1
|
Takimura H, Tajima E, Taniguchi R, Tsuzuki I, Makino K, Yamaguchi Y, Kawano M, Takimura Y, Nishio S, Nakano M, Tsukahara R. Early and Late Ruptured Aneurysm After Endovascular Therapy With Paclitaxel-Coated Balloon. JACC Cardiovasc Interv 2023; 16:3041-3044. [PMID: 37804291 DOI: 10.1016/j.jcin.2023.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/22/2023] [Indexed: 10/09/2023]
Affiliation(s)
| | - Emi Tajima
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | | | - Ippei Tsuzuki
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | - Kenji Makino
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | | | - Mami Kawano
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | - Yukako Takimura
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | - Satoru Nishio
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | | | - Reiko Tsukahara
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| |
Collapse
|
2
|
Takimura H, Taniguchi R, Tsuzuki I, Tajima E, Yamaguchi Y, Kawano M, Takimura Y, Nishio S, Nakano M, Tsukahara R. Impact of the time-to-target rate of urine volume concept on the outcome of acute decompensated heart failure. Int J Cardiol 2023; 379:89-95. [PMID: 36934988 DOI: 10.1016/j.ijcard.2023.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/10/2023] [Accepted: 03/16/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND Early decongestion with diuretics could improve clinical outcomes. This study aimed to examine the impact of the time-to-target rate of urine volume (T2TUV) concept on the outcome of acute decompensated heart failure (ADHF). METHODS This multicenter retrospective study included 1670 patients with ADHF who received diuretics within 24 h of admission. T2TUV was defined as the time from admission to the rate of urine volume of 100 ml/h. The primary outcomes were in-hospital death, mortality, and re-hospitalization for 1 year. RESULTS A total of 789 patients met the inclusion criteria (T2TUV on day 1, n = 248; day 2-3, n = 172; no target rate UV, n = 369). In-hospital mortality in the day 1 group was significantly lower (2.7% vs. 5.9% vs. 11.1%; p < 0.001) than that of other groups. The mortality and re-hospitalization for 1 year in the day 1 group was significantly lower (event-free rate: 67.7% vs. 54.1% vs. 56.9%; log-lank p = 0.004) than that of other groups. In multivariate analysis, predictors of T2TUV at day 1 were age (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01-1.04, p = 0.007), previous hospitalized heart failure (OR: 1.47, 95% CI: [1.03-2.12], p = 0.03), N-terminal-pro B type natriuretic peptide per 1000 pg/ml (OR: 1.02, 95% CI: 1.01-1.04, p = 0.007), carperitide (OR: 0.69, 95% CI: 0.48-0.99, p = 0.05), and early administration of tolvaptan (OR: 0.6, 95% CI: 0.42-0.85, p = 0.004). CONCLUSIONS T2TUV of less than day 1 was associated with lower in-hospital mortality and decreased mortality and re-hospitalization at 1 year.
Collapse
Affiliation(s)
| | | | - Ippei Tsuzuki
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | - Emi Tajima
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | | | - Mami Kawano
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | - Yukako Takimura
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | - Satoru Nishio
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | | | - Reiko Tsukahara
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| |
Collapse
|
3
|
Aihara H, Higashitani M, Takimura H, Tobita K, Jujo K, Hozawa K, Yamaguchi T, Iwata Y, Tokuyama H, Sakurai M, Murata N, Fujimoto Y, Kikuchi A, Koganei H, Sato A, Noguchi Y, Ieda M. Differences in Intravascular Ultrasound Measurement Values Between Treatment Modalities for Restenosis in Femoropopliteal Lesions. Circ J 2020; 84:1320-1329. [PMID: 32581151 DOI: 10.1253/circj.cj-20-0218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The risk of restenosis after intervention is higher in femoropopliteal than in aortoiliac lesions. However, the appropriate endovascular therapy (EVT) for preventing restenosis after intervention for femoropopliteal lesions remains unknown. This study aimed to elucidate the relationship between lesion characteristics and patency after EVT using intravascular ultrasound (IVUS) measurement and to determine the predictors of restenosis on IVUS.Methods and Results:This prospective observational study was performed at 18 Japanese centers. We evaluated the lesion characteristics before and after EVT for femoropopliteal lesion using IVUS. Angiographic or duplex ultrasound follow-up was performed at 1 year after EVT. A total of 263 lesions underwent EVT between December 2016 and December 2017. In total, 20 lesions (8 cases of isolated common femoral artery lesion and 12 cases of restenosis lesion) were excluded, and 243 lesions were enrolled in this study. A total of 181 lesions were treated with stent placement, and 62 lesions were treated only with balloon angioplasty. In the case of stent use, a larger distal plaque burden was associated with restenosis, while a lower calcification angle was associated with higher patency in the case of balloon angioplasty alone. CONCLUSIONS The factors related to patency differed depending on the treating modality. The findings suggest that IVUS is a useful tool for predicting patency because it can provide a more accurate evaluation after EVT for femoropopliteal lesions.
