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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 2024; 31:450-456. [PMID: 36382873 DOI: 10.1177/15266028221134890] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [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.
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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
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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.
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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
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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.
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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
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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.
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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
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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
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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
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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
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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.
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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
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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.
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Affiliation(s)
| | - Taku Kato
- Corresponding author. Department of Cardiology, Rakuwakai Otowa Hospital, 2 Otowachinji-cho, Yamashina-ku, Kyoto, 607-8062, Japan.
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Yanagiuchi T, Tada N, Suchi T, Mizutani Y, Matsumoto T, Sakurai M, Ootomo T. Spontaneous Resolution of Residual Shunting in 2 Compromised Patients after Amplatzer Occlusion of Postinfarction Ventricular Septal Defects. Tex Heart Inst J 2019; 46:44-47. [PMID: 30833838 DOI: 10.14503/thij-17-6416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Ventricular septal defect (VSD) is a rare, potentially fatal complication of acute myocardial infarction. When surgical closure is contraindicated, transcatheter closure may be an alternative. Residual shunting after transcatheter closure of postinfarction VSDs has been reported; however, we found few cases of this in patients who also had severe heart failure or hemolysis. We report 2 closures of postinfarction VSDs with use of the Amplatzer Septal Occluder. Both elderly patients-one with severe heart failure, one with persistent hemolysis, and neither a surgical candidate-had high-velocity residual shunting through the occluders. We intensively managed the patients' conditions and used angiography and transthoracic echocardiography to record the gradual disappearance of each shunt over 4 months-the first such serial monitoring of which we are aware. We think that even substantial shunting in the presence of severe heart failure or hemolysis can eventually resolve spontaneously, assuming effective management of the concomitant medical conditions.
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Yanagiuchi T, Tada N, Haga Y, Suzuki S, Sakurai M, Taguri M, Ootomo T. Utility of preprocedural multidetector computed tomography in alcohol septal ablation for hypertrophic obstructive cardiomyopathy. Cardiovasc Interv Ther 2019; 34:364-372. [PMID: 30725361 DOI: 10.1007/s12928-019-00574-0] [Citation(s) in RCA: 3] [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: 06/09/2018] [Accepted: 01/23/2019] [Indexed: 10/27/2022]
Abstract
Preprocedural computed tomography (CT) imaging appears to provide an advantage in localization of the appropriate septal branch targeted for alcohol septal ablation (ASA). The objective of this study was to compare the clinical backgrounds, procedural characteristics, and outcomes of patients who underwent ASA with preprocedural CT assessment against those without CT assessment. Thirty consecutive patients with obstructive hypertrophic cardiomyopathy who underwent ASA were retrospectively included. Patients who underwent preprocedural CT (CT-guided ASA group, n = 11) were compared with patients who underwent ASA without CT (traditional ASA group, n = 19). The CT-guided ASA group had a significantly lower number of approached target vessels (1 [interquartile range {IQR}, 1-2] vs. 2 [IQR, 2-3], P = 0.036) and non-ablated target vessels (0 [IQR, 0-1] vs. 1 [IQR, 0-2], P = 0.031) than the traditional ASA group. There were no differences between the two groups in total fluoroscopy time, the amount of delivered radiation dose, and the volume of contrast medium used during the procedures. There were also no differences between the two groups in procedural success rate and improvement of left ventricular outflow tract gradient and New York Heart Association functional class at 1 month follow-up. CT had a significant impact on the ASA procedure diminishing the number of target vessels, and could be a reliable assessment modality to build its procedural strategy.
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Affiliation(s)
- Takashi Yanagiuchi
- Department of Cardiology, Rakuwakai Otowa Hospital, Otowachinji-cho, Yamashina-ku, Kyoto, 607-8062, Japan.,Department of Cardiology, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, 980-0873, Japan
| | - Norio Tada
- Department of Cardiology, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, 980-0873, Japan.
| | - Yoshihiro Haga
- Department of Radiology, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, 980-0873, Japan
| | - Shinichi Suzuki
- Department of Radiology, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, 980-0873, Japan
| | - Mie Sakurai
- Department of Cardiology, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, 980-0873, Japan
| | - Masataka Taguri
- Department of Biostatistics and Epidemiology, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Tatsushi Ootomo
- Department of Cardiology, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, 980-0873, Japan
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Yanagiuchi T, Tada N, Enta Y, Hata M, Abe H, Ootomo T. Percutaneous closure of iatrogenic ventricular septal rupture following septal branch obstruction during elective coronary angioplasty. Cardiovasc Interv Ther 2018; 34:72-73. [PMID: 29363045 DOI: 10.1007/s12928-018-0512-2] [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: 08/30/2017] [Accepted: 01/14/2018] [Indexed: 10/18/2022]
Affiliation(s)
- Takashi Yanagiuchi
- Department of Cardiology, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, 980-0873, Japan.
