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Araki M, Bandi MM, Yazaki-Sugiyama Y. Mind the gap: Neural coding of species identity in birdsong prosody. Science 2016; 354:1282-1287. [DOI: 10.1126/science.aah6799] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Accepted: 10/24/2016] [Indexed: 11/02/2022]
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Brand M, Stefanidis A, Morbach C, Fan YT, Elremisy DRA, Kuznetsov VA, Carrero C, Almodares Q, Abdulrahim H, Galli E, Galli E, Moreno J, Lerena Saenz P, Ikonomidis I, Galuszka OM, Bonapace S, Clerc OF, Kuznetsov VA, Tadic S, Kataoka A, Abdul Rahman E, Calin A, Antonini-Canterin F, Schwartzenberg SS, Christ M, Roeing J, Amirie S, Grett M, Beko M, Breker I, Wennemann R, Trappe HJ, Lagoudakou S, Vintzilaios K, Mokadem N, Vlachou J, Komatanou E, Korlou P, Kakkavas A, Komninos K, Kranidis A, Gelbrich G, Simon J, Cramer M, Knobeloch F, Tiffe T, Wagner M, Heuschmann PU, Stoerk S, Yang D, Wang X, Chan AK, Cheung SH, Lee AP, Salim FF, Bakhoum SW, Ashour ZA, Soldatova AM, Krinochkin DV, Enina TN, Altamirano C, Pipkin M, Constantin I, Fava A, Diaz Babio G, Masson Juarez G, San Miguel J, Vera Janavel G, Stutzbach P, Wallentin Guron C, Thurin A, Fu M, Kontogeorgos S, Thunstrom E, Johansson MC, Da Silva C, Venkateshvaran A, Nagy AI, Lund LH, Manouras A, Leclercq C, Fournet M, Bernard A, Mabo P, Samset E, Hernandez A, Donal E, Leclercq C, Fournet M, Bernard A, Mabo P, Samset E, Hernandez A, Donal E, Martinez Lugo CML, Zuniga Sedano JZD, Alexanderson EAR, Camilletti JC, Ahmed Abdelrahman M, Raslan H, Ruisanchez Villar C, Cuesta Cosgalla JM, Zarauza Navarro J, Veiga Fernandez G, Rifaie O, Omar AMS, Vlastos D, Frogoudaki A, Vrettou AR, Vlachos S, Varoudi M, Triantafyllidi H, Parissis J, Tsivgoulis G, Lekakis J, Steffens D, Friebel J, Rauch-Krohnert U, Landmesser U, Kasner M, Adamo E, Valbusa F, Ciccio' C, Rossi A, Lanzoni L, Chiampan A, Cecchetto A, Canali G, Barbieri E, Fuchs TA, Stehli J, Benz DC, Graeni C, Buechel RR, Kaufmann PA, Gaemperli O, Yaroslavskaya EI, Krinochkin DV, Kolunin GV, Gorbatenko EA, Dyachkov SM, Jung R, Ilic A, Stojsic-Milosavljevic A, Dejanovic J, Stefanovic M, Stojsic S, Sladojevic M, Watanabe Y, Kozuma K, Yamamoto M, Takagi K, Araki M, Tada N, Shirai S, Tamanaka F, Hayashida K, Ewe SH, Fadzil MA, Najme Khir R, Ismail JR, Lim CW, Chua N, Ibrahim ZO, Kasim SS, Ding ZP, Mateescu AD, Beladan CC, Rosca M, Enache R, Calin C, Cosei I, Botezatu S, Simion M, Ginghina C, Popescu BA, Di Nora C, Poli S, Vriz O, Zito C, Carerj S, Pavan D, Vaturi M, Kazum S, Monakier D, Sagie A, Kornowski R, Shapira Y. Poster Session 2The imaging examination and quality assessmentP520Benefit of early basic transthoracic echocardiography (TTE) in emergency patients performed by physicians with low to intermediate TTE experienceP521Appropriateness criteria in echocardiography. A contemporary necessity in clinical practiceP522Interobserver variability in 2d transthoracic echocardiography impact of scanning and reading on total variability results from the STAAB cohort study quality controlP5233D printing for personalised planning of catheter-based left atrial appendage occlusionP524Central obesity: an independent role or synergistic effect to metabolic syndrome on right atrial structure?P525Dynamics of left ventricular volumes and mortality in patients with early and late effect of cardiac resynchronization therapyP526Variability of thoracic aortic diameters according to gender, age and body surface area. Time to forget absolute cut-off values?P527The association of left ventricular outflow tract velocity time integral to all-cause mortality in elderly patients with heart failureP528Left ventricular myocardial performance and atrioventricular coupling in patients with primary arterial hypertensionP529Interest of a combinatory approach based on traditional left ventricular dyssynchrony parameters and cardiac work estimated by pressure-strain loop curves for the prediction of cardiac resynchronizatP530The evaluation of cardiac performance by pressure-strain loops: a useful tool for