Collapse
Affiliation(s)
- Hideaki Aihara
- Department of Cardiology, Tsukuba Medical Center Hospital
| | | | | | - Kazuki Tobita
- Department of Cardiology, Shonan Kamakura General Hospital
| | - Kentaro Jujo
- Department of Cardiology, Nishiarai Heart Center Hospital
| | - Koji Hozawa
- Department of Cardiology, New Tokyo Hospital
| | | | - Yo Iwata
- Department of Cardiology, Funabashi Municipal Medical Center
| | - Hideo Tokuyama
- Department Cardiology, Kawaguchi Cardiovascular and Respiratory Hospital
| | | | - Naotaka Murata
- Department of Cardiology, Tokyo Medical University Hospital
| | - Yo Fujimoto
- Department of Cardiology, Toranomon Hospital
| | - Arifumi Kikuchi
- Department Cardiology, Nippon Medical School Musashi Kosugi Hospital
| | - Hiroshi Koganei
- Department of Cardiology, Cardiovascular Center, Ogikubo Hospital
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Yuichi Noguchi
- Department of Cardiology, Tsukuba Medical Center Hospital
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| |
Collapse
|
4
|
Takimura H, Nakano M, Tajima E, Yamaguchi Y, Kawano M, Tsukahara R. First-in-man short-term optical frequency domain imaging of new-generation fluoropolymer-based paclitaxel-eluting stents after endovascular therapy. Cardiovasc Interv Ther 2020; 36:260-262. [PMID: 32323258 DOI: 10.1007/s12928-020-00667-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 04/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Hideyuki Takimura
- Department of Cardiology, Tokyo General Hospital, 3-15-2 Egota, Nakano-ku, Tokyo, 165-0022, Japan.
| | - Masatsugu Nakano
- Department of Cardiology, Tokyo General Hospital, 3-15-2 Egota, Nakano-ku, Tokyo, 165-0022, Japan
| | - Emi Tajima
- Department of Cardiology, Tokyo General Hospital, 3-15-2 Egota, Nakano-ku, Tokyo, 165-0022, Japan
| | - Yukihiro Yamaguchi
- Department of Cardiology, Tokyo General Hospital, 3-15-2 Egota, Nakano-ku, Tokyo, 165-0022, Japan
| | - Mami Kawano
- Department of Cardiology, Tokyo General Hospital, 3-15-2 Egota, Nakano-ku, Tokyo, 165-0022, Japan
| | - Reiko Tsukahara
- Department of Cardiology, Tokyo General Hospital, 3-15-2 Egota, Nakano-ku, Tokyo, 165-0022, Japan
| |
Collapse
|
5
|
Yabe T, Muramatsu T, Tsukahara R, Nakano M, Takimura H, Kawano M, Hada T, Ikeda T. The impact of percutaneous coronary intervention using the novel dynamic coronary roadmap system. Heart Vessels 2020; 35:323-330. [PMID: 31522247 DOI: 10.1007/s00380-019-01502-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 09/06/2019] [Indexed: 10/26/2022]
Abstract
The dynamic coronary roadmap (DCR) is a novel technology that creates a dynamic, motion-compensated, real-time overlay of the coronary arteries on a fluoroscopic image. Whether the DCR reduces contrast volume and enables safe and effective treatment was examined. A total of 146 patients undergoing percutaneous coronary intervention (PCI) from June 2017 to September 2017 in our hospital were retrospectively evaluated. Chronic total occlusion lesions, acute coronary syndrome, and hemodialysis patients were excluded. Patients were divided into the control group (PCI without DCR, 92 patients, 103 lesions) and the DCR group (38 patients, 43 lesions). The primary endpoint was contrast medium volume, and secondary endpoints were radiation dose, fluoroscopy time, and clinical success rate. There was no significant difference in the success rate (100% vs. 100%, P = 1.000) between the groups. Fluoroscopy time (16.3 ± 11.2 min. vs. 11.4 ± 5.5 min, P = 0.007) and contrast medium volume (152.1 ± 73.0 ml vs. 118.8 ± 49.7 ml, P = 0.006) were significantly lower in the DCR group than in the control group. DCR use during PCI was associated with a significant reduction in contrast volume and fluoroscopy time compared to a control group despite similar clinical, lesion, and procedural characteristics.