| | - Norio Tada
- Department of Cardiology, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, 980-0873, Japan
| | - Yusuke Enta
- Department of Cardiology, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, 980-0873, Japan
| | - Masaki Hata
- Department of Cardiovascular Surgery, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, 980-0873, Japan
| | - Hideki Abe
- Department of Cardiology, Sanyudo Hospital, Tyuou, Yonezawa, Yamagata, 992-0045, Japan
| | - Tatsushi Ootomo
- Department of Cardiology, Sendai Kousei Hospital, Hirosemachi, Aoba-ku, Sendai, 980-0873, Japan
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Yanagiuchi T, Shiraishi J, Shoji K, Hyogo M, Sawada T, Kohno Y. Entrapped optical frequency domain imaging-guided rewiring and reconstruction of a deformed coronary stent. Cardiovasc Interv Ther 2017; 32:247-253. [DOI: 10.1007/s12928-016-0400-6] [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: 02/29/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022]
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Shiraishi J, Shoji K, Yanagiuchi T, Yashige M, Shikuma A, Ito D, Kimura M, Kishita E, Nakagawa Y, Hyogo M, Sawada T. Rotational Atherectomy Followed by Drug-Coated Balloon Dilation for Left Main In-Stent Restenosis in the Setting of Acute Coronary Syndrome Complicated with Right Coronary Chronic Total Occlusion. Int Heart J 2017; 58:806-811. [DOI: 10.1536/ihj.16-518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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
| | - Keisuke Shoji
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Masaki Yashige
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Akira Shikuma
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Daisuke Ito
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Eigo Kishita
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Masayuki Hyogo
- Department of Cardiology, Kyoto First Red Cross Hospital
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Yanagiuchi T, Tada N, Mizutani Y, Matsumoto T, Sakurai M, Ootomo T. Feasibility Assessment of Alcohol Septal Ablation in Transcatheter Aortic Valve Replacement Using Multidetector Computed Tomography. JACC Cardiovasc Interv 2016; 10:e7-e9. [PMID: 28040442 DOI: 10.1016/j.jcin.2016.10.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 10/20/2016] [Indexed: 10/20/2022]
Affiliation(s)
| | - Norio Tada
- Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan
| | - Yukiko Mizutani
- Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan
| | | | - Mie Sakurai
- Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan
| | - Tatsushi Ootomo
- Department of Cardiology, Sendai Kousei Hospital, Sendai, Japan
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Yanagiuchi T, Kimura M, Shiraishi J, Sawada T. Endovascular Treatment for Infra-inguinal Autologous Saphenous Vein Graft Occlusion Using Self Expanding Nitinol Stents. EJVES Short Rep 2016; 30:16-19. [PMID: 28856296 PMCID: PMC5573116 DOI: 10.1016/j.ejvssr.2016.02.001] [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] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Revised: 01/29/2016] [Accepted: 02/03/2016] [Indexed: 12/04/2022] Open
Abstract
Introduction For patients with infra-inguinal autologous vein bypass graft occlusion, conventional open surgical repair or endovascular treatment (EVT) for native vessel occlusion have generally been performed. Report A 73 year old female with non-healing ulcer and gangrene of the left lower leg was diagnosed as having infra-inguinal autologous saphenous vein graft occlusion. In this case, surgical repair such as patch angioplasty, interposition graft, or replacement graft did not seem promising because of repeated previous infection in the polytetrafluoroethylene (PTFE) vascular prosthesis and absence of available autologous vein due to past surgery. Moreover, there was no chance of crossing the native vessel, since the proximal superficial femoral artery (SFA) had already been resected. Thus, EVT was performed for the occluded autologous vein graft, implanting multiple self expanding bare nitinol stents throughout the vein graft achieving complete revascularization, good medium term patency, and dramatically improved wound healing. Conclusion Endovascular recanalization using multiple bare stents could be an alternative treatment for infra-inguinal autologous vein graft occlusion. This report highlights EVT for infra-inguinal autologous vein graft occlusion. Self-expanding nitinol bare stents were implanted throughout the vein graft. Just after the procedure, we confirmed sufficient expansion of the nitinol stents. The treated vessel had good patency without repetitive intervention for 15 months. The ulcer and gangrene gradually healed.
