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Coronary Artery Disease: HELP
Articles by Christos V. Bourantas
Based on 76 articles published since 2010
(Why 76 articles?)
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Between 2010 and 2020, Christos Bourantas wrote the following 76 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Editorial Hybrid intravascular imaging: the key for a holistic evaluation of plaque pathology. 2014

Bourantas, Christos V / Serruys, Patrick W. ·Department of Cardiology, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom. ·EuroIntervention · Pubmed #25042263.

ABSTRACT: -- No abstract --

2 Review Intravascular imaging in cardiovascular ageing. 2018

Bourantas, Christos V / Crake, Tom / Zhang, Yao-Jun / Ozkor, Mick / Ahmed, Javed / Garcia-Garcia, Hector M / Serruys, Patrick W. ·Barts Heart Centre, Barts Health NHS Trust, London, UK; Institute of Cardiovascular Sciences, University College London, London, UK. Electronic address: christos.bourantas@bartshealth.nhs.uk. · Barts Heart Centre, Barts Health NHS Trust, London, UK. · Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. · Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK. · Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. · Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands; International Centre for Circulatory Health, NHLI, Imperial College London, London, UK. ·Exp Gerontol · Pubmed #28522312.

ABSTRACT: Ageing is related to complex molecular, inflammatory and biochemical changes that affect coronary pathology and often lead to coronary artery disease and cardiovascular events. Intravascular imaging is considered as the ideal technique to study coronary plaque morphology and assess its burden. Over the recent years several studies have been performed that investigated the association between pathophysiological mechanisms that promote vascular ageing and plaque morphology. In addition, several reports have compared plaque pathology in different age groups and a few studies included serial intravascular imaging to assess changes in the atheroma burden and compositional characteristics of the plaque. This review article summarizes the evidence derived from intravascular imaging studies about the implications of vascular ageing on coronary artery morphology and discusses the potential of coronary imaging in assessing atherosclerotic evolution.

3 Review Local Hemodynamic Forces After Stenting: Implications on Restenosis and Thrombosis. 2017

Ng, Jaryl / Bourantas, Christos V / Torii, Ryo / Ang, Hui Ying / Tenekecioglu, Erhan / Serruys, Patrick W / Foin, Nicolas. ·From the National Heart Centre Singapore (J.N., H.Y.A., N.F.) · Department of Biomedical Engineering, National University of Singapore, Singapore (J.N.) · Departments of Cardiovascular Sciences (C.V.B.) and Mechanical Engineering (R.T.), University College London, United Kingdom · Department of Cardiology, Barts Health NHS Trust, London, United Kingdom (C.V.B.) · Thoraxcenter, Erasmus MC, Rotterdam Erasmus University, The Netherlands (E.T., P.W.S.) · National Heart & Lung Institute, Imperial College London, United Kingdom (P.W.S.) · and Duke-NUS Medical School, National University of Singapore (N.F.). ·Arterioscler Thromb Vasc Biol · Pubmed #29122816.

ABSTRACT: Local hemodynamic forces are well-known to modulate atherosclerotic evolution, which remains one of the largest cause of death worldwide. Percutaneous coronary interventions with stent implantation restores blood flow to the downstream myocardium and is only limited by stent failure caused by restenosis, stent thrombosis, or neoatherosclerosis. Cumulative evidence has shown that local hemodynamic forces affect restenosis and the platelet activation process, modulating the pathophysiological mechanisms that lead to stent failure. This article first covers the pathophysiological mechanisms through which wall shear stress regulates arterial disease formation/neointima proliferation and the role of shear rate on stent thrombosis. Subsequently, the article reviews the current evidence on (1) the implications of stent design on the local hemodynamic forces, and (2) how stent/scaffold expansion can influence local flow, thereby affecting the risk of adverse events.

4 Review State of the art: role of intravascular imaging in the evolution of percutaneous coronary intervention - a 30-year review. 2017

Bourantas, Christos V / Tenekecioglu, Erhan / Radu, Maria / Räber, Lorenz / Serruys, Patrick W. ·Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom. ·EuroIntervention · Pubmed #28844027.

ABSTRACT: It has been 40 years since percutaneous coronary intervention (PCI) was introduced into the clinical setting. Over these years significant advances in device technology and the invention of new therapeutic strategies have broadened its applications in the clinical arena, rendering this treatment the first-line therapy for patients with obstructive coronary artery disease. The evolution of PCI would not have been possible without intravascular imaging which provided unique insights about coronary artery pathology, enabled evaluation of vessel wall response following PCI and allowed meticulous evaluation of the advantages and limitations of emerging devices. This review article appraises the role of intravascular imaging in the evolution of PCI, summarises the findings of invasive imaging studies that examined the efficacy of new therapies and endovascular devices, presents the evidence that supports its use in current clinical practice and discusses its future potential in PCI.

