Ohya M.,Kurashiki Central Hospital |
Kadota K.,Kurashiki Central Hospital |
Sotomi Y.,Erasmus University Rotterdam |
Kozuma K.,Teikyo University |
And 16 more authors.
EuroIntervention | Year: 2017
Aims: We aimed to investigate the impact of lesion calcification on angiographic outcomes after Absorb everolimus-eluting bioresorbable vascular scaffold (BVS) implantation in comparison with those after cobalt-chromium everolimus-eluting stent (CoCr-EES) implantation. Methods and results: The present post hoc analysis of the ABSORB Japan randomised trial compared post-procedure and 13-month angiographic outcomes between patients implanted with BVS and CoCr-EES based on the presence or absence of calcification, excluding extremely heavily calcified lesions or lesions requiring rotational atherectomy. The study population comprised 384 patients with 384 lesions (including 114 lesions [29.7%] with moderate or severe calcification), classified into two subgroups: calcification, 114 (BVS: n=72 and CoCr-EES: n=42) and non-calcification, 270 (BVS: n=181 and CoCr-EES: n=89). Follow-up angiography was performed in 94.8% of patients. Both post-procedure and follow-up indevice minimal lumen diameters were comparable in both the BVS arm (calcification vs. non-calcification: 2.43±0.32 mm vs. 2.43±0.39 mm, p=0.91 and 2.17±0.49 mm vs. 2.27±0.47 mm, p=0.17) and in the CoCr-EES arm (2.68±0.34 mm vs. 2.65±0.42 mm, p=0.62 and 2.57±0.52 mm vs. 2.47±0.53 mm, p=0.36). Conclusions: Moderate or severe lesion calcification (excluding patients with extremely heavily calcified lesions or lesions requiring rotational atherectomy) does not negatively affect angiographic outcomes at both post-procedure and 13-month follow-up after BVS implantation. © Europa Digital & Publishing 2017. All rights reserved.
Muramatsu T.,Saiseikai Yokohamashi Tobu Hospital |
Tsuchikane E.,Toyohashi Heart Center |
Oikawa Y.,Cardiovascular Institute |
Otsuji S.,Higashi Takarazuka Satoh Hospital |
And 6 more authors.
EuroIntervention | Year: 2014
Aims: To assess the incidence and impact on clinical outcomes of subintimal tracking in patients undergoing percutaneous coronary intervention for chronic total occlusion (CTO).Methods and results: Patients at 27 centres were consecutively enrolled when guidewire crossing of the CTO by either the antegrade or the retrograde approach was confirmed by intravascular ultrasound (IVUS). IVUS images were examined to identify the course of the wire. Clinical follow-up at one year and angiographic follow-up at nine months were performed after everolimus-eluting stent implantation. Among a total of 163 patients (59 antegrade and 104 retrograde), subintimal tracking was more frequent with the retrograde approach (24.2- vs. 12.3-, p=0.10). Although there was no difference in the one-year target vessel revascularisation rate between intimal and subintimal tracking with either the antegrade or the retrograde approach, angiographic follow-up revealed greater late loss in the subintimal group compared with the intimal group. Multivariate analysis identified the pre-procedural reference diameter as a predictor of subintimal tracking.Conclusions: Subintimal tracking was more frequent with the retrograde approach. After medium-term follow-up, no negative clinical impact of subintimal tracking was observed in this small study. However, further evaluation of the angiographic impact is needed.
Yamamoto H.,Shiga University of Medical Science |
Nakae H.,Akita University |
Uji Y.,Shinkoga Hospital |
Maeda K.,Osaka University |
And 2 more authors.
Therapeutic Apheresis and Dialysis | Year: 2015
Plasma filtration with dialysis (PDF) is a blood purification therapy in which simple plasma exchange (PE) is performed using a selective membrane plasma separator while the dialysate flows outside of the hollow fibers. Improvement of hypoadiponectinemia is considered to be a useful therapeutic approach for ameliorating fatal conditions including cardio-metabolic and infectious disease. We investigated the effects of PDF in comparison to PE in terms of plasma adiponectin (APN) changes in patients with acute liver failure. Seventeen patients with liver failure were studied; PDF was performed 55 times and PE 14 times. Plasma APN levels increased significantly after PDF, while decreasing significantly after PE. PDF appears to be among the most useful blood purification therapies in acute liver failure cases in terms of increasing APN levels. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society of Dialysis Therapy.
PubMed | Shiga University of Medical Science, Akita University, Shinkoga Hospital and Osaka University
Type: Journal Article | Journal: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy | Year: 2015
Plasma filtration with dialysis (PDF) is a blood purification therapy in which simple plasma exchange (PE) is performed using a selective membrane plasma separator while the dialysate flows outside of the hollow fibers. Improvement of hypoadiponectinemia is considered to be a useful therapeutic approach for ameliorating fatal conditions including cardio-metabolic and infectious disease. We investigated the effects of PDF in comparison to PE in terms of plasma adiponectin (APN) changes in patients with acute liver failure. Seventeen patients with liver failure were studied; PDF was performed 55 times and PE 14 times. Plasma APN levels increased significantly after PDF, while decreasing significantly after PE. PDF appears to be among the most useful blood purification therapies in acute liver failure cases in terms of increasing APN levels.
Akazawa S.,Shinkoga Hospital |
Tojikubo M.,Shinkoga Hospital |
Kuratomi A.,Shinkoga Hospital |
Towatari T.,Shinkoga Hospital |
And 2 more authors.
Journal of the Japan Diabetes Society | Year: 2010
We studied the relationship between carotid atherosclerosis and coronary artery disease in 131 subjects with diabetes mellitus undergoing multislice computed tomography (MSCT) coronary angiography. Carotid atherosclerosis was evaluated based on intima-media complex thickness (IMT) in the common carotid artery and plaque score (PS), defined as the sum of maximum thickness of all plaque observed in the bilateral carotid artery. IMT and PS were significantly higher in subjects with significant (≧50%) coronary artery disease (CAD) than in those without Logistic regression analysis of significant CAD showed PS to be a significant independent variable. The receiver operating characteristic for IMT and PS use in predicting significant CAD showed sensitivity of 59% and specificity of 60% in IMT for a cutoff of 0.888 mm. Sensitivity was 74% and specificity 70% for PS for a cutoff of 3.6 mm. The number of significant (≧50%) stenotic segments correlated significantly with IMT (r = 0.252, p<0.01) and PS (r = 0.391, p <0.01). Multiple regression analysis showed PS and LDL-C to be significantly associated with the number of significant (≧50%) stenotic segments in the coronary artery (R2 = 0.205, p <0.001). The proportion of plaque type in the carotid artery was 3.1% in hypoechoic lesions, 20.8% in isoechoic lesions, 20.5% in hyperechoic lesions, and 55.6% in heterogenous (mixed) lesions. The proportion of plaque type in the coronary artery was 35.2% in noncalcified lesions, 30.4% in calcified lesions, and 34.4% in mixed lesions. The plaque type in the carotid and coronary arteries was similar in 24% of subjects. These results indicate that PS was more useful than IMT in identifying significant coronary artery disease. PS was also independently associated with coronary artery disease, together with such conventional risk factors as hyperlipidemia.