the identification of cardiac resynchronization therapy respondersP531Left ventricle cardiac function by 2D-speckle tracking echocardiography in diabetes mellitus population: sub-clinical systolic disfunction studyP532Biphasic tissue doppler mitral annular isovolumic contraction velocities are associated with left ventricular function, isovolumic relaxation, and pulmonary wedge pressure in heart failure patientsP533Abnormal left atrial volumes and strains are associated with increased arterial stiffnes in patients with cryptogenic stroke: a novel pathophysiological pathP534Detection of coronary microvascular disease using two-dimensional speckle-tracking echocardiographyP535Predictive value of a bi-dimensional transthoracic echocardiographic sign of " binary image" to identify the anomalous origin of the left circumflex coronary artery from the right coronary sinusP536Systematic review and meta-analysis of screening for coronary artery disease in asymptomatic diabetic patientsP537Noninvasive screening test for diagnosis of nonobstructive coronary artery disease using echocardiographic criteriaP538Early echocardiography after primary angioplasty, important role in predicting left ventricular remodelingP539Prognostic impact of low-flow severe aortic stenosis in Japanese patients undergoing transcatheter aortic valve implantation: the ocean-tavi registryP540Left ventricular outflow tract geometry and its impact on aortic valve area calculations in aortic stenosis using 3D transoesophageal echocardiography and 2D transthoracic echocardiographyP541Impaired left atrial myocardial deformation predicts postoperative atrial fibrillation after aortic valve replacement in patients with aortic stenosisP542Ejection fraction-velocity ratio in predicting symptoms in severe aortic stenosisP543Incremental value of transesophageal echocardiography in conjunction with transthoracic echocardiography in the assessment of aortic stenosis severity. Eur Heart J Cardiovasc Imaging 2016. [DOI: 10.1093/ehjci/jew248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kobayashi N, Hirano K, Yamawaki M, Araki M, Takimura H, Sakamoto Y, Mori S, Ito Y. Clinical effects of single or double tibial artery revascularization in critical limb ischemia patients with tissue loss. J Vasc Surg 2016; 65:744-753. [PMID: 27876517 DOI: 10.1016/j.jvs.2016.08.106] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/16/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The achievement of single vessel inflow to the wound is an acceptable end point of peripheral vascular intervention for patients with critical limb ischemia (CLI) with tissue loss. However, CLI patients often have multitibial artery lesions. We evaluated the clinical effects of single or double tibial artery revascularization for CLI patients. METHODS This study was conducted retrospectively in a single center. Between April 2007 and January 2015, we treated 123 CLI patients (137 limbs) who had lesions in both the anterior tibial artery and the posterior tibial artery. Of these, single tibial artery (anterior or posterior tibial artery) revascularization was performed in 84 limbs (group S) and double tibial artery (both anterior and posterior tibial arteries) revascularization was performed in 53 limbs (group D). RESULTS The wound healing rate was significantly higher (87% vs 79%; P = .003), the time to wound healing was shorter (median, 83 vs 142 days; P = .01), and the repeat peripheral vascular intervention rate was lower (15% vs 35%; P = .03) in group D than in group S. The wound healing rate was nearly similar between the 2 groups in patients with a low clinical stage as assessed by Society for Vascular Surgery Wound, Ischemia, and foot Infection (90% in group D vs 93% in group S; P = .20); however, the wound healing rate was significantly higher in group D in patients with a high clinical stage (85% vs 72%; P = .007). CONCLUSIONS The achievement of double vessel inflows to the wound by double tibial artery revascularization positively affects wound healing, particularly in severe CLI patients.
