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Cardiovascular Intervention and Therapeutics

Kenya Nasu, Yuji Oikawa, Maoto Habara, Shinichi Shirai, Hidetoshi Abe, Makoto Kadotani, Ryo Gotoh, Hidenari Hozawa, Hiroshi Ota, Takashi Suzuki, Yoshihisa Shibata, Masaki Tanabe, Yuya Nakagawa, Takeshi Serikawa, Shiro Nagasaka, Yasuyo Takeuchi, Yoshihide Fujimoto, Hiroshi Tamura, Yuichi Kobori, Junji Yajima, Tadanori Aizawa, Takahiko Suzuki
The aim of this study was to assess the efficacy of a biolimus A9-eluting stent in patients with a right coronary artery (RCA) ostial lesion. Ostial lesions of the RCA have been a limitation of percutaneous coronary intervention even in the drug-eluting stent (DES) era. However, clinical outcomes after the deployment of a second generation DES to an RCA ostial lesion with intravascular ultrasound (IVUS) guidance have not been fully elucidated. From September 2011 to March 2013, 74 patients were enrolled in 17 centers from Japan...
September 19, 2017: Cardiovascular Intervention and Therapeutics
Yousuke Taniguchi, Kenichi Sakakura, Yusuke Adachi, Naoyuki Akashi, Yusuke Watanabe, Masamitsu Noguchi, Kei Yamamoto, Yusuke Ugata, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
In-hospital outcomes of acute myocardial infarction (AMI) with cardiogenic shock (CS) were still not satisfactory even in the primary percutaneous coronary intervention (PCI) era. The aim of this study was to compare in-hospital outcomes of AMI with CS caused by right coronary artery (RCA) occlusion vs. left coronary artery (LCA) occlusion. Consecutive 894 AMI patients from January 2010 to March 2015 were screened for inclusion. A total of 114 AMI patients with CS were included as the final study population, and were divided into the RCA group (n = 56) and LCA group (n = 58)...
September 16, 2017: Cardiovascular Intervention and Therapeutics
Takuya Sumi, Akihito Tanaka, Hideki Ishii, Susumu Suzuki, Mitsutoshi Oguri, Toyoaki Murohara
No abstract text is available yet for this article.
September 11, 2017: Cardiovascular Intervention and Therapeutics
Jan B Pietzsch, Benjamin P Geisler, Fumiaki Ikeno
Compared to rotational atherectomy (RA), orbital atherectomy (OA) has been shown to decrease procedure failure and reintervention rates in the treatment of severely calcified coronary artery lesions. Our objective was to explore the cost-effectiveness of OA compared to RA in the Japanese healthcare system. A decision-analytic model calculated reintervention rates and consequent total 1-year costs. Effectiveness inputs were therapy-specific target lesion revascularization (TLR) rates and all-cause mortality, pooled from clinical studies...
September 5, 2017: Cardiovascular Intervention and Therapeutics
Futoshi Yamanaka, Koki Shishido, Shigeru Saito
No abstract text is available yet for this article.
August 18, 2017: Cardiovascular Intervention and Therapeutics
Yohei Sotomi, Pannipa Suwannasom, Erhan Tenekecioglu, Carlos Collet, Shimpei Nakatani, Takayuki Okamura, Takashi Muramatsu, Yuki Ishibashi, Hiroki Tateishi, Yosuke Miyazaki, Taku Asano, Yuki Katagiri, Constantin von Zur Muehlen, Kengo Tanabe, Ken Kozuma, Yukio Ozaki, Patrick W Serruys, Yoshinobu Onuma
Vascular reparative therapy has become a reality with bioresorbable scaffolds (BRSs). To assess acute and long-term performance of the device, multimodality imaging would be essential. Radiopacity of metal hinders the imaging assessment, whereas radiolucent polymeric scaffolds allow for a precise imaging assessment with either invasive or non-invasive modality at baseline and at follow-up, which is one of the advantages of polymeric BRSs. Recent large trials evaluating clinical results of the first-generation BRS technology raised concerns about the safety and efficacy of these devices, namely, scaffold thrombosis...
August 1, 2017: Cardiovascular Intervention and Therapeutics
Nobuo Shiode, Ken Kozuma, Jiro Aoki, Masaki Awata, Mamoru Nanasato, Kengo Tanabe, Junichi Yamaguchi, Hajime Kusano, Hong Nie, Takeshi Kimura
Coronary calcification (CCA) is one of the independent predictors for major adverse cardiac events (MACEs) in coronary intervention. Post-marketing surveillance study Japan is a prospective registry designed to evaluate the safety and efficacy of the everolimus-eluting stent (EES, XIENCE V/PROMUS Stent) in routine clinical practice at 47 centers. In this study, 1848 lesions (1546 patients) were assessed using quantitative coronary angiography. In these 1546 patients, renal function data were unknown in 26 patients...