5 Review Intravascular multimodality imaging: feasibility and role in the evaluation of coronary plaque pathology. 2017

Michail, Michael / Serruys, Patrick W / Stettler, Rodrigue / Crake, Tom / Torii, Ryo / Tenekecioglu, Erhan / Zeng, Yaping / Onuma, Yoshinobu / Mathur, Anthony / Bourantas, Christos V. ·Barts Heart Centre, Barts Health NHS Trust, London, UK. · Faculty of Medicine, National Heart & Lung Institute, Imperial College London, UK. · Department of Interventional Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands. · Department of Mechanical Engineering, University College London, UK. · Department of Cardiovascular Sciences, University College London, UK. ·Eur Heart J Cardiovasc Imaging · Pubmed #28329320.

ABSTRACT: Coronary artery disease remains the leading cause of death in the developed world. Over recent years, research has been focused on the development of diagnostic intravascular imaging techniques that enable assessment of plaque composition and morphology, and allow identification of vulnerable, high-risk lesions. Nevertheless recent studies of coronary atherosclerosis have shown that invasive modalities have a limited accuracy in detecting lesions that will progress and cause events, whilst histology-based studies also highlighted the limitations of invasive imaging in assessing plaque characteristics. To overcome these drawbacks, multimodality imaging has been proposed. Although it is apparent that coronary imaging with two or three imaging modalities is time consuming and is associated with a risk of complications, evidence from small clinical studies demonstrated that it provides incremental information about plaque pathology and biology and underscored the need to develop dual-probe hybrid imaging catheters that would enable complete and comprehensive assessment of plaque morphology. This paper reviews the current clinical evidence that supports the use of multimodality intravascular imaging in the study of atherosclerosis, summarizes the key findings of the first invasive imaging studies that utilize hybrid dual-probe catheters, and discusses the limitations of combined intravascular imaging that restrict its broad application in both the clinical and research arena.

6 Review Invasive or non-invasive imaging for detecting high-risk coronary lesions? 2017

Patel, Kush / Tarkin, Jason / Serruys, Patrick W / Tenekecioglu, Erhan / Foin, Nicolas / Zhang, Yao-Jun / Crake, Tom / Moon, James / Mathur, Anthony / Bourantas, Christos V. ·a Barts Heart Centre, Barts Health NHS Trust , London , UK. · b Division of Cardiovascular Medicine , University of Cambridge , Cambridge , UK. · c Thoraxcenter , Erasmus Medical Centre , Rotterdam , The Netherlands. · d Faculty of Medicine , National Heart & Lung Institute, Imperial College , London , UK. · e National Heart Centre Singapore , Duke-NUS Medical School , Singapore. · f Nanjing First Hospital , Nanjing Medical University , Nanjing , China. · g Institute of Cardiovascular Sciences , University College London , London , UK. ·Expert Rev Cardiovasc Ther · Pubmed #28256179.

ABSTRACT: INTRODUCTION: Advances in our understanding about atherosclerotic evolution have enabled us to identify specific plaque characteristics that are associated with coronary plaque vulnerability and cardiovascular events. With constant improvements in signal and image processing an arsenal of invasive and non-invasive imaging modalities have been developed that are capable of identifying these features allowing in vivo assessment of plaque vulnerability. Areas covered: This review article presents the available and emerging imaging modalities introduced to assess plaque morphology and biology, describes the evidence from the first large scale studies that evaluated the efficacy of invasive and non-invasive imaging in detecting lesions that are likely to progress and cause cardiovascular events and discusses the potential implications of the in vivo assessment of coronary artery pathology in the clinical setting. Expert commentary: Invasive imaging, with its high resolution, and in particular hybrid intravascular imaging appears as the ideal approach to study the mechanisms regulating atherosclerotic disease progression; whereas non-invasive imaging is expected to enable complete assessment of coronary tree pathology, detection of high-risk lesions, more accurate risk stratification and thus to allow a personalized treatment of vulnerable patients.

7 Review Percutaneous coronary intervention vs. cardiac surgery in diabetic patients. Where are we now and where should we be going? 2017

Kassimis, George / Bourantas, Christos V / Tushar, Raina / de Maria, Giovanni Luigi / Davlouros, Periklis / Hahalis, George / Alexopoulos, Dimitrios / Banning, Adrian P. ·Cardiology Department, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham General Hospital, Cheltenham, United Kingdom. Electronic address: gksup@yahoo.gr. · Institute of Cardiovascular Sciences, University College of London, London, United Kingdom; Department of Cardiology, Barts Health NHS Trust, London, United Kingdom. · Cardiology Department, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham General Hospital, Cheltenham, United Kingdom. · Oxford Heart Center, John Radcliffe Hospital, Oxford, United Kingdom. · Cardiology Department, University Hospital of Patras, Rion, Greece. · Cardiology Department, Attikon University Hospital, Athens, Greece. ·Hellenic J Cardiol · Pubmed #28212871.

ABSTRACT: Patients with diabetes mellitus are at increased risk of developing coronary artery disease (CAD) and have an increased incidence of recurrent events following revascularization. Choosing the most appropriate strategy to revascularize these high-risk patients is crucial for improving the clinical outcomes. Several studies, randomized trials and meta-analyses have compared short- and long-term outcomes following coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in diabetic patients suffering from CAD. The aim of this article is to review the currently available evidence on the role of PCI and CABG in the management of diabetic patients with CAD.