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Tokuda T, Hirano K, Sakamoto Y, Takimura H, Kobayashi N, Araki M, Yamawaki M, Ito Y. Incidence and clinical outcomes of the slow-flow phenomenon after infrapopliteal balloon angioplasty. J Vasc Surg 2016; 65:1047-1054. [PMID: 27865638 DOI: 10.1016/j.jvs.2016.08.118] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/12/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study investigated the incidence and clinical relevance of the slow-flow phenomenon after infrapopliteal balloon angioplasty. METHODS This retrospective, single-center study included 161 consecutive patients with critical limb ischemia (173 limbs) who underwent endovascular treatment for infrapopliteal lesions between January 2012 and May 2015. The overall technical success rate was 88%. Of these lesions, 30 limbs presented with slow flow after angioplasty. RESULTS Total occlusion (90% vs 63%; P < .01) and severe calcification (43% vs 8%; P < .01) were more common in the slow-flow group. Kaplan-Meier curve analysis revealed that freedom from major amputation (60% vs 86%; log-rank, P < .01) and wound healing at 2 years (77% vs 91%; log-rank, P = .03) were significantly less common in the slow-flow group. Univariate Cox proportional hazard analysis identified Rutherford class 6 (hazard ratio [HR], 6.4; 95% confidence interval [CI], 2.8-15.8; P < .01), the slow-flow phenomenon (HR, 3.9; 95% CI, 1.6-8.9; P < .01), and hemodialysis (HR, 3.2; 95% CI, 1.2-11.1; P = .02) as independent predictors of major amputation and Rutherford class 6 (HR, 0.3; 95% CI, 0.2-0.6; P < .01), the slow-flow phenomenon (HR, 0.5; 95% CI, 0.3-0.9; P = .02), and pedal arch (HR, 1.6; 95% CI, 1.0-2.5; P = .04) as predictors of wound healing. CONCLUSIONS The slow-flow phenomenon after infrapopliteal balloon angioplasty occurred in 18.6% of limbs. This phenomenon may result in poor outcomes.
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Kobayashi N, Yamawaki M, Nakano M, Hirano K, Araki M, Takimura H, Sakamoto Y, Mori S, Tsutsumi M, Ito Y. A new scoring system (DAIGA) for predicting bleeding complications in atrial fibrillation patients after drug-eluting stent implantation with triple antithrombotic therapy. Int J Cardiol 2016; 223:985-991. [PMID: 27591697 DOI: 10.1016/j.ijcard.2016.08.310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/18/2016] [Accepted: 08/19/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND No scoring system for evaluating the bleeding risk of atrial fibrillation (AF) patients after drug-eluting stent (DES) implantation with triple antithrombotic therapy (TAT) is available. We aimed to develop a new scoring system for predicting bleeding complications in AF patients after DES implantation with TAT. METHODS AND RESULTS Between April 2007 and April 2014, 227 AF patients undergoing DES implantation with TAT were enrolled. Bleeding incidence defined as Bleeding Academic Research Consortium criteria≥2 was investigated and predictors of bleeding complications were evaluated using multivariate analysis. Bleeding complications occurred in 58 patients (25.6%) during follow-up. Multivariate analysis revealed dual antiplatelet therapy (DAPT) continuation (OR 3.33, P=0.01), age>75 (OR 2.14, P=0.037), international normalized ratio>2.2 (OR 5.82, P<0.001), gastrointestinal ulcer history (OR 3.06, P=0.037), and anemia (OR 2.15, P=0.042) as predictors of major bleeding complications. A score was created using the weighted points proportional to the beta regression coefficient of each variable. The DAIGA score showed better predictive ability for bleeding complications than the HAS-BLED score (AUC: 0.79 vs. 0.62, P=0.0003). Bleeding incidence was well stratified: 17.8% in low-risk (scores 0-1), 55.5% in moderate-risk (2-3), and 83.0% in high-risk (4-7) patients (P<0.001). CONCLUSIONS This scoring system is useful for predicting bleeding complications and risk stratification of AF patients after DES implantation with TAT.
