Coronary Angiography: Recent Advances in Cardiovascular Imaging

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 3545

Special Issue Editors


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Guest Editor
Department of Cardiology, University Hospital of Patras, 26504 Rion-Patras, Greece
Interests: coronary artery disease; platelets; anticoagulation therapy; acute coronary syndromes; radial access for coronary interventions-snuffbox access; primary prevention
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
1. Department of Cardiology, University Hospital of Patras, 26504 Rion-Patras, Greece
2. First Department of Cardiology, Hippocration General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece
Interests: coronary artery disease; percutaneous coronary interventions; intravascular imaging; acute coronary syndromes; antiplatelets; structural heart diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We currently serve as the Guest Editors of the new Special Issue, “Coronary Angiography: Recent Advances in Cardiovascular Imaging”, to be published in the Journal of Clinical Medicine (IF 2022: 4.964). Invasive coronary angiography remains the main tool for diagnosing coronary artery disease. The better comprehension of pathophysiology of coronary artery disease and the progress of biomedical technology has given us the opportunity to use multiple techniques for achieving intravascular imaging of coronary arteries. Intravascular ultrasound (IVUS) and Optical Coherence Tomography (OCT) are the two approaches used for the evaluation of coronary plagues and percutaneous coronary interventions optimization. The aim of this special issue is to present the recent advances in intracoronary imaging.

Dr. Grigorios Tsigkas
Dr. Anastasios Apostolos
Guest Editors

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Keywords

  • coronary artery disease
  • intravascular imaging
  • optical coherence tomography
  • intravascular ultrasound
  • computed coronary
  • computed tomography

Published Papers (4 papers)

