1
|
Yanagiuchi T, Kato T, Hirano K, Hanabusa K, Ota Y, Yamazaki S, Fushimura Y, Ushimaru S, Yokoi H, Zen K, Matoba S. Infrapopliteal 3-Vessel Occlusive Disease Is the Only Predictor of Wound Recurrence After Complete Wound Healing via Endovascular Therapy in Patients With Chronic Limb-threatening Ischemia. J Endovasc Ther 2023:15266028231197983. [PMID: 37702477 DOI: 10.1177/15266028231197983] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
PURPOSE To determine the predictors of wound recurrence after complete wound healing in patients with chronic limb-threatening ischemia (CLTI) who underwent endovascular therapy (EVT) for infrapopliteal (IP) lesions with consideration of IP arterial anatomic severity, including classification by the Global Limb Anatomic Staging System (GLASS). MATERIALS AND METHODS This retrospective single-center study assessed patients with de novo CLTI limbs with tissue loss treated via EVT for IP lesions from September 2016 to May 2021. Among these patients, 149 consecutive limbs from 133 patients who achieved complete wound healing were enrolled. The Kaplan-Meier method was used to estimate the wound recurrence rate after complete wound healing. The Cox proportional hazard model was used to assess the association between baseline characteristics and wound recurrence. RESULTS The cumulative wound recurrence rate 1 year after complete wound healing was 30%. The mean time for wound recurrence was 7±5 months. Only IP arterial anatomic characteristics remained as a predictor of wound recurrence, whereas wound status and management, including the Wound, Ischemia, and foot Infection (WIfI) clinical stage and minor amputation, were not associated with wound recurrence. Multivariate analysis revealed independent associations between wound recurrence and IP 3-vessel occlusive disease (hazard ratio, 2.97; 95% confidence interval, 1.39-6.35), but not poor below-the-ankle runoff, IP Peripheral Arterial Calcium Scoring System (PACSS) grade, and the GLASS IP grade. CONCLUSION The only independent predictor of wound recurrence after complete wound healing via EVT in patients with CLTI was IP 3-vessel occlusive disease. CLINICAL IMPACT In patients with chronic limb-threatening ischemia (CLTI), wound recurrence after complete wound healing remains a challenge, and studies focused exclusively on wound recurrence are still limited. The present study aimed to determine the risk factors for wound recurrence after complete wound healing in patients with CLTI who underwent endovascular therapy (EVT) for infrapopliteal (IP) lesions, with consideration of IP arterial anatomic severity for the first time. The results showed that IP 3-vessel occlusive disease was the only predictor of wound recurrence, whereas wound status/management and other arterial anatomic characteristics including WIfI clinical stages and GLASS grades were not predictors.
Collapse
Affiliation(s)
| | - Taku Kato
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Keita Hirano
- Department of Nephrology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | | | - Yutaro Ota
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Shinya Yamazaki
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Yohei Fushimura
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Shunpei Ushimaru
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Hirokazu Yokoi
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Kan Zen
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
2
|
Yanagiuchi T, Kato T, Hirano K, Toki H, Imura H, Matsubara K, Ushimaru S, Yokoi H, Zen K, Matoba S. Predictors of delayed wound healing after simultaneous endovascular treatment and minor forefoot amputation for chronic limb-threatening ischemia with wound infection. Vascular 2023; 31:333-340. [PMID: 35105193 DOI: 10.1177/17085381211067601] [Citation(s) in RCA: 1] [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: 11/17/2022]
Abstract
OBJECTIVES To assess wound healing after simultaneous endovascular treatment (EVT) and minor forefoot amputation and identify the predictors of delayed wound healing in patients with chronic limb-threatening ischemia (CLTI) and bacterial infections of the wounds. METHODS In this single-center retrospective cohort study, we evaluated 79 consecutive limbs with tissue loss from 73 CLTI patients who underwent simultaneous EVT and minor forefoot amputation between November 2017 and May 2020. To estimate the rate of wound healing after the simultaneous procedure, we used the Kaplan-Meier method. To assess the association between baseline characteristics and delayed wound healing, we used the Cox proportional hazard model. RESULTS All patients who underwent the simultaneous procedure had ischemic wounds with bacterial infection. The rate of wound healing at 6 months reached 82%. The median time for wound healing was 76 days. According to multivariable analysis, Lisfranc/Chopart amputation (hazard ratio (HR) 2.46, 95% confidence interval (CI) 1.09-6.60), absence of above-the-knee (ATK) occlusive lesions (HR 1.89, 95% CI 1.04-3.45), and poor below-the-ankle (BTA) runoff (HR 1.77, 95% CI 1.01-3.11) were independent predictors of delayed wound healing. CONCLUSION Lisfranc/Chopart amputation, absence of ATK occlusive lesions, and poor BTA runoff were independent predictors of delayed wound healing after simultaneous EVT and minor forefoot amputation in patients with CLTI and bacterial infections of the wound.
Collapse
Affiliation(s)
| | - Taku Kato
- Department of Cardiology, 13684Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Keita Hirano
- Department of Nephrology, 38049Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroyuki Toki
- Department of Plastic and Reconstructive Surgery, 13684Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Haruki Imura
- Department of Infectious Diseases, 13684Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Kunihiko Matsubara
- Department of Dermatology, 13684Rakuwakai Otowa Kinen Hospital, Kyoto, Japan
| | - Shunpei Ushimaru
- Department of Cardiology, 13684Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Hirokazu Yokoi
- Department of Cardiology, 13684Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Kan Zen
- Department of Cardiovascular Medicine, 12898Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, 12898Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
3
|
Yanagiuchi T, Kato T, Hirano K, Hanabusa K, Ota Y, Yamazaki S, Fushimura Y, Ushimaru S, Yokoi H, Zen K, Matoba S. High Global Limb Anatomic Staging System Femoropopliteal Grade is Positively Associated with Wound Healing in Patients with Chronic Limb-Threatening Ischemia Undergoing Endovascular Therapy Only for Femoropopliteal Disease. Ann Vasc Surg 2023; 92:264-271. [PMID: 36634898 DOI: 10.1016/j.avsg.2022.11.032] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND To investigate the prognostic impact of femoropopliteal (FP) arterial anatomic severity including classification by the global limb anatomic staging system (GLASS) on wound healing in patients with chronic limb-threatening ischemia (CLTI) who had undergone endovascular therapy (EVT) only for FP lesions. METHODS This was a retrospective single-center study. We treated 349 consecutive de novo CLTI limbs with tissue loss from January 2017 to May 2021. Among these, 91 limbs treated via EVT only for FP lesions were enrolled. We compared the clinical background, infrapopliteal (IP)/FP arterial anatomical characteristics, and EVT results between the limbs with GLASS FP grade 1 or 2 (low GLASS FP, n = 20) and those with GLASS FP grade 3 or 4 (high GLASS FP, n = 71). The Kaplan-Meier method was used to estimate the wound healing rate. The Cox proportional hazard model was used to assess the association between baseline characteristics and wound healing. RESULTS No patient underwent EVT for IP lesions. IP arterial anatomical characteristics did not show any significant difference between the low and high GLASS FP groups. The cumulative wound healing rate after EVT was significantly higher in the high GLASS FP group than in the low GLASS FP group (88% vs. 39% at 6 months; P < 0.001). Multivariate analysis revealed that low wound, ischemia, and foot infection (WIfI) clinical stage (stage 1 or 2) (hazard ratio [HR] 2.33; 95% confidence interval [CI] 1.32-4.17) and high GLASS FP (grade 3 or 4) (HR 5.18; 95% CI 1.99-13.51) were independent factors for wound healing. CONCLUSIONS High GLASS FP grade was positively associated with wound healing after EVT only for FP lesions.