8 Review Biomechanical stress in coronary atherosclerosis: emerging insights from computational modelling. 2017

Thondapu, Vikas / Bourantas, Christos V / Foin, Nicolas / Jang, Ik-Kyung / Serruys, Patrick W / Barlis, Peter. ·Melbourne Medical School, Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Victoria, Australia · Department of Mechanical Engineering, Melbourne School of Engineering, The University of Melbourne, Victoria, Australia · University College London Hospitals, National Health Service Foundation Trust, London, UK. · National Heart Centre, Singapore, Singapore · Duke-National University Singapore Medical School, Singapore · Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. · National Heart & Lung Institute, Imperial College, London, UK. ·Eur Heart J · Pubmed #28158723.

ABSTRACT: Coronary plaque rupture is the most common cause of vessel thrombosis and acute coronary syndrome. The accurate early detection of plaques prone to rupture may allow prospective, preventative treatment; however, current diagnostic methods remain inadequate to detect these lesions. Established imaging features indicating vulnerability do not confer adequate specificity for symptomatic rupture. Similarly, even though experimental and computational studies have underscored the importance of endothelial shear stress in progressive atherosclerosis, the ability of shear stress to predict plaque progression remains incremental. This review examines recent advances in image-based computational modelling that have elucidated possible mechanisms of plaque progression and rupture, and potentially novel features of plaques most prone to symptomatic rupture. With further study and clinical validation, these markers and techniques may improve the specificity of future culprit plaque detection.

9 Review Intracoronary optical coherence tomography: Clinical and research applications and intravascular imaging software overview. 2017

Tenekecioglu, Erhan / Albuquerque, Felipe N / Sotomi, Yohei / Zeng, Yaping / Suwannasom, Pannipa / Tateishi, Hiroki / Cavalcante, Rafael / Ishibashi, Yuki / Nakatani, Shimpei / Abdelghani, Mohammad / Dijkstra, Jouke / Bourantas, Christos / Collet, Carlos / Karanasos, Antonios / Radu, Maria / Wang, Ancong / Muramatsu, Takashi / Landmesser, Ulf / Okamura, Takayuki / Regar, Evelyn / Räber, Lorenz / Guagliumi, Giulio / Pyo, Robert T / Onuma, Yoshinobu / Serruys, Patrick W. ·Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands. · Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, United States. · Academic Medical Center-University of Amsterdam, Amsterdam, The Netherlands. · Leiden University Medical Center, Leiden, The Netherlands. · University College of London Hospitals, London, United Kingdom. · Copenhagen University Hospital, Copenhagen, Denmark. · Fujita Health University Hospital, Toyoake, Japan. · Charite Universitätsmedizin Berlin, Berlin, Germany. · Yamaguchi University, Yamaguchi, Japan. · Department of Cardiovascular Surgery, University Hospital Zürich, Switzerland. · Bern University Hospital, Bern, Switzerland. · Ospedali Riuniti di Bergamo, Bergamo, Italy. · Albert Einstein College of Medicine, Montefiore Medical Center, NY. · International Centre for Circulatory Health, Imperial College, London, United Kingdom. ·Catheter Cardiovasc Interv · Pubmed #28109054.

ABSTRACT: By providing valuable information about the coronary artery wall and lumen, intravascular imaging may aid in optimizing interventional procedure results and thereby could improve clinical outcomes following percutaneous coronary intervention (PCI). Intravascular optical coherence tomography (OCT) is a light-based technology with a tissue penetration of approximately 1 to 3 mm and provides near histological resolution. It has emerged as a technological breakthrough in intravascular imaging with multiple clinical and research applications. OCT provides detailed visualization of the vessel following PCI and provides accurate assessment of post-procedural stent performance including detection of edge dissection, stent struts apposition, tissue prolapse, and healing parameters. Additionally, it can provide accurate characterization of plaque morphology and provides key information to optimize post-procedural outcomes. This manuscript aims to review the current clinical and research applications of intracoronary OCT and summarize the analytic OCT imaging software packages currently available. © 2017 Wiley Periodicals, Inc.

10 Review Hybrid intravascular imaging: recent advances, technical considerations, and current applications in the study of plaque pathophysiology. 2017

Bourantas, Christos V / Jaffer, Farouc A / Gijsen, Frank J / van Soest, Gijs / Madden, Sean P / Courtney, Brian K / Fard, Ali M / Tenekecioglu, Erhan / Zeng, Yaping / van der Steen, Antonius F W / Emelianov, Stanislav / Muller, James / Stone, Peter H / Marcu, Laura / Tearney, Guillermo J / Serruys, Patrick W. ·Department of Cardiovascular Sciences, University College London, London, UK. · Cardiovascular Research Center and Cardiology Division, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA. · Thorax Center, Erasmus MC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. · InfraReDx, Inc., Burlington, MA, USA. · Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. · Wellman Center for Photomedicine, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA. · Department of Biomedical Engineering, University of Texas at Austin, Austin, TX, USA. · Cardiovascular Division, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA. · Department of Biomedical Engineering, University of California, CA, USA. · International Centre for Cardiovascular Health, NHLI, Imperial College London, London, UK. ·Eur Heart J · Pubmed #27118197.