July 19, 2017: Cardiovascular Intervention and Therapeutics
Teruyoshi Kume, Shiro Uemura
Optical coherence tomography (OCT) is an intra-coronary diagnostic technique that provides detailed imagings of blood vessels in the current cardiac catheterization laboratory. The higher resolution of OCT often provides superior delineation of each structure compared with intravascular ultrasound (IVUS), and it can reliably visualize the microstructure of normal and diseased arteries. The capabilities of OCT are well suited for the identification of calcified plaque and neointima formation after stent implantation...
July 14, 2017: Cardiovascular Intervention and Therapeutics
Soichiro Ebisawa, Yasushi Ueki, Tomoaki Mochidome, Keisuke Senda, Hitoshi Nishimura, Tatsuya Saigusa, Takashi Miura, Hirohiko Motoki, Jun Koyama, Uichi Ikeda
Little is known about the response of platelet aggregation in patients with acute coronary syndrome (ACS) when prasugrel is changed to clopidogrel. In this study, we evaluated the pharmacodynamic effects of this medication switch. Twenty-one consecutive ACS patients received prasugrel 20 mg as a loading dose before emergent percutaneous coronary intervention and 3.75 mg as a maintenance dose on days 2-7 (prasugrel phase). From day 8, prasugrel was switched to clopidogrel 75 mg/day (clopidogrel phase). P2Y12 reaction units (PRU) were measured 2-4 h after prasugrel loading, and on days 7, 11, 13, 15, and 42...
July 5, 2017: Cardiovascular Intervention and Therapeutics
Yoshiaki Kawase, Toru Tanigaki, Akihiro Hirakawa, Hiroyuki Omori, Tetsuo Hirata, Syuuichi Okamoto, Hideaki Ota, Jun Kikuchi, Munenori Okubo, Hiroki Kamiya, Masanori Kawasaki, Takahiko Suzuki, Hitoshi Matsuo
The frequency of a large pressure signal drift (PDs) caused by pressure wire using optical fibers and its effect on fractional flow reserve (FFR)-based decision-making is not clear. We used pressure wires using optical fibers as "workhorse wires" for 95 consecutive lesions. The wire was normalized at the tip of the guiding catheter just before performing the percutaneous coronary intervention (PCI) and was used without re-normalization until the end of the PCI. The drift value at the end of the procedures was evaluated...
July 3, 2017: Cardiovascular Intervention and Therapeutics
Mihir Barvalia, Mohammad Thawabi, Yassir Nawaz, Nishant Sethi, John Shao, Michael Amponsah, Gautam Visveswaran, Marc Cohen, Najam Wasty
Arteriotomy closure devices (ACDs) are routinely used for vascular closure during invasive cardiovascular procedures. They decrease time to hemostasis as well as length of stay. Major complications such as arterial ischemia and occlusion can be encountered in a minority of patients. We are describing a series of 3 patients with access site closure using Angio-Seal after coronary angiography who developed intermittent claudication within 2-3 weeks of follow-up. Access site thrombosis/stenosis in the CFA was found in all the three cases...
June 28, 2017: Cardiovascular Intervention and Therapeutics
Yu Horiuchi, Mika Izumo, Takayoshi Kusuhara, Motoi Yokozuka, Takeshi Taketani, Kengo Tanabe
This report describes an elderly severe aortic stenosis (AS) patient, who had a history of coronary artery bypass grafting and endovascular repair for an abdominal aortic aneurysm (AAA). Type II endoleak with enlargement of AAA was diagnosed and ligation of inferior mesenteric artery (IMA) was recommended. Because aortic valve replacement (AVR) was high risk, we planned transcatheter aortic valve implantation (TAVI). Considering risks of IMA ligation under dual antiplatelet therapy, increased blood pressure after TAVI, and general anesthesia, we performed combined TAVI and IMA ligation...
July 2017: Cardiovascular Intervention and Therapeutics
Tatsuya Nakama, Hiroshi Ando, Nozomi Watanabe, Kenji Ogata, Tatsuro Takei, Yoshisato Shibata
Patients with critical limbs ischemia received endovascular revascularization for his posterior tibial artery (PTA) to plantar artery long occlusion without proximal stump. Antegrade recanalization seemed impossible, so retrograde access should be considered. However, the conventional retrograde puncture was also not available. Therefore, novel retrograde transplantar access was conducted. The plantar artery was successfully punctured with a 20-G needle. In addition, a guidewire was retrogradely inserted with a sheathless technique...
July 2017: Cardiovascular Intervention and Therapeutics
Shunichi Imamura, Koji Nishida, Kazuya Kawai, Naohisa Hamashige, Hiroaki Kitaoka
A 75-year-old man with a severe calcified atheromatous plaque of the right coronary artery underwent percutaneous coronary intervention using a Rotablator(®). During the procedure, the 1.5-mm burr became entrapped, and the driveshaft fractured. While various techniques for retrieving the burr were attempted, a new technique was created. The entrapped burr was sandwiched between an inflated balloon and the GuideLiner(®), and a strong back-up force was obtained. Finally, the system was pulled back safely, and the entrapped burr was retrieved without complications...