Collapse
Affiliation(s)
| | - Taku Kato
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Keita Hirano
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | - Yutaro Ota
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Shinya Yamazaki
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Yohei Fushimura
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Shunpei Ushimaru
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Hirokazu Yokoi
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Kan Zen
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
4
|
Kato T, Yanagiuchi T, Hirano K, Imura H, Matsubara K, Hanabusa K, Ota Y, Yamazaki S, Ushimaru S, Yokoi H. Impact of Antimicrobial-Resistant Bacterial and Polymicrobial Infection on Wound Healing After Minor Forefoot Amputation in Chronic Limb-Threatening Ischemia With Infection. J Endovasc Ther 2022:15266028221134890. [PMID: 36382873 DOI: 10.1177/15266028221134890] [Citation(s) in RCA: 2] [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: 02/17/2024]
Abstract
OBJECTIVES This study aimed to evaluate the relationship between bacteriological findings and wound healing after minor amputation in the treatment of chronic limb-threatening ischemia (CLTI) with infection. METHODS This single-center retrospective study analyzed 135 consecutive limbs with tissue loss and infection from 120 patients who underwent endovascular therapy (EVT) and minor forefoot amputation for CLTI with wound infection between November 2017 and August 2021. The Kaplan-Meier method was used to assess the rate of wound healing after the procedure. The Cox proportional-hazards model was used to examine the impact of bacteriological findings and baseline characteristics on wound healing. RESULTS The wound healing rate at 6 months was 72.6%. In a multivariate analysis, in addition to hemodialysis (hazard ratio [HR]=1.73; p=0.009) and amputation above the metatarsophalangeal (MP) joint (HR=1.81; p=0.006), antimicrobial-resistant bacterial infection (HR=1.80, p=0.004) and polymicrobial infection (H=1.51; p=0.049) were predictors of delayed wound healing. CONCLUSION Antimicrobial-resistant bacterial infection, polymicrobial infection, hemodialysis, and amputation above the MP joint were independent predictors of delayed wound healing after EVT and minor forefoot amputation in patients with CLTI and bacterial wound infection. CLINICAL IMPACT In this single-center retrospective study, we analyzed 136 consecutive limbs with tissue loss and infection from 120 patients who underwent endovascular therapy and minor forefoot amputation for chronic limb-threatening ischemia (CLTI) with wound infection between November 2017 and August 2021. Our main findings were that antimicrobial-resistant bacterial infection, polymicrobial infection, hemodialysis, and amputation above the metatarsophalangeal joint were independent predictors of delayed wound healing after minor amputation. This is the first report of the association between bacteriological studies and wound healing in CLTI with infection, and will be of great help in the future clinical practice.
Collapse
Affiliation(s)
- Taku Kato
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | | | - Keita Hirano
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Haruki Imura
- Department of Infectious Diseases, Rakuwakai Otowa Hospital, Kyoto, Japan
| | | | | | - Yutaro Ota
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Shinya Yamazaki
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Shunpei Ushimaru
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Hirokazu Yokoi
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| |
Collapse
|
5
|
Yanagiuchi T, Kato T, Kitani K, Yamazaki S, Ushimaru S, Yokoi H. Double-Balloon Technique Using Optimo Balloon Guiding Catheter for Blood Flow Occlusion During Open Surgical Repair of Femoral Artery Pseudoaneurysm. Tex Heart Inst J 2022; 49:487381. [DOI: 10.14503/thij-20-7323] [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] [Indexed: 11/07/2022]
Affiliation(s)
- Takashi Yanagiuchi
- 1 Department of Cardiology, Rakuwakai Otowa Hospital, Otowachinji-cho, Yamashina-ku, Kyoto, Japan
| | - Taku Kato
- 1 Department of Cardiology, Rakuwakai Otowa Hospital, Otowachinji-cho, Yamashina-ku, Kyoto, Japan
| | - Kimitoshi Kitani
- 2 Department of Cardiovascular Surgery, Rakuwakai Otowa Hospital, Otowachinji-cho, Yamashina-ku, Kyoto, Japan
| | - Shinya Yamazaki
- 1 Department of Cardiology, Rakuwakai Otowa Hospital, Otowachinji-cho, Yamashina-ku, Kyoto, Japan
| | - Shunpei Ushimaru
- 1 Department of Cardiology, Rakuwakai Otowa Hospital, Otowachinji-cho, Yamashina-ku, Kyoto, Japan
| | - Hirokazu Yokoi
- 1 Department of Cardiology, Rakuwakai Otowa Hospital, Otowachinji-cho, Yamashina-ku, Kyoto, Japan
| |
Collapse
|
6
|
Yanagiuchi T, Kato T, Hanabusa K, Ushimaru S, Yokoi H, Zen K. Successful Percutaneous Fogarty Thrombectomy for Subacute Lower Limb Ischemia Due to Resistant Thrombus in the Popliteal Artery. Am J Case Rep 2022; 23:e936377. [PMID: 35763450 PMCID: PMC9251805 DOI: 10.12659/ajcr.936377] [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: 11/27/2022] Open
Abstract
Patient: Male, 73-year-old
Final Diagnosis: Subacute lower limb ischemia
Symptoms: Coldness • pallor • numbness • rest pain of the right toes
Medication: —
Clinical Procedure: Percutaneous Fogarty thrombectomy
Specialty: Cardiac Surgery • Cardiology
Collapse
Affiliation(s)
| | - Taku Kato
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | | | - Shunpei Ushimaru
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Hirokazu Yokoi
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Kan Zen
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| |
Collapse
|
7
|
Sato T, Goto S, Kishi S, Yamaguchi K, Warisawa T, Kozuki A, Toshihiro S, Tsuchida K, Yokoi H, Kazuya K, Akazawa K, Aizawa Y. Predictors and outcomes of ischemia-driven target lesion revascularization in deferred lesion based on fractional flow reserve: a multi-center retrospective cohort study. Cardiovasc Diagn Ther 2022; 12:485-494. [PMID: 36033217 PMCID: PMC9412208 DOI: 10.21037/cdt-21-773] [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] [Received: 12/22/2021] [Accepted: 06/01/2022] [Indexed: 11/30/2022]
Abstract
Background Fractional flow reserve (FFR) has become the gold standard for diagnosing ischemia in angiographically intermediate epicardial coronary artery stenosis. This study investigated the clinical outcomes and predictors of revascularization deferral based on FFR. Methods In this retrospective cohort study, we assessed 474 lesions (440 patients) where revascularization was deferred based on the FFR value. Minimum lumen diameter and %-diameter stenosis were measured. Calcification was graded as none, mild, moderate, or heavy. The synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score I was also determined. The primary outcome was ischemia-driven target lesion revascularization (TLR) in deferred lesions within 3 years. Patients were also assigned into two groups based on FFR value. Results The average age of the patients was 69.7±10.4 years. The average FFR value was 0.86±0.05. Stable angina pectoris was noted in 298 (67.7%) cases, and in-stent restenosis (ISR) was present in 28 (5.9%). The average SYNTAX score was 7.2±4.2. The 3-year ischemia-driven TLR was 18 lesions (3.8%). Cox proportional hazard model revealed that the SYNTAX score and ISR were independent predictors for TLR in deferred lesions [hazard ratio (HR) =1.10, 95% confidential interval (CI): 1.01–1.19, P=0.03; HR =6.33; 95% CI: 2.25–17.8, P<0.01, respectively]. The deferral group, with a low FFR value, tended to have higher TLR rates than other groups. Conclusions Lesions with lower FFR values were associated with a higher incidence of ischemia-driven TLR than those with higher FFR values. SYNTAX score and ISR were predictors for ischemia-driven TLR at 3 years in the deferred lesions.
