Microcatheter collateral channel tracking failure in retrograde percutaneous coronary intervention for chronic total occlusion: incidence, predictors, and management.

AIMS: This study sought to demonstrate the incidence, predictors, and management of microcatheter collateral channel (CC) tracking failure in retrograde percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions. METHODS AND RESULTS: Prospectively collected data from 371 consecutive retrograde CTO-PCI procedures between March 2015 and January 2018 were retrospectively analysed. The incidence of initial microcatheter CC tracking failure was 22.5% in 280 procedures with wire CC tracking success. For septal collaterals, CC grade 0-1 collaterals (odds ratio [OR]: 8.3; p<0.001), channel entry angle <90° (OR: 13.0; p=0.001), channel exit angle <90° (OR: 44.3; p=0.004), and Finecross MG as initial microcatheter (OR: 2.7; p=0.032) were independently related to initial microcatheter CC tracking failure. Meanwhile, the only predictor for epicardial collaterals was CC 1 collaterals (OR: 26.9; p<0.001). Frequently applied solutions included microcatheter switching (61.9%), and microcatheter switching combined with GUIDEZILLA (14.3%) or anchoring balloon technique (6.3%). CONCLUSIONS: Initial microcatheter CC tracking failure was found in nearly one quarter of procedures after wire CC tracking success. Independent angiographic predictors of initial microcatheter CC tracking failure included CC 0-1 collaterals, channel entry angle <90°, and channel exit angle <90° for septal collaterals, and CC 1 collaterals for epicardial collaterals.

A three-dimensional origami-based immuno-biofuel cell for self-powered, low-cost, and sensitive point-of-care testing.

A three-dimensional microfluidic origami glucose-air immuno-biofuel cell has been successfully demonstrated for the first time to implement self-powered, sensitive, and low-cost sandwich immunoassay for cancer markers based on the signal amplifications of a porous Au-paper electrode and Au nanoparticles attached to carbon nanotubes.

Flexible paper-based ZnO nanorod light-emitting diodes induced multiplexed photoelectrochemical immunoassay.

ZnO nanorods inorganic-organic heterostructured light-emitting diodes have been demonstrated on a cheap/disposable paper substrate and applied in multiplexed photoelectrochemical immunoassay.

A paper-based photoelectrochemical immunoassay for low-cost and multiplexed point-of-care testing.

A photoelectrochemical immunoassay was introduced for the first time into a microfluidic paper-based analytical device equipped with a paper supercapacitor for low-cost, simple, portable, and disposable point-of-care testing, based on a chemiluminescence light source and a digital multi-meter.

Rechargeable battery-triggered electrochemiluminescence detection on microfluidic origami immunodevice based on two electrodes.

A low-cost, portable rechargeable battery was firstly used to fabricate a battery-triggered, screen-printed two-electrode electrochemiluminescent immunoassay on a 3D microfluidic origami electronic device.

3D origami-based multifunction-integrated immunodevice: low-cost and multiplexed sandwich chemiluminescence immunoassay on microfluidic paper-based analytical device.

A novel 3D microfluidic paper-based immunodevice, integrated with blood plasma separation from whole blood samples, automation of rinse steps, and multiplexed CL detections, was developed for the first time based on the principle of origami (denoted as origami-based device). This 3D origami-based device, comprised of one test pad surrounded by four folding tabs, could be patterned and fabricated by wax-printing on paper in bulk. In this work, a sandwich-type chemiluminescence (CL) immunoassay was introduced into this 3D origami-based immunodevice, which could separate the operational procedures into several steps including (i) folding pads above/below and (ii) addition of reagent/buffer under a specific sequence. The CL behavior, blood plasma separation, washing protocol, and incubation time were investigated in this work. The developed 3D origami-based CL immunodevice, combined with a typical luminuol-H(2)O(2) CL system and catalyzed by Ag nanoparticles, showed excellent analytical performance for the simultaneous detection of four tumor markers. The whole blood samples were assayed and the results obtained were in agreement with the reference values from the parallel single-analyte test. This paper-based microfluidic origami CL detection system provides a new strategy for a low-cost, sensitive, simultaneous multiplex immunoassay and point-of-care diagnostics.

A novel chemiluminescence paper microfluidic biosensor based on enzymatic reaction for uric acid determination.

In this work, chemiluminescence (CL) method was combined with microfluidic paper-based analytical device (µPAD) to establish a novel CL µPAD biosensor for the first time. This novel CL µPAD biosensor was based on enzyme reaction which produced H(2)O(2) while decomposing the substrate and the CL reaction between rhodanine derivative and generated H(2)O(2) in acid medium. Microchannels in µPAD were fabricated by cutting method. And the possible CL assay principle of this CL µPAD biosensor was explained. Rhodanine derivative system was used to reach the purpose of high sensitivity and well-defined signal for this CL µPAD biosensor. And the optimum reaction conditions were investigated. The quantitative determination of uric acid could be achieved by this CL µPAD biosensor with accurate and satisfactory result. And this biosensor could provide good reproducible results upon storage at 4°C for at least 10 weeks. The successful integration of µPAD and CL reaction made the final biosensor inexpensive, easy-to-use, low-volume, and portable for uric acid determination, which also greatly reduces the cost and increases the efficiency required for an analysis. We believe this simple, practical CL µPAD biosensor will be of interest for use in areas such as disease diagnosis.