July 2017: Cardiovascular Intervention and Therapeutics
Hashrul N Rashid, Liam M McCormick, Robert P Gooley, Ian T Meredith
A 79-year-old man with stable chronic obstructive pulmonary disease was found to have an abdominal aortic aneurysm and worsening dyspnoea. Echocardiography demonstrated critical aortic stenosis. Simultaneous endovascular aneurysm repair (EVAR) and transcatheter aortic valve replacement (TAVR) was recommended due to high surgical risk. Procedural strategy was to perform balloon valvuloplasty (BAV), followed by EVAR then TAVR. The initial 25 mm Lotus valve adopted a barrel shape suggestive of an undersized valve and was thus replaced with a 27 mm valve...
July 2017: Cardiovascular Intervention and Therapeutics
Takanari Fujita, Naritatsu Saito, Kenji Minakata, Masao Imai, Kazuhiro Yamazaki, Takeshi Kimura
An 82-year-old woman with severe aortic stenosis was referred. She had previously undergone mitral valve replacement. We planned transcatheter aortic valve implantation (TAVI) with transfemoral approach. We planned to use the Safari-dedicated TAVI guidewire. No studies have reported clinical application of the dedicated TAVI guidewire in a patient with the previous mitral valve replacement. Thus, we conducted a simulation using a three-dimensional heart model to confirm the safety of the procedure. The procedure was successful without any complications...
July 2017: Cardiovascular Intervention and Therapeutics
Masayuki Hyogo, Takahisa Sawada, Jun Shiraishi, Yoshio Kohno
A 62-year-old male underwent three percutaneous coronary interventions involving four bare metal stents and six Cypher sirolimus-eluting stents within 1 month. At the latest coronary angiographic examination, all of the Cypher stents, but none of the bare metal stents, exhibited peri-stent contrast staining. Moreover, these findings had progressively worsened over time, especially for lesions where two stents came into contact or stent fracture had occurred. It is rare for Cypher stent implantation to result in progressive peri-stent contrast staining, but patients who are treated with these stents should be carefully followed-up, including for stent thrombosis...
July 2017: Cardiovascular Intervention and Therapeutics
Kenji Ando, Katsuhisa Ishii, Eiji Tada, Kazuaki Kataoka, Atsushi Hirohata, Kenji Goto, Katsuyuki Kobayashi, Hiroshi Tsutsui, Makoto Nakahama, Hitoshi Nakashima, Shinichiroh Uchikawa, Junji Kanda, Satoshi Yasuda, Junji Yajima, Hiroshi Kitabayashi, Shumpei Sakurai, Keita Nakanishi, Naoto Inoue, Hirofumi Noike, Terumitsu Hasebe, Tetsuya Sato, Masao Yamasaki, Takeshi Kimura
The purpose of this multi-center, non-randomized, and open-label clinical trial was to determine the non-inferiority of diamond-like carbon (DLC)-coated cobalt-chromium coronary stent, the MOMO DLC coronary stent, relative to commercially available bare-metal stents (MULTI-LINK VISION(®)). Nineteen centers in Japan participated. The study cohort consisted of 99 patients from 19 Japanese centers with single or double native coronary vessel disease with de novo and restenosis lesions who met the study eligibility criteria...
July 2017: Cardiovascular Intervention and Therapeutics
Kiron Varghese, Srilakshmi M Adhyapak, S B Lohitashwa, Priya Pais, Arpana A Iyengar
The occurrence of vascular lesions in neurofibromatosis is uncommon but well documented. These vascular lesions when present, occur predominantly in the kidneys, endocrine glands, heart and gastrointestinal tract, causing stenosis or obliteration of the lumen. We report a case of uncontrolled resistant hypertension in a 2-year-old child presenting with neurofibromatosis who was found to have a high-grade ostial left renal artery stenosis and obliteration of the right renal artery. As the right kidney was small and hypo-functioning, and its renal artery was totally occluded, we subjected the child to a left renal angioplasty and bailout stenting...
July 2017: Cardiovascular Intervention and Therapeutics
Hiroyuki Omori, Yoshiaki Kawase, Toru Tanigaki, Hitoshi Matsuo
A 56-year-old male was admitted to our hospital complaining of chest pain. The patient had chronic kidney disease requiring a minimum contrast procedure when performing percutaneous coronary intervention. A jailed wire technique is known to reduce the risk of side branch occlusion. We report a case measuring the presence of ischemia in the side branch (SB) by a jailed Opto Wire (Opsens, Quebec) after implantation of a stent in the main vessel for the treatment of a bifurcation lesion. This method provides for a decrease in usage of contrast without leaving the side branch at risk of ischemia...
July 2017: Cardiovascular Intervention and Therapeutics
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