ABSTRACT: Cumulative evidence from histology-based studies demonstrate that the currently available intravascular imaging techniques have fundamental limitations that do not allow complete and detailed evaluation of plaque morphology and pathobiology, limiting the ability to accurately identify high-risk plaques. To overcome these drawbacks, new efforts are developing for data fusion methodologies and the design of hybrid, dual-probe catheters to enable accurate assessment of plaque characteristics, and reliable identification of high-risk lesions. Today several dual-probe catheters have been introduced including combined near infrared spectroscopy-intravascular ultrasound (NIRS-IVUS), that is already commercially available, IVUS-optical coherence tomography (OCT), the OCT-NIRS, the OCT-near infrared fluorescence (NIRF) molecular imaging, IVUS-NIRF, IVUS intravascular photoacoustic imaging and combined fluorescence lifetime-IVUS imaging. These multimodal approaches appear able to overcome limitations of standalone imaging and provide comprehensive visualization of plaque composition and plaque biology. The aim of this review article is to summarize the advances in hybrid intravascular imaging, discuss the technical challenges that should be addressed in order to have a use in the clinical arena, and present the evidence from their first applications aiming to highlight their potential value in the study of atherosclerosis.

11 Review Optimisation of percutaneous coronary intervention: indispensables for bioresorbable scaffolds. 2016

Tenekecioglu, Erhan / Bourantas, Christos V / Abdelghani, Mohammad / Sotomi, Yohei / Suwannasom, Pannipa / Tateishi, Hiroki / Onuma, Yoshinobu / Yılmaz, Mustafa / Serruys, Patrick W. ·a Department of Cardiology, ThoraxCentre , Erasmus Medical Center , Rotterdam , The Netherlands. · b Institute of Cardiovascular Sciences , University College of London , London , UK. · c Department of Cardiology , Barts Health NHS Trust , London , UK. · d Academic Medical Center , University of Amsterdam , Amsterdam , The Netherlands. · e Department of Cardiology , Bursa Postgraduate Research and Education Hospital , Bursa , Turkey. · f International Centre for Circulatory Health , Imperial College , London , UK. ·Expert Rev Cardiovasc Ther · Pubmed #27376592.

ABSTRACT: INTRODUCTION: With new developments in percutaneous coronary intervention (PCI), such as the introduction of bioresorbable scaffolds (BRS), percutaneous treatment of coronary artery diseases has entered a new era. Without metallic remnants, BRSs appear able to overcome several limitations of the existing metallic stents and provide a physiologic treatment of coronary artery pathology. AREAS COVERED: BRS have different mechanical properties compared to the traditional metallic stents that should be taken into account during their implantation. Lesion selection, device sizing and satisfied pre-dilatation should be implemented prudently. Although intravascular imaging is not mandatory for the implantation of BRSs it may have a value in optimizing device deployment assess final results and reduce the risk of device related adverse events such as re-stenosis, or scaffold thrombosis. This review aims to reveal the crucial points about the methods of optimization in each steps of BRS implantation. Expert commentary: The target lesions for BRS should be selected meticulously. Pre-dilatation, post-dilatation and intra-vascular imaging techniques should be implemented appropriately to avoid undesirable events after scaffold implantation.

12 Review Bioresorbable scaffolds: a new paradigm in percutaneous coronary intervention. 2016

Tenekecioglu, Erhan / Farooq, Vasim / Bourantas, Christos V / Silva, Rafael Cavalcante / Onuma, Yoshinobu / Yılmaz, Mustafa / Serruys, Patrick W. ·ThoraxCentre, Erasmus Medical Centre, Rotterdam, The Netherlands. erhantenekecioglu@yahoo.com. · Manchester Heart Centre, Manchester Royal Infirmary, Central Manchester University, Hospitals NHS Trust, Manchester, UK. vasimfarooq@hotmail.com. · Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK. vasimfarooq@hotmail.com. · Institute of Cardiovascular Sciences, University College of London, London, UK. cbourantas@gmail.com. · Department of Cardiology, Barts Health NHS Trust, London, UK. cbourantas@gmail.com. · ThoraxCentre, Erasmus Medical Centre, Rotterdam, The Netherlands. rafacavasi@hotmail.com. · ThoraxCentre, Erasmus Medical Centre, Rotterdam, The Netherlands. yoshinobuonuma@gmail.com. · Department of Cardiology, Bursa Postgraduate Education and Research Hospital, Bursa, Turkey. mustafayih@yahoo.com.tr. · ThoraxCentre, Erasmus Medical Centre, Rotterdam, The Netherlands. patrick.w.j.c.serruys@gmail.com. · International Centre for Circulatory Health, Imperial College, London, UK. patrick.w.j.c.serruys@gmail.com. · Interventional Cardiology Department, Erasmus MC, 's-Gravendijkwal 230, Rotterdam, 3015 CE, The Netherlands. patrick.w.j.c.serruys@gmail.com. ·BMC Cardiovasc Disord · Pubmed #26868826.

