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Coronary Artery Disease: HELP
Articles by Carlo di Mario
Based on 95 articles published since 2009
(Why 95 articles?)

Between 2009 and 2019, C. Di Mario wrote the following 95 articles about Coronary Artery Disease.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Guideline 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. 2013

Anonymous3190768 / Montalescot, Gilles / Sechtem, Udo / Achenbach, Stephan / Andreotti, Felicita / Arden, Chris / Budaj, Andrzej / Bugiardini, Raffaele / Crea, Filippo / Cuisset, Thomas / Di Mario, Carlo / Ferreira, J Rafael / Gersh, Bernard J / Gitt, Anselm K / Hulot, Jean-Sebastien / Marx, Nikolaus / Opie, Lionel H / Pfisterer, Matthias / Prescott, Eva / Ruschitzka, Frank / Sabaté, Manel / Senior, Roxy / Taggart, David Paul / van der Wall, Ernst E / Vrints, Christiaan J M / Anonymous3200768 / Zamorano, Jose Luis / Achenbach, Stephan / Baumgartner, Helmut / Bax, Jeroen J / Bueno, Héctor / Dean, Veronica / Deaton, Christi / Erol, Cetin / Fagard, Robert / Ferrari, Roberto / Hasdai, David / Hoes, Arno W / Kirchhof, Paulus / Knuuti, Juhani / Kolh, Philippe / Lancellotti, Patrizio / Linhart, Ales / Nihoyannopoulos, Petros / Piepoli, Massimo F / Ponikowski, Piotr / Sirnes, Per Anton / Tamargo, Juan Luis / Tendera, Michal / Torbicki, Adam / Wijns, William / Windecker, Stephan / Anonymous3210768 / Knuuti, Juhani / Valgimigli, Marco / Bueno, Héctor / Claeys, Marc J / Donner-Banzhoff, Norbert / Erol, Cetin / Frank, Herbert / Funck-Brentano, Christian / Gaemperli, Oliver / Gonzalez-Juanatey, José R / Hamilos, Michalis / Hasdai, David / Husted, Steen / James, Stefan K / Kervinen, Kari / Kolh, Philippe / Kristensen, Steen Dalby / Lancellotti, Patrizio / Maggioni, Aldo Pietro / Piepoli, Massimo F / Pries, Axel R / Romeo, Francesco / Rydén, Lars / Simoons, Maarten L / Sirnes, Per Anton / Steg, Ph Gabriel / Timmis, Adam / Wijns, William / Windecker, Stephan / Yildirir, Aylin / Zamorano, Jose Luis. ·The disclosure forms of the authors and reviewers are available on the ESC website www.escardio.org/guidelines. ·Eur Heart J · Pubmed #23996286.

ABSTRACT: -- No abstract --

2 Guideline Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care** and Thrombosis of the European Society of Cardiology. 2013

Hamon, Martial / Pristipino, Christian / Di Mario, Carlo / Nolan, James / Ludwig, Josef / Tubaro, Marco / Sabate, Manel / Mauri-Ferré, Josepa / Huber, Kurt / Niemelä, Kari / Haude, Michael / Wijns, William / Dudek, Dariusz / Fajadet, Jean / Kiemeneij, Ferdinand / Anonymous3350748 / Anonymous3360748 / Anonymous3370748. ·Recherche Clinique, Bureau 364, Centre Hospitalier Universitaire de Caen, Avenue Côte de Nacre, 14033 Caen, Normandie, France. hamon-m@chu-caen.fr ·EuroIntervention · Pubmed #23354100.

ABSTRACT: Radial access use has been growing steadily but, despite encouraging results, still varies greatly among operators, hospitals, countries and continents. Twenty years from its introduction, it was felt that the time had come to develop a common evidence-based view on the technical, clinical and organisational implications of using the radial approach for coronary angiography and interventions. The European Association of Percutaneous Cardiovascular Interventions (EAPCI) has, therefore, appointed a core group of European and non-European experts, including pioneers of radial angioplasty and operators with different practices in vascular access supported by experts nominated by the Working Groups on Acute Cardiac Care and Thrombosis of the European Society of Cardiology (ESC). Their goal was to define the role of the radial approach in modern interventional practice and give advice on technique, training needs, and optimal clinical indications.

3 Editorial Which Stent Should We Select for the Left Main? 2018

Di Mario, Carlo / Secco, Gioel Gabrio. ·Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy. Electronic address: carlo.dimario@unifi.it. · Interventional Cardiology, Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. ·J Am Coll Cardiol · Pubmed #29471934.

ABSTRACT: -- No abstract --

4 Editorial A Brief History of Coronary Artery Stents. 2018

Tomberli, Benedetta / Mattesini, Alessio / Baldereschi, Giorgio Iacopo / Di Mario, Carlo. ·Division of Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy. · Division of Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy. Electronic address: carlo.dimario@unifi.it. ·Rev Esp Cardiol (Engl Ed) · Pubmed #29361499.