Collapse
Affiliation(s)
- Takao Sato
- Cardiology, Tachikawa General Hospital, Nagaoka, Japan
- Clinical Trials Center, Cardiovascular Research Foundation, New York, NY, USA
- NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, NY, USA
| | - Sonoka Goto
- Cardiology, Tachikawa General Hospital, Nagaoka, Japan
| | - Shohei Kishi
- Division of Cardiology, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | - Kohei Yamaguchi
- Division of Cardiology, Niigata Prefectural Shibata Hospital, Shibara, Japan
| | | | - Amane Kozuki
- Division of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Suga Toshihiro
- Division of Cardiology, Gunma Chou Hospital, Gunma, Japan
| | - Keiichi Tsuchida
- Division of Cardiology, Niigata Municipal Hospital, Niigata, Japan
| | - Hirokazu Yokoi
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | - Kawai Kazuya
- Department of Cardiology, Chikamori Hospital, Kochi, Japan
| | - Kohei Akazawa
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | | |
Collapse
|
8
|
Shiono Y, Matsuo H, Fujita H, Tanaka N, Ogasawara Y, Kawamura I, Katayama Y, Matsuo A, Kawase Y, Kakuta T, Takashima H, Yokoi H, Ohira H, Suwa S, Oguri M, Yamamoto F, Kubo T, Akasaka T, Shiono Y, Katayama Y, Hironori K, Kubo T, Akasaka T, Tanaka N, Yamashita J, Fujita H, Matsuo A, Matsuo H, Kawase Y, Kawamura I, Kakuta T, Hoshino M, Sugano T, Takashima H, Amano T, Yokoi H, Yamamoto Y, Nozaki Y, Machida M, Kobori M, Kikuchi T, Ohira H, Yoshino H, Ishiguro H, Wakabayashi Y, Kondo T, Terai H, Suwa T, Kimura T, Kawajiri T, Hirohata A, Uemura S, Neishi Y, Sakamoto T, Yamada M, Okeie K, Hishikari K, Oguri M, Uetani T, Saegusa T, Yamamoto F, Yamada M. Diagnostic Accuracy of Diastolic Fractional Flow Reserve for Functional Evaluation of Coronary Stenosis. JACC: Asia 2021; 1:230-241. [PMID: 36338166 PMCID: PMC9627917 DOI: 10.1016/j.jacasi.2021.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/28/2021] [Accepted: 07/08/2021] [Indexed: 01/10/2023]
Abstract
Background In the resting conditions, narrowing the window of coronary pressure measurements from the whole cardiac cycle to diastole improves diagnostic performance of coronary pressure–derived physiological index. However, whether this also applies to the hyperemic conditions has not yet been thoroughly evaluated. Objectives The purpose of this study was to assess whether diastolic fractional flow reserve (diastolic FFR) has better diagnostic performance in identifying ischemia-causing coronary lesions than conventional FFR in a prospective, multicenter, and independent core laboratory–based environment. Methods In this prospective multicenter registry at 29 Japanese centers, we compared the diagnostic performance of FFR, diastolic FFR, resting distal to aortic coronary pressure (Pd/Pa), and diastolic pressure ratio (dPR) using myocardial perfusion scintigraphy (MPS) as the reference standard in 378 patients with single-vessel coronary disease. Results Inducible myocardial ischemia was found on MPS in the relevant myocardial territory of the target vessel in 85 patients (22%). In the receiver-operating curve analyses, diastolic FFR had comparable area under the curve (AUC) compared with FFR (AUCdiastolic FFR: 0.66; 95% confidence interval [CI]: 0.58-0.73, vs AUCFFR: 0.66; 95% CI: 0.58-0.74, P = 0.624). FFR and diastolic FFR showed significantly larger AUCs than resting Pd/Pa (0.62; 95% CI: 0.54-0.70; P = 0.033 and P = 0.046) but did not show significantly larger AUCs than dPR (0.62; 95% CI: 0.55-0.70; P = 0.102 and P = 0.113). Conclusions Diastolic FFR showed a similar diagnostic performance to FFR as compared with MPS. This result reaffirms the use of FFR as the most accurate invasive physiological lesion assessment. (Diagnostic accuracy of diastolic fractional flow reserve (d-FFR) for functional evaluation of coronary stenosis; UMIN000015906)
Collapse
|
9
|
Kawamoto A, Furukawa Y, Fujita Y, Kobayashi S, Tobita K, Yamaguchi J, Shimizu W, Takagi G, Matsumura H, Murata N, Nakamura M, Kitano I, Yokoi H, Azuma N, Kozuki A, Obara H, Furukawa M, Sietsema W, Takagi H, Wang J, Bartel R, Losordo D. Honedra® (CLBS12) autologous CD34+ cells improve outcomes in patients with Buerger’s disease. Cytotherapy 2021. [DOI: 10.1016/s146532492100390x] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
10
|
Yokoi H, Yanagiuchi T, Ushimaru S, Kato T. Primary percutaneous coronary intervention without stenting using excimer laser and manual thrombectomy in STEMI with duodenal ulcer perforation: a case report. Eur Heart J Case Rep 2021; 4:1-6. [PMID: 33442619 PMCID: PMC7793135 DOI: 10.1093/ehjcr/ytaa389] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/03/2020] [Accepted: 09/17/2020] [Indexed: 11/14/2022]
Abstract
Background ST-segment elevation myocardial infarction (STEMI) and peptic ulcer perforation are both medical emergencies that require urgent intervention. In case that these time-sensitive medical emergencies present concomitantly, it remains unclear which one should be treated first. Case summary An 85-year-old man with melaena, epigastric pain, and severe anaemia was transferred to our emergency department and diagnosed as having inferior STEMI based on electrocardiogram. Emergency coronary angiography (CAG) revealed severe stenosis with thrombus in the proximal right coronary artery. Immediate oesophagogastroduodenoscopy and abdominal computed tomography detected the presence of duodenal ulcer perforation. Primary percutaneous coronary intervention (PCI) without stenting using excimer laser coronary angioplasty and manual thrombectomy was performed under intravascular ultrasound (IVUS) guidance to avoid dual antiplatelet therapy (DAPT). After successful PCI, the perforated viscus was surgically repaired with a laparoscopic omental patch. On Day 7, endoscopic haemostasis treated the oozing of blood from the duodenal ulcer. On Day 21, follow-up CAG and IVUS showed residual stenosis with organized thrombus in the culprit lesion, in which a drug-coated stent was directly implanted. He was discharged with a favourable clinical course on Day 23. Discussion We judged that PCI should take precedence over the surgical repair of perforated duodenal ulcer in our case since STEMI was an immediate life-threatening compared to the perforated viscus which had no active exsanguination. Excimer laser coronary angioplasty with manual thrombectomy might be an adequate option to avoid stent deployment and subsequent DAPT in such complex scenarios.
Collapse
Affiliation(s)
- Hirokazu Yokoi
- Department of Cardiology, Rakuwakai Otowa Hospital, 2 Otowa-chinji-cho, Yamashina-ku, Kyoto 607-8062, Japan
| | - Takashi Yanagiuchi
- Department of Cardiology, Rakuwakai Otowa Hospital, 2 Otowa-chinji-cho, Yamashina-ku, Kyoto 607-8062, Japan
| | - Shunpei Ushimaru
- Department of Cardiology, Rakuwakai Otowa Hospital, 2 Otowa-chinji-cho, Yamashina-ku, Kyoto 607-8062, Japan
| | - Taku Kato
- Department of Cardiology, Rakuwakai Otowa Hospital, 2 Otowa-chinji-cho, Yamashina-ku, Kyoto 607-8062, Japan
| |
Collapse
|
11
|
Kuramitsu S, Matsuo H, Takashima H, Yokoi H, Tanaka N. Three-year outcomes after deferral of revascularization based on instantaneous wave-free ratio or fractional flow reserve: insights from the J-CONFIRM Registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1402] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The safety of deferral of revascularization based on instantaneous wave-free ratio (iFR) is established in randomized controlled trials. However, there is little data regarding long-term outcomes after deferral of revascularization based on iFR in real-world practice.
Purpose
We sought to assess clinical outcomes after deferral of revascularization based on iFR in clinical practice as compared with those based on fractional flow reserve (FFR).
Methods
This is a post hoc analysis of the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on fractional flow reserve in multicenter registry), in which 1262 patients with 1447 lesions deferred the revascularization based on FFR. Of these, both FFR and iFR were measured in 399 patients with 452 lesions. The patients were classified into the two groups: the iFR group (iFR >0.89; 308 patients with 348 lesions) and the FFR group (FFR >0.80; 740 patients with 855 lesions). The primary study endpoint was the 3-year target vessel failure (TVF) including cardiac death, target-vessel related myocardial infarction (TVMI), and clinically driven target vessel revascularization (CDTVR).
Results
Mean iFR was 0.96±0.04 in the iFR group. Mean FFR was significantly lower in the iFR group than in the FFR group (0.87±0.05 vs. 0.89±0.05, p=0.002). The iFR group included 35 lesions (11.4%) with FFR ≤0.80. At 3 years, the rate of TVF on a lesion basis were not significantly different between the iFR and FFR groups (8.8% vs. 6.1%, p=0.10), whereas CDTVR rate was significantly higher in the iFR group than in the FFR group (8.5% vs. 5.3%, p=0.044). Cardiac death and TVMI on a patient basis rarely occurred in both groups during the 3-year follow-up (0.33% vs. 0.77%, p=0.47; 0.66% vs. 0.56%, p=0.85, respectively).
Conclusion
At 3 years, TVF rate in deferred lesions was numerically higher in the iFR group than in the FFR group, driven by a higher rate of CDTVR. However, cardiac death and TVMI was very rare in both groups, highlighting the safety of both iFR- and FFR-based deferral of revascularization in daily practice.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
| | | | | | - H Yokoi
- Fukuoka Sanno Hospital, Fukuoka, Japan
| | - N Tanaka
- Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| |
Collapse
|
12
|
Yokoi H. Paclitaxel-coated Zilver PTX drug-eluting stent treatment does not result in increased long-term all-cause mortality compared to uncoated devices from Japan post-market surveillance study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2379] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Purpose
Favorable long-term outcomes with the Zilver PTX drug-eluting stent (DES) in treating patients with femoropopliteal lesions have been demonstrated. A multicenter, prospective, post-market surveillance study (PMS) in Japan evaluated this DES in a real-world patient population. Recently, meta-analysis that grouped both DES and drug-coated balloons (DCB) together indicated a higher incidence of late all-cause mortality for paclitaxel- based devices compared to uncoated balloon or bare-metal stent (BMS) at 2 years up to 5 years. To evaluate the long-term safety of the Zilver PTX DES, compared with BMS using Japan-PMS study.
Methods
The Japan DES PMS had no exclusion criteria and enrolled consecutive patients with symptomatic PAD involving the above-the-knee femoropopliteal arteries. Safety and effectiveness of the DES was evaluated in real-world patients with complex femoropopliteal artery lesions through 5 years. Follow-up in the study is complete. The concurrent Japan BMS PMS also had no exclusion criteria and enrolled consecutive patients with symptomatic PAD involving the above-the-knee femoropopliteal arteries. Patients who were enrolled in the BMS study but who also had a DES placed (n=18) were excluded from the current analysis. Follow-up in the BMS study was only required through 3 years and is complete.