ABSTRACT: Numerous advances and innovative therapies have been introduced in interventional cardiology over the recent years, since the first introduction of balloon angioplasty, but bioresorbable scaffold is certainly one of the most exciting and attracting one. Despite the fact that the metallic drug-eluting stents have significantly diminished the re-stenosis ratio, they have considerable limitations including the hypersensitivity reaction to the polymer that can cause local inflammation, the risk of neo-atherosclerotic lesion formation which can lead to late stent failure as well as the fact that they may preclude surgical revascularization and distort vessel physiology. Bioresorbable scaffolds overcome these limitations as they have the ability to dissolve after providing temporary scaffolding which safeguards vessel patency. In this article we review the recent developments in the field and provide an overview of the devices and the evidence that support their efficacy in the treatment of CAD. Currently 3 devices are CE marked and in clinical use. Additional 24 companies are developing these kind of coronary devices. Most frequently used material is PLLA followed by magnesium.

13 Review Vulnerable plaque detection: an unrealistic quest or a feasible objective with a clinical value? 2016

Bourantas, Christos V / Garcia-Garcia, Hector M / Torii, Ryo / Zhang, Yao-Jun / Westwood, Mark / Crake, Tom / Serruys, Patrick W. ·Department of Cardiovascular Sciences, University College London, London, UK Department of Cardiology, Barts Heart Centre, London, UK. · Department of Interventional Cardiology, Erasmus MC, Thoraxcenter, Rotterdam, The Netherlands. · Department of Mechanical Engineering, University College London, London, UK. · Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. · Department of Cardiology, Barts Heart Centre, London, UK. · Department of Interventional Cardiology, Erasmus MC, Thoraxcenter, Rotterdam, The Netherlands Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, UK. ·Heart · Pubmed #26783236.

ABSTRACT: Evidence from the first prospective studies of coronary atherosclerosis demonstrated that intravascular imaging has limited accuracy in detecting lesions that are likely to progress and cause future events, and divided the scientific community into experts who advocate abandoning this quest and others who suggest intensifying our efforts improve and optimise the available imaging techniques. Although the current evidence may not justify the use of invasive or non-invasive imaging in the clinical setting for the detection of vulnerable, high-risk lesions, it is apparent that imaging has provided unique insights about plaque pathophysiology and evolution. Recent evidence indicates that both invasive and non-invasive imaging also provides useful prognostic information in patients with established coronary artery disease and in asymptomatic individuals and is likely to enable more accurate risk stratification. Future studies are anticipated to provide further insights about the value of novel hybrid imaging techniques, which are expected to enable complete assessment of plaque pathophysiology, in detecting vulnerable lesions and identifying high-risk patients that would benefit from new aggressive treatments targeting coronary atherosclerosis.

14 Review Comparison of intravascular ultrasound guided versus angiography guided drug eluting stent implantation: a systematic review and meta-analysis. 2015

Zhang, Yao-Jun / Pang, Si / Chen, Xiao-Yun / Bourantas, Christos V / Pan, Dao-Rong / Dong, Sheng-Jie / Wu, Wen / Ren, Xiao-Min / Zhu, Hao / Shi, Shun-Yi / Iqbal, Javaid / Gogas, Bill D / Xu, Bo / Chen, Shao-Liang. ·Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. 13770668667@139.com. · Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. 13951617825@139.com. · Medical School of Southeast University, Nanjing, China. 13951617825@139.com. · Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. siry_chen1226@126.com. · Medical School of Southeast University, Nanjing, China. siry_chen1226@126.com. · University College of London Hospital NHS Foundation Trust, University College of London, London, UK. cbourantas@gmail.com. · Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. pdrcn2014@163.com. · Department of the Joint and Bone Surgery, Yantaishan hospital, Yantai, Shandong province, China. dongshengjay@126.com. · Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. timwu1988@126.com. · Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. renxm0073@163.com. · Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. 1013656830@qq.com. · Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. Ssy10170819@126.com. · University of Sheffield, Sheffield, UK. j.iqbal@sheffield.ac.uk. · Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, GA, USA. bgogas@gmail.com. · Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science, Beijing, China. bxu@citmd.com. · Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. chmengx126@gmail.com. · Nanjing First Hospital, Nanjing Medical University, No. 68, Changle Road, 210006, Nanjing, Jiangsu, China. chmengx126@gmail.com. ·BMC Cardiovasc Disord · Pubmed #26577590.

ABSTRACT: BACKGROUND: Intravascular ultrasound (IVUS) can be a useful tool during drug-eluting stents (DES) implantation as it allows accurate assessment of lesion severity and optimal treatment planning. However, numerous reports have shown that IVUS guided percutaneous coronary intervention is not associated with improved clinical outcomes, especially in non-complex patients and lesions. METHODS: We searched the literature in Medline, the Cochrane Library, and other internet sources to identify studies that compare clinical outcomes between IVUS-guided and angiography-guided DES implantation. Random-effects model was used to assess treatment effect. RESULTS: Twenty eligible studies with a total of 29,068 patients were included in this meta-analysis. The use of IVUS was associated with significant reductions in major adverse cardiovascular events (MACE, odds ratios [OR] 0.77, 95 % confidence intervals [CI] 0.71-0.83, P < 0.001), death (OR 0.62, 95 % CI 0.54-0.71, p < 0.001), and stent thrombosis (OR 0.59, 95 % CI: 0.47-0.73, P < 0.001). The benefit was also seen in the repeated analysis of matched and randomized studies. In stratified analysis, IVUS guidance appeared to be beneficial not only in patients with complex lesions or acute coronary syndromes (ACS) but also patients with mixed lesions or presentations (MACE: OR 0.69, 95 % CI: 0.60-0.79, p < 0.001, OR 0.81, 95 % CI 0.74-0.90, p < 0.001, respectively). By employing meta-regression analysis, the benefit of IVUS is significantly pronounced in patients with complex lesions or ACS with respect to death (p = 0.048). CONCLUSIONS: IVUS guidance was associated with improved clinical outcomes, especially in patients with complex lesions admitted with ACS. Large, randomized clinical trials are warranted to identify populations and lesion characteristics where IVUS guidance would be associated with better outcomes.