ABSTRACT: -- No abstract --

5 Editorial Calcium: A predictor of interventional treatment failure across all fields of cardiovascular medicine. 2017

Mattesini, Alessio / Di Mario, Carlo. ·Structural Interventional Cardiology Unit, Careggi University Hospital, Florence, Italy. · Structural Interventional Cardiology Unit, Careggi University Hospital, Florence, Italy. Electronic address: carlo.dimario@unifi.it. ·Int J Cardiol · Pubmed #28096040.

ABSTRACT: In this substudy of the ADAPT-DES trial Généreux et al. compared two years outcomes according to the presence or absence of coronary artery calcification (CAC) as assessed by coronary angiography. Coronary calcification was an independent predictor of interventional treatment failure and a higher incidence of both ischemic events and bleeding. The cohort with CAC was older with a higher prevalence of risk factors and comorbidities and an increased anatomical complexity of the target lesions, explaining only in part the worse outcome of the CAC population that persisted at multivariate analysis. Incomplete expansion and poor stent apposition, more frequent in calcified lesions, are predictive of target lesion failure and late stent thrombosis. The main limitation of the study is the use of angiography for CAC assessment with a likely major underestimation of CAC burden. Intravascular imaging might also help for a more accurate quantification of the CAC burden and characteristics, selecting the lesions in need of a calcium modification with atherectomy or lithotripsy before stent implantation.

6 Editorial Balancing idealism with realism to safeguard the welfare of patients: The importance of Heart Team led decision-making in patients with complex coronary artery disease. 2016

Farooq, Vasim / Di Mario, Carlo / Serruys, Patrick W. ·Institute of Cardiovascular Sciences, Manchester Academic Health Sciences Centre, University of Manchester and Manchester Heart Centre, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Trust, Manchester, United Kingdom. Electronic address: vasimfarooq@icloud.com. · NIHR Cardiovascular BRU, Royal Brompton & Harefield NHS Foundation Trust and Imperial College London, London, United Kingdom. · Emeritus Professor of Medicine with a Chair in Interventional Cardiology at the Erasmus University, Rotterdam, The Netherlands; International Centre for Circulatory Health, NHLI, Imperial College, London, United Kingdom. ·Indian Heart J · Pubmed #26896257.

ABSTRACT: -- No abstract --

7 Editorial Biodegradable vascular scaffold: is optimal expansion the key to minimising flow disturbances and risk of adverse events? 2015

Foin, Nicolas / Torii, Ryo / Mattesini, Alessio / Wong, Philip / Di Mario, Carlo. ·National Heart Centre Singapore, Singapore. ·EuroIntervention · Pubmed #25420789.

ABSTRACT: -- No abstract --

8 Editorial Bifurcational lesions: do we really need dedicated devices? 2013

Secco, Gioel Gabrio / Di Mario, Carlo. ·Department of Clinical and Experimental Medicine, University of Eastern Piedmont, Novara, Italy. Electronic address: gioel.gabrio.secco@gmail.com. ·Int J Cardiol · Pubmed #24080361.

ABSTRACT: Provisional stenting of the side-branch is the universally accepted gold standard while there is still controversy on the role of kissing balloon dilatation. During treatment of bifurcation, most experienced operators prefer to correct the carina shift leading to ostial stenosis after the deployment of the main vessel stent by apposing the free struts jailing the origin of the side-branch to the ostium of the side-branch. Recrossing the struts of a previously deployed stent with a wire and an appropriately sized balloon can prove challenging and is occasionally unsuccessful, mainly because the balloon tip hits a stent strut. Thanks to its short beveled tip and the torquable shaft, the glider balloon can be easily rotated during advancement and might offer a rapid solution during treatment of complex bifurcational lesions.

9 Editorial Stent flexibility versus concertina effect: mechanism of an unpleasant trade-off in stent design and its implications for stent selection in the cath-lab. 2013

Foin, N / Di Mario, C / Francis, D P / Davies, J E. · ·Int J Cardiol · Pubmed #23084111.

ABSTRACT: The "concertina effect", longitudinal deformation of the proximal segments of a deployed stent when force is applied from a guide catheter or other equipment, is a recently recognised problem which seems to particularly affect more recent stent designs. Until now, flexibility and deliverability have been paramount aims in stent design. Developments have focussed on optimising these features which are commonly evaluated by clinicians and demanded by regulatory bodies. Contemporary stent designs now provide high flexibility by reducing the number of connecting links between stent segments and by allowing the connecting links to easily change their length. These design evolutions may, however, simultaneously reduce longitudinal strength and have the unintended effect of inducing some risk of longitudinal compression of the stent (the "concertina effect") during difficult clinical cases. Progress in stent design and elimination of restenosis by drug coating has improved PCI outcome and enabled new applications. Here we discuss design trade-offs that shaped evolution and improvement in stent design, from early bare metal designs to the latest generation of drug eluting stent (DES) platforms. Longitudinal strength was not recognised as a critical parameter by clinicians or regulators until recently. Measurements, only now becoming publically available, seem to confirm vulnerability of some modern designs to longitudinal deformation. Clinicians could be more guarded in their assumption that changes in technology are beneficial in all clinical situations. Sometimes a silent trade-off may have taken place, adopting choices that are favourable for the vast majority of patients but exposing a few patients to unintended hazard.