Results
The Japan DES PMS enrolled 904 DES patients, and the Japan BMS PMS enrolled 190 BMS patients. In the DES group, there were 127 deaths through 3 years and 186deaths through 5 years. In the BMS group, there were 22 deaths through 3 years. Through 3 years, the risk of mortality was 15.7% for DES group and 15.3% for BMS group. Through 5 years, the risk of mortality was 25.8% for the DES group. There was no difference in mortality between the two groups (log-rank p=0.92).The Cox proportional hazards model revealed that CLI (p<0.0001), age (p<0.0001), gender (p=0.001), renal failure (p<0.0001) were significantly associated with mortality. Hypercholesterolemia (p=0.004) was associated with lower risk of mortality. Treatment with Zilver PTX (p=0.49) was not associated with mortality. In the covariate analysis of paclitaxel dose, the significant factors were identical to the treatment analysis, and there was no association or trend of paclitaxel dose (p=0.07) with mortality.
Conclusion
Analyses of the paclitaxel-coated Zilver PTX DES utilizing patient-level data from the Japan PMS demonstrated no increase in long-term all-cause mortality. The 5-year results from this real-world, all-comers study continue to show positive long-term outcomes and demonstrate the benefit of the Zilver PTX DES across a broad patient population.
Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): COOK
Collapse
Affiliation(s)
- H Yokoi
- Fukuoka Sanno Hospital, Cardiovascular Medicine, Fukuoka, Japan
| |
Collapse
|
13
|
NISHIGUCHI Y, Kuwabara T, Fujimoto D, Kanki T, Hata Y, Yokoi H, Izumi Y, Kakizoe Y, Mochizuki N, Mukoyama M. SUN-004 Osteocrin, a bone-originated humoral factor, exerts a renoprotective role in ischemia-reperfusion injury in mice. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.526] [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] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
14
|
Ota Y, Kato T, Yanagiuchi T, Ushimaru S, Yokoi H. Successful Retrieval of a Stuck Guidewire by Guiding Catheter Lock Technique in Renal Artery Stenting. EJVES Vasc Forum 2020; 49:30-33. [PMID: 33294882 PMCID: PMC7691746 DOI: 10.1016/j.ejvsvf.2020.10.004] [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] [Received: 06/03/2020] [Revised: 10/09/2020] [Accepted: 10/27/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction The guiding catheter lock technique is a therapeutic technique to increase backup force of the guiding catheter in coronary artery interventions. Surgical technique A 71 year old man presented with rapidly declining kidney function resulting from bilateral renal artery stenosis. During the renal artery stenting procedure, the 0.014" guidewire became trapped at the stent's distal edge. Although attempts were made to advance a microcatheter and balloon catheter over the trapped guidewire, these failed because of insufficient pushability of the guiding catheter. Therefore, the guiding catheter lock technique was used with a second guiding catheter, and the guidewire was successfully retrieved. Discussion The guiding catheter lock technique facilitated strong pushability to allow for successful retrieval of a stuck guidewire during renal artery stenting. During renal artery stenting, a guidewire was trapped at the stent's distal edge. The stuck guidewire was retrieved using the guiding catheter lock technique. The guiding catheter lock technique can be useful for bailout of a stuck guidewire.
Collapse
Affiliation(s)
| | - Taku Kato
- Corresponding author. Department of Cardiology, Rakuwakai Otowa Hospital, 2 Otowachinji-cho, Yamashina-ku, Kyoto, 607-8062, Japan.
| | | | | | | |
Collapse
|
15
|
Tsujimura T, Iida O, Takahara M, Yamauchi Y, Shintani Y, Sugano T, Yamamoto Y, Kawasaki D, Yokoi H, Miyamoto A, Mano T. P4704The efficacy of intravascular ultrasound for patients with peripheral artery diseases presenting aorto-iliac artery disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1085] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The use of intravascular ultrasound (IVUS) promotes better clinical outcomes for intervention in complex lesions. However, the data demonstrating whether use of IVUS improves primary patency following stenting for aorto-iliac lesions in patients with peripheral artery disease (PAD) are limited.
Purpose
The purpose of the current study was to investigate the impact of IVUS use on primary patency 12 months after stent implantation for aorto-iliac lesions.
Methods
We analyzed a clinical database of the OMOTENASHI registry (Observational prospective Multicenter registry study on Outcomes of peripheral arTErial disease patieNts treated by AngioplaSty tHerapy in aortoIliac artery), registering symptomatic PAD patients (Rutherford category 2, 3, or 4) undergoing endovascular therapy for aorto-iliac lesions between January 2014 and April 2016 in Japan. The current study analyzed 803 patients who underwent self-expandable stent implantation at 61 centers with the institutional volume known. The primary endpoint was 12-month restenosis, defined as ≥50% stenosis on computed tomography or angiography, or a peak systolic velocity ratio ≥2.5 on duplex ultrasound. When treatment strategies, endovascular procedures and clinical outcomes were compared between the patients treated with IVUS use and those treated without IVUS use, the propensity score matching was performed to minimize the inter-group difference in baseline characteristics.
Results
A total of 545 patients (67.9%) underwent IVUS-supported stent implantation. Patients treated with IVUS use had a lower prevalence of regular dialysis, whereas they had a higher prevalence of TASC II class D and chronic total occlusion. In patients treated with IVUS use, carbon dioxide contrast agent were more often used, and 0.035-inch guidewire was less frequently selected. Implanted stents in these patients were longer and smaller in diameter. The propensity score matching extracted 138 pairs, with no remarkable intergroup difference in baseline characteristics. Procedure time ≤1 hour was less frequent in patients treated with IVUS use; their radiation time was longer. Endovascular strategies, as well as postoperative medication were not significantly different between patients with and without IVUS use. The 12-month restenosis risk was not significantly different between patients with and without IVUS use (10.2% [6.9 to 14.9%] versus 10.3% [5.4 to 18.6%], P=0.99).
Conclusion
IVUS use in aorto-iliac stenting for patients with PAD was not associated with primary patency at 12 months.
Acknowledgement/Funding
None
Collapse
Affiliation(s)
- T Tsujimura
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - O Iida
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - M Takahara
- Osaka University Graduate School of Medicine, Department of Metabolic Medicine, Osaka, Japan
| | - Y Yamauchi
- Takatsu General Hospital, Cardiovascular Center, Kawasaki, Japan
| | - Y Shintani
- Shin-Koga Hospital, Department of Cardiology, Fukuoka, Japan
| | - T Sugano
- Yokohama City University Hospital, Department of Cardiovascular Medicine, Yokohama, Japan
| | - Y Yamamoto
- Iwaki Kyoritsu General Hospital, Department of Cardiovascular Medicine, Fukushima, Japan
| | - D Kawasaki
- Morinomiya Hospital, Cardiovascular Division, Department of Internal Medicine, Osaka, Japan
| | - H Yokoi
- Fukuoka Sanno Hospital, Cardiovascular Center, Fukuoka, Japan
| | - A Miyamoto
- Takatsu General Hospital, Cardiovascular Center, Kawasaki, Japan
| | - T Mano
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| |
Collapse
|
16
|
Yashige M, Kato T, Zen K, Toki H, Matsubara K, Yokoi H. Striking wound blush in the giant gout tophus detected immediately after endovascular revascularization. Cardiovasc Interv Ther 2019; 35:316-317. [PMID: 31292930 DOI: 10.1007/s12928-019-00604-x] [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: 05/05/2019] [Accepted: 07/05/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Masaki Yashige
- Department of Cardiology, Rakuwakai Otowa Hospital, 2, Otowachinji-cho, Yamashina-ku, Kyoto city, Kyoto, 607-8062, Japan.,Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto city, Japan
| | - Taku Kato
- Department of Cardiology, Rakuwakai Otowa Hospital, 2, Otowachinji-cho, Yamashina-ku, Kyoto city, Kyoto, 607-8062, Japan. .,Rakuwakai Kyoto Limb Wound Center, Kyoto city, Japan.