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Tokuda T, Hirano K, Ito Y, Yamawaki M, Araki M, Kobayashi N, Takimura H, Mori S, Sakamoto Y, Tsutsumi M, Takama T, Makino K. TCT-18 Validation of Wound, Ischemia, foot Ischemia (WIFI) classification system in Japanese patients after endovascular treatment for critical limb ischemia (CLI). J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Watanabe Y, Kozuma K, Hioki H, Kawashima H, Nara Y, Nakashima M, Nagura F, Kataoka A, Shinichi S, Tada N, Araki M, Takagi K, Yamanaka F, Yamamoto M, Hayashida K. TCT-685 Pre-existing Right Bundle-Branch Block Increases Risk of Death after Transcatheter Aortic Valve Implantation with a Balloon-Expandable Valve. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kobayashi N, Ito Y, Hirano K, Yamawaki M, Araki M. TCT-241 Optimal endpoint of rotational atherectomy for coronary severe calcified lesion: optical frequency-domain imaging analysis. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Watanabe Y, Kozuma K, Hioki H, Kawashima H, Nara Y, Kataoka A, Nagura F, Nakashima M, Shirai S, Tada N, Araki M, Takagi K, Yamanaka F, Yamamoto M, Hayashida K. Pre-Existing Right Bundle Branch Block Increases Risk for Death After Transcatheter Aortic Valve Replacement With a Balloon-Expandable Valve. JACC Cardiovasc Interv 2016; 9:2210-2216. [DOI: 10.1016/j.jcin.2016.08.035] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 08/14/2016] [Accepted: 08/25/2016] [Indexed: 10/20/2022]
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Kodama A, Yamamoto M, Shimura T, Kagase A, Koyama Y, Tada N, Takagi K, Araki M, Yamanaka F, Shirai S, Watanabe Y, Hayashida K. Comparative data of single versus double proglide vascular preclose technique after percutaneous transfemoral transcatheter aortic valve implantation from the optimized catheter valvular intervention (OCEAN-TAVI) japanese multicenter registry. Catheter Cardiovasc Interv 2016; 90:E55-E62. [DOI: 10.1002/ccd.26686] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 07/03/2016] [Indexed: 12/17/2022]
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Honda Y, Hirano K, Yamawaki M, Mori S, Shirai S, Makino K, Tokuda T, Takama T, Tsutumi M, Sakamoto Y, Takimura H, Kobayashi N, Araki M, Ito Y. Wound healing of critical limb ischemia with tissue loss in patients on hemodialysis. Vascular 2016; 25:272-282. [PMID: 27758848 DOI: 10.1177/1708538116673015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We assessed wound healing in patients on hemodialysis (HD) with critical limb ischemia (CLI). This study enrolled 267 patients (including 120 patients on HD and 147 patients not on HD) who underwent endovascular therapy (EVT) for CLI. The primary endpoint was wound-healing rate at two years. Secondary endpoints were time to wound healing, wound recurrence rate, and limb salvage at two years. The percentage of male and young patients was higher in the HD patients ( p < 0.01). A lower patency of the pedal arch after EVT was observed frequently in HD patients ( p < 0.01). The wound-healing rate was significantly lower in HD patients (79.5% vs. 92.4%, p < 0.001). Time to wound healing was significantly longer in HD patients (median 132 days vs. 82 days, p = 0.005). Wound recurrence was observed more frequently in HD patients (25.0% vs. 10.2%, p = 0.007). Limb salvage (72.8% vs. 86.4%, p = 0.002) was significantly lower in HD patients. In a cox proportional hazard model, HD was an independent predictor of wound healing (risk ratio (RR), 0.46; 95% confidence interval (CI), 0.33-0.62; p < 0.001) and wound recurrence (RR, 1.58; 95% CI, 1.11-2.22; p = 0.01). HD was independently associated with lower and delayed wound healing, and wound recurrence.
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Kurashige T, Morino H, Kanbara T, Nagano Y, Araki M, Maruyama H, Torii T, Matsumoto M. TBK1 exists with optineurin around rimmed vacuoles. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mori S, Hirano K, Ito Y, Yamawaki M, Araki M, Kobayashi N, Takimura H, Sakamoto Y, Tsutsumi M, Takama T, Honda Y, Tokuda T, Makino K, Shirai S. Clinical Outcomes of the Intraluminal Approach for Long Occlusive Femoropopliteal Lesions Assessed by Intravascular Ultrasound. J Atheroscler Thromb 2016; 24:477-486. [PMID: 27725364 PMCID: PMC5429163 DOI: 10.5551/jat.36749] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: To investigate the relationship between intravascular ultrasound (IVUS) findings and restenosis after stent implantation for long occlusive femoropopliteal (FP) lesions using the intraluminal approach. Methods: This was a single-center retrospective study of 45 patients (49 lesions) with de novo long occlusive FP lesions treated with bare metal stents implanted using the intraluminal approach under IVUS guidance from April 2007 to December 2014. All patients were followed up at least 12 months. The preprocedural and postprocedural IVUS findings were compared for patients with and without restenosis, which was defined as a peak systolic velocity ratio of > 2.4 on duplex ultrasonography or > 50% diameter stenosis on angiography. Results: Within 12 months, 13 patients (14 lesions) developed restenosis, whereas 32 patients (35 lesions) did not (restenosis rate = 29%). The male:female ratio and the prevalence of diabetes mellitus, hemodialysis, and critical limb ischemia were similar between the two groups. No significant differences were observed in lesion length, chronic total occlusion (CTO) length, and the percentage of involving popliteal lesion between the two groups. A whole intraplaque route was gained in 15 lesions (31%). Multivariate analysis revealed that the within-CTO intramedial route proportion and the distal lumen cross-sectional area (CSA) were independent predictors of restenosis. Receiver operating characteristic analysis showed that the best cutoff values of these parameters were 14.4% and 17.7 mm2, respectively. Conclusions: In patients with long occlusive FP lesions undergoing stent placement using the intraluminal approach, a whole intraplaque route was gained in 31%. Restenosis is more likely if IVUS shows a within-CTO intramedial route proportion of > 14.4% or distal lumen CSA of < 17.7 mm2.
