Imaging during percutaneous coronary intervention for optimizing outcomes

Mehrotra, Saurabh; Mishra, Sundeep; Paramasivam, Ganesh

doi:10.1016/j.ihj.2018.08.012

Cited by 5 publications

(5 citation statements)

References 123 publications

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“…The technologies range from angiography and intravascular ultrasound (IVUS), which offer an unparalleled view inside the arteries, to fractional flow reserve (FFR), which quantifies the functional significance of stenosis. Other imaging techniques, like intracardiac echo (ICE), which enables real-time images of the heart, near-infrared spectroscopy (NIRS), which assesses plaque composition, and optical coherence tomography (OCT), which unveils microscopic details of vessel walls, are also gaining popularity [58,59].…”

Section: Imaging Guide For Percutaneous Coronary Interventionmentioning

confidence: 99%

Revascularization Modalities in Acute Coronary Syndrome: A Review of the Current State of Evidence

Surve,

Kazim,

Sughra

et al. 2023

Cureus

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Acute coronary syndrome (ACS) stands as a leading global cause of mortality, underscoring the importance of effective prevention, early diagnosis, and timely intervention. While medications offer benefits to many patients, revascularization procedures such as coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), and emerging hybrid approaches remain pivotal for ACS management. This review delves into the 2018 ESC/EACTS guidelines alongside an analysis of existing literature to shed light on the spectrum of revascularization methods. While both CABG and PCI demonstrate promising outcomes, the optimal choice between the two hinges on a comprehensive assessment of individual patient factors, anatomical complexity guided by advanced imaging, comorbidities, and age. The determination of whether to pursue culprit or total revascularization, as well as immediate or staged revascularization, is contingent upon various factors, including age, disease complexity, and clinical outcomes. This evidence-based decision-making process is orchestrated by a multidisciplinary heart team grounded in ongoing clinical evaluation. The primary objective of this review is to provide valuable insights into revascularization strategies and scrutinize the congruence of current guidelines with recent advancements in the field.

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Section: Imaging Guide For Percutaneous Coronary Interventionmentioning

confidence: 99%

Revascularization Modalities in Acute Coronary Syndrome: A Review of the Current State of Evidence

Surve,

Kazim,

Sughra

et al. 2023

Cureus

View full text Add to dashboard Cite

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“…Angiography is the current gold standard for imaging during PCI but has significant limitations such as inaccurate vessel diameter calculation, missing benign plaques [13].…”

Section: F Imagingmentioning

confidence: 99%

“…OCT utilizes infrared light, has better spatial resolution allowing better view of superficial surface of vessel wall, but the penetration isn't as good as IVUS. IVUS on the other hand is ultrasound based, and has poorer resolution but can map the whole thickness of the vessel wall [13].…”

Section: F Imagingmentioning

confidence: 99%

Percutaneous Coronary Intervention: An Overview

Farooqi

Hussein

et al. 2022

EJMED

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PCI remains the mainstay treatment for acute cardiac ischemia. The indications for PCI include Stable Ischemic Heart Disease, STEMI and NSTEMI. The procedure involves the use of a guided catheter steered to the site of coronary arterial blockage, followed by dilation of the balloon at its end to remove the blockage and placement of a stent to maintain the patency. The choice of stent varies from case to case. Certain alternatives and adjuvant therapies are incorporated in order to adapt to specific scenarios. Complications can arise, which may require operative intervention. Mortality rate associated with the procedure is affected by the age and gender of the patient. The decision to opt for either CABG or PCI is based on the complexity of the vessel disease, and scales like the SYNTAX score are used to make this decision.

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“…Coronary imaging guidance during PCI is one of the key determinants of treatment outcomes. Imaging is integral to every stage of PCI, such as assessment of lesion severity, preprocedural planning, optimization, and management of immediate complications 18 , 19 . OCT has significant advantages for characterizing coronary calcification that typically has a signal-poor area with sharply delineated borders 20 .…”

Section: Introductionmentioning

confidence: 99%

“…Imaging is integral to every stage of PCI, such as assessment of lesion severity, preprocedural planning, optimization, and management of immediate complications. 18 , 19 OCT has significant advantages for characterizing coronary calcification that typically has a signal-poor area with sharply delineated borders. 20 A typical OCT system can achieve a high axial resolution at the micron level and a penetration depth of up to 2 mm, indicating superior imaging capability.…”

Section: Introductionmentioning

confidence: 99%

Toward reliable calcification detection: calibration of uncertainty in object detection from coronary optical coherence tomography images

Liu

Bamba

et al. 2023

J. Biomed. Opt.

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Significance: Optical coherence tomography (OCT) has become increasingly essential in assisting the treatment of coronary artery disease (CAD). However, unidentified calcified regions within a narrowed artery could impair the outcome of the treatment. Fast and objective identification is paramount to automatically procuring accurate readings on calcifications within the artery.Aim: We aim to rapidly identify calcification in coronary OCT images using a bounding box and reduce the prediction bias in automated prediction models.Approach: We first adopt a deep learning-based object detection model to rapidly draw the calcified region from coronary OCT images using a bounding box. We measure the uncertainty of predictions based on the expected calibration errors, thus assessing the certainty level of detection results. To calibrate confidence scores of predictions, we implement dependent logistic calibration using each detection result's confidence and center coordinates. Results:We implemented an object detection module to draw the boundary of the calcified region at a rate of 140 frames per second. With the calibrated confidence score of each prediction, we lower the uncertainty of predictions in calcification detection and eliminate the estimation bias from various object detection methods. The calibrated confidence of prediction results in a confidence error of ∼0.13, suggesting that the confidence calibration on calcification detection could provide a more trustworthy result.Conclusions: Given the rapid detection and effective calibration of the proposed work, we expect that it can assist in clinical evaluation of treating the CAD during the imaging-guided procedure.

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Imaging during percutaneous coronary intervention for optimizing outcomes

Cited by 5 publications

References 123 publications

Revascularization Modalities in Acute Coronary Syndrome: A Review of the Current State of Evidence

Revascularization Modalities in Acute Coronary Syndrome: A Review of the Current State of Evidence

Percutaneous Coronary Intervention: An Overview

Toward reliable calcification detection: calibration of uncertainty in object detection from coronary optical coherence tomography images

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