10 Review Invasive coronary imaging: any role in primary and secondary prevention? 2016

Di Mario, Carlo / Moreno, Pedro R. ·NIHR Cardiovascular BRU, Royal Brompton Hospital & NIHL Imperial College, London, UK c.dimario@rbht.nhs.uk. · Cardiovascular Institute, Ichan School of Medicine at Mount Sinai, New York, NY, USA. ·Eur Heart J · Pubmed #27002121.

ABSTRACT: This review discusses the possibilities offered by new modalities of non-invasive and invasive coronary imaging in an effort to optimize risk stratification for coronary artery disease, and identify subgroups at high risk that may benefit from an aggressive, personalized approach, with access to a growing number of novel drugs and interventions. Special emphasis is placed on the progress of novel invasive imaging techniques such as near infrared spectroscopy and optical coherence tomography that can reliably identify thin-capped fibroatheromas. Multiple trials are exploring the feasibility of these techniques to guide modulation of risk factor control and treatment of non-flow limiting lesions at high risk of destabilization and progression in patients undergoing clinically mandated angioplasty of angiographically critical lesions. Asymptomatic patients at high risk of cardiovascular ischaemic events may also benefit, with the intermediate step of a wider application of calcium score and angiography with multi-slice computed tomography, by a selective use of invasive imaging.

11 Review Absorb bioresorbable vascular scaffold: What have we learned after 5 years of clinical experience? 2015

Caiazzo, Gianluca / Kilic, Ismail Dogu / Fabris, Enrico / Serdoz, Roberta / Mattesini, Alessio / Foin, Nicolas / De Rosa, Salvatore / Indolfi, Ciro / Di Mario, Carlo. ·Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy; Cardiovascular National Institute of Health Research Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom. · Cardiovascular National Institute of Health Research Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom. · Cardiovascular National Institute of Health Research Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom; Cardiovascular Department, "Ospedali Riuniti" & University of Trieste, Trieste, Italy. · Department of Heart and Vessels, AOUC Careggi, Florence, Italy. · National Heart Centre Singapore, Singapore. · Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy. · Cardiovascular National Institute of Health Research Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom. Electronic address: c.dimario@rbht.nhs.uk. ·Int J Cardiol · Pubmed #26298354.

ABSTRACT: Bioresorbable scaffolds have the potential to introduce a paradigm shift in interventional cardiology, a true anatomical and functional "vascular restoration" instead of an artificial stiff tube encased by persistent metallic foreign body. Early clinical studies using the first commercially available drug-eluting bioresorbable vascular scaffold (BVS) reported very promising safety and efficacy outcomes, comparable to best-in-class second-generation drug-eluting metal stent. To date, more than 60,000 Absorb BVSs have been implanted with only the interim analysis of one randomized trial (ABSORB II RCT) available. Recent registries have challenged the initial claim that BVS is immune from Scaffold Thrombosis (ST). However, suboptimal device expansion and insufficient intracoronary imaging guidance can explain higher than expected ST, especially in complex lesions. The aim of this review article is to critically evaluate the results of the available Absorb BVS studies and discuss the lessons learned to optimize lesion selection and implantation technique of such devices.

12 Review Intracoronary optical coherence tomography: a review of clinical applications. 2014

Zivelonghi, Carlo / Ghione, Matteo / Kilickesmez, Kadriye / Loureiro, Rodrigo Estevez / Foin, Nicolas / Lindsay, Alistair / de Silva, Ranil / Ribichini, Flavio / Vassanelli, Corrado / Di Mario, Carlo. ·aCardiovascular Biomedical Research Unit, Royal Brompton Hospital bImperial College, London, UK cDepartment of Medicine, University of Verona, Verona, Italy. ·J Cardiovasc Med (Hagerstown) · Pubmed #24922045.

ABSTRACT: Optical coherence tomography (OCT) is a light-based technology that provides very high spatial resolution images. OCT has been initially employed as a research tool to investigate plaque morphology and stent strut coverage. The introduction of frequency domain OCT allowing fast image acquisition during a prolonged contrast injection via the guiding catheter has made OCT applicable for guidance of coronary interventions. In this manuscript, the various applications of OCT are reviewed, from assessment of plaque vulnerability and severity to characteristics of unstable lesions and thrombus burden to stent optimization and evaluation of late results.