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Kobayashi N, Hirano K, Yamawaki M, Araki M, Sakai T, Takimura H, Sakamoto Y, Mori S, Tsutsumi M, Takama T, Honda Y, Tokuda T, Makino K, Shirai S, Ito Y. Ability of Fractional Flow Reserve to Predict Restenosis After Superficial Femoral Artery Stenting. J Endovasc Ther 2016; 23:896-902. [PMID: 27604452 DOI: 10.1177/1526602816668306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the clinical efficacy of poststenting fractional flow reserve (FFR) in terms of predicting restenosis in superficial femoral artery (SFA) disease. METHODS This prospective, single-center, nonrandomized study enrolled 48 patients (mean age 76±9 years; 38 men) with 51 SFA lesions from July 2013 to June 2014. Mean FFR (distal mean pressure/proximal mean pressure) and systolic FFR (distal systolic pressure/proximal systolic pressure) were calculated, and the relationship between these FFR values and restenosis at 12 months was investigated using receiver operating characteristic (ROC) curve analysis. RESULTS Poststenting FFR was significantly lower in the restenosis group (poststenting mean FFR 0.85±0.07 vs 0.93±0.05, p=0.001; poststenting systolic FFR 0.76±0.14 vs 0.87±0.08, p=0.015). The area under the ROC curve for restenosis in poststenting mean FFR was higher, but not statistically significant, than that in poststenting systolic FFR (0.84 vs 0.74, p=0.08). The best poststenting mean FFR cutoff value for predicting restenosis was 0.92 (sensitivity 0.64, specificity 0.91). The 4.5% restenosis rate at 12 months in the high (>0.92) poststenting mean FFR group was significantly lower (35.7%, p=0.008) than in the low (≤0.92) poststenting mean FFR group. CONCLUSION Poststenting mean FFR is useful for predicting restenosis in SFA disease.
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Hioki H, Watanabe Y, Kozuma K, Nara Y, Kawashima H, Kataoka A, Yamamoto M, Takagi K, Araki M, Tada N, Shirai S, Yamanaka F, Hayashida K. Pre-procedural dual antiplatelet therapy in patients undergoing transcatheter aortic valve implantation increases risk of bleeding. Heart 2016; 103:361-367. [DOI: 10.1136/heartjnl-2016-309735] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 07/19/2016] [Accepted: 07/30/2016] [Indexed: 11/03/2022] Open
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Watanabe Y, Kozuma K, Hioki H, Kawashima H, Nara Y, Kataoka A, Shirai S, Tada N, Araki M, Takagi K, Yamanaka F, Yamamoto M, Hayashida K. Comparison of Results of Transcatheter Aortic Valve Implantation in Patients With Versus Without Active Cancer. Am J Cardiol 2016; 118:572-7. [PMID: 27324159 DOI: 10.1016/j.amjcard.2016.05.052] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/23/2016] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
Abstract
The aim of this study was to evaluate postprocedural and midterm outcomes of transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis and active cancer. From October 2013 to August 2015, a total of 749 patients undergoing TAVI using the Edwards Sapien XT prosthesis (Edwards Lifesciences, Irvine, California) were prospectively included in the OCEAN-TAVI registry from 8 Japanese centers. A total of 47 patients (44.7% men; median age 83 years) had active cancer. The transfemoral approach was implemented in 85.1% of patients in the cancer group and 78.1% in the noncancer group (p = 0.22). The occurrence of major vascular complication (4.3% vs 7.5%, p = 0.24), life-threatening bleeding (2.1% vs 7.1%, p = 0.15), and major bleeding (8.5% vs 13%, p = 0.38) was similar between the cancer and noncancer groups. No significant differences were observed regarding device success (100% vs 96.2%, p = 0.17) or 30-day survival (95.7% vs 97.3%, p = 0.38). No difference in midterm survival was found between the patients with cancer and without cancer (log-rank, p = 0.42), regardless of advanced or limited cancer (log-rank, p = 0.68). In a multivariable Cox proportional hazard regression analysis, cancer metastasis was one of the most significant predictors of late mortality (hazard ratio 4.73, 95% CI 1.12 to 20.0; p = 0.035). In conclusion, patients with cancer with severe aortic stenosis who underwent TAVI had similar acute outcomes and midterm survival rates compared with patients without cancer. Cancer metastasis was associated with increased mortality after TAVI.