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Review

18 pages, 2181 KiB  
Review
Virtual Hemodynamic Assessment of Coronary Lesions: The Advent of Functional Angiography and Coronary Imaging
by Sotirios Nikopoulos, Michail I. Papafaklis, Panagiota Tsompou, Antonis Sakellarios, Panagiotis Siogkas, Spyros Sioros, Dimitrios I. Fotiadis, Christos S. Katsouras, Katerina K. Naka, Dimitrios Nikas and Lampros Michalis
J. Clin. Med. 2024, 13(8), 2243; https://doi.org/10.3390/jcm13082243 - 12 Apr 2024
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Abstract
The fractional flow reserve (FFR) is well recognized as a gold standard measure for the estimation of functional coronary stenosis. Technological progressions in image processing have empowered the reconstruction of three-dimensional models of the coronary arteries via both non-invasive and invasive imaging modalities. [...] Read more.
The fractional flow reserve (FFR) is well recognized as a gold standard measure for the estimation of functional coronary stenosis. Technological progressions in image processing have empowered the reconstruction of three-dimensional models of the coronary arteries via both non-invasive and invasive imaging modalities. The application of computational fluid dynamics (CFD) techniques to coronary 3D anatomical models allows the virtual evaluation of the hemodynamic significance of a coronary lesion with high diagnostic accuracy. Methods: Search of the bibliographic database for articles published from 2011 to 2023 using the following search terms: invasive FFR and non-invasive FFR. Pooled analysis of the sensitivity and specificity, with the corresponding confidence intervals from 32% to 94%. In addition, the summary processing times were determined. Results: In total, 24 studies published between 2011 and 2023 were included, with a total of 13,591 patients and 3345 vessels. The diagnostic accuracy of the invasive and non-invasive techniques at the per-patient level was 89% (95% CI, 85–92%) and 76% (95% CI, 61–80%), respectively, while on the per-vessel basis, it was 92% (95% CI, 82–88%) and 81% (95% CI, 75–87%), respectively. Conclusion: These opportunities providing hemodynamic information based on anatomy have given rise to a new era of functional angiography and coronary imaging. However, further validations are needed to overcome several scientific and computational challenges before these methods are applied in everyday clinical practice. Full article
(This article belongs to the Special Issue Coronary Angiography: Recent Advances in Cardiovascular Imaging)
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14 pages, 1354 KiB  
Review
Intravascular Imaging in Ultra-Low or Zero-Contrast Percutaneous Coronary Interventions: The Time Is Now?
by Kyriakos Dimitriadis, Nikolaos Pyrpyris, Aggelos Papanikolaou, Eirini Beneki, Panagiotis Tsioufis, Alexios Antonopoulos, Christos Fragoulis, Fotis Tatakis, Georgios Koutsopoulos, Konstantinos Aznaouridis, Konstantina Aggeli and Konstantinos Tsioufis
J. Clin. Med. 2023, 12(23), 7499; https://doi.org/10.3390/jcm12237499 - 04 Dec 2023
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Abstract
Ultra-low contrast percutaneous coronary interventions (ULPCIs) are a novel field of interventional cardiology, aiming to reduce the risk of contrast-induced nephropathy (CIN), which is a well-described adverse event after angiography. CIN is a well-described adverse event following PCI, especially in high-risk patients, i.e., [...] Read more.
Ultra-low contrast percutaneous coronary interventions (ULPCIs) are a novel field of interventional cardiology, aiming to reduce the risk of contrast-induced nephropathy (CIN), which is a well-described adverse event after angiography. CIN is a well-described adverse event following PCI, especially in high-risk patients, i.e., patients with an already deteriorating renal function or chronic kidney disease, as well as patients of advanced age or requiring an increased amount of contrast during their intervention. Among the techniques described for ULPCI procedures, intravascular imaging guidance seems a promising option, as it allows lesion recognition and characterization, stent implantation, and PCI optimization. Intravascular ultrasound (IVUS) is the modality most commonly used, as it does not require contrast injection, contrary to optical coherence tomography (OCT). Several clinical trials, assessing IVUS in the context of ULPCI, have shown that it can be safely used in this setting while offering a substantial reduction in contrast media volume, as well as renal adverse outcomes. This review aims to describe the need for ULPCI and technical considerations regarding the use of intravascular imaging in this setting, as well as analyze the available evidence from clinical trials regarding the safety and efficacy of IVUS-ULPCI, in order to provide a comprehensive summary for practicing physicians. Full article
(This article belongs to the Special Issue Coronary Angiography: Recent Advances in Cardiovascular Imaging)
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14 pages, 4725 KiB  
Review
The Usefulness of Intracoronary Imaging in Patients with ST-Segment Elevation Myocardial Infarction
by Grigoris V. Karamasis, Charalampos Varlamos, Despoina-Rafailia Benetou, Andreas S. Kalogeropoulos, Thomas R. Keeble, Grigorios Tsigkas and Iosif Xenogiannis
J. Clin. Med. 2023, 12(18), 5892; https://doi.org/10.3390/jcm12185892 - 11 Sep 2023
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Abstract
Intracoronary imaging (ICI) modalities, namely intravascular ultrasound (IVUS) and optical coherence tomography (OCT), have shown to be able to reduce major adverse cardiovascular events in patients undergoing percutaneous coronary intervention (PCI). Nevertheless, patients with ST-segment elevation myocardial infarction (STEMI) have been practically excluded [...] Read more.
Intracoronary imaging (ICI) modalities, namely intravascular ultrasound (IVUS) and optical coherence tomography (OCT), have shown to be able to reduce major adverse cardiovascular events in patients undergoing percutaneous coronary intervention (PCI). Nevertheless, patients with ST-segment elevation myocardial infarction (STEMI) have been practically excluded from contemporary large randomized controlled trials. The available data are limited and derive mostly from observational studies. Nevertheless, contemporary studies are in favor of ICI utilization in patients who undergo primary PCI. Regarding technical aspects of PCI, ICI has been associated with the implantation of larger stent diameters, higher balloon inflations and lower residual in-stent stenosis post-PCI. OCT, although used significantly less often than IVUS, is a useful tool in the context of myocardial infarction without obstructive coronary artery disease since, due to its high spatial resolution, it can identify the underlying mechanism of STEMI, and, thus, guide therapy. Stent thrombosis (ST) is a rare, albeit a potential lethal, complication that is expressed clinically as STEMI in the vast majority of cases. Use of ICI is encouraged with current guidelines in order to discriminate the mechanism of ST among stent malapposition, underexpansion, uncovered stent struts, edge dissections, ruptured neoatherosclerotic lesions and coronary evaginations. Finally, ICI has been proposed as a tool to facilitate stent deferring during primary PCI based on culprit lesion characteristics. Full article
(This article belongs to the Special Issue Coronary Angiography: Recent Advances in Cardiovascular Imaging)
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17 pages, 2717 KiB  
Review
The Role of Intracoronary Imaging for the Management of Calcified Lesions
by Stylianos Petousis, Emmanouil Skalidis, Evangelos Zacharis, George Kochiadakis and Michalis Hamilos
J. Clin. Med. 2023, 12(14), 4622; https://doi.org/10.3390/jcm12144622 - 11 Jul 2023
Cited by 1 | Viewed by 1222
Abstract
Interventional cardiologists in everyday practice are often confronted with calcified coronary lesions indicated for percutaneous transluminal coronary angioplasty (PTCA). PTCA of calcified lesions is associated with diverse technical challenges resulting in suboptimal coronary stenting and adverse long-term clinical outcomes. Angiography itself offers limited [...] Read more.
Interventional cardiologists in everyday practice are often confronted with calcified coronary lesions indicated for percutaneous transluminal coronary angioplasty (PTCA). PTCA of calcified lesions is associated with diverse technical challenges resulting in suboptimal coronary stenting and adverse long-term clinical outcomes. Angiography itself offers limited information regarding coronary calcification, and the adjuvant use of intracoronary imaging such as intravascular ultrasound (IVUS) and Optical Coherence Tomography (OCT) can guide the treatment of calcified coronary lesions, optimizing the different stages of the procedure. This review offers a description of why, when, and how to use intracoronary imaging for PTCA of calcified coronary lesions in order to obtain the most favorable results. We used the PubMed and Google Scholar databases to search for relevant articles. Keywords were calcified coronary lesions, intracoronary imaging, IVUS, OCT, coronary calcium modification techniques, PTCA, and artificial intelligence in intracoronary imaging. A total of 192 articles were identified. Ninety-one were excluded because of repetitive or non-important information. Full article
(This article belongs to the Special Issue Coronary Angiography: Recent Advances in Cardiovascular Imaging)
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