Collapse
Affiliation(s)
- Takayuki Yabe
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
- Cardiology, Tokyo General Hospital, Tokyo, Japan.
| | | | | | | | | | - Mami Kawano
- Cardiology, Tokyo General Hospital, Tokyo, Japan
| | - Tasuku Hada
- Cardiology, Tokyo General Hospital, Tokyo, Japan
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan
| |
Collapse
|
6
|
Kodama K, Sakamoto T, Kubota T, Takimura H, Hongo H, Chikashima H, Shibasaki Y, Yada T, Node K, Nakayama T, Nakao K. Construction of a Heart Failure Database Collating Administrative Claims Data and Electronic Medical Record Data to Evaluate Risk Factors for In-Hospital Death and Prolonged Hospitalization. Circ Rep 2019; 1:582-592. [PMID: 33693104 PMCID: PMC7897689 DOI: 10.1253/circrep.cr-19-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background:
Clinical studies on heart failure (HF) using diagnosis procedure combination (DPC) databases have attracted attention recently, but data obtained from such databases may lack important information essential for determining the severity of HF. Methods and Results:
Using a HF database that collates DPC data and electronic medical records from 3 hospitals in Japan, we investigated factors contributing to prolonged hospitalization and in-hospital death, based on clinical characteristics and data obtained early during hospitalization in 2,750 Japanese patients with HF hospitalized between 2011 and 2015. Mean age was 77.0±13.0 years; 55.3% (n=1,520) were men, and 39.1% (n=759) had left ventricular ejection fraction <40%. In-hospital mortality was 6.0% (n=164) and mean length of stay for patients who were discharged alive was 18.2±13.7 days (median, 15 days). Factors contributing to in-hospital death were advanced age, higher New York Heart Association (NYHA) class, low albumin and sodium, and high creatinine and C-reactive protein (CRP). Factors contributing to prolonged hospitalization were higher NYHA class, low Barthel index, low albumin, and high B-type natriuretic peptide, lactate dehydrogenase, and CRP. Conclusions:
We have constructed a database of HF hospitalized patients in acute care hospitals in Japan. This approach may be helpful to address clinical parameters of HF patients in any acute care hospital in Japan.
Collapse
Affiliation(s)
- Kazuhisa Kodama
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center
| | - Tomohiro Sakamoto
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center
| | - Toru Kubota
- Division of Cardiology, Saiseikai Fukuoka General Hospital
| | | | - Hiroshi Hongo
- Division of Cardiology, Saiseikai Fukuoka General Hospital
| | | | | | - Toru Yada
- Statistical Analysis Department 1, EPS Corporation
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Takeo Nakayama
- Department of Health Informatics Kyoto University School of Public Health
| | - Koichi Nakao
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center
| |
Collapse
|
7
|
Takimura H, Hada T, Kawano M, Yabe T, Takimura Y, Nishio S, Nakano M, Tsukahara R, Muramatsu T. A novel validated method for predicting the risk of re-hospitalization for worsening heart failure and the effectiveness of the diuretic upgrading therapy with tolvaptan. PLoS One 2018; 13:e0207481. [PMID: 30427915 PMCID: PMC6235362 DOI: 10.1371/journal.pone.0207481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 10/31/2018] [Indexed: 11/19/2022] Open
Abstract
Increased re-hospitalization due to acute decompensated heart failure (ADHF) is a modern issue in cardiology. The aim of this study was to investigate risk factors for re-hospitalization due to worsening heart failure, and the effect of tolvaptan (TLV) on decreasing the number of re-hospitalizations. This was a multicenter, retrospective study. The re-hospitalization factors for 1191 patients with ADHF were investigated; patients receiving continuous administration of TLV when they were discharged from the hospital (n = 194) were analyzed separately. Patients were classified into 5 risk groups based on their calculated Preventing Re-hospitalization with TOLvaptan (Pretol) score. The total number of patients re-hospitalized due to worsening heart failure up to one year after discharge from the hospital was 285 (23.9%). Age ≥80 years, duration since discharge from the hospital after previous heart failure <6 months, diabetes mellitus, hemoglobin <10 g/dl, uric acid >7.2 mg/dl, left ventricular ejection fraction (LVEF) <40%, left atrial volume index (LAVI) >44.7 ml/m2, loop diuretic dose ≥20 mg/day, hematocrit <31.6%, and estimated glomerular filtration rate (eGFR) <50 ml/min/1.73m2 were independent risk factors for re-hospitalization for worsening heart failure. There was a significant reduction in the re-hospitalization rate among TLV treated patients in the Risk 3 group and above. In conclusions, age, duration since previous heart failure, diabetes mellitus, hemoglobin, uric acid, LVEF, LAVI, loop diuretic dose, hematocrit, and eGFR were all independent risk factors for re-hospitalization for worsening heart failure. Long-term administration of TLV significantly decreases the rate of re-hospitalization for worsening heart failure in patients with a Pretol score of 7.