| | - Kan Zen
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto city, Japan
| | - Hiroyuki Toki
- Rakuwakai Kyoto Limb Wound Center, Kyoto city, Japan.,Department of Plastic Surgery, Rakuwakai Otowa Hospital, Kyoto city, Japan
| | | | - Hirokazu Yokoi
- Department of Cardiology, Rakuwakai Otowa Hospital, 2, Otowachinji-cho, Yamashina-ku, Kyoto city, Kyoto, 607-8062, Japan
| |
Collapse
|
17
|
Yokoi H, Osaki K, Kato Y, Toda N, Ishii A, Mori K, Mori K, Kasahara M, Mukoyama M, Yanagita M. SUN-143 MATRIX METALLOPROTEINASE-10 (MMP-10) IS A KEY MOLECULE IN ALDOSTERONE-INDUCED GLOMERULAR INJURY IN SYSTEMIC GUANYLYL CYCLASE-A KNOCKOUT MICE. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.543] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
18
|
Affiliation(s)
- H Yokoi
- Fukuoka Sanno Hospital, Cardiovascular Medicine, Fukuoka, Japan
| | - E Oda
- AC Medical Inc., Tokyo, Japan
| | - K Kaneko
- Medical Data Vision Co., Ltd., Tokyo, Japan
| | - H Matsuo
- Daiichi Sankyo Co., Ltd., Tokyo, Japan
| |
Collapse
|
19
|
Affiliation(s)
- Y Nishikawa
- Department of Clinical Oncology, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan; Department of Health Informatics, Kyoto University School of Public Health, Yoshida-Konoe, Sakyo-ku, Kyoto 606-8501, Japan
| | - H Yokoi
- Department of Nephrology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - T Sakurai
- Department of Diagnostic Pathology, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - T Horimatsu
- Department of Clinical Oncology, Kyoto University Hospital, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - S Miyamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| |
Collapse
|
20
|
Abstract
A 68-year-old man with a history of coronary artery bypass surgery was referred to our hospital because of pre-syncope on effort. During a treadmill exercise electrocardiogram test, the patient developed advanced atrioventricular block associated with dizziness. Coronary angiography revealed significant stenosis of the right coronary artery, which had not existed at the time of the bypass surgery. We implanted drug-eluting stents in the stenotic lesion, and an exercise test showed resolution of the atrioventricular block. Exercise-induced atrioventricular block is rare, and it is necessary to distinguish it from ischemic heart disease, especially in patients with a history of coronary artery disease.
Collapse
Affiliation(s)
| | - Taku Kato
- Department of Cardiology, Rakuwakai Otowa Hospital, Japan
| | | | - Hirokazu Yokoi
- Department of Cardiology, Rakuwakai Otowa Hospital, Japan
| | - Hiroki Mani
- Department of Arrhythmia, Rakuwakai Otowa Hospital, Japan
| |
Collapse
|
21
|
Abstract
Summary
Objectives:
We extracted index terms related to diseases recorded in hospital discharge summaries and examined the capability of the vector space model to select a suitable diagnosis with these terms.
Methods:
By morphological analysis, we extracted index terms and constructed an original dictionary for the discharge summary analysis. We chose 125 different DPC (Japanese DRG system) codes for the diseases, each of which had more than 20 cases. We divided them into two groups. One group consisted of 5927 cases from 2004 fiscal year and was used to generate the document vector space according to the DPC. The other group of 3187 cases was collected to verify the automatic DPC selection by using data from 2005 fiscal year. The top 200 extracted index terms for each disease were used to calculate the weight of each disease.
Results:
The DPC code obtained by the calculated similarity was compared with the original codes of patients for 125 DPCs of 3187 cases. Eighty percent of the cases matched the diagnosis of the DPC (first six digits) and 56% of the cases completely matched all 14 digits of the DPC.
Conclusions:
We demonstrated that we could extract suitable terms for each disease and obtain characteristics, such as the diagnosis, from the calculated vectors. This technique can be used to measure the qualification of discharge summaries and to integrate discharge summaries among different facilities. By the text mining technique, we can characterize the contents of electronic discharge summaries and deduce diagnoses with the data.
Collapse
|
22
|
Yokoi H. P5212The Zilver PTX Japanese post-market surveillance study of paclitaxel-eluting stents: 3 year results of the diabetic and in-stent restenosis subgroups. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5212] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H. Yokoi
- Fukuoka Sanno Hospital, Cardiovascular Medicine, Fukuoka, Japan
| | | |
Collapse
|
23
|
Cipollari S, Yokoi H, Ohki T, Kichikawa K, Nakamura M, Komori K, Nanto S, O'Leary E, Lotters A, Snyder S, Dake M. Effectiveness of the Zilver PTX drug-eluting stent for femoropopliteal peripheral arterial disease in patients with no tibial runoff vessels: 24-month results from the Zilver PTX Post-Market Study in Japan. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.685] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
24
|
Nakagawa T, Sakamoto T, Kodama S, Kobayashi M, Hanai N, Yokoi H, Suzuki M. Clinical and Pathological Outcomes of Multilayer Resection of Olfactory Neuroblastomas via Endoscopic Endonasal Approach. Skull Base Surg 2016. [DOI: 10.1055/s-0036-1579973] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
25
|
Hashimoto S, Shiraishi J, Kimura M, Nishikawa M, Yanagiuchi T, Ito D, Kishita E, Yokoi H, Hyogo M, Shima T, Sawada T, Kohno Y. Usefulness of continuous compression using TR Band™ for radial arteriovenous fistula following trans-radial intervention. J Cardiol Cases 2015; 12:192-194. [PMID: 30546593 DOI: 10.1016/j.jccase.2015.08.007] [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] [Received: 04/06/2015] [Revised: 07/29/2015] [Accepted: 08/10/2015] [Indexed: 01/09/2023] Open
Abstract
Arteriovenous fistula (AVF) after trans-radial catheterization is an extremely rare complication. A 61-year-old man experienced a painful swelling in the left radial punctured site. The findings of vascular ultrasound and angiography led to a diagnosis of an iatrogenic radial AVF. We performed continuous compression using a hemostatic band for 24 h after which the radial AVF completely disappeared without vessel occlusion, and no relapse occurred. Eight cases of catheterization-induced radial AVF have been mentioned in the literature, but the treatment has not been noninvasive in any case. This is the first report of an iatrogenic radial AVF that was noninvasively repaired using continuous low-pressure compression with a hemostatic band. <Learning objective: Arteriovenous fistula (AVF) after trans-radial catheterization is a rare complication. The literature reports only 8 cases of catheterization-induced radial AVF and no patient has been cured noninvasively. This is the first report of an iatrogenic radial AVF that was repaired noninvasively. We believe that continuous low-pressure compression using a hemostatic band is an effective therapeutic option for this complication.>.
Collapse
Affiliation(s)
- Sho Hashimoto
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Jun Shiraishi
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Masayoshi Kimura
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Marie Nishikawa
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Takashi Yanagiuchi
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Daisuke Ito
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Eigo Kishita
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Hirokazu Yokoi
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Masayuki Hyogo
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Takatomo Shima
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Takahisa Sawada
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Yoshio Kohno
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| |
Collapse
|
26
|
Yokoi H, Tsutsumi S, Kohno N. Schwannoma of the nasal septum presenting as a multicentric neuronal tumour. B-ENT 2015; 11:141-145. [PMID: 26563015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
PROBLEM Schwannomas (neurilemmomas) are benign primary tumours that arise from Schwann cells. Schwannomas arising from the nasal septum are exceptionally rare. Here, we report a unique case of schwannoma of the nasal septum presenting as a multicentric neuronal tumour. RESULTS A 40-year old male sustained intermittent left tinnitus. Magnetic resonance imaging revealed masses near the nasal septum and upper cervical cord in addition to a tumour in the left cerebellopontine (CP) angle. The tumour in the nasal septum was completely resected by endoscopic endonasal surgery and diagnosed as a typical schwannoma. The CP angle tumour was treated with stereotactic radiosurgery, while the asymptomatic cord lesion showed no significant growth and remains under observation. CONCLUSION Endoscopic endonasal surgery is useful for the resection of schwannomas of the nasal septum. Schwannomas of the nasal septum may present as multiple neuronal tumours.