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Affiliation(s)
- T Yanagiuchi
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - M Kimura
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - J Shiraishi
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - T Sawada
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
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16
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Shiraishi J, Nakamura T, Shikuma A, Shoji K, Nishikawa M, Yanagiuchi T, Ito D, Kimura M, Kishita E, Nakagawa Y, Hyogo M, Sawada T, Yamada H, Matsumuro A, Shirayama T, Kitamura M, Kohno Y, Furukawa K, Matoba S. Relationship Between Mean Blood Pressure at Admission and In-Hospital Outcome After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction. Int Heart J 2016; 57:547-52. [DOI: 10.1536/ihj.15-480] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Jun Shiraishi
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Takeshi Nakamura
- Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
| | - Akira Shikuma
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Keisuke Shoji
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | | | - Daisuke Ito
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Eigo Kishita
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Masayuki Hyogo
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - 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
| | | | - Yoshio Kohno
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Satoaki Matoba
- Department of Cardiovascular Medicine, Kyoto Prefectural University School of Medicine
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17
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Shiraishi J, Matsubara Y, Yanagiuchi T, Shikuma A, Shoji K, Nishikawa M, Ito D, Kimura M, Kishita E, Nakagawa Y, Hyogo M, Sawada T, Kohno Y. Rotational Atherectomy Followed by Drug-Coated Balloon Dilation in Possible Coronary Sequelae of Kawasaki Disease. Int Heart J 2016; 57:367-71. [DOI: 10.1536/ihj.15-354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [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
| | - Yuki Matsubara
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Akira Shikuma
- Department of Cardiology, Kyoto First Red Cross Hospital
| | - Keisuke Shoji
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Daisuke Ito
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Eigo Kishita
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Masayuki Hyogo
- Department of Cardiology, Kyoto First Red Cross Hospital
| | | | - Yoshio Kohno
- Department of Cardiology, Kyoto First Red Cross Hospital
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18
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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.>.
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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
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Hashimoto S, Shiraishi J, Nakamura T, Nishikawa M, Yanagiuchi T, Ito D, Kimura M, Kishita E, Nakagawa Y, Hyogo M, Shima T, Sawada T, Matoba S, Yamada H, Matsumuro A, Shirayama T, Kitamura M, Kohno Y, Furukawa K. Survivors of acute myocardial infarction at left main trunk undergoing primary percutaneous coronary intervention. Cardiovasc Interv Ther 2015; 31:89-95. [DOI: 10.1007/s12928-015-0352-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 08/20/2015] [Indexed: 11/29/2022]
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20
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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.
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Affiliation(s)
- Jun Shiraishi
- Department of Cardiology, Kyoto First Red Cross Hospital, Japan
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21
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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
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Fukuda K, Kiyokawa Y, Yanagiuchi T, Wakai Y, Kitamoto K, Inoue Y, Kimura A. Purification and characterization of isoamyl acetate-hydrolyzing esterase encoded by the IAH1 gene of Saccharomyces cerevisiae from a recombinant Escherichia coli. Appl Microbiol Biotechnol 2000; 53:596-600. [PMID: 10855721 DOI: 10.1007/s002530051662] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The IAH1 gene of Saccharomyces cerevisiae encodes an esterase that preferentially acts on isoamyl acetate; however, the enzyme has not yet been completely purified from the yeast S. cerevisiae. We constructed the IAH1 gene expression system in Escherichia coli, and purified the IAH1 gene product (Iah1p). The amount of Iah1p produced by recombinant E. coli was more than 40% of total cellular proteins. The molecular size of Iah1p was 28 kDa by SDS-polyacrylamide gel electrophoresis. Judging from the molecular weight estimation by gel filtration of purified Iah1p, the enzyme was thought to be a homodimer. The Km values for isoamyl acetate and isobutyl acetate were 40.3 mM and 15.3 mM, respectively. The enzyme activity was inhibited by Hg2+, p-chloromercuribenzoate, and diisopropylfluorophosphate.
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Affiliation(s)
- K Fukuda
- Kizakura Sake Brewing Co., Ltd., Kyoto, Japan.
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23
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Fukuda K, Yamamoto N, Kiyokawa Y, Yanagiuchi T, Wakai Y, Kitamoto K, Inoue Y, Kimura A. Balance of activities of alcohol acetyltransferase and esterase in Saccharomyces cerevisiae is important for production of isoamyl acetate. Appl Environ Microbiol 1998; 64:4076-8. [PMID: 9758847 PMCID: PMC106606 DOI: 10.1128/aem.64.10.4076-4078.1998] [Citation(s) in RCA: 91] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Isoamyl acetate is synthesized from isoamyl alcohol and acetyl coenzyme A by alcohol acetyltransferase (AATFase) in Saccharomyces cerevisiae and is hydrolyzed by esterases at the same time. We hypothesized that the balance of both enzyme activities was important for optimum production of isoamyl acetate in sake brewing. To test this hypothesis, we constructed yeast strains with different numbers of copies of the AATFase gene (ATF1) and the isoamyl acetate-hydrolyzing esterase gene (IAH1) and used these strains in small-scale sake brewing. Fermentation profiles as well as components of the resulting sake were largely alike; however, the amount of isoamyl acetate in the sake increased with an increasing ratio of AATFase/Iah1p esterase activity. Therefore, we conclude that the balance of these two enzyme activities is important for isoamyl acetate accumulation in sake mash.
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Affiliation(s)
- K Fukuda
- Kizakura Sake Brewing Co., Ltd., Fushimi-ku, Kyoto 612-8046, Japan.
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