15 Review OCT for the identification of vulnerable plaque in acute coronary syndrome. 2015

Sinclair, Hannah / Bourantas, Christos / Bagnall, Alan / Mintz, Gary S / Kunadian, Vijay. ·Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom; Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom. · Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom. · Cardiovascular Research Foundation, New York, New York. · Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom; Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom. Electronic address: vijay.kunadian@newcastle.ac.uk. ·JACC Cardiovasc Imaging · Pubmed #25677892.

ABSTRACT: After 2 decades of development and use in interventional cardiology research, optical coherence tomography (OCT) has now become a core intravascular imaging modality in clinical practice. Its unprecedented spatial resolution allows visualization of the key components of the atherosclerotic plaque that appear to confer "vulnerability" to rupture-namely the thickness of the fibrous cap, size of the necrotic core, and the presence of macrophages. The utility of OCT in the evaluation of plaque composition can provide insights into the pathophysiology of acute coronary syndrome and the healing that occurs thereafter. A brief summary of the principles of OCT technology and a comparison with other intravascular imaging modalities is presented. The review focuses on the current evidence for the use of OCT in identifying vulnerable plaques in acute coronary syndrome and its limitations.

16 Review Stenting strategy for coronary artery bifurcation with drug-eluting stents: a meta-analysis of nine randomised trials and systematic review. 2014

Gao, Xiao-Fei / Zhang, Yao-Jun / Tian, Nai-Liang / Wu, Wen / Li, Ming-Hui / Bourantas, Christos V / Jiang, Xiao-Min / Wang, Zhi-Mei / Li, Bing / Mao, Wen-Xing / Zhang, Jun-Jie / Chen, Shao-Liang. ·Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. ·EuroIntervention · Pubmed #24970736.

ABSTRACT: AIMS: The present study sought to compare angiographic and clinical outcomes of a simple strategy versus a complex strategy in patients with coronary bifurcation lesions undergoing drug-eluting stent implantation. METHODS AND RESULTS: Medline, the Cochrane Library, and other internet sources were searched for randomised trials comparing simple strategy versus complex strategy for treating patients with bifurcation lesions. Nine eligible randomised trials including 2,569 patients were identified. The meta-analysis showed that cardiac death (odds ratio [OR]: 0.99, 95% confidence interval [CI]: 0.40- 2.41, p=0.98) and stent thrombosis (OR: 0.64, 95% CI: 0.31-1.34, p=0.24) were similar in the simple and the complex strategy. Compared with the complex strategy, the simple strategy was associated with a reduced risk of either early or follow-up myocardial infarction (OR: 0.53, 95% CI: 0.36-0.79, p=0.002; OR: 0.60, 95% CI: 0.43-0.86, p=0.01, respectively). The overall risks of side branch restenosis (OR: 1.44, 95% CI: 0.73-2.87, p=0.30), target lesion (OR: 1.72, 95% CI: 0.95-3.12, p=0.07) and target vessel revascularisation (OR: 1.59, 95% CI: 0.94-2.69, p=0.09) were comparable between the two groups. In the true bifurcation, with large side branches, and DK-crush subgroups, there were higher rates of reintervention seen in the simple strategy than in the complex strategy. CONCLUSIONS: A complex strategy remains an optional treatment for patients with coronary bifurcation lesions without severe safety concerns. A complex strategy may be an optimal treatment for true bifurcation lesions with large side branches.

17 Review Currently available methodologies for the processing of intravascular ultrasound and optical coherence tomography images. 2014

Athanasiou, Lambros / Sakellarios, Antonis I / Bourantas, Christos V / Tsirka, Georgia / Siogkas, Panagiotis / Exarchos, Themis P / Naka, Katerina K / Michalis, Lampros K / Fotiadis, Dimitrios I. ·Unit of Medical Technology and Intelligent Information Systems, Department of Materials Science and Engineering, University of Ioannina, GR 45110 Ioannina, Greece. ·Expert Rev Cardiovasc Ther · Pubmed #24949801.

ABSTRACT: Optical coherence tomography and intravascular ultrasound are the most widely used methodologies in clinical practice as they provide high resolution cross-sectional images that allow comprehensive visualization of the lumen and plaque morphology. Several methods have been developed in recent years to process the output of these imaging modalities, which allow fast, reliable and reproducible detection of the luminal borders and characterization of plaque composition. These methods have proven useful in the study of the atherosclerotic process as they have facilitated analysis of a vast amount of data. This review presents currently available intravascular ultrasound and optical coherence tomography processing methodologies for segmenting and characterizing the plaque area, highlighting their advantages and disadvantages, and discusses the future trends in intravascular imaging.