13 Review Optical coherence tomography in bioabsorbable stents: mechanism of vascular response and guidance of stent implantation. 2014

Mattesini, A / Pighi, M / Konstantinidis, N / Ghione, M / Kilic, D / Foin, N / Dall'ara, G / Secco, G G / Valente, S / Di Mario, C. ·NIHR Biomedical Research Unit Royal Brompton & Harefield NHS Foundation Trust, London, UK2 Interventional Cardiology Unit Department of Heart and Vessels Florence University AOU Careggi, Florence, Italy3 National Heart Centre Singapore, Singapore4 University of Eastern Piedmont "Maggiore della Carità" Hospital, Novara, Italy - c.dimario@rbht.nhs.uk. ·Minerva Cardioangiol · Pubmed #24500218.

ABSTRACT: Fully biodegradable L-polylactic acid stents (biodegradable vascular scaffold, BVS), the latest breakthrough in the area of coronary implants, entered clinical trials in 2005 and became commercially available in 2011. Optical coherence tomography (OCT) was used from the first implants to study the vessel wall response and the timing of the resorption process in man. Analysis of BVS with OCT has several advantages over that of metallic stents. BVS polymeric struts are transparent to the light so that scaffold integrity, apposition to the underlying wall, presence of thrombus and hyperplasia, and changes in the strut characteristics over time can be easily studied. We present a comprehensive review of the findings OCT provided when used as a research tool in serial examination up to five years for investigation of the mechanism of resorption, neointimal coverage, shrinkage and late lumen enlargement. We also report our experience with OCT in 47 lesions of various complexity as a practical means of percutaneous coronary intervention guidance during BVS implantation.

14 Review How to optimize the percutaneous treatment of bifurcated lesions: dedicated stents vs. provisional stenting. 2013

Alegria-Barrero, E / Foin, N / Lindsay, A C / Paulo, M / Hei Chan, P / Syrseloudis, D / Viceconte, N / Martos, R / Beatt, K / Di Mario, C. ·Cardiovascular Biomedical Research Unit Royal Brompton Hospital, London, UK - c.dimario@rbht.nhs.uk. ·Minerva Cardioangiol · Pubmed #24096251.

ABSTRACT: Although provisional T-stenting with stenting of the main branch and optional side branch stenting is nowadays the default strategy generally preferred for simple bifurcation lesions, percutaneous coronary intervention (PCI) of complex true bifurcation lesions remains a difficult task to achieve also with modern second generation drug eluting stents. Treatment of complex bifurcational lesions is not only more time consuming but can lead to significantly higher rate of periprocedural myocardial infarction and late estenosis, stent thrombosis and target lesion revascularization. These clinical complications may be at least in part be due to the fact that current bifurcation techniques often fail to ensure continuous stent coverage of the SB ostium and the bifurcation branches and often leave a significant number of malapposed struts. Struts left unapposed in the lumen are not efficient for drug delivery to the vessel wall, disturb blood flow and may increase the risk of restenosis and stent thrombosis. This article summarises the various techniques of bifurcation stenting, highlighting their relative merits and disadvantages. In addition, the role of newer dedicated bifurcation stent devices, as well as the role of imaging in guiding optimal stent deployment will be discussed.

15 Review STEMI guidelines: from formulation to implementation. 2012

Di Mario, Carlo / Syrseloudis, Dimitrios / James, Stefan / Viceconte, Nicola / Wijns, William. ·Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom. ·EuroIntervention · Pubmed #22917781.

ABSTRACT: -- No abstract --

16 Review Tools & Techniques: Intravascular ultrasound and optical coherence tomography. 2012

Chan, Pak Hei / Alegria-Barrero, Eduardo / Di Mario, Carlo. ·Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, London, United Kingdom. ·EuroIntervention · Pubmed #22433197.

ABSTRACT: -- No abstract --

17 Review Optical coherence tomography: from research to practice. 2012

Gutiérrez-Chico, Juan Luis / Alegría-Barrero, Eduardo / Teijeiro-Mestre, Rodrigo / Chan, Pak Hei / Tsujioka, Hiroto / de Silva, Ranil / Viceconte, Nicola / Lindsay, Alistair / Patterson, Tiffany / Foin, Nicolas / Akasaka, Takashi / di Mario, Carlo. ·Institute for Cardiovascular Translational Research of the Atlantic, Vigo (Pontevedra), Spain. ·Eur Heart J Cardiovasc Imaging · Pubmed #22330231.

ABSTRACT: Optical coherence tomography (OCT) is a high-resolution imaging technique with great versatility of applications. In cardiology, OCT has remained hitherto as a research tool for characterization of vulnerable plaques and evaluation of neointimal healing after stenting. However, OCT is now successfully applied in different clinical scenarios, and the introduction of frequency domain analysis simplified its application to the point it can be considered a potential alternative to intravascular ultrasound for clinical decision-making in some cases. This article reviews the use of OCT for assessment of lesion severity, characterization of acute coronary syndromes, guidance of intracoronary stenting, and evaluation of long-term results.