Collapse
|
27
|
Yanagisawa T, Fukuma R, Hirata M, Matsushita K, Kishima H, Saitoh Y, Kato R, Seki T, Sugata H, Yokoi H, Kamitani Y, Yoshimine Y. O21: Neuroprosthetic arm using MEG signals of paralyzed patients. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50127-7] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
28
|
Hanatani T, Sai K, Tohkin M, Segawa K, Antoku Y, Nakashima N, Yokoi H, Ohe K, Kimura M, Hori K, Kawakami J, Saito Y. Evaluation of two Japanese regulatory actions using medical information databases: a ‘Dear Doctor’ letter to restrict oseltamivir use in teenagers, and label change caution against co-administration of omeprazole with clopidogrel. J Clin Pharm Ther 2014; 39:361-7. [DOI: 10.1111/jcpt.12153] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 02/20/2014] [Indexed: 12/22/2022]
Affiliation(s)
- T. Hanatani
- Division of Medicinal Safety Science; National Institute of Health Sciences; Tokyo Japan
- Department of Regulatory Science; Graduate School of Pharmaceutical Sciences; Nagoya City University; Aichi Japan
| | - K. Sai
- Division of Medicinal Safety Science; National Institute of Health Sciences; Tokyo Japan
| | - M. Tohkin
- Department of Regulatory Science; Graduate School of Pharmaceutical Sciences; Nagoya City University; Aichi Japan
| | - K. Segawa
- Division of Medicinal Safety Science; National Institute of Health Sciences; Tokyo Japan
| | - Y. Antoku
- Medical Information Center; Kyushu University Hospital; Fukuoka Japan
| | - N. Nakashima
- Medical Information Center; Kyushu University Hospital; Fukuoka Japan
| | - H. Yokoi
- Department of Medical Informatics; Kagawa University Hospital; Kagawa Japan
| | - K. Ohe
- Department of Medical Informatics and Economics; Division of Social Medicine; Graduate School of Medicine; The University of Tokyo; Tokyo Japan
| | - M. Kimura
- Department of Medical Informatics; Hamamatsu University School of Medicine; Shizuoka Japan
| | - K. Hori
- Department of Hospital Pharmacy; Hamamatsu University School of Medicine; Shizuoka Japan
| | - J. Kawakami
- Department of Hospital Pharmacy; Hamamatsu University School of Medicine; Shizuoka Japan
| | - Y. Saito
- Division of Medicinal Safety Science; National Institute of Health Sciences; Tokyo Japan
| |
Collapse
|
29
|
Shiraishi J, Kohno Y, Nakamura T, Yanagiuchi T, Hashimoto S, Ito D, Kimura M, Matsui A, Yokoi H, Arihara M, Hyogo M, Shima T, Sawada T, Matoba S, Yamada H, Matsumuro A, Shirayama T, Kitamura M, Furukawa K. Predictors of in-hospital outcomes after primary percutaneous coronary intervention for acute myocardial infarction in patients with a high Killip class. Intern Med 2014; 53:933-9. [PMID: 24785883 DOI: 10.2169/internalmedicine.53.1144] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE The predictors of in-hospital outcomes after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) complicated with heart failure or cardiogenic shock at presentation remain unclear. METHODS Using the AMI-Kyoto Multi-Center Risk Study database, the clinical background characteristics, angiographic findings, primary PCI results, and in-hospital prognoses were retrospectively compared between primary PCI-treated AMI patients with a Killip class status of ≥2 (Killip 2-4 patients, n=390) and those with a Killip class 1 status (Killip 1 patients, n=1,057). RESULTS The Killip 2-4 patients were more likely to have a higher age and proportion of women and exhibited a higher prevalence of previous myocardial infarction, diabetes mellitus and chronic kidney disease or anemia on admission, lower systolic blood pressure (SBP) values on admission, a higher rate of multivessels or left main trunk as the culprit artery, a larger number of diseased vessels, a lower Thrombolysis In Myocardial Infarction (TIMI) grade in the infarct-related artery (IRA) before/after primary PCI and a significantly higher in-hospital mortality rate than the Killip 1 patients. According to a multivariate analysis, age was found to be an independent positive predictor of in-hospital mortality, while admission SBP was an independent positive predictor of in-hospital survival in both groups. In contrast, anemia on admission was found to be an independent predictor of in-hospital death, while the TIMI 3 flow in the IRA after PCI was found to be an independent factor for survival in the Killip 2-4 patients, but not the Killip 1 patients. CONCLUSION Anemia on admission and the final TIMI 3 flow in the IRA are critical determinants of in-hospital death in AMI patients with a Killip class status of ≥2 undergoing primary PCI.
Collapse
Affiliation(s)
- Jun Shiraishi
- Department of Cardiology, Kyoto First Red Cross Hospital, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Shiraishi J, Kohno Y, Nakamura T, Yanagiuchi T, Hashimoto S, Ito D, Kimura M, Matsui A, Yokoi H, Arihara M, Hyogo M, Shima T, Sawada T, Matoba S, Yamada H, Matsumuro A, Shirayama T, Kitamura M, Furukawa K. Prognostic Impact of Chronic Kidney Disease and Anemia at Admission on In-Hospital Outcomes After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction. Int Heart J 2014; 55:301-6. [DOI: 10.1536/ihj.13-367] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Jun Shiraishi
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Yoshio Kohno
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takeshi Nakamura
- Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
| | | | - Sho Hashimoto
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Daisuke Ito
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Akihiro Matsui
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Hirokazu Yokoi
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Masayasu Arihara
- Department of Emergency Medicine, Kyoto First Red Cross Hospital
| | - Masayuki Hyogo
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takatomo Shima
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Satoaki Matoba
- Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
| | - Hiroyuki Yamada
- Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
| | - Akiyoshi Matsumuro
- Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
| | - Takeshi Shirayama
- Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
| | | | | | | |
Collapse
|
31
|
Domei T, Amemiya K, Enomoto S, Ichihashi K, Yokoi H, Iwabuchi M, Nobuyoshi M. Eicosapentaenoic acid reduced the progression of the coronary atherosclerosis in the patients with optimal LDL cholesterol lowering therapy. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
32
|
Arihara M, Matsubara H, Shimokawahara H, Kohno Y, Sawada T, Shima T, Hyogo M, Shiraishi J, Matsui A, Yokoi H, Kimura M, Ito D, Hoshimoto S, Yanagiuchi T. TCT-677 Efficacy and safety of Refined Balloon Pulmonary Angioplasty for Inoperable Patients with Chronic Thromboembolic Pulmonary Hypertension: A Multicenter Study. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.1427] [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: 11/30/2022]
|
33
|
Kamioka N, Soga Y, Aihara H, Kobayashi Y, Ichihashi K, Hiramori S, Murata N, Tomoi Y, Yokoi H. Long-term follow-up after endovascular treatment in patients with femoropopliteal TASC II class A and B lesion. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p367] [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: 11/13/2022] Open
|
34
|
Amemiya K, Domei T, Yokoi H, Iwabuchi M. Impact of bifurcation angle on mace after cross over single drug-eluting stent strategy in unprotected left main bifurcation lesion: 3-dimensional quantitative coronary angiographic analysis. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3014] [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: 11/14/2022] Open
|
35
|
Shimotakahara J, Yamaji K, Iwabuchi M, Yokoi H, Nobuyoshi M. Long-term outcomes in patients with early, late and very late stent thrombosis after bare metal stenting. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4897] [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: 11/12/2022] Open
|
36
|
Kamioka N, Soga Y, Aihara H, Yokoi H, Iwabuchi M, Nobuyoshi M. Impact of stent placement compared with balloon angioplasty in small vessel of femoropopliteal disease. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht307.p363] [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: 11/14/2022] Open
|
37
|
Kozuma K, Otsuka M, Ikari Y, Uehara Y, Yokoi H, Sano K, Tanabe K, Kimura K, Yamane M, Ishiwata S. Clinical and angiographic outcomes of paclitaxel-eluting stent implantation in patients on maintenance hemodialysis. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1209] [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: 11/14/2022] Open
|
38
|
Domei T, Amemiya K, Ito T, Kuramitsu S, Yokoi H, Iwabuchi M, Nobuyoshi M. Insights into longitudinal stent elongation phenomenon after high pressure additional post stent dilatation from bench testing. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3043] [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: 11/14/2022] Open
|
39
|
Amemiya K, Yokoi H, Iwabuchi M, Nobuyoshi M. Effect of aggressive lipid-lowering therapy with rosuvastatin on reduction of coronary plaque in Japanese patients: APOLLO study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.1050] [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: 11/13/2022] Open
|
40
|
Yokoi H, Kanetoh Y. Visualization Analysis of Asymmetric Fountain Flow Phenomenon in Injection Molding of Filler-reinforced Resins by Rotary Runner Exchange System. INT POLYM PROC 2013. [DOI: 10.3139/217.1875] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
In this study, we attempted to visualize the flow patterns inside molded samples of glass-fibers or talc reinforced GPPS and PP especially in the vicinity of the flow front, using a rotary runner exchange system which instantaneously switches melt flowing into the cavity. From the visualization results, an extremely characteristic flow behavior was seen at the flow front area for resins with fillers which was not observed for those without fillers. Especially in the case of resins with 40 wt.% talc or 30 wt.% GF, a-symmetric zigzag fountain flows were generated alternately upward and downward along the cavity width direction. Moreover along the outer layer of the flow front, one observed a large amount of residual resin remaining for a long time during the cavity filling process, in the case of 40 wt.% GF, primarily due to the increase of viscosity which restricts the occurrence of diverging flow. Based on the above visualization results, we proposed a generic model of zigzag fountain flow; an a-symmetric upward flow in a certain area starts preventing the fountain flow in the upper side of the adjacent area, causing the diverging center to sink. This phenomenon subsequently causes an a-symmetric flow in the opposite direction in the next adjacent area, which continuously propagates along the cavity width direction.