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Yamamoto M, Shimura T, Kano S, Kagase A, Kodama A, Koyama Y, Watanabe Y, Tada N, Takagi K, Araki M, Shirai S, Hayashida K. Impact of preparatory coronary protection in patients at high anatomical risk of acute coronary obstruction during transcatheter aortic valve implantation. Int J Cardiol 2016; 217:58-63. [DOI: 10.1016/j.ijcard.2016.04.185] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 04/29/2016] [Accepted: 04/30/2016] [Indexed: 11/16/2022]
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Honda Y, Yamawaki M, Mori S, Shirai S, Makino K, Tokuda T, Maruyama T, Takafuji H, Takama T, Tsutumi M, Sakamoto Y, Takimura H, Kobayashi N, Araki M, Hirano K, Sakai T, Ito Y. Frequency and predictors of bleeding events after 2nd generation drug-eluting stent implantation differ depending on time after implantation. J Cardiol 2016; 69:632-639. [PMID: 27371500 DOI: 10.1016/j.jjcc.2016.05.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 04/29/2016] [Accepted: 05/27/2016] [Indexed: 01/29/2023]
Abstract
BACKGROUND Antiplatelet therapy is required after drug-eluting stent (DES) implantation, but bleeding events occur unexpectedly. We aimed to assess whether bleeding event predictors after 2nd generation DES (2nd DES) implantation differed by time after implantation. METHODS We studied 1912 consecutive patients who underwent successful 2nd DES implantation (70±10 years, 72% male). Bleeding events were recorded as early (≤1 year) and late (>1 year). Major bleeding events were defined as a composite of type 5, 3, and 2 bleeding in the Bleeding Academic Research Consortium criteria. Predictors were assessed using a Cox proportional hazard model. RESULTS Bleeding event rates were 3.3%, 5.1%, and 6.7% at 1, 2, and 3 years, respectively, with the highest 1-year rate in year 1 (p<0.001). Cause and severity of bleeding events were similar between early and late bleeding events. Prior history of gastrointestinal bleeding, non-steroidal anti-inflammatory drug use, and triple antithrombotic therapy [adjusted risk ratio (RR): 3.68, 3.21, 4.57, respectively; p<0.01] were independent predictors of early bleeding events. Age >80 years and severe renal dysfunction (adjusted RR: 2.27, 2.02, respectively; p<0.01) were independent predictors of late bleeding events. Survival rate was significantly lower in patients with bleeding events compared with patients without bleeding events (82.4% vs 90.1%; p<0.001). CONCLUSION Frequency and predictors of bleeding events after 2nd DES implantation differ by time after implantation. Treatment strategies corresponding to individual patients are required.
