Duodenal mucosal resurfacing: proof-of-concept, procedural development, and initial implementation in the clinical setting.

Background And Aims: We aimed to develop duodenal mucosal resurfacing (DMR), a minimally invasive upper endoscopic hydrothermal ablation procedure, to treat insulin-resistant metabolic diseases.

Methods: We completed a sham-controlled, rodent proof-of-concept study and longitudinal safety study in pigs to demonstrate feasibility to test DMR in humans. Subsequently, the DMR procedure was implemented in an open-label first-in-human (FIH) study of safety and efficacy in patients with type 2 diabetes (T2D).

Endoscopic Duodenal Mucosal Resurfacing for the Treatment of Type 2 Diabetes: 6-Month Interim Analysis From the First-in-Human Proof-of-Concept Study.

Objective: To assess procedural safety and glycemic indices at 6 months in a first-in-human study of duodenal mucosal resurfacing (DMR), a novel, minimally invasive, upper endoscopic procedure involving hydrothermal ablation of the duodenal mucosa, in patients with type 2 diabetes and HbA ≥7.5% (58 mmol/mol) on one or more oral antidiabetic agents.

Research Design And Methods: Using novel balloon catheters, DMR was conducted on varying lengths of duodenum in anesthetized patients at a single medical center.

Detection of lipid core coronary plaques in autopsy specimens with a novel catheter-based near-infrared spectroscopy system.

Objectives: This study sought to assess agreement between an intravascular near-infrared spectroscopy (NIRS) system and histology in coronary autopsy specimens.

Background: Lipid core plaques cannot be detected by conventional tests, yet are suspected to be the cause of most acute coronary syndromes. Near-infrared spectroscopy is widely used to determine the chemical content of substances.

Frequency and distribution of thin-cap fibroatheroma and ruptured plaques in human coronary arteries: a pathologic study.

Objectives: Our purpose was to quantify the frequency and distribution of suspected vulnerable lesions, defined as thin-capped fibroatheroma (TCFA) and ruptured plaque, in human coronary artery autopsy specimens.

Background: Most acute coronary events and sudden death are believed to arise from rupture of a TCFA followed by thrombosis. Although there is general agreement that clinical events are usually caused by focal lesions, there is considerable debate over the relative importance of focal versus systemic factors in the pathogenesis of atherosclerosis.

Near-infrared spectroscopy for the detection of vulnerable coronary artery plaques.

This review describes efforts to use near-infrared (NIR) spectroscopy to identify chemical components of coronary artery plaques as a means to assess vulnerability. Near-infrared spectroscopy has been well-validated by the physical sciences as a method to characterize chemical composition of various bio-materials and could be ideal to detect vulnerable coronary plaques in patients. Recent studies in aortic and coronary artery autopsy specimens have confirmed the ability of the technique to identify lipid-rich thin-cap fibroatheromas through blood.