Collapse
Affiliation(s)
- Hideyuki Takimura
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
- * E-mail:
| | - Tasuku Hada
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | - Mami Kawano
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | - Takayuki Yabe
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | - Yukako Takimura
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | - Satoru Nishio
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | | | - Reiko Tsukahara
- Department of Cardiology, Tokyo General Hospital, Tokyo, Japan
| | | |
Collapse
|
8
|
Higashimori A, Takahara M, Utsunomiya M, Fukunaga M, Kawasaki D, Mori S, Takimura H, Hirano K, Tsubakimoto Y, Nakama T, Yokoi Y. Utility of indigo carmine angiography in patients with critical limb ischemia: Prospective multi-center intervention study (DIESEL-study). Catheter Cardiovasc Interv 2018; 93:108-112. [PMID: 30144339 DOI: 10.1002/ccd.27813] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/23/2018] [Accepted: 07/14/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To assess the efficacy of indigo carmine angiography for wound healing after successful below-the-knee intervention in patients with critical limb ischemia (CLI). METHODS A multi-center prospective intervention study was conducted. Fifty-four limbs of 53 patients in Rutherford categories 5 and 6 underwent endovascular therapy (EVT). After successful EVT, 5 mL of indigo carmine was injected through a catheter at the distal popliteal artery and color changes in the foot were evaluated. The results of indigo carmine angiography were divided into three groups: In type I, the color change of the wound was deeper than the surrounding tissue; in type II, the change in wound color was similar to the surrounding tissue; and in type III, no discoloration of the wound was observed by the indigo carmine. RESULTS The wound healing rates at 3 months were 78% (25/32) for type I, 70% (7/10) for type II, and 42% (5/12) for type III (P for trend = 0.025). Indigo carmine angiography-related complications were not seen. CONCLUSION Indigo carmine angiography was found to be a safe and useful procedure to provide visual information on foot perfusion. This dye coloring method demonstrated that after successful angioplasty, the perfused area was made visible at the microcirculation level. Indigo carmine angiography can thus be considered an important predictor for wound healing by EVT in patients with CLI.
Collapse
Affiliation(s)
- Akihiro Higashimori
- Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Osaka Prefecture, Japan
| | - Mitsuyoshi Takahara
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Osaka Prefecture, Japan
| | | | - Masashi Fukunaga
- Department of Cardiology, Morinomiya Hospital, Osaka, Osaka Prefecture, Japan
| | - Daizo Kawasaki
- Department of Cardiology, Morinomiya Hospital, Osaka, Osaka Prefecture, Japan
| | - Shinsuke Mori
- Department of Cardiology, Saisekikai Tobu Hospital, Yokohama, Kanagawa Prefecture, Japan
| | | | - Keisuke Hirano
- Department of Cardiology, Saisekikai Tobu Hospital, Yokohama, Kanagawa Prefecture, Japan
| | - Yoshinori Tsubakimoto
- Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Kyoto Prefecture, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Miyazaki Medical Association Hospital, Miyazaki-City, Miyazaki, Japan
| | - Yoshiaki Yokoi
- Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Osaka Prefecture, Japan
| |
Collapse
|
9
|
Yabe T, Muramatsu T, Tsukahara R, Nakano M, Takimura Y, Takimura H, Kawano M, Hada T. THE IMPACT OF PERCUTANEOUS CORONARY INTERVENTION USING THE NOVEL DYNAMIC CORONARY ROADMAP SYSTEM. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31644-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
10
|
Takimura H, Muramatsu T, Tsukahara R, Nakano M, Nishio S, Takimura Y, Yabe T, Kawano M, Hata T. TCT-764 Usefulness of the Novel Ultrasonography Guided Central Wiring Technique in Endovascular Therapy for Chronic Total Occlusion of Femoro-popliteal Arteries. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.1003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
11
|
Tokuda T, Hirano K, Yamawaki M, Araki M, Kobayashi N, Mori S, Sakamoto Y, Takimura H, Tsutsumi M, Ito Y. Efficacy and safety of a coagulated thrombus injection for peripheral artery perforation: The coagulated thrombus hemostasis method. Catheter Cardiovasc Interv 2017; 91:302-307. [DOI: 10.1002/ccd.27163] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 12/22/2016] [Accepted: 06/05/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Takahiro Tokuda
- Department of Cardiovascular Medicine; Saiseikai Yokohama City Eastern Hospital; Yokohama Kanagawa Japan
| | - Keisuke Hirano
- Department of Cardiovascular Medicine; Saiseikai Yokohama City Eastern Hospital; Yokohama Kanagawa Japan
| | - Masahiro Yamawaki
- Department of Cardiovascular Medicine; Saiseikai Yokohama City Eastern Hospital; Yokohama Kanagawa Japan
| | - Motoharu Araki
- Department of Cardiovascular Medicine; Saiseikai Yokohama City Eastern Hospital; Yokohama Kanagawa Japan
| | - Norihiro Kobayashi
- Department of Cardiovascular Medicine; Saiseikai Yokohama City Eastern Hospital; Yokohama Kanagawa Japan
| | - Shinsuke Mori
- Department of Cardiovascular Medicine; Saiseikai Yokohama City Eastern Hospital; Yokohama Kanagawa Japan
| | - Yasunari Sakamoto
- Department of Cardiovascular Medicine; Saiseikai Yokohama City Eastern Hospital; Yokohama Kanagawa Japan
| | - Hideyuki Takimura
- Department of Cardiovascular Medicine; Saiseikai Yokohama City Eastern Hospital; Yokohama Kanagawa Japan
| | - Masakazu Tsutsumi
- Department of Cardiovascular Medicine; Saiseikai Yokohama City Eastern Hospital; Yokohama Kanagawa Japan
| | - Yoshiaki Ito
- Department of Cardiovascular Medicine; Saiseikai Yokohama City Eastern Hospital; Yokohama Kanagawa Japan
| |
Collapse
|
12
|
Yabe T, Muramatsu T, Nakano M, Takimura H. TCTAP A-074 The Clinical Outcome of Percutaneous Coronary Intervention for Very Elderly Ischemic Coronary Artery Disease Patients in Japan. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.03.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
13
|
Yabe T, Muramatsu T, Nakano M, Takimura H. TCTAP C-172 A Patient with High SYNTAX Score and Chronic Total Occlusion Who Was Able to be Treated by the Bi-radial Approach Using 7Fr GLIDESHEATH. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.03.403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
14
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- Norihiro Kobayashi
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, Kanagawa, Japan.