18 Review Optical coherence tomography for guidance in bifurcation lesion treatment. 2010

Di Mario, Carlo / Iakovou, Ioannis / van der Giessen, Wim J / Foin, Nicolas / Adrianssens, Tom / Tyczynski, Pawel / Ghilencea, Liviu / Viceconte, Nicola / Lindsay, Alistair C. ·Department of Cardiology, Royal Brompton Hospital, Sydney Street, London, United Kingdom. c.dimario@rbht.nhs.uk ·EuroIntervention · Pubmed #21930500.

ABSTRACT: Optical coherence tomography (OCT) has higher resolution than IVUS (approximately 10 times), with the potential to precisely measure lumen diameters in the variable geometry of a bifurcational lesion and to identify superficial lipid laden plaques and calcium, relevant to confirm the severity of the lumen obstruction before treatment and guide location and diameter of the stent. In addition, OCT produces fewer strut-induced artifacts and offers precise evaluation of strut apposition in a real-life clinical setting. The increase in the speed of image acquisition consequent to the introduction of frequency domain OCT allows rapid pull-back at a speed of 2 cm/sec, minimising the amount of contrast required to clear blood during image acquisition, with an average injection of 10-18 ml required for the maximal length currently available of 5.6 cm. This allows serial OCT acquisitions, typically before treatment if the lesion is not very severe and flow is expected to be present around the OCT catheter, after predilatation and to assess and guide stent expansion. Repeated OCT examinations at follow-up may help to detect presence and characteristics of strut coverage, a potential predictor of late stent thrombosis. These applications are of particular interest in the context of bifurcational lesion treatment because this condition is still associated with a higher number of malapposed stent struts and frequent impairment of stent expansion, explaining the higher incidence of stent thrombosis and restenosis. In this article, all potential applications of OCT for bifurcational lesion treatment are explored. The use of OCT to characterise plaque components, and to optimise stent expansion and strut apposition are first discussed in detail. The conclusion of the article highlights some future research and technological developments that promise to expand the role of OCT further still.

19 Review Physiologic lesion assessment during percutaneous coronary intervention. 2010

Melikian, Narbeh / Del Furia, Francesca / Di Mario, Carlo. ·Cardiology Department, King's College London British Heart Foundation Centre of Excellence and King's College Hospital, Denmark Hill, London SE5 9RS, UK. narbeh.melikian@kcl.ac.uk ·Cardiol Clin · Pubmed #19962048.

ABSTRACT: The 2-dimensional silhouette image provided by coronary angiography has well-recognized limitations. Angiographic images do not accurately represent the true complexity of the luminal morphology in coronary disease and give no indication of the functional influence of luminal changes on coronary blood flow. These limitations are more pronounced in angiographically intermediate stenoses and in patients in whom there is a clear discrepancy between the clinical picture and angiographic findings. In such cases there is often poor concordance between the estimated percentage angiographic stenosis and the corresponding intravascular ultrasound image or noninvasive functional data. The validation and clinical availability of robust and accurate physiologic indices, which can be used as an adjunct to diagnostic angiography in the cardiac catheterization laboratory, have been pivotal in promoting ischemia-driven coronary revascularization. Deferral or revascularization based on such physiologic indices is associated with improved clinical outcome as well as more favorable health economic data. Although there are several clinical indices, fractional flow reserve remains the "gold standard," with indications for physiologic assessment of angiographic intermediate stenoses, including left main stem stenoses and ostial disease as well as serial lesions. The availability of such indices is an important step in streamlining management of patients undergoing cardiac catheterization by allowing routine provision of an "all-in-one" ischemia-driven revascularization service.

20 Review Expert review document on methodology, terminology, and clinical applications of optical coherence tomography: physical principles, methodology of image acquisition, and clinical application for assessment of coronary arteries and atherosclerosis. 2010

Prati, Francesco / Regar, Evelyn / Mintz, Gary S / Arbustini, Eloisa / Di Mario, Carlo / Jang, Ik-Kyung / Akasaka, Takashi / Costa, Marco / Guagliumi, Giulio / Grube, Eberhard / Ozaki, Yukio / Pinto, Fausto / Serruys, Patrick W J / Anonymous4880642. ·Interventional Cardiology, San Giovanni Hospital, Via dell'Amba Aradam 8, 00184 Rome, Italy. fprati@hsangiovanni.roma.it ·Eur Heart J · Pubmed #19892716.

ABSTRACT: Optical coherence tomography (OCT) is a novel intravascular imaging modality, based on infrared light emission, that enables a high resolution arterial wall imaging, in the range of 10-20 microns. This feature of OCT allows the visualization of specific components of the atherosclerotic plaques. The aim of the present Expert Review Document is to address the methodology, terminology and clinical applications of OCT for qualitative and quantitative assessment of coronary arteries and atherosclerosis.