18 Review Impact of biodegradable versus durable polymer drug-eluting stents on clinical outcomes in patients with coronary artery disease: a meta-analysis of 15 randomized trials. 2014

Zhang, Yaojun / Tian, Nailiang / Dong, Shengjie / Ye, Fei / Li, Minghui / Bourantas, Christos V / Iqbal, Javaid / Onuma, Yoshinobu / Muramatsu, Takashi / Diletti, Roberto / Garcia-Garcia, Hector M / Xu, Bo / Serruys, Patrick W / Chen, Shaoliang. ·Thoraxcenter, Erasmus Medical Center, Rotterdam, 3015CE, The Netherlands. · Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China. · Soochow University, Suzhou, Jiangsu 215021, China. · Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases of China, Beijing 100037, China. · Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210006, China. Email: chmengx126@gmail.com. ·Chin Med J (Engl) · Pubmed #24890171.

ABSTRACT: BACKGROUND: Drug eluting stents (DESs) made with biodegradable polymer have been developed in an attempt to improve clinical outcomes. However, the impact of biodegradable polymers on clinical events and stent thrombosis (ST) remains controversial. METHODS: We searched Medline, the Cochrane Library and other internet sources, without language or date restrictions for articles comparing clinical outcomes between biodegradable polymer DES and durable polymer DES. Safety endpoints were ST (definite, definite/probable), mortality, and myocardial infarction (MI). Efficacy endpoints were major adverse cardiac event (MACE) and target lesion revascularization (TLR). RESULTS: We identified 15 randomized controlled trials (n = 17 068) with a weighted mean follow-up of 20.6 months. There was no statistical difference in the incidence of definite/probable ST between durable polymer- and biodegradable polymer- DES; relative risk (RR) 0.83; 95% confidence interval (CI) 0.62-1.11; P = 0.22. Biodegradable polymer DES had similar rates of definite ST (RR 0.94, 95% CI 0.66-1.33, P = 0.72), mortality (RR 0.94, 95% CI 0.82-1.09, P = 0.43), MI (RR 1.08, 95% CI 0.92-1.26. P = 0.35), MACE (RR 0.99, 95% CI 0.91-1.09, P = 0.85), and TLR (RR, 0.94, 95% CI 0.83-1.06, P = 0.30) compared with durable polymer DES. Based on the stratified analysis of the included trials, the treatment effect on definite ST was different at different follow-up times: ≤ 1 year favoring durable polymer DES and >1 year favoring biodegradable polymer DES. CONCLUSIONS: Biodegradable polymer DES has similar safety and efficacy for treating patients with coronary artery disease compared with durable polymer DES. Further data with longer term follow-up are warranted to confirm the potential benefits of biodegradable polymer DES.

19 Review Early detection and invasive passivation of future culprit lesions: a future potential or an unrealistic pursuit of chimeras? 2013

Bourantas, Christos V / Garcia-Garcia, Hector M / Diletti, Roberto / Muramatsu, Takashi / Serruys, Patrick W. ·Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. ·Am Heart J · Pubmed #23708157.

ABSTRACT: New advances in image and signal processing have allowed the development of numerous invasive and noninvasive imaging modalities that have revealed details of plaque pathology and allowed us to study in vivo the atherosclerotic evolution. Recent natural history of atherosclerosis studies permitted us to evaluate changes in the compositional and morphological characteristics of the plaque and identify predictors of future events. The idea of being able to identify future culprit lesions and passivate these plaques has gradually matured, and small scale studies have provided proofs about the feasibility of this concept. This review article summarizes the recent advances in the study of atherosclerosis, cites the current evidence, highlights our limitations in understanding the evolution of the plaque and in predicting plaque destabilization, and discusses the potentiality of an early invasive sealing of future culprit lesions.

20 Review Hybrid intravascular imaging: current applications and prospective potential in the study of coronary atherosclerosis. 2013

Bourantas, Christos V / Garcia-Garcia, Hector M / Naka, Katerina K / Sakellarios, Antonios / Athanasiou, Lambros / Fotiadis, Dimitrios I / Michalis, Lampros K / Serruys, Patrick W. ·Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. ·J Am Coll Cardiol · Pubmed #23500282.

ABSTRACT: The miniaturization of medical devices and the progress in image processing have allowed the development of a multitude of intravascular imaging modalities that permit more meticulous examination of coronary pathology. However, these techniques have significant inherent limitations that do not allow a complete and thorough assessment of coronary anatomy. To overcome these drawbacks, fusion of different invasive and noninvasive imaging modalities has been proposed. This integration has provided models that give a more detailed understanding of coronary artery pathology and have proved useful in the study of the atherosclerotic process. In this review, the authors describe the currently available hybrid imaging approaches, discuss the technological innovations and efficient algorithms that have been developed to integrate information provided by different invasive techniques, and stress the advantages of the obtained models and their potential in the study of coronary atherosclerosis.

