-up: comparison with sirolimus-eluting stents Optical coherence tomography evaluation of zotarolimus-eluting stents at 9-month follow-up: comparison with sirolimus-eluting stents J-S Kim, 1 I-K Jang, 2 J-S Kim, 1 T H Kim, 1 M Takano, 3 T Kume, 4 N

More information

A Histological and Clinical Comparison of New and Conventional Integrated Backscatter Intravascular Ultrasound (IB-IVUS)

A Histological and Clinical Comparison of New and Conventional Integrated Backscatter Intravascular Ultrasound (IB-IVUS) Circulation Journal Official Journal of the Japanese Circulation Society http://www.j-circ.or.jp ORIGINAL ARTICLE Imaging A Histological and Clinical Comparison of New and Conventional Integrated Backscatter

More information