| | - Keisuke Hirano
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, Kanagawa, Japan
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, Kanagawa, Japan
| | - Motoharu Araki
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, Kanagawa, Japan
| | - Hideyuki Takimura
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, Kanagawa, Japan
| | - Yasunari Sakamoto
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, Kanagawa, Japan
| | - Shinsuke Mori
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, Kanagawa, Japan
| | - Yoshiaki Ito
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, Kanagawa, Japan
| |
Collapse
|
15
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- Takahiro Tokuda
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan.
| | - Keisuke Hirano
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Yasunari Sakamoto
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Hideyuki Takimura
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Norihiro Kobayashi
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Motoharu Araki
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Masahiro Yamawaki
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Yoshiaki Ito
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| |
Collapse
|
16
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- Norihiro Kobayashi
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Japan.
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Japan
| | | | - Keisuke Hirano
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Japan
| | - Motoharu Araki
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Japan
| | - Hideyuki Takimura
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Japan
| | - Yasunari Sakamoto
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Japan
| | - Shinsuke Mori
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Japan
| | - Masakazu Tsutsumi
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Japan
| | - Yoshiaki Ito
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Japan
| |
Collapse
|
17
|
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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
18
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- Yohsuke Honda
- Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan
| | - Keisuke Hirano
- Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan
| | | | - Shinsuke Mori
- Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan
| | | | - Kenji Makino
- Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan
| | - Takahiro Tokuda
- Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan
| | - Takuro Takama
- Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan
| | | | | | | | | | - Motoharu Araki
- Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan
| | - Yoshiaki Ito
- Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan
| |
Collapse
|
19
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- Shinsuke Mori
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital
| | - Keisuke Hirano
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital
| | - Yoshiaki Ito
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital
| | | | - Motoharu Araki
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital
| | | | | | | | | | - Takuro Takama
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital
| | - Yohsuke Honda
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital
| | - Takahiro Tokuda
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital
| | - Kenji Makino
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital
| | | |
Collapse
|
20
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- Norihiro Kobayashi
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Keisuke Hirano
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Motoharu Araki
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Tsuyoshi Sakai
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Hideyuki Takimura
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Yasunari Sakamoto
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Shinsuke Mori
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Masakazu Tsutsumi
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Takuro Takama
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Yohsuke Honda
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Takahiro Tokuda
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Kenji Makino
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Shigemitsu Shirai
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| | - Yoshiaki Ito
- Department of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Yokohama, Japan
| |
Collapse
|
21
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- Yohsuke Honda
- Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan.