21 Review New concepts in the design of drug-eluting coronary stents. 2013

Garg, Scot / Bourantas, Christos / Serruys, Patrick W. ·Department of Cardiology, East Lancashire NHS Trust, Haslingden Road, Blackburn, Lancashire BB2 3HH, UK. ·Nat Rev Cardiol · Pubmed #23419901.

ABSTRACT: Drug-eluting stents (DES) have revolutionized the practice of interventional cardiology over the past decade. Although their efficacy has never been called into question, concerns have been raised regarding their safety, particularly with respect to very late stent thrombosis. These valid concerns have prompted extensive research into improving stent safety, with particular interest in modifying the permanent polymer used on first-generation DES. Subsequently, various new types of coronary stent have been developed, including DES with biocompatible polymers, DES with biodegradable polymers, polymer-free DES, and completely bioresorbable scaffolds. Some of these new DES are already available in clinical practice, and others are currently undergoing clinical evaluation. Improvements in stent performance have made detecting statistically robust and clinically relevant differences between contemporary devices difficult. The wide array of available stents enables the choice of device to be tailored to the individual patient.

22 Review Bioresorbable scaffolds: current knowledge, potentialities and limitations experienced during their first clinical applications. 2013

Bourantas, Christos V / Onuma, Yoshinobu / Farooq, Vasim / Zhang, Yaojun / Garcia-Garcia, Hector M / Serruys, Patrick W. ·Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. ·Int J Cardiol · Pubmed #22748288.

ABSTRACT: The traditional metallic stents have significant limitations as they predispose to late thrombosis, may preclude surgical revascularization and distort vessel physiology. Bioresorbable scaffolds (BRSs) are a relatively new technology introduced to overcome these drawbacks. The potential of these devices as well as the reported results from their clinical applications attracted interest and drove research and industry towards the development of new BRSs and the improvement of the existing devices. Thus, over the last years considerable progress has been made and today numerous BRSs are available. The aim of this review article is to highlight the potentialities of these devices, describe the evidence from the recent clinical trials and discuss the advantages, limitations and concerns that were aroused during the first implementation of BRSs in clinical arena.

23 Review Bioresorbable scaffolds: current evidence and ongoing clinical trials. 2012

Bourantas, Christos V / Zhang, Yaojun / Farooq, Vasim / Garcia-Garcia, Hector M / Onuma, Yoshinobu / Serruys, Patrick W. ·Thoraxcenter, Erasmus Medical Center, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands. ·Curr Cardiol Rep · Pubmed #22810889.

ABSTRACT: Bioresorbable scaffolds (BRS) represent a novel approach in coronary stent technology. In contrast to the metallic stents, they provide transient scaffolding, thereby safeguarding early vessel patency and acute gain. Subsequently a process of "decomposition" occurs, that results in the complete absorption of the scaffold. This reduces the risk of late complications, allowing the vessel to maintain its integrity and physiological function. This unique ability has attracted interest and nowadays several BRS are available. The aim of this review article is to describe the advances in the field, present the evidence from the preclinical and clinical evaluation of these devices, and provide an overview of the ongoing clinical trials that were designed to examine the effectiveness of BRS in the clinical setting.

24 Review Clinical indications for intravascular ultrasound imaging. 2010

Bourantas, Christos V / Naka, Katerina K / Garg, Scot / Thackray, Simon / Papadopoulos, Dimitris / Alamgir, Farqad M / Hoye, Angela / Michalis, Lampros K. ·Department of Cardiology, Castle Hill Hospital, East Yorkshire NHS Trust, Cottingham, Kingston upon Hull, UK. cbourantas@gmail.com ·Echocardiography · Pubmed #21092059.

ABSTRACT: Intravascular ultrasound (IVUS) is a catheter-based imaging modality, which provides high resolution cross-sectional images of the coronary arteries. Unlike angiography, which displays only the opacified luminal silhouette, IVUS permits imaging of both the lumen and vessel wall and allows characterization of the type of the plaque. Although IVUS provides accurate quantitative and qualitative information regarding the lumen and outer vessel wall, it is not routinely used during coronary angiography or in angioplasty procedures because the risk to benefit ratio (additional expense, procedural time, certain degree of risk, and complication versus improvement in the outcome) does not justify routine utilization. Nevertheless, there are situations where IVUS is extremely useful tool both for diagnosis and management so the aim of this review is to summarize the indications for IVUS imaging in the contemporary clinical practice.

25 Clinical Trial The Effect of Strut Protrusion on Shear Stress Distribution: Hemodynamic Insights From a Prospective Clinical Trial. 2017

Tenekecioglu, Erhan / Torii, Ryo / Sotomi, Yohei / Collet, Carlos / Dijkstra, Jouke / Miyazaki, Yosuke / Crake, Tom / Su, Solomon / Costa, Ricardo / Chámie, Daniel / Liew, Houng-Bang / Santoso, Teguh / Onuma, Yoshinobu / Abizaid, Alexander / Bourantas, Christos V / Serruys, Patrick W. · ·JACC Cardiovasc Interv · Pubmed #28882287.

ABSTRACT: -- No abstract --

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