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Habara M, Tsuchikane E, Shimizu K, Kawasaki T. Japanese multicenter registry evaluating the antegrade dissection reentry with cardiac computed tomography for chronic coronary total occlusion. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2568] [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
Objective
This study was performed to evaluate the efficacy of cardiac computed tomography (CT) for antegrade dissection re-entry (ADR) technique in chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Background
Although PCI of CTO is a rapidly evolving field, procedure success rate remains suboptimal. Recently, ADR with Stingray device for CTO-PCI has also evolved to one of the pillar technique of the hybrid algorithm. Although the success rate of the device could be improved, it also remains not always high especially as first crossing strategy.
Methods
Forty eight patients with total occlusion suitable for revascularization evaluated by baseline coronary angiography and cardiac CT were enrolled in this study from April 2017 to April 2019 from 30 enrolled centers. The primary observation was procedural success. Furthermore, all puncture point with Stingray were analyzed by cardiac CT. In each point, 1) plaques on the isolated myocardial side at distal puncture site (+1 point), 2) any plaques excluded above definition at distal puncture site (+2 points), 3) calcification on both 1 and 2 at distal puncture site (+1 point) were analyzed and calculated the score (Score 0–3) (Figure 1).
Results
Overall procedure success rate was 95.8% (46/48) and antegrade success rate was 91.3% (42/46). Sixteen cases were succeeded with single guidewire escalation and 32 cases were attempted ADR with Stingray system. Within them, 25 cases were succeeded and 7 cases were observed puncture failure. And 3cases were succeeded with IVUS guide and 2 cases were with retrograde appTechnical success rate with stingray was 78.1% (25/32). Cardiac CT was analyzed 60 puncture sites in 32 cases which were attempted ADR with stingray system (1.88 sites/case). CT score at ADR success point was significantly smaller compare to that at ADR failure point (0.68±1.09 vs 1.77±1.09, p<0.0001).
Conclusions
Pre procedure Cardiac CT and CT score might be useful for ADR technique in CTO PCI not only for case selection but also for puncture site selection.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Habara
- Toyohashi Heart Center, Toyohashi, Japan
| | | | - K Shimizu
- Toyohashi Heart Center, Toyohashi, Japan
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Habara M, Tsuchikane E, Nasu K, Kinoshita Y, Terashima M, Matsubara T, Murata A, Suzuki Y, Kawase Y, Okubo M, Matsuo H, Suzuki T. P974Efficacy of plaque debulking for bifurcated or ostial lesion by directional coronary atherectomy before 2nd generation drug eluting stent (PERFECT2). Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0568] [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: 11/12/2022] Open
Abstract
Abstract
Objectives
We sought to evaluate the efficacy of plaque debulking by directional coronary atherectomy (DCA) before 2nd generation drug-eluting stent (DES) implantation for bifurcated coronary lesions.
Background
Percutaneous coronary intervention (PCI) for bifurcated lesions still remains complex and challenging in terms of restenosis or stent thrombosis regardless of whether simple or complex stenting used.
Methods
Patients with bifurcated lesions were enrolled in this prospective multicenter registry. Pre-2nd generation DES plaque debulking with a novel DCA was conducted. All patients were scheduled to perform a follow up (9–12 months) angiography (coronary angiography or coronary computed tomography). The primary end point was the target vessel failure (TVF) at follow-up. Secondary end points were procedure-related events and major adverse cardiac events at 1 year.
Results
A total of 77 patients with bifurcated lesions were enrolled. PCI with DCA was performed successfully in all without any major procedure-related event and only 1 case needed complex stenting. TVF rate at 9–12 months follow up was 3.9% (3 of 77) and those were all associated with revascularization of the target vessel. Restenosis was only observed at ostial of main-branch in 3cases. No death, no coronary artery bypass grafting, and no myocardial infarction were reported in the patients within the first year.
Figure1
Conclusion
DCA before 2nd generation DES implantation can possibly avoid complex stenting and provide a good mid-term outcome in patients with bifurcated lesions.