| | | | - Shinsuke Mori
- Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
| | | | - Kenji Makino
- Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
| | | | | | | | - Takuro Takama
- Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
| | | | | | | | | | - Motoharu Araki
- Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
| | - Keisuke Hirano
- Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
| | - Tsuyoshi Sakai
- Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
| | - Yoshiaki Ito
- Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
| |
Collapse
|
22
|
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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
23
|
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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
24
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- Takahiro Tokuda
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Masahiro Yamawaki
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Mitsuyohi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Shinsuke Mori
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Kenji Makino
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Yosuke Honda
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Hiroya Takafuji
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Takuro Takama
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Masakazu Tsutsumi
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Yasunari Sakamoto
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Hideyuki Takimura
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Norihiro Kobayashi
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Motoharu Araki
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Keisuke Hirano
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Yoshiaki Ito
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| |
Collapse
|
25
|
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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 02/19/2016] [Indexed: 12/21/2022]
|
26
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
| | - Keisuke Hirano
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | | | | | | | - Yoshiaki Ito
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | | | | | - Motoharu Araki
- Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | | | | |
Collapse
|
27
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
Affiliation(s)
- Takahiro Tokuda
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Masahiro Yamawaki
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Shinsuke Mori
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Hideyuki Takimura
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Yasunari Sakamoto
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Norihiro Kobayashi
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Motoharu Araki
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Keisuke Hirano
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| | - Yoshiaki Ito
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Yokohama, Kanagawa, Japan
| |
Collapse
|
28
|
Kobayashi N, Ito Y, Nakano M, Araki M, Hirano K, Yamawaki M, Takimura H, Sakamoto Y, Tsukahara R, Muramatsu T. Incidence and Characteristics of Late Catch-Up Phenomenon Between Sirolimus-Eluting Stent and Everolimus-Eluting Stent: A Propensity Matched Study. J Interv Cardiol 2015; 28:551-62. [DOI: 10.1111/joic.12247] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Norihiro Kobayashi
- Department of Cardiology; Saiseikai Yokohama-City Eastern Hospital; Yokohama Kanagawa Japan
| | - Yoshiaki Ito
- Department of Cardiology; Saiseikai Yokohama-City Eastern Hospital; Yokohama Kanagawa Japan
| | | | - Motoharu Araki
- Department of Cardiology; Saiseikai Yokohama-City Eastern Hospital; Yokohama Kanagawa Japan
| | - Keisuke Hirano
- Department of Cardiology; Saiseikai Yokohama-City Eastern Hospital; Yokohama Kanagawa Japan
| | - Masahiro Yamawaki
- Department of Cardiology; Saiseikai Yokohama-City Eastern Hospital; Yokohama Kanagawa Japan
| | - Hideyuki Takimura
- Department of Cardiology; Saiseikai Yokohama-City Eastern Hospital; Yokohama Kanagawa Japan
| | - Yasunari Sakamoto
- Department of Cardiology; Saiseikai Yokohama-City Eastern Hospital; Yokohama Kanagawa Japan
| | - Reiko Tsukahara
- Department of Cardiology; General Tokyo Hospital; Tokyo Japan
| | - Toshiya Muramatsu
- Department of Cardiology; Saiseikai Yokohama-City Eastern Hospital; Yokohama Kanagawa Japan
| |
Collapse
|
29
|
Takimura H, Hirano K, Muramatsu T, Tsukahara R, Ito Y, Sakai T, Ishimori H, Nakano M, Yamawaki M, Araki M, Kato T, Kobayashi N, Sakamoto Y, Ishii A, Takama T, Tokuda T. Vascular elastography: a novel method to characterize occluded lower limb arteries prior to endovascular therapy. J Endovasc Ther 2015; 21:654-61. [PMID: 25290793 DOI: 10.1583/13-4487mr.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To examine the effectiveness of vascular elastography (VE) for the assessment of totally occluded lower limb arteries prior to endovascular treatment (EVT). METHODS Of 812 consecutive patients who underwent EVT between April 2010 and April 2012, VE was used to evaluate the hardness of chronic total occlusions of the femoropopliteal segment prior to EVT in 65 consecutive patients (48 men; mean 73.9 years, range 63-86). Elastograms of the CTOs proximally and distally were scored using a 5-point scale, and outcomes in limbs with hard lesions (VE score 0-2) were compared to those with soft lesions (VE score 3-4) according to lesion length. The interventionists who performed the endovascular procedures were not informed of the VE score results. RESULTS CTO characteristics could be evaluated in all cases. A VE score ≤2 was found in 14 of the 23 lesions <150 mm in length. A flexible guidewire was sufficient for recanalization in more of the soft lesions than in the hard lesions [6/9 vs. 2/14, respectively]. In 39 lesions >150 mm, a VE score of 3 was recorded in most lesions proximally, while lesions distally were hard in many cases (VE score 1 or 2). A flexible guidewire alone was sufficient in many soft CTOs (8/13, p<0.01). In 16 cases, hard calcified plaque was indicated by difficulty in penetrating the lesion even with a stiff guidewire; all these cases had a VE score of 1 or 2. A retrograde approach was required only in hard CTOs (p<0.01). The procedure time was significantly longer for the hard lesion group (152.9±63.2 vs. 87.0±29.8 minutes, p=0.001). In 11 in-stent occlusions, only VE scores of 3 (n=4) or 4 (n=7) were recorded, indicating soft thrombus, which was aspirated under distal protection in 7 cases. CONCLUSION VE may be a useful method for determining the hardness of CTO lesions noninvasively before endovascular therapy, providing information that can help plan the procedure.
