MD PhD | Cardiology Resident, Radboudumc, NL | Intracoronary Imaging 📸 | High-risk plaques ⚠️ | Artificial Intelligence 🧠
Joined July 2011
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Rick Volleberg retweeted
Meta-analyses of intravascular imaging guidance of PCI show markedly improved outcomes, but only if you use this tool properly — pre-, intra- and post-PCI and with appropriate targets. How do you do it? Our new state-of-the-art review in EHJ takes you through it step by step.
Rick Volleberg retweeted
Our work from PREVENT now publ in Circ. Only 37% of FFR neg severe lsns (PB>70% & MLA<4mm2) were lipid-rich plaques (LRP) by NIRS. Event rates were much higher and preventive PCI was only effective in LRPs. PCI of "true vulnerable plaques" may improve prognosis and avoid over-Rx.
Rick Volleberg retweeted
High-risk coronary plaques (HRPs) predict adverse outcomes — but can clinical risk scores identify them?
@RickVolleberg
et al. showed that OCT-detected HRPs carry prognostic value beyond traditional risk factors, underscoring the role of intracoronary imaging for risk stratification.
eurointervention.pcronline.c…
#OCT #CoronaryPlaque #Cardiology #PCI
@rroku_andi
@drdotter
@WWojakowski
@troleder
@NielsRoyen
Rick Volleberg retweeted
Check out this state-of-the-art #JACCIMG review of how #AI #deeplearning is reshaping #cvImaging. From CNNs to transformers, GNNs, INRs & foundation models, discover the architectures driving the future of cardiac image analysis. jacc.org/doi/10.1016/j.jcmg.…
@RNijveldt @RickVolleberg
New study out!
Spatial and volumetric plaque quantification shows that plaque vulnerability is not uniformly distributed among coronary plaques.
Instead, it shows a proximal predominance which may explain similar proximal predominance for plaque rupture.
Where AI meets the plaque. Artificial intelligence-derived volumetric high-risk plaque features are predominantly located proximal to maximal luminal stenosis @RickVolleberg ahajrnls.org/4hmixTX
This one took countless hours of many people!
AI-based OCT image analysis tested against expert interobserver agreement in a large-scale consecutive real-world dataset.
🚨🚨 Consistent performance supporting generalizability!
ahajournals.org/doi/10.1161/…
@ziadalinyc @NielsRoyen
Rick Volleberg retweeted
Our work from ILUMIEV IV in diabetic pts w/ and w/o complex lesions publ in JACC Interv, a particularly hazardous combination w/poor outcomes after PCI. OCT guidance → ↓ stent thrombosis in all groups w/trend for ↓serious MACE w/o ΔTVF. Free download: authors.elsevier.com/a/1nn9E…
Outstanding deep dive into the major trials evaluating the value of intracoronary imaging-guided PCI, with practical evidence-based recommendations.
New online! Intracoronary imaging in percutaneous coronary intervention: why, when, how and which from large, randomized trials dlvr.it/TVHrzV
Rick Volleberg retweeted
New online! Intracoronary imaging in percutaneous coronary intervention: why, when, how and which from large, randomized trials dlvr.it/TVHrzV
Rick Volleberg retweeted
Original Article: Prevalence of Silent Atherosclerosis across Adult Life (REACT trial) nej.md/46gp1hP
#ESCCongress | @escardio
ALT This image contains four graphs showing the prevalence of peripheral and coronary-artery silent atherosclerosis throughout adult life. Panel A shows a cross-sectional age pattern of silent atherosclerosis prevalence in men and women. Panel B shows the distribution of atherosclerosis in the three arterial vascular territories (coronary, femoral, and carotid), stratified according to age and sex. Panel C shows the prevalence of atherosclerosis among male participants in any territory and for each vascular site, and Panel D shows the same data for female participants.
ALT This image contains two bar graphs showing age-related distribution of silent atherosclerosis across vascular territories according to sex. Panel A shows data for men, while Panel B for women.
ALT This image contains four graphs showing age-related differences in plaque burden across vascular territories. Panel A shows the percentage of participants with coronary atherosclerosis that was classified as obstructive or nonobstructive and as extensive or nonextensive. Panel B shows the cross-sectional calcium scores in participants with calcium scores of greater than 0 for men and women. Panels C and D show predicted cross-sectional plaque volume in participants with plaque, with cross-sectional age-related patterns consistent with an exponential increase, for the respective arterial territory.
Rick Volleberg retweeted
🎙️Editor's Choice Podcast is back!