Acknowledgement/Funding
None
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Affiliation(s)
- M Habara
- Toyohashi Heart Center, Toyohashi, Japan
| | | | - K Nasu
- Toyohashi Heart Center, Toyohashi, Japan
| | | | | | | | - A Murata
- Nagoya Heart Center, Cardiovascular medicine, Nagoya, Japan
| | - Y Suzuki
- Nagoya Heart Center, Cardiovascular medicine, Nagoya, Japan
| | | | - M Okubo
- Gifu Heart Center, Gifu, Japan
| | | | - T Suzuki
- Toyohashi Heart Center, Toyohashi, Japan
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Kano S, Nasu K, Habara M, Shimura T, Yamamoto M, Adachi Y, Konishi H, Kodama A, Koshida R, Kinoshita Y, Tsuchikane E, Terashima M, Matsubara T, Suzuki T. 124Impact of intimal tracking for recanalization of CTO lesions on long-term clinical outcomes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/12/2022] Open
Abstract
Abstract
Background
For recanalization of coronary chronic total occlusion (CTO) lesions, subintimal guidewire tracking in both antegrade and retrograde approaches are commonly used.
Purpose
This study aimed to assess the impact of subintimal tracking on long-term clinical outcomes after recanalization of CTO lesions.
Methods
Between January 2009 and December 2016, 474 CTO lesions (434patients) were successfully recanalized in our center. After guidewire crossing in a CTO lesion, those lesions were divided into intimal tracking group (84.6%, n=401) and subintimal tracking group (15.4%, n=73) according to intravascular ultrasound (IVUS) findings. Long-term clinical outcomes including death, target lesion revascularization (TLR), target vessel revascularization (TVR) were compared between the two groups. In addition, the rate of re-occlusion after successful revascularization was also evaluated.
Results
The median follow-up period was 4.7 years (interquartile range, 2.8–6.1). There was no significant difference of the rate of cardiac death between the two groups (intimal tracking vs. subintimal tracking: 7.0% vs. 4.1%; hazard ratio, 0.61; 95% confidence interval [CI], 0.19 to 2.00; p=0.41), TLR (14.3% vs. 16.2%; hazard ratio, 1.34; 95% CI, 0.71 to 2.53; p=0.37), and TVR (17.5% vs. 20.3%; hazard ratio, 1.27; 95% CI, 0.72 to 2.23; p=0.42). However, the rate of re-occlusion was significantly higher in the subintimal tracking group than intimal tracking group at 3-years re-occlusion (4.2% vs. 14.5%; log-rank test, p=0.002, Figure). In the multivariate COX regression, subintimal guidewire tracking was an independent predictor of re-occlusion after CTO recanalization (HR: 5.40; 95% CI: 2.11–13.80; p<0.001).
Figure 1
Conclusions
Subintimal guidewire tracking for recanalization of coronary CTO was associated with significantly higher incidence of target lesion re-occlusion during long-term follow-up period.
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Affiliation(s)
- S Kano
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - K Nasu
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - M Habara
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - T Shimura
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - M Yamamoto
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - Y Adachi
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - H Konishi
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - A Kodama
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - R Koshida
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - Y Kinoshita
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - E Tsuchikane
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - M Terashima
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - T Matsubara
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
| | - T Suzuki
- Toyohashi Heart Center, cardiovascular medicine, Toyohashi, Japan
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Matsuno S, Yamane M, Muramatsu T, Okamura A, Kashima Y, Sakurada M, Kijima M, Tanabe M, Mutoh M, Habara M. P4220Feasibility of contemporary percutaneous coronary intervention for chronic total occlusion in chronic kidney disease patients: sub-analysis of Japanese multicenter registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4220] [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: 11/14/2022] Open
Affiliation(s)
- S. Matsuno
- Cardiovascular Institute, Dept. of Cardiovascular Medicine, Tokyo, Japan
| | - M. Yamane
- Saitama Sekishinkai Hospital, Cardiology Department, Saitama, Japan
| | - T. Muramatsu
- Tokyo General Hospital, Cardiovascular Center, Tokyo, Japan
| | - A. Okamura
- Sakurabashi-Watanabe Hospital, Division of Cardiology, Osaka, Japan
| | - Y. Kashima
- Sapporo CardioVascular Clinic, Division of Cardiology, Hokkaido, Japan
| | - M. Sakurada
- Tokorozawa Heart Center, Dept. of Cardiology, Saitama, Japan
