Intravascular Ultrasound-guided Management of Diffuse Stenosis

Abstract

Javier Escaned is Head of the Interventional Cardiology Section at Hospital Clinico San Carlos (Madrid, Spain). He trained as a cardiologist in the United Kingdom (Queen Elizabeth University Hospital, Birmingham and Walsgrave Hospital, Coventry) before moving to the Thoraxcenter/Rotterdam (The Netherlands), where he obtained his PhD degree in 1994. He has authored over 300 scientific articles, books and book chapters on different aspects of interventional cardiology; his latest contribution is Coronary Stenosis. Imaging, Structure and Physiology, a large textbook endorsed by the European Association of Percutaneous Cardiovascular Interventions/European Society of Cardiology (EAPCI/ESC), with its latest edition published in 2015. His main interests in the field of interventional cardiology include intracoronary imaging and physiology, complex percutaneous coronary intervention including chronic total occlusion recanalisation, and acute coronary syndromes. He is currently principal investigator in the SYNTAX II and DEFINE FLAIR multicentre studies. Current and recent positions in scientific organisations include co-director of EuroPCR, board member of the EAPCI, nucleus member of the ESC Working Group on Pathophysiology and Microcirculation and board member of the EuroCTO Club.

One-Stage Detection without Segmentation for Multi-Type Coronary Lesions in Angiography Images Using Deep Learning

“…Four types of lesions ( Figure 2 ) were analyzed in this study: (1) Local stenosis (LS): A local stenosis defined as any stenosis under 20 mm in length; (2) diffuse stenosis (DS): A diffuse stenosis defined as any stenosis over 20 mm in length, which was also named long lesion [ 23 , 24 ]; (3) bifurcation stenosis (BS): A bifurcation stenosis defined as any stenosis adjacent to, and/or involving, the origin of a significant side branch [ 25 ]; (4) chronic total occlusion (CTO): A chronic total occlusion defined as 100% occlusion of a coronary artery for a duration of greater than or equal to 3 months based on angiographic evidence. The details of image distribution are shown in Table 2 .…”

Three-dimensional reconstruction of conventional catheter angiography-identified coronary artery aneurysms and ectasias

“…Optimizing the methodology of CAAEs qualitative and quantitative evaluation based on routine image acquisition may play a role in both triggering the intervention and selecting the type of intervention (percutaneous vs. surgical) [2]. Stent revascularisation of lesions involving CAAE poses particular difficulties in relation to stent sizing (diameter, length) and the risk (and consequences) of stent malapposition [7]. On the other hand, aneurysm formation may occur as a late complication of (drugeluting in particular) stent use [8].…”

“…CTA, however, it is not performed prior to CAG identification of CAAE but, rather, as a subsequent step in arbitrarily selected cases [9]. Importantly, CTA resolution is > 2-fold lower than that of CAG (≈ 0.5 vs. ≈ 0.2 mm) [6,7], and CTA is prone to gating-related (increased heart rate, arrhythmias) and calcifications-related artifacts [4]. Further-more, CTA following CAG requires another contrast medium dose and X-ray exposure [10].…”