21 Guideline Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. 2012

Tearney, Guillermo J / Regar, Evelyn / Akasaka, Takashi / Adriaenssens, Tom / Barlis, Peter / Bezerra, Hiram G / Bouma, Brett / Bruining, Nico / Cho, Jin-man / Chowdhary, Saqib / Costa, Marco A / de Silva, Ranil / Dijkstra, Jouke / Di Mario, Carlo / Dudek, Darius / Falk, Erling / Feldman, Marc D / Fitzgerald, Peter / Garcia-Garcia, Hector M / Gonzalo, Nieves / Granada, Juan F / Guagliumi, Giulio / Holm, Niels R / Honda, Yasuhiro / Ikeno, Fumiaki / Kawasaki, Masanori / Kochman, Janusz / Koltowski, Lukasz / Kubo, Takashi / Kume, Teruyoshi / Kyono, Hiroyuki / Lam, Cheung Chi Simon / Lamouche, Guy / Lee, David P / Leon, Martin B / Maehara, Akiko / Manfrini, Olivia / Mintz, Gary S / Mizuno, Kyiouchi / Morel, Marie-angéle / Nadkarni, Seemantini / Okura, Hiroyuki / Otake, Hiromasa / Pietrasik, Arkadiusz / Prati, Francesco / Räber, Lorenz / Radu, Maria D / Rieber, Johannes / Riga, Maria / Rollins, Andrew / Rosenberg, Mireille / Sirbu, Vasile / Serruys, Patrick W J C / Shimada, Kenei / Shinke, Toshiro / Shite, Junya / Siegel, Eliot / Sonoda, Shinjo / Suter, Melissa / Takarada, Shigeho / Tanaka, Atsushi / Terashima, Mitsuyasu / Thim, Troels / Uemura, Shiro / Ughi, Giovanni J / van Beusekom, Heleen M M / van der Steen, Antonius F W / van Es, Gerrit-Anne / van Soest, Gijs / Virmani, Renu / Waxman, Sergio / Weissman, Neil J / Weisz, Giora / Anonymous6690720. ·The Massachusetts General Hospital and the Wellman Center for Photomedicine, Boston, Massachusetts 02114, USA. gtearney@partners.org ·J Am Coll Cardiol · Pubmed #22421299.

ABSTRACT: OBJECTIVES: The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease. BACKGROUND: Intravascular optical coherence tomography (IVOCT) is a catheter-based modality that acquires images at a resolution of ~10 μm, enabling visualization of blood vessel wall microstructure in vivo at an unprecedented level of detail. IVOCT devices are now commercially available worldwide, there is an active user base, and the interest in using this technology is growing. Incorporation of IVOCT in research and daily clinical practice can be facilitated by the development of uniform terminology and consensus-based standards on use of the technology, interpretation of the images, and reporting of IVOCT results. METHODS: The IWG-IVOCT, comprising more than 260 academic and industry members from Asia, Europe, and the United States, formed in 2008 and convened on the topic of IVOCT standardization through a series of 9 national and international meetings. RESULTS: Knowledge and recommendations from this group on key areas within the IVOCT field were assembled to generate this consensus document, authored by the Writing Committee, composed of academicians who have participated in meetings and/or writing of the text. CONCLUSIONS: This document may be broadly used as a standard reference regarding the current state of the IVOCT imaging modality, intended for researchers and clinicians who use IVOCT and analyze IVOCT data.

22 Clinical Trial Early- and long-term intravascular ultrasound and angiographic findings after bioabsorbable magnesium stent implantation in human coronary arteries. 2009

Waksman, Ron / Erbel, Raimund / Di Mario, Carlo / Bartunek, Jozef / de Bruyne, Bernard / Eberli, Franz R / Erne, Paul / Haude, Michael / Horrigan, Mark / Ilsley, Charles / Böse, Dirk / Bonnier, Hans / Koolen, Jacques / Lüscher, Thomas F / Weissman, Neil J / Anonymous4890629. ·Division of Cardiology, Washington Hospital Center, Washington, DC 20010, USA. ron.waksman@medstar.net ·JACC Cardiovasc Interv · Pubmed #19463443.