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Shigemitsu S, Ito Y, Sakai T, Hirano K, Yamawaki M, Araki M, Kobayashi N, Takimura H, Sakamoto Y, Mori S, Tsutsumi M, Takama T, Takafuji H, Maruyama T, Honda Y, Makino K, Tokuda T. FREQUENCY AND PREDICTORS OF WOUND FORMATION IN RUTHERFORD CATEGORY 4 PATIENTS AFTER ENDOVASCULAR THERAPY. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)32330-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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145
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Makino K, Ito Y, Hirano K, Yamawaki M, Araki M, Kobayashi N, Takimura H, Sakamoto Y, Mori S, Tsutsumi M, Takama T, Takafuji H, Honda Y, Tokuda T. TECHNICAL EFFICACY OF ULTRASOUND-GUIDED TIBIAL ARTERY END VASCULAR INTERVENTIONS FOR CHRONIC TOTAL OCCLUSION LESIONS IN CRITICAL LIMB ISCHEMIA. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)32253-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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146
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Tokuda T, Yamawaki M, Takahara M, Mori S, Makino K, Honda Y, Takafuji H, Takama T, Tsutsumi M, Sakamoto Y, Takimura H, Kobayashi N, Araki M, Hirano K, Ito Y. Comparison of Long-Term Clinical Outcomes of Lesions Exhibiting Focal and Segmental Peri-Stent Contrast Staining. J Am Heart Assoc 2016; 5:e002878. [PMID: 26994133 PMCID: PMC4943264 DOI: 10.1161/jaha.115.002878] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Peri‐stent contrast staining (PSS) after metallic drug‐eluting stent deployment is associated with target lesion revascularization and very late stent thrombosis. However, the type of PSS that influences the clinical outcomes is unknown. Therefore, we aimed to reveal which PSS type was influencing clinical outcomes. Methods and Results This study included 5580 de novo lesions of 4405 patients who were implanted with a first‐ or second‐generation drug‐eluting stent and who were evaluated using follow‐up angiography within 12 months after stent implantation. We compared the clinical outcomes of patients divided into focal PSS and segmental PSS groups for 6 years after stent implantation. Total PSS was observed in 97 lesions (2.2%), of which 42 and 55 lesions were focal and segmental PSS, respectively. Baseline characteristics were similar between groups, except for intraoperative chronic total occlusion (segmental PSS=47.3% versus focal PSS=11.9%, P=0.0001). The incidence of segmental PSS tended to be higher in patients with a first‐generation drug‐eluting stent (83.6% versus 16.4%, P=0.05). The cumulative incidence of stent thrombosis in the 6 years of segmental PSS group was significantly higher than that of the focal PSS group (13.9% versus 0%, P=0.04). The cumulative incidence of overall target lesion revascularization for restenosis, excluding target lesion revascularization procedures for stent thrombosis, was significantly higher in the segmental PSS group (38.0% versus 0%, P=0.01). Conclusions The incidence of segmental PSS tended to be higher in patients with a first‐generation drug‐eluting stent and appeared to be significantly associated with target lesion revascularization and stent thrombosis.
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147
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Kobayashi N, Ito Y, Hirano K, Yamawaki M, Araki M, Sakai T, Takimura H, Sakamoto Y, Mori S, Tsutsumi M, Takama T, Takafuji H, Maruyama T, Honda Y, Tokuda T, Makino K, Shirai S, Muramatsu T. Comparison of first- and second-generation drug-eluting stent efficacies for treating left main and/or three-vessel disease: a propensity matched study. Heart Vessels 2016; 31:1930-1942. [DOI: 10.1007/s00380-016-0824-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 02/19/2016] [Indexed: 12/21/2022]
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148
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Kobayashi N, Hirano K, Nakano M, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Yamawaki M, Araki M, Takimura H, Sakamoto Y. Development and validation of a new scoring system to predict wound healing after endovascular therapy in critical limb ischemia with tissue loss. J Endovasc Ther 2016; 22:48-56. [PMID: 25775680 DOI: 10.1177/1526602814564370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To develop a scoring system to predict wound healing in critical limb ischemia (CLI) patients treated with endovascular therapy (EVT). METHODS Between July 2007 and January 2013, 184 patients (118 men; mean age 73.0 years) with CLI (217 limbs) and tissue loss underwent EVT. From this cohort 236 separate wounds were divided into development (n = 118) and validation (n = 118) groups. Predictors of wound healing were identified using multivariable analysis. Each predictor was assigned a score based on its regression coefficient, and total scores were calculated, ranging from 0 to 1 for low risk up to ≥ 4 for high risk of a nonhealing wound. The performance of the scoring system in the prediction of wound healing was evaluated by calculating the area under the receiver operating characteristics (ROC) curve. RESULTS By multivariable analysis, a University of Texas grade ≥ 2 (HR 0.524, 95% CI 0.288-0.951, p = 0.034), an infected wound (HR 0.497, 95% CI 0.276-0.894, p = 0.020), dependence on hemodialysis (HR 0.459, 95% CI 0.259-0.814, p = 0.008), no visible blood flow to the wound (HR 0.343, 95% CI 0.146-0.802, p = 0.014), and major tissue loss (HR 0.322, 95% CI 0.165-0.630, p = 0.001) predicted a non-healing wound. The 1-year rates of wound healing in the low-, intermediate-, and high-risk groups were 94.6%, 67.6%, and 9.1%, respectively, in the development group (p < 0.001) and 92.3%, 70.5%, and 31.3%, respectively, in the validation sample (p < 0.001). The area under the ROC curve was 0.922 in the development group and 0.808 in the validation sample. CONCLUSION This scoring system reliably predicts wound healing in CLI patients after endovascular revascularization and is potentially helpful in deciding if additional adjuncts or revascularization should be considered.