Collapse
Affiliation(s)
- H. Yokoi
- Center for Collaborative Research, The University of Tokyo, Tokyo, Japan
| | - Y. Kanetoh
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
41
|
Abstract
Abstract
In this study, cross-sectional analyses were performed on microcellular injection-molded high-impact polystyrene products. The results confirm that the following five types of layers were formed: Skin layers I (the silver streak layer) and II (a nonfoamed layer), Core layers I (cell diameter, d > 150 μm), II (d < 50 μm), and III (d > 100 μm). As the maximum in-mold pressure (Pmax) was increased from 5 to 30 MPa, the thickness of Skin layer II remained nearly constant. However, the foam types in the core layers changed from I and II to II and III or III only, resulting in an increase in cell diameter and a decrease in cell density. The process of cellular structure formation was observed using a glass-inserted mold, which revealed that this process consists of a flow (with a burst of cells at the melt front and the subsequent flow of the melt containing the cells), an end of the filling (involving elastic compression or the dissolution and disappearance of cells formed in the flow stage), and a cooling (new cell generation and growth and cooling solidification). Based on these cross-sectional observations, in concert with melt-pressure measurements and visualizations, we developed a model describing the formation process of Skin layer II and the core layers including a new concept that considers the melt pressure inside the cavity. The following layers are incorporated into the model: Skin layer II: A nonfoamed layer is formed in the area of the melt front where gases diffuse out from within the melt during the filling stage, and this nonfoamed layer moves to from melt front to the surface of the product due to fountain flow. Core layers I and II: A multilayer is formed containing a distribution of cells preserved from the flow stage due to the low compression forces, Core layer III: cells are dissolved in the melt due to strong compression forces at the end of the filling stage and then reform and grow in the cooling stage.
Collapse
Affiliation(s)
- T. Yamada
- Saitama Industrial Technology Center, Saitama, Japan
| | - Y. Murata
- Nippon Institute of Technology, Saitama, Japan
| | - H. Yokoi
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
42
|
Abstract
Abstract
In plastic injection molding, external defects such as flow marks are serious problems. These external defects are known to occur during cavity filling processes inside the mold, and are closely related to resin flow behavior in the flow front area. In this study, the authors propose a new method for visualizing in-mold resin flow behavior using a glass-inserted mold and rotary runner exchange system capable of instantaneously switching two types of melt at the runner just before the gate. This method is capable not only of dynamic visualization, but also static visualization by the observation of cross-sections of a sample, because colored resins switched multiple times at the gate spread in layers inside the sample and freeze. Using this method and general purpose polystyrene, visualization analysis of the flow behavior of inner layer resins near the flow front in simple rectangular cavities was carried out. As a result, it was found that resins reaching the flow front are not exposed at the molded product surface immediately after the fountain-flow process, but remain along the circumference of the flow front for a long period of time, and then stretch out into a thin film-like shape to form the surface of the molded product. In addition, the inner layer resins near the flow front form a converging flow just before reaching the flow front and then form a fountain flow. It was also confirmed that this is a general phenomenon in the fountain-flow process during injection molding regardless of whether the resin is crystalline or noncrystalline. Based on these results, we built a model on the flow of inner layer resins near the flow front of general resins.
Collapse
Affiliation(s)
- Y. Kanetoh
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - H. Yokoi
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
43
|
Hashimoto S, Shiraishi J, Kimura M, Ito D, Matsui A, Yokoi H, Arihara M, Irie H, Hyogo M, Shima T, Kohno Y. Zilver stent implantation through 4.5 French guiding sheath in iliac vein compression syndrome complicated with acute deep vein thrombosis. J Cardiol Cases 2013; 7:e53-e56. [DOI: 10.1016/j.jccase.2012.11.001] [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] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Revised: 09/21/2012] [Accepted: 11/01/2012] [Indexed: 11/26/2022] Open
|
44
|
Iida O, Soga Y, Kawasaki D, Hirano K, Yamaoka T, Suzuki K, Miyashita Y, Yokoi H, Takahara M, Uematsu M. Angiographic Restenosis and Its Clinical Impact after Infrapopliteal Angioplasty. Eur J Vasc Endovasc Surg 2012; 44:425-31. [DOI: 10.1016/j.ejvs.2012.07.017] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2012] [Accepted: 07/23/2012] [Indexed: 11/28/2022]
|
45
|
Totzeck M, Hendgen-Cotta U, Rammos C, Petrescu A, Stock P, Goedecke A, Shiva S, Kelm M, Rassaf T, Duerr GD, Heuft T, Klaas T, Suchan G, Roell W, Zimmer A, Welz A, Fleischmann BK, Dewald O, Luedde M, Carter N, Lutz M, Sosna J, Jacoby C, Floegel U, Hippe HJ, Adam D, Heikenwaelder M, Frey N, Sobierajski J, Luedicke P, Hendgen-Cotta U, Lue H, Totzeck M, Dewor M, Kelm M, Bernhagen J, Rassaf T, Cortez-Dias N, Costa M, Carrilho-Ferreira P, Silva D, Jorge C, Robalo Martins S, Fiuza M, Pinto FJ, Nunes Diogo A, Enguita FJ, Tsiachris D, Tsioufis C, Kasiakogias A, Flessas D, Antonakis V, Kintis K, Giakoumis M, Hatzigiannis P, Katsimichas T, Stefanadis C, Andrikou E, Tsioufis C, Thomopoulos C, Kasiakogias A, Tzamou V, Andrikou I, Bafakis I, Lioni L, Kintis K, Stefanadis C, Lazaros G, Tsiachris D, Tsioufis C, Vlachopoulos C, Brili S, Chrysohoou C, Tousoulis D, Stefanadis C, Santos De Sousa CI, Pires S, Nunes A, Cortez Dias N, Belo A, Cabrita I, Pinto FJ, Benova T, Radosinska J, Viczenczova C, Bacova B, Knezl V, Dosenko V, Navarova J, Zeman M, Tribulova N, Maceira Gonzalez AM, Cosin Sales J, Igual B, Ruvira J, Diago JL, Aguilar J, Lopez Lereu MP, Monmeneu JV, Estornell J, Choi JC, Cha KS, Lee HW, Yun EY, Ahn JH, Oh JH, Choi JH, Lee HC, Hong TJ, Manzano Fernandez S, Lopez-Cuenca A, Januzzi JL, Mateo-Martinez A, Sanchez-Martinez M, Parra-Pallares S, Orenes-Pinero E, Romero-Aniorte AI, Valdes-Chavarri M, Marin F, Bouzas Mosquera A, Peteiro J, Broullon FJ, Alvarez Garcia N, Couto Mallon D, Bouzas Zubeldia B, Martinez Ruiz D, Yanez Wonenburger JC, Fabregas Casal R, Castro Beiras A, Backus BE, Six AJ, Cullen L, Greenslade J, Than M, Kameyama T, Sato T, Noto T, Nakadate T, Ueno H, Yamada K, Inoue H, Albrecht-Kuepper B, Kretschmer A, Kast R, Baerfacker L, Schaefer S, Kolkhof P, Andersson C, Kober L, Christensen SB, Nguyen CD, Nielsen MB, Olsen AMS, Gislason GH, Torp-Pedersen C, Shigekiyo M, Harada K, Lieu H, Neutel J, Maddock S, Goldsmith S, Koren M, Antwerp BV, Burnett J, Christensen SB, Charlot MG, Madsen M, Andersson C, Kober L, Gustafsson F, Torp-Pedersen C, Gislason GH, Cavusoglu Y, Mert KU, Nadir A, Mutlu F, Gencer E, Ulus T, Birdane A, Lim HS, Tahk SJ, Yang HM, Kim JW, Seo KW, Choi BJ, Choi SY, Yoon MH, Hwang GS, Shin JH, Russ MA, Wackerl C, Hochadel M, Brachmann J, Mudra H, Zeymer U, Weber MA, Menozzi A, Saia F, Valgimigli M, Belotti LM, Casella G, Manari A, Cremonesi A, Piovaccari G, Guastaroba P, Marzocchi A, Kuramitsu S, Iwabuchi M, Haraguchi T, Domei T, Nagae A, Hyodo M, Takabatake Y, Yokoi H, Toyota F, Nobuyoshi M, Kaitani K, Hanazawa K, Izumi C, Nakagawa Y, Ando K, Arita T, Nobuyoshi M, Shizuta S, Kimura T, Isshiuki T, Trucco ME, Tolosana JM, Castel MA, Borras R, Sitges M, Khatib M, Arbelo E, Berruezo A, Brugada J, Mont L, Romanov A, Pokushalov E, Prokhorova D, Chernyavskiy A, Shabanov V, Goscinska-Bis K, Bis J, Bochenek A, Gersak B, Karaskov A, Linde C, Daubert C, Bergemann TL, Abraham WT, Gold MR, Van Boven N, Bogaard K, Ruiter JH, Kimman GP, Kardys I, Umans VA, Cipriani M, Lunati M, Landolina M, Vittori C, Vargiu S, Ghio S, Petracci B, Campo C, Bisetti S, Frigerio M, Bongiorni MG, Soldati E, Segreti L, Zucchelli G, Di Cori A, De Lucia R, Viani S, Paperini L, Boem A, Levorato D, Kutarski A, Malecka B, Zabek A, Czajkowski M, Chudzik M, Kutarski A, Mitkowski P, Maciag A, Kempa M, Golzio PG, Fanelli A, Vinci M, Pelissero E, Morello M, Grosso Marra W, Gaita