ABSTRACT: OBJECTIVES: This study aimed to evaluate the degradation rate and long-term vascular responses to the absorbable metal stent (AMS). BACKGROUND: The AMS demonstrated feasibility and safety at 4 months in human coronary arteries. METHODS: The PROGRESS-AMS (Clinical Performance and Angiographic Results of Coronary Stenting) was a prospective, multicenter clinical trial of 63 patients with coronary artery disease who underwent AMS implantation. Angiography and intravascular ultrasound (IVUS) were conducted immediately after AMS deployment and at 4 months. Eight patients who did not require repeat revascularization at 4 months underwent late angiographic and IVUS follow-up from 12 to 28 months. RESULTS: The AMS was well-expanded upon deployment without immediate recoil. The major contributors for restenosis as detected by IVUS at 4 months were: decrease of external elastic membrane volume (42%), extra-stent neointima (13%), and intra-stent neointima (45%). From 4 months to late follow-up, paired IVUS analysis demonstrated complete stent degradation with durability of the 4-month IVUS indexes. The neointima was reduced by 3.6 +/- 5.2 mm(3), with an increase in the stent cross sectional area of 0.5 +/- 1.0 mm(2) (p = NS). The median in-stent minimal lumen diameter was increased from 1.87 to 2.17 mm at long-term follow-up. The median angiographic late loss was reduced from 0.62 to 0.40 mm by quantitative coronary angiography from 4 months to late follow-up. CONCLUSIONS: Intravascular ultrasound imaging supports the safety profile of AMS with degradation at 4 months and maintains durability of the results without any early or late adverse findings. Slower degradation is warranted to provide sufficient radial force to improve long-term patency rates of the AMS.

23 Clinical Trial Initial evidence for the return of coronary vasoreactivity following the absorption of bioabsorbable magnesium alloy coronary stents. 2009

Ghimire, Gopal / Spiro, Jonathan / Kharbanda, Rajesh / Roughton, Micheal / Barlis, Peter / Mason, Mark / Ilsley, Charles / Di Mario, Carlo / Erbel, Raimund / Waksman, Ron / Dalby, Miles. ·Royal Brompton and Harefield NHS Trust, Imperial College, London, United Kingdom. ·EuroIntervention · Pubmed #19284070.

ABSTRACT: AIMS: To investigate the endothelium independent coronary smooth muscle vasomotor function four months after implantation of magnesium alloy absorbable metal stents (AMS) as part of the Progress-AMS clinical trial (n = 5), compared with a control group of patients implanted with permanent metal stents (PMS) (n = 10) undergoing follow-up angiography, but who were free from angiographic restenosis. METHODS AND RESULTS: Quantitative coronary angiogram (QCA) using an automated edge detection system was performed before and after the administration of 2 mg intracoronary isosorbide dinitrate (ISDN). The vessel diameter was measured at 0.2 mm intervals throughout the stented segments and a 1 cm proximal reference segment. The cross sectional area (CSA) was calculated before and after the ISDN, averaged and the percentage change measured. Reference segments demonstrated preserved vasomotor function in all cases: +13.28% (AMS) versus +17.15% (PMS), p = 0.39. The mean percentage increase in CSA for the stented segment was +6.78% for the AMS versus -1.30% for PMS, p = 0.003. CONCLUSION: These data demonstrate that four months after AMS implantation vasomotor function in reference segments is no different to that observed with PMS. However in contrast to PMS, within the AMS-stented segments there is demonstrable vasodilatation. These observations may have important implications for future stent design.

24 Article Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions. 2018

Räber, Lorenz / Mintz, Gary S / Koskinas, Konstantinos C / Johnson, Thomas W / Holm, Niels Ramsing / Onuma, Yoshinobu / Radu, Maria D / Joner, Michael / Yu, Bo / Jia, Haibo / Meneveau, Nicolas / de la Torre Hernandez, Jose Maria / Escaned, Javier / Hill, Jonathan / Prati, Francesco / Colombo, Antonio / Di Mario, Carlo / Regar, Evelyn / Capodanno, Davide / Wijns, William / Byrne, Robert A / Guagliumi, Giulio. ·Department of Cardiology, Bern University Hospital, Bern, Switzerland. ·EuroIntervention · Pubmed #29939149.

ABSTRACT: This Consensus Document is the first of two reports summarizing the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) on the clinical use of intracoronary imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The first document appraises the role of intracoronary imaging to guide percutaneous coronary interventions (PCIs) in clinical practice. Current evidence regarding the impact of intracoronary imaging guidance on cardiovascular outcomes is summarized, and patients or lesions most likely to derive clinical benefit from an imaging-guided intervention are identified. The relevance of the use of IVUS or OCT prior to PCI for optimizing stent sizing (stent length and diameter) and planning the procedural strategy is discussed. Regarding post-implantation imaging, the consensus group recommends key parameters that characterize an optimal PCI result and provides cut-offs to guide corrective measures and optimize the stenting result. Moreover, routine performance of intracoronary imaging in patients with stent failure (restenosis or stent thrombosis) is recommended. Finally, strengths and limitations of IVUS and OCT for guiding PCI and assessing stent failures and areas that warrant further research are critically discussed.