Collapse
Affiliation(s)
- Hideyuki Takimura
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Honda Y, Muramatsu T, Ito Y, Sakai T, Hirano K, Yamawaki M, Araki M, Kobayashi N, Takimura H, Sakamoto Y, Mouri S, Tsutumi M, Takama T, Takafuji H, Tokuda T, Makino K. Impact of ultra-long second-generation drug-eluting stent implantation. Catheter Cardiovasc Interv 2015; 87:E44-53. [DOI: 10.1002/ccd.26010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/08/2015] [Accepted: 04/11/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Yohsuke Honda
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Toshiya Muramatsu
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Yoshiaki Ito
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Tsuyoshi Sakai
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Keisuke Hirano
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Masahiro Yamawaki
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Motoharu Araki
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | | | - Hideyuki Takimura
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Yasunari Sakamoto
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Shinsuke Mouri
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Masakazu Tsutumi
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Takuro Takama
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Hiroya Takafuji
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Takahiro Tokuda
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| | - Kenji Makino
- Saiseikai Yokohama City Eastern Hospital; Yokohama City Kanagawa Japan
| |
Collapse
|
31
|
Tokuda T, Muramatsu T, Ishimori H, Hirano K, Nakano M, Yamawaki M, Araki M, Kobayashi N, Takimura H, Sakamoto Y, Mori S, Tsutsumi M, Takafuji H, Takama T, Honda Y. TCTAP A-058 The Changes and Clinical Outcomes of Peri-Contrast Staining (PSS) in First Generation DES Era to Second Generation DES Era. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.03.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
32
|
Tsutsumi M, Muramatsu T, Ishimori H, Hirano K, Nakano M, Yamawaki M, Araki M, Kobayashi N, Takimura H, Sakamoto Y, Mori S, Takama T, Takafuji H, Honda Y, Tokuda T. TCTAP A-149 Clinical Outcome of Drug-Eluting Stent Implantation for Isolated Left Circumflex Ostial Stenosis. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.03.224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
33
|
Tokuda T, Hirano K, Muramatsu T, Ishimori H, Nakano M, Yamawaki M, Araki M, Kobayashi N, Takimura H, Sakamoto Y, Mori S, Tsutsumi M, Takafuji H, Takama T, Honda Y. TCTAP A-098 The Clinical Outcomes of EVT for Restenosis of Superficial Femoral Artery Stent with Jailed Deep Femoral Artery. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.03.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
34
|
Tokuda T, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Yamawaki M, Araki M, Kobayashi N, Takimura H, Sakamoto Y, Tsutsumi M, Takafuji H, Takama T. THE RELEVANCE TO CLINICAL OUTCOMES AND RISK FACTORS OF PERI-CONTRAST STAINING (PSS) AFTER SECOND GENERATION DES DEPLOYMENT. J Am Coll Cardiol 2015. [DOI: 10.1016/s0735-1097(15)61602-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
35
|
Kobayashi N, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Yamawaki M, Araki M, Takimura H, Sakamoto Y. Influence of hemodialysis duration on mid-term clinical outcomes in hemodialysis patients with coronary artery disease after drug-eluting stent implantation. Heart Vessels 2014; 31:330-40. [PMID: 25523891 DOI: 10.1007/s00380-014-0615-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 12/12/2014] [Indexed: 11/29/2022]
Abstract
Accelerated atherosclerosis in prolonged maintenance hemodialysis (HD) has been recognized; however, whether HD duration is associated with poor clinical outcome in HD patients with coronary artery disease (CAD) after drug-eluting stent (DES) implantation is unknown. We evaluated the impact of HD duration on clinical outcomes in HD patients with CAD after DES implantation. Between April 2007 and December 2012, 168 angina pectoris patients (320 de novo lesions) on HD were treated with DES. Major adverse cardiovascular events (MACE) and target lesion revascularization (TLR) were investigated at 3 years according to the HD duration (≤ 3 years, 83 patients; >3 years, 85 patients). The incidence of MACE was significantly higher in the long HD duration group (25.3 vs. 50.6 %; P = 0.001). Especially, sudden cardiac death (SCD) was significantly higher in the long HD duration group (3.6 vs. 16.5 %; P = 0.006). On the other hand, the rates of TLR were similar between the two groups (12.0 vs. 14.1 %; P = 0.69). Cox's proportional hazard analysis revealed that HD duration (HR 1.08 per year, 95 % CI 1.03-1.13, P = 0.002), β-blocker use (0.28, 0.17-0.46, P < 0.001), and diabetes mellitus (2.10, 1.23-3.56, P = 0.007) were independent predictors of MACE. Longer HD duration did not affect TLR; however, SCD was significantly higher in the long HD duration group.
