Optical coherence tomography (OCT) is slowly but surely gaining a foothold in the hands of interventional cardiologists. Intraluminal and transmural contents of the coronary arteries are no longer elusive to the cardiologist's probing eye. Although the graduation of an interventionalist in imaging techniques right from naked eye angiographies to ultrasound-based coronary sonographies to the modern light-based OCT has been slow, with the increasing regularity of complex coronary cases in practice, such a transition is inevitable. Although intravascular ultrasound (IVUS) due to its robust clinical data has been the preferred imaging modality in recent years, OCT provides a distinct upgrade over it in many imaging and procedural aspects. Better image resolution, accurate estimation of the calcified lesion, and better evaluation of acute and chronic stent failure are the distinct advantages of OCT over IVUS. Despite the obvious imaging advantages of OCT, its clinical impact remains subdued. However, upcoming newer trials and data have been encouraging for expanding the use of OCT to wider indications in clinical utility. During percutaneous coronary intervention (PCI), OCT provides the detailed information (dissection, tissue prolapse, thrombi, and incomplete stent apposition) required for optimal stent deployment, which is the key to successfully reducing the major adverse cardiovascular event (MACE) and stent-related morbidities. The increasing use of OCT in complex bifurcation stenting involving the left main (LM) is being studied. Also, the traditional pitfalls of OCT, such as additional contrast load for image acquisition and stenting involving the ostial and proximal LM, have also been overcome recently. In this review, we discuss the interpretation of OCT images and its clinical impact on the outcome of procedures along with current barriers to its use and newer paradigms in which OCT is starting to become a promising tool for the interventionalist and what can be expected for the immediate future in the imaging world.
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http://dx.doi.org/10.3389/fcvm.2022.854554 | DOI Listing |
Best Pract Res Clin Anaesthesiol
December 2023
Université d'Angers, Département Anesthésie Réanimation, CHU Angers, Angers, France; Université d'Angers, UMR CNRS 6015, Inserm U1083, Unité MitoVasc, Team Carme, Angers, France.
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View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
December 2023
School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.
Preoperative anemia affects one-third of patients undergoing major surgery and is associated with worse perioperative and postoperative outcomes; including length of hospital stay, allogeneic blood transfusion, morbidity, and mortality. Iron deficiency is the most common cause of anemia, and associative data suggests that preoperative correction of iron deficiency anemia could improve postoperative patient outcomes. However, data from randomized controlled trials (RCTs) do not appear to support the routine use of iron therapy to treat preoperative anemia.
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December 2023
Department of Anesthesiology and Perioperative Medicine, The University of Texas, MD Anderson Cancer Center, USA; Anesthesiology and Surgical Oncology Research Group, USA. Electronic address:
Patients with cancer who receive allogeneic red blood cell transfusions are at risk of adverse reactions of varying severity. One of these reactions is immunomodulation, also known as transfusion-related immunomodulation. With the exact mechanism of transfusion related immunomodulation being unclear, storage lesions (both the cellular and cytokine component) are considered a major contributor.
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December 2023
Sydney Medical School, University of Sydney, Royal North Shore Hospital, Pacific Highway, St Leonards, NSW 2065, Australia. Electronic address:
Patient Blood Management evolved in recent years, focusing on the haematopoietic system as relevant to all disciplines of medicine. The allogeneic blood supply chain travels from donation, to fractionation, preservation, and storage, to therapeutic, established treatments, or prophylactics for a wide range of medical conditions. This supply chain 'connects' altruistic blood donors to patients in need, symbolising a 'gift relationship', emphasising the empathetic bond between donor and recipient.
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October 2024
Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada.
Background: Use of health applications (apps) to support healthy lifestyles has intensified. Different app features may support effectiveness, including gamification defined as the use of game elements in a non-game situation. Whether health apps with gamification can impact behaviour change and cardiometabolic risk factors remains unknown.
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