Quantitative and qualitative assessment of non-obstructive left main coronary artery plaques using 64-multislice computed tomography compared with intravascular ultrasound.

BACKGROUND: There are few reports of quantitative and qualitative measuring of left main coronary artery (LMCA) plaques by multislice computed tomography coronary angiography (MSCTA), especially when compared with intravascular ultrasound (IVUS) as reference standard. The aim of this study was to evaluate the use of 64-MSCTA in the diagnosis of LMCA disease, and the accuracy of MSCTA in the quantitative and qualitative assessment of the LMCA lesion as compared with IVUS. METHODS: A total of 91 patients (53 men, 38 women, mean age (64.78 +/- 9.19) years) were examined by 64-MSCTA and IVUS. Compared with the IVUS, the sensitivity, specificity, positive and negative predictive values (PPV and NPV) of the MSCTA on the diagnosis of LMCA diseases were calculated. Also, kappa index (kappa) for the agreement between MSCTA and IVUS was calculated. Minimal lumen area (MLA), external elastic membrane cross-sectional area (EEM-CSA) and plaque burden were measured by two blinded and independent operators on MSCTA cross-sectional reconstruction and compared with the parameters measured from IVUS by manually tracing. The CT value of soft, fibrous and calcific plaques was measured using IVUS classification of the plaques. RESULTS: The sensitivity, specificity, PPV and NPV of MSCTA for detecting LMCA plaques were 93.1%, 84.2%, 95.7%, 76.2%, respectively. Kappa index (kappa = 0.744, P < 0.001) indicated excellent agreement between MSCTA and IVUS. The Pearson index between MLA on IVUS and MLA on MSCTA was 0.815 (P < 0.01). The Pearson index of plaque burden and EEM-CSA between IVUS and MSCTA was 0.736 and 0.740 respectively (both P < 0.01). The CT value of soft plaque, fibrous plaque and calcific plaque compared with IVUS were (52.52 +/- 15.71) HU, (108.32 +/- 43.44) HU and (604.16 +/- 377.67) HU (P < 0.001). Receiver operating characteristic curve analysis of CT value of non-calcific plaques for predicting soft plaques showed the cutpoint was 54.35 HU, with a sensitivity of 83.3% and specificity of 94.4%. CONCLUSIONS: Sixty-four section MSCTA is an effective diagnostic tool for the detection of LMCA plaques with higher sensitivity and specificity. The correlation of quantitative and qualitative analysis between MSCTA and IVUS was excellent. The CT value of plaques can help the diagnosis of plaque composition.

[Intravascular ultrasound assessment of sirolimus-eluting stent restenosis or thrombosis after stent implantation].

OBJECTIVE: To identify underlying mechanical risk factors of that developed in-stent restenosis (ISR) or early stent thrombosis in sirolimus-eluting stent (SES)-treated lesions using intravascular ultrasound (IVUS). METHODS: IVUS were performed in 60 (ISR, n = 43; early stent thrombosis, n = 17) patients (event group) and in 34 patients without ISR and early stent thrombosis (no-event group) underwent SES implantations. RESULTS: Compared with the no-event group, minimum stent area [MSA, (4.6 +/- 1.6) mm(2) vs. (5.8 +/- 1.6) mm(2), P < 0.01], minimum stent diameter [(2.2 +/- 0.5) mm vs. (2.5 +/- 0.4) mm, P < 0.01], and stent expansion [(69.2 +/- 20.7)% vs. (80.6 +/- 17.2)%, P < 0.01] were significantly smaller, and longitudinal stent symmetry index (MSA/maximum stent area, 2.0 +/- 0.6 vs. 1.7 +/- 0.6, P < 0.05) was significantly larger in the event group. Incidence of MSA < 4.0 mm(2) (43.3% vs. 14.7%, P < 0.01) and stent expansion < 60% (40.7% vs. 11.8%, P < 0.01) were more frequent in the event group than that in no-event group. Furthermore, proximal residual plaque burden was significantly higher compared to the no-event group [(49.0 +/- 15.5)% vs. (38.4 +/- 17.6)%, P < 0.01]. Independent predictors of post SES ISR or early thrombosis were MSA (OR:0.7, 95%CI:0.5 - 0.8, P < 0.01) and proximal residual plaque burden (OR: 280.7, 95%CI: 17.2 - 40 583.6, P < 0.01). CONCLUSION: Smaller MSA and higher proximal residual plaque burden are independent predictors of ISR or early thrombosis post SES implantations.