Collapse
Affiliation(s)
- Norihiro Kobayashi
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan.
| | - Toshiya Muramatsu
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Reiko Tsukahara
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Yoshiaki Ito
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Hiroshi Ishimori
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Keisuke Hirano
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Masatsugu Nakano
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Motoharu Araki
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Hideyuki Takimura
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Yasunari Sakamoto
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| |
Collapse
|
36
|
Takama T, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Nakano M, Hirano K, Araki M, Yamawaki M, Kobayashi N, Mori S, Takafuji H, Tsutsumi M, Takimura H, Sakamoto Y, Tokuda T. TCT-392 Relation Between Malapposition And Thrombus In ST-segment Elevation Myocardial Infarction using Optical Coherence Tomography. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
37
|
Tokuda T, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Araki M, Kobayashi N, Takimura H, Sakamoto Y, Mori S, Tsutsumi M, Takafuji H. TCT-651 The Relevance to Clinical Outcomes of Stent Fracture after Second Generation DES deployment. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
38
|
Mori S, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Yamawaki M, Araki M, Kobayashi N, Takimura H, Sakamoto Y, Tsutsumi M, Takama T, Takafuji H, Honda Y, Tokuda T, Makino K. TCT-544 Post-Procedural Intravascular Ultrasound Findings on Short-Term Outcomes of Drug-Eluting Stent Implantation for Femoropopliteal Lesions. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
39
|
Tsutsumi M, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Yamawaki M, Araki M, Kobayashi N, Takimura H, Sakamoto Y, Mori S, Takafuji H, Takama T, Honda Y, Tokuda T. TCT-543 Middle-Term Clinical Outcome of Femoropopliteal Stenting with Drug-Eluting Stent for Diabetic Patients. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
40
|
Tokuda T, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Araki M, Kobayashi N, Takimura H, Sakamoto Y, Mori S, Tsutsumi M, Takafuji H. TCT-88 The Clinical Outcomes of Peri-contrast Staining (PSS) after Second Generation DES Implantation. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
41
|
Tsutsumi M, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Yamawaki M, Araki M, Kato T, Kobayashi N, Takimura H, Sakamoto Y, Mori S, Takafuji H, Tokuda T, Kenji M. TCTAP A-104 Real World Clinical Outcome of Drug-eluting Stent Implantation in Femoropopliteal Lesions. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.02.124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
42
|
Kobayashi N, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Yamawaki M, Araki M, Kato T, Inoue Y, Takimura H, Sakamoto Y, Mori S, Tsutsumi M, Takafuji H, Tokuda T, Kenji M. TCTAP A-099 Predictors of Wound Healing in Patients with Critical Limb Ischemia with Tissue Loss Following Successful Endovascular Treatment. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.02.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
43
|
Mori S, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Yamawaki M, Araki M, Kato T, Kobayashi N, Takimura H, Sakamoto Y, Tsutsumi M, Takafuji H, Tokuda T, Kenji M. TCTAP A-073 Angiographic and Clinical Outcome of Drug-eluting Stent Implantation for Right Coronary Ostial Lesion. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.02.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
44
|
Kenji M, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Araki M, Kato T, Kobayashi N, Inoue Y, Takimura H, Sakamoto Y, Mori S, Tsutsumi M, Takafuji H, Tokuda T. TCTAP A-017 The Clinical Result of Percutaneous Coronary Intervention for Acute Myocardial Infarction with Cardio-pulmonary Arrest. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
45
|
Takimura H, Muramatsu T, Tsukahara R, Ito Y, Sakai T, Ishimori H, Hirano K, Nakano M, Yamawaki M, Araki M, Kato T, Kobayashi N, Sakamoto Y, Mori S, Tsutsumi M, Takafuji H, Tokuda T, Kenji M. TCTAP A-101 Efficacy of the Preoperative Assessment with Ultrasonography “Vascular Elastograph” in Endovascular Therapy. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.02.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
46
|
Takafuji H, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Araki M, Kato T, Kobayashi N, Takimura H, Sakamoto Y, Mori S, Tsutsumi M, Takama T, Tokuda T, Makino K. TCTAP A-022 Comparison of PCI Procedure and Outcomes in Patients with STEMI (Differences in TIMI Risk Score). J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.02.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
47
|
Takimura H, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Araki M, Kato T, Kobayashi N, Sakamoto Y, Mori S, Tsutsumi M, Takama T, Takafuji H, Tokuda T. TCT-552 Nitinol Selfexpanding Paclitaxel-eluting Stent is Useful in Endovascular Therapy for In-stent Restenosis after Superficial Femoral Artery Stenting. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.1298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
48
|
Takimura H, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Araki M, Kato T, Kobayashi N, Sakamoto Y, Mori S, Tsutsumi M, Takama T, Takafuji H, Tokuda T. TCT-485 Paclitaxel Prevented the Intimal Proliferation after Percutaneous Coronary Intervention for Patients with Renal Insufficiency. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.1228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
49
|
Tsutsumi M, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Araki M, Kato T, Kobayashi N, Takimura H, Sakamoto Y, Mori S, Takama T, Takafuji H, Tokuda T. TCT-201 The middle-term outcome of small-vessel stenting with the second-generation drug-eluting stents. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
50
|
Takimura H, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Araki M, Kobayashi N, Kato T, Sakamoto Y, Mori S, Tsutsumi M, Takama T, Takafuji H, Tokuda T. TCT-551 Efficacy of the Preoperative Assessment with a Ultrasonography "Vascular Elastography" in Endovascular Therapy. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.1297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|