@aayshacader is joined by Niels van Royen & Rick Volleberg to discuss the PECTUS-obs study.
🫀 High-risk plaques with negative FFR were associated with ~2× higher 5-year MACE, highlighting the value of combining imaging and physiology to assess non-culprit lesions.
🎧 Listen to the new episode: eurointervention.pcronline.c…
📖 Read the Original Research: eurointervention.pcronline.c…
#InterventionalCardiology #FFR #CoronaryImaging #PCI #CardioEducation #CardioEd
Rick Volleberg retweeted
Three key messages from the prospective PECTUS-obs study, which included 438 patients with recent MI undergoing OCT assessment of FFR-negative non-culprit lesions:
- OCT-defined high-risk plaques were associated with an approximately twofold higher 5-year risk of MACE, primarily driven by unplanned revascularisation and spontaneous non-fatal MI.
- High-risk plaque features identified lesions at increased risk despite the absence of flow limitation, highlighting the complementary value of OCT and physiological assessment.
- Plaque rupture emerged as the strongest individual predictor of adverse outcomes. The increased risk was concentrated mainly within the first 2 years, suggesting that plaque vulnerability may evolve over time, potentially influenced by plaque stabilisation and intensive medical therapy.
eurointervention.pcronline.c…
@RickVolleberg @NielsRoyen @RGeuns
Rick Volleberg retweeted
Three key messages from the prospective PECTUS-obs study, including 438 patients with recent MI who underwent OCT of all FFR-negative non-culprit lesions:
1) OCT-defined high-risk plaque was associated with an approximately twofold higher risk of MACE over 5 years, mainly driven by unplanned revascularization and spontaneous non-fatal MI.
2) Even non-flow-limiting lesions may carry increased risk when high-risk features are present, supporting the complementary role of OCT and physiological assessment.
3) Plaque rupture was the strongest individual predictor of adverse outcomes. The excess risk was mainly observed within the first 2 years, suggesting that plaque vulnerability is a dynamic process potentially modified by plaque stabilisation and intensive medical therapy. eurointervention.pcronline.c…
Rick Volleberg retweeted
How much coronary calcium on CT is real, & how much is artifact? In this episode of Behind the Science, Dr. @DoosupShin discusses how photon-counting CT reduces calcium overestimation & blooming artifact vs conventional CT.
📽️: youtu.be/sPu2rVBTROI?si=UO60…
#JACC @aditharun_
Rick Volleberg retweeted
In ILUMIEN IV, #PCI of predominantly calcific lesions on preprocedural #OCT had a 2-year target-vessel failure of 10.7% vs 4.0% for fibrotic lesions (adj HR 2.20). Get the details: jacc.org/doi/10.1016/j.jcmg.…
#JACCIMG @GreggWStone @ziadalinyc @RickVolleberg @BURZOTTA_F
Rick Volleberg retweeted
NEW ISSUE ONLINE -
A State-of-the-Art on computational wireless indices for the assessment of myocardial ischaemia;
- Coronary bioadaptors vs DES;
- 5-year results of PECTUS-obs;
- LAD involvement in SCAD;
- CO2 flushing and vascular brain injuries;
- Transcatheter tricuspid valve replacement outcomes in large anatomies;
- Catheter-directed thrombolysis in acute pulmonary embolism;
and more eurointervention.pcronline.c…
Rick Volleberg retweeted
Watch OPCI Journal Club: Determining the Physiological Threshold for Angina (ORBITA-FIRE): A Double-Blind, Randomized, Placebo-Controlled Study with Drs. Fiyyaz Ahmed & @rallamee. Along with panelists @DFCapodanno @djc795 @ziadalinyc @DrAllenJ @JEscaned @JWMoses.
opci.live/opci-lives/determi…
Rick Volleberg retweeted
New online! The biomechanical environment of coronary atherosclerotic plaque rupture dlvr.it/TTymPR
Rick Volleberg retweeted
Our publ in JACC CV Imaging from ILUMIEN IV: Pre-PCI OCT stratifies 2-year TVF based on plaque morphology. Highest risk (mainly due to TVR) were calcific > lipidic > fibrotic lsns, related to stent under-expansion. Despite median calc arc 271°, only 26% had advanced lesion prep.
Calcific lesions only occasionally cause ACS, why?
📈 Most calcified lesions harbor less plaque vulnerability features
⚠️ Our study suggests a biological continuum: inflamed > rupture prone > stable
@JACCJournals @RubenWaerden @NielsRoyen
jacc.org/doi/10.1016/j.jacad…