F, Kutarski A, Czajkowski M, Pietura R, Golzio PG, Vinci M, Pelissero E, Fanelli A, Ferraris F, Gaita F, Cuypers JAAE, Menting ME, Opic P, Utens EMWJ, Van Domburg RT, Helbing WA, Witsenburg M, Van Den Bosch AE, Bogers AJJC, Roos-Hesselink JW, Van Der Linde D, Takkenberg JJM, Rizopoulos D, Heuvelman HJ, Witsenburg M, Budts W, Van Dijk APJ, Bogers AJJC, Oechslin EN, Roos-Hesselink JW, Diller GP, Kempny A, Liodakis E, Alonso-Gonzalez R, Orwat S, Dimopoulos K, Swan L, Li W, Gatzoulis MA, Baumgartner H, Andrade AC, Voges I, Jerosch-Herold M, Pham M, Hart C, Hansen T, Kramer HH, Rickers C, Kempny A, Wustmann K, Borgia F, Dimopoulos K, Uebing A, Piorkowski A, Yacoub MH, Gatzoulis MA, Swan L, Diller GP, Mueller J, Weber R, Pringsheim M, Hoerer J, Hess J, Hager A, Hu K, Liu D, Niemann M, Herrmann S, Cikes M, Stoerk S, Knob S, Ertl G, Bijnens B, Weidemann F, Mornos C, Cozma D, Dragulescu D, Ionac A, Mornos A, Petrescu L, Mingo S, Ruiz Bautista L, Monivas Palomero V, Prados C, Maiz L, Giron R, Martinez M, Cavero Gibanel MA, Segovia J, Pulpon L, Kato H, Kubota S, Takasawa Y, Kumamoto T, Iacoviello M, Puzzovivo A, Forleo C, Lattarulo MS, Monitillo F, Antoncecchi V, Malerba G, Marangelli V, Favale S, Ruiz Bautista L, Mingo S, Monivas V, Segovia J, Prados C, Maiz L, Giron R, Martinez MT, Gonzalez Estecha M, Alonso Pulpon LA, Ren B, De Groot-De Laat L, Mcghie J, Vletter W, Ten Cate F, Geleijnse M, Looi JL, Lam YY, Yu CM, Lee PW, Apor A, Sax B, Huttl T, Nagy A, Kovacs A, Merkely B, Vecera J, Bartunek J, Vanderheyden M, Mertens P, Bodea O, Penicka M, Biaggi P, Gaemperli O, Corti R, Gruenenfelder J, Felix C, Bettex D, Datta S, Jenni R, Tanner F, Herzog B, Fattouch K, Murana G, Castrovinci S, Sampognaro R, Bertolino EC, Caccamo G, Ruvolo G, Speziale G, Lancellotti P. Saturday, 25 August 2012. Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs280] [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: 11/13/2022] Open
|
46
|
Kuwabara T, Mori K, Mukoyama M, Kasahara M, Yokoi H, Saito Y, Ogawa Y, Imamaki H, Kawanishi T, Ishii A, Koga K, Mori KP, Kato Y, Sugawara A, Nakao K. Exacerbation of diabetic nephropathy by hyperlipidaemia is mediated by Toll-like receptor 4 in mice. Diabetologia 2012; 55:2256-66. [PMID: 22610400 DOI: 10.1007/s00125-012-2578-1] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 04/04/2012] [Indexed: 12/24/2022]
Abstract
AIMS/HYPOTHESIS Hyperlipidaemia is an independent risk factor for the progression of diabetic nephropathy, but its molecular mechanism remains elusive. We investigated in mice how diabetes and hyperlipidaemia cause renal lesions separately and in combination, and the involvement of Toll-like receptor 4 (TLR4) in the process. METHODS Diabetes was induced in wild-type (WT) and Tlr4 knockout (KO) mice by intraperitoneal injection of streptozotocin (STZ). At 2 weeks after STZ injection, normal diet was substituted with a high-fat diet (HFD). Functional and histological analyses were carried out 6 weeks later. RESULTS Compared with treatment with STZ or HFD alone, treatment of WT mice with both STZ and HFD markedly aggravated nephropathy, as indicated by an increase in albuminuria, mesangial expansion, infiltration of macrophages and upregulation of pro-inflammatory and extracellular-matrix-associated gene expression in glomeruli. In Tlr4 KO mice, the addition of an HFD to STZ had almost no effects on the variables measured. Production of protein S100 calcium binding protein A8 (calgranulin A; S100A8), a potent ligand for TLR4, was observed in abundance in macrophages infiltrating STZ-HFD WT glomeruli and in glomeruli of diabetic nephropathy patients. High-glucose and fatty acid treatment synergistically upregulated S100a8 gene expression in macrophages from WT mice, but not from KO mice. As putative downstream targets of TLR4, phosphorylation of interferon regulatory factor 3 (IRF3) was enhanced in kidneys of WT mice co-treated with STZ and HFD. CONCLUSIONS/INTERPRETATION Activation of S100A8/TLR4 signalling was elucidated in an animal model of diabetic glomerular injury accompanied with hyperlipidaemia, which may provide novel therapeutic targets in progressive diabetic nephropathy.
Collapse
Affiliation(s)
- T Kuwabara
- Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawaharacho, Sakyoku, Kyoto, 606-8507, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Shiraishi J, Kohno Y, Sawada T, Hashimoto S, Ito D, Kimura M, Matsui A, Yokoi H, Arihara M, Irie H, Hyogo M, Shima T, Nakamura T, Matoba S, Yamada H, Matsumuro A, Shirayama T, Kitamura M, Furukawa K, Matsubara H. Prognostic impact of systolic blood pressure at admission on in-hospital outcome after primary percutaneous coronary intervention for acute myocardial infarction. J Cardiol 2012; 60:139-44. [DOI: 10.1016/j.jjcc.2012.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Revised: 02/09/2012] [Accepted: 02/20/2012] [Indexed: 12/20/2022]
|
48
|
Ito D, Shiraishi J, Nakamura T, Maruyama N, Iwamura Y, Hashimoto S, Kimura M, Matsui A, Yokoi H, Arihara M, Irie H, Hyogo M, Shima T, Kohno Y, Matsumuro A, Sawada T, Matsubara H. Primary percutaneous coronary intervention and intravascular ultrasound imaging for coronary thrombosis after cisplatin-based chemotherapy. Heart Vessels 2012; 27:634-8. [PMID: 22218740 DOI: 10.1007/s00380-011-0222-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 12/08/2011] [Indexed: 01/25/2023]
Abstract
Although cisplatin is indispensable for the chemotherapy treatment of many malignancies, cisplatin-associated thrombosis is attracting increasing attention. However, experience of primary percutaneous coronary intervention (PCI) and intravascular ultrasound imaging (IVUS) for coronary thrombosis, possibly due to cisplatin-based chemotherapy, has been limited. Case 1 with postoperative gastric cancer developed acute myocardial infarction (AMI) on the sixth day of the second chemotherapy course with conventional doses of cisplatin and tegafur gimeracil oteracil potassium. Emergency coronary angiography (CAG) showed a filling defect in the proximal left anterior descending coronary artery (LAD) concomitant with no reflow in the distal LAD. Case 2 with advanced lung cancer and brain metastasis suffered AMI on the fifth day of the first chemotherapy course with conventional doses of cisplatin and gemcitabine. Emergency CAG delineated a total occlusion in the proximal right coronary artery. In both cases, thrombectomy using aspiration catheter alone obtained optimal angiographic results and subsequent IVUS revealed no definite atherosclerotic plaque, while slow flow still remained even after selective intra-coronary infusion of vasodilator in the case 1. These cases suggest that primary PCI using thrombus-aspiration catheter might be safe and effective for coronary thrombosis due to cisplatin-based chemotherapy.
Collapse
Affiliation(s)
- Daisuke Ito
- Department of Cardiology, Kyoto First Red Cross Hospital, Honmachi, Higashiyama-ku, Kyoto, 605-0981, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Inohira E, Yokoi H. Evaluation of an optimal design method for a multilayer perceptron by using the design of experiments. Artif Life Robotics 2011. [DOI: 10.1007/s10015-011-0962-4] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
50
|
Abstract
The output error of a neuron network cannot converge at zero, even if the training for a neuron network is iterated many times. “Error-convergence neuron network” in which the output error of a singleoutput system uses neuron networks with multiplestep convergence, has been designed to resolve this problem. The output error is converged at zero by setting infinite steps of the neuron network. Three types of neuron network systems also have been designed. They are “Error-convergence parallel neuron network,” “Error-convergence recurrent neuron network,” and “Error-convergence parallel recurrent neuron network.” A subsequent prediction can be obtained by recurring the prediction of a predictor to its input if the predictor is free of prediction error. An error-convergence neuron network can be applied to realize this predictor. “Error-convergence neuron network predictor” has been proposed as such a predictor. In this study, its feasibility is investigated by performing prediction training for the errorconvergence neuron network predictor constructed of second-order Volterra neuron networks with two steps, using the nonlinear time series signal of a normal sinus rhythm electrocardiogram. Predictions without any error were obtained.
Collapse
|