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Tokuda T, Yamawaki M, Mori S, Takimura H, Sakamoto Y, Kobayashi N, Araki M, Hirano K, Ito Y. Risk Factors and Clinical Impacts of Peri-Stent Contrast Staining After Second-Generation Drug-Eluting Stent Implantation. J Interv Cardiol 2016; 29:179-87. [PMID: 26822952 DOI: 10.1111/joic.12282] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Peri-stent contrast staining (PSS) after sirolimus-eluting stent implantation is associated with target lesion revascularization (TLR) and very late stent thrombosis. However, the risk factors and clinical sequelae of PSS after second-generation DES implantation remain unclear. METHODS AND RESULTS This study comprised 2,090 patients with 2,883 lesions treated with second-generation DES from April 2009 to February 2013. Angiographic findings and clinical outcomes were compared between PSS and non-PSS groups. Follow-up angiography was available for 2,411 lesions. PSS was observed in 23 lesions: 4 in biolimus-eluting stents, 4 in zotarolimus-eluting stents (ZES), and 15 in everolimus-eluting stents (EES). Right coronary artery lesions, chronic total occlusion (CTO), and lesions with severe angulation (>90°) were more frequent in the PSS group compared with the non-PSS group. Lesions were longer and the cumulative TLR incidence at 3 years was higher in the PSS group than those in the non-PSS group (27.9 mm vs. 19.4 mm, P < 0.0001; 27.4% vs. 8.6%, P = 0.0002). There was no significant difference in stent thrombosis between the two groups. Multivariable analysis identified CTO [odds ratio (OR) 3.75, 95%CI 1.52-8.88, P = 0.005] as an independent predictor of PSS. CONCLUSIONS PSS after second-generation DES implantation was associated with an increased risk of subsequent TLR. CTO was the independent predictor of PSS.
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Yoon SH, Ohno Y, Araki M, Barbanti M, Lin MS, Ahn JM, Yang DH, Kim YH, Immé S, Gulino S, Tamburino CI, Sgroi C, Park DW, Kang SJ, Lee SW, Lee CW, Park SW, Muramatsu T, Kao HL, Tamburino C, Park SJ. Comparison of aortic root anatomy and calcification distribution between Asian and Caucasian patients who underwent transcatheter aortic valve implantation. Am J Cardiol 2015; 116:1566-73. [PMID: 26428022 DOI: 10.1016/j.amjcard.2015.08.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/18/2015] [Accepted: 08/18/2015] [Indexed: 10/23/2022]
Abstract
The current transcatheter aortic valve implantation (TAVI) devices have been designed to fit Caucasian and Latin American aortic root anatomies. We evaluated the racial differences in aortic root anatomy and calcium distribution in patients with aortic stenosis who underwent TAVI. We conducted a multicenter study of 4 centers in Asia and Europe, which includes consecutive patients who underwent TAVI with preprocedural multidetector computed tomography. Quantitative assessment of aortic root dimensions, calcium volume for leaflet, and left ventricular outflow tract were retrospectively performed in a centralized core laboratory. A total of 308 patients (Asian group, n = 202; Caucasian group, n = 106) were analyzed. Compared to Caucasian group, Asian group had smaller annulus area (406.3 ± 69.8 vs 430.0 ± 76.8 mm(2); p = 0.007) and left coronary cusp diameter (30.2 ± 3.2 vs 31.1 ± 3.4 mm; p = 0.02) and lower height of left coronary artery ostia (12.0 ± 2.5 vs 13.4 ± 3.4 mm; p <0.001). Of baseline anatomic characteristics, body height showed the highest correlation with annulus area (Pearson correlation r = 0.64; p <0.001). Co-existence of lower height of left coronary artery ostia (<12 mm) and small diameter of left coronary cusp (<30 mm) were more frequent in Asian group compared with Caucasian group (35.6% vs 20.8%; p = 0.02). In contrast, there were no differences in calcium volumes of leaflet (367.2 ± 322.5 vs 359.1 ± 325.7 mm(3); p = 0.84) and left ventricular outflow tract (8.9 ± 23.4 vs 10.1 ± 23.8 mm(3); p = 0.66) between 2 groups. In conclusion, judicious consideration will be required to perform TAVI for short patients with lower height of left coronary artery ostia and small sinus of Valsalva.
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