25 Article Pre-Angioplasty Instantaneous Wave-Free Ratio Pullback Predicts Hemodynamic Outcome In Humans With Coronary Artery Disease: Primary Results of the International Multicenter iFR GRADIENT Registry. 2018

Kikuta, Yuetsu / Cook, Christopher M / Sharp, Andrew S P / Salinas, Pablo / Kawase, Yoshiaki / Shiono, Yasutsugu / Giavarini, Alessandra / Nakayama, Masafumi / De Rosa, Salvatore / Sen, Sayan / Nijjer, Sukhjinder S / Al-Lamee, Rasha / Petraco, Ricardo / Malik, Iqbal S / Mikhail, Ghada W / Kaprielian, Raffi R / Wijntjens, Gilbert W M / Mori, Shinsuke / Hagikura, Arata / Mates, Martin / Mizuno, Atsushi / Hellig, Farrel / Lee, Kelvin / Janssens, Luc / Horie, Kazunori / Mohdnazri, Shah / Herrera, Raul / Krackhardt, Florian / Yamawaki, Masahiro / Davies, John / Takebayashi, Hideo / Keeble, Thomas / Haruta, Seiichi / Ribichini, Flavio / Indolfi, Ciro / Mayet, Jamil / Francis, Darrel P / Piek, Jan J / Di Mario, Carlo / Escaned, Javier / Matsuo, Hitoshi / Davies, Justin E. ·Imperial College London and Hammersmith Hospital NHS Trust, London, United Kingdom; Fukuyama Cardiovascular Hospital, Fukuyama, Japan. · Imperial College London and Hammersmith Hospital NHS Trust, London, United Kingdom. · Royal Devon and Exeter Hospital and University of Exeter, Exeter, United Kingdom. · Hospital Clínico San Carlos, Faculty of Medicine, Complutense University, Madrid, Spain. · Gifu Heart Center, Gifu, Japan. · Royal Brompton Hospital and Harefield Trust, London, United Kingdom. · Toda Central General Hospital, Toda, Japan. · Universita degli Studi Magna Græcia di Catanzaro, Catanzaro, Italy. · Academic Medical Centre, Amsterdam, the Netherlands. · Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan. · Fukuyama Cardiovascular Hospital, Fukuyama, Japan. · Na Homolce Hospital, Prague, Czech Republic. · St Luke's International Hospital, Tokyo, Japan. · Sunninghill Hospital, Johannesburg, University of Cape Town, South Africa. · United Lincolnshire Hospital, Lincoln, United Kingdom. · Imelda Hospital, Bonheiden, Belgium. · Sendai Kousei Hospital, Sendai, Japan. · Essex Cardiothoracic Centre, Basildon and Anglia Ruskin University, Chelmsford, Essex, United Kingdom. · Charité-Universitätsmedizin Campus Virchow, Berlin, Germany. · University of Verona, Verona, Italy. · Imperial College London and Hammersmith Hospital NHS Trust, London, United Kingdom. Electronic address: justindavies@heart123.com. ·JACC Cardiovasc Interv · Pubmed #29673507.

ABSTRACT: OBJECTIVES: The authors sought to evaluate the accuracy of instantaneous wave-Free Ratio (iFR) pullback measurements to predict post-percutaneous coronary intervention (PCI) physiological outcomes, and to quantify how often iFR pullback alters PCI strategy in real-world clinical settings. BACKGROUND: In tandem and diffuse disease, offline analysis of continuous iFR pullback measurement has previously been demonstrated to accurately predict the physiological outcome of revascularization. However, the accuracy of the online analysis approach (iFR pullback) remains untested. METHODS: Angiographically intermediate tandem and/or diffuse lesions were entered into the international, multicenter iFR GRADIENT (Single instantaneous wave-Free Ratio Pullback Pre-Angioplasty Predicts Hemodynamic Outcome Without Wedge Pressure in Human Coronary Artery Disease) registry. Operators were asked to submit their procedural strategy after angiography alone and then after iFR-pullback measurement incorporating virtual PCI and post-PCI iFR prediction. PCI was performed according to standard clinical practice. Following PCI, repeat iFR assessment was performed and the actual versus predicted post-PCI iFR values compared. RESULTS: Mean age was 67 ± 12 years (81% male). Paired pre- and post-PCI iFR were measured in 128 patients (134 vessels). The predicted post-PCI iFR calculated online was 0.93 ± 0.05; observed actual iFR was 0.92 ± 0.06. iFR pullback predicted the post-PCI iFR outcome with 1.4 ± 0.5% error. In comparison to angiography-based decision making, after iFR pullback, decision making was changed in 52 (31%) of vessels; with a reduction in lesion number (-0.18 ± 0.05 lesion/vessel; p = 0.0001) and length (-4.4 ± 1.0 mm/vessel; p < 0.0001). CONCLUSIONS: In tandem and diffuse coronary disease, iFR pullback predicted the physiological outcome of PCI with a high degree of accuracy. Compared with angiography alone, availability of iFR pullback altered revascularization procedural planning in nearly one-third of patients.