| | - M. Kijima
- Hoshi General Hospital, Cardiology and Vascular Medicine, Fukushima, Japan
| | - M. Tanabe
- Kyoto Okamoto Memorial Hospital, Dept. of Cardiology, Kyoto, Japan
| | - M. Mutoh
- Saitama Prefecture Cardiovascular and Respiratory Center, Division of Cardiology, Saitama, Japan
| | - M. Habara
- Toyohashi Heart Center, Dept. of Cardiology, Aichi, Japan
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Katoh H, Yamane M, Muramatsu T, Okamura A, Kashima Y, Matsuno S, Sakurada M, Kijima M, Tanabe M, Habara M. P4222Examination of chronic total occlusion cases who were switched to antegrade approach after failure of retrograde procedure from the Japanese Retrograde Summit Registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4222] [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
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Ichihashi T, Kurita T, Yokota D, Ito T, Kodama A, Habara M, Nasu K, Ehara M, Kinoshita Y, Suzuki T. Prognostic significance of follow up CT coronary angiography for the patients after percutaneous coronary intervention compared to invasive coronary angiography. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4782] [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: 11/12/2022] Open
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Oshima S, Kisa K, Terashita T, Habara M, Kawabata H, Maezawa M. A qualitative study of Japanese patients' perspectives on post-treatment care for gynecological cancer. Asian Pac J Cancer Prev 2011; 12:2255-2261. [PMID: 22296366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
The perspectives of cancer patients are important for designing a medically and economically effective follow-up program to help in the rapid recovery of patients. However, research focusing on the perspectives of Japanese gynecological cancer patients on follow-up programs is extremely scarce. In this study, we explored the perspectives and expectations of Japanese gynecological cancer patients with regard to post-treatment follow-up. Twenty-eight patients recruited through a gynecological cancer support group were included in focus groups 1-10 years post-treatment. Participants' accounts related to their perspectives on follow-up were coded and grouped into themes according to commonalities and differences. Seven themes emerged as follows: (1) living with uncertainty, (2) monitoring recurrence, (3) test content and frequency, (4) coping with "another illness", (5) provider communication and attitude, (6) holistic care, and (7) compromising with the reality of changed body. While these Japanese gynecological patients regarded follow-up as an opportunity for reassurance, they also wanted treatment for adverse effects and the opportunity to discuss their concerns. On the basis of the study findings, we conclude that during follow-up after cancer treatment, Japanese gynecological cancer patients not only prioritize recurrence management of cancer but also place a significant amount of importance on the management of symptoms and doctor-patient communication. However, these expectations for communication and care are often unmet. Thus, there is a need to fulfill the gap between the current follow-up programs and patients' expectations by reviewing and changing the hospital's policy that mainly focuses on the detection of recurrent diseases.
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Affiliation(s)
- S Oshima
- Department of Psychology and Communication, School of Humanities, Hokusei Gakuen University, Sapporo, Japan.
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Affiliation(s)
- K Toko
- Graduate School of Information Science and Electrical Engineering, Kyushu University, 6-10-1 Hakozaki, Higashi-ku, Fukuoka, 812-8581, Japan.
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Kato K, Habara M, Yoshizawa Y, Biebel U, Haberstock G, Heinzl J, Korschinek G, Morinaga H, Nolte E. Accelerator mass spectrometry of 36Cl produced by neutrons from the Hiroshima bomb. Int J Radiat Biol 1990; 58:661-72. [PMID: 1976726 DOI: 10.1080/09553009014552011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Accelerator mass spectrometry was performed at the Munich tandem laboratory to determine 36Cl/Cl ratios of samples from a tombstone exposed to neutrons from the Hiroshima bomb. The ratios were determined from the surface to deeper positions. The depth profile of 36Cl/Cl can be used for estimating the neutron energy distribution and intensity near the hypocentre in Hiroshima.
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Affiliation(s)
- K Kato
- Research Institute for Nuclear Medicine and Biology, Hiroshima University, Japan
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