1. Articles from shigeho takarada

    1-24 of 32 1 2 »
    1. Effect of Atorvastatin Therapy on Fibrous Cap Thickness in Coronary Atherosclerotic Plaque as Assessed by Optical Coherence Tomography The EASY-FIT Study

      Effect of Atorvastatin Therapy on Fibrous Cap Thickness in Coronary Atherosclerotic Plaque as Assessed by Optical Coherence Tomography The EASY-FIT Study

      Background The detailed mechanism of plaque stabilization by statin therapy is not fully understood. Objectives The aim of this study was to assess the effect of lipid-lowering therapy with 20 mg/day of atorvastatin versus 5 mg/day of atorvastatin on fibrous cap thickness in coronary atherosclerotic plaques by using optical coherence tomography (OCT). Methods Seventy patients with unstable angina pectoris and untreated dyslipidemia were randomized to either 20 mg/day or 5 mg/day of atorvastatin therapy. OCT was performed to assess intermediate nonculprit lesions at baseline and 12-month follow-up. Results Serum low-density lipoprotein cholesterol level was significantly lower ...

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    2. Coronary Superficial and Spotty Calcium Deposits in Culprit Coronary Lesions of Acute Coronary Syndrome as Determined by Optical Coherence Tomography

      Coronary Superficial and Spotty Calcium Deposits in Culprit Coronary Lesions of Acute Coronary Syndrome as Determined by Optical Coherence Tomography

      The characteristics of coronary artery calcium responsible for vulnerable plaque remain incompletely elucidated. We used optical coherence tomography to investigate the characteristics of coronary calcium in acute myocardial infarction (AMI), unstable angina pectoris (UAP), and stable angina pectoris (SAP). We evaluated calcium deposits in the culprit lesions (30-mm segment) using optical coherence tomography in 187 patients with AMI (n = 44), UAP (n = 73), or SAP (n = 70). The arc, area, and length of calcium were significantly smaller in those with AMI and UAP than in those with SAP (p <0.001). The number of spotty calcium deposits (with an arc ...

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    3. Clinical Significance of Low Signal Intensity Area Surrounding Stent Struts Identified by Optical Coherence Tomography

      Clinical Significance of Low Signal Intensity Area Surrounding Stent Struts Identified by Optical Coherence Tomography

      Previous intravascular ultrasound studies have shown that echolucent neointimal hyperplasia occasionally appears after bare-metal stent (BMS) or sirolimus-eluting stent (SES) implantation. Optical coherence tomography (OCT) studies have also demonstrated that paclitaxel-eluting stent (PES) restenosis exhibited similar images showing low signal intensity areas (LSIA) surrounding stent struts and three-layer appearance (TLA). The aim of the present study was to investigate the clinical significance of LSIA on OCT images in various types of stents. Fifty nine consecutive patients who underwent scheduled follow-up coronary angiography and OCT were enrolled. There was no significant difference in the prevalence of LSIA among the 3 stent ...

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    4. Effect of strut thickness on neointimal atherosclerotic change over an extended follow-up period (≥4 years) after bare-metal stent implantation: Intracoronary optical coherence tomography examination

      Effect of strut thickness on neointimal atherosclerotic change over an extended follow-up period (≥4 years) after bare-metal stent implantation: Intracoronary optical coherence tomography examination

      Background Neointima inside the bare-metal stents (BMSs) can transform into atherosclerotic tissue during an extended follow-up because of a persistent inflammatory reaction to the metal. We sought to investigate whether strut thickness may impact on the atherosclerotic change in neointima 4 years or more after BMS implantation using optical coherence tomography. Methods Forty-six stented lesions of 41 patients with BMS ≥4 years after implantation who underwent optical coherence tomography were enrolled in the study. The strut was defined as thin when less than 100 μm and thick when ≥100 μm. According to these criteria, stents were divided into 2 groups ...

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    5. Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies: A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

      Consensus Standards for Acquisition, Measurement, and Reporting of Intravascular Optical Coherence Tomography Studies: A Report From the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation

      Objectives: The purpose of this document is to make the output of the International Working Group for Intravascular Optical Coherence Tomography (IWG-IVOCT) Standardization and Validation available to medical and scientific communities, through a peer-reviewed publication, in the interest of improving the diagnosis and treatment of patients with atherosclerosis, including coronary artery disease.Background: Intravascular optical coherence tomography (IVOCT) is a catheter-based modality that acquires images at a resolution of 10 μm, enabling visualization of blood vessel wall microstructure in vivo at an unprecedented level of detail. IVOCT devices are now commercially available worldwide, there is an active user base, and ...

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    6. Comparison of Contrast Media and Low-Molecular-Weight Dextran for Frequency-Domain Optical Coherence Tomography

      Comparison of Contrast Media and Low-Molecular-Weight Dextran for Frequency-Domain Optical Coherence Tomography

      Although an intracoronary frequency-domain optical coherence tomography (FD-OCT) system overcomes several limitations of the time-domain OCT (TD-OCT) system, the former requires injection of contrast media for image acquisition. The increased total amount of contrast media for FD-OCT image acquisition may lead to the impairment of renal function. The safety and usefulness of the non-occlusion method with low-molecular-weight dextran L (LMD-L) via a guiding catheter for TD-OCT image acquisition have been reported previously. The aim of the present study was to compare the image quality and quantitative measurements between contrast media and LMD-L for FD-OCT image acquisition in coronary stented lesions ...

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    7. Conformational Change in Coronary Artery Structure Assessed by Optical Coherence Tomography in Patients With Vasospastic Angina

      Conformational Change in Coronary Artery Structure Assessed by Optical Coherence Tomography in Patients With Vasospastic Angina
      Objectives The aim of this study was to investigate the conformational change of arterial structure in the vasospastic lesion with optical coherence tomography. Background Coronary artery spasm plays an important role in the pathogenesis of ischemic heart diseases. The conformational change of each arterial layer during vasospasm has not been studied in detail. Methods We assessed 19 coronary arteries (10 spasm and 9 nonspasm lesions) with optical coherence tomography during the provocation test for coronary spasm. An intimal bump was defined as 1 or more intimal projections into the lumen that disappeared after the administration of nitroglycerine (NTG). Intimal gathering ...
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    8. Thin-Cap Fibroatheroma as High Risk Plaque for Microvascular Obstruction in Patients With Acute Coronary Syndrome

      Thin-Cap Fibroatheroma as High Risk Plaque for Microvascular Obstruction in Patients With Acute Coronary Syndrome
      Background—Plaque contents can cause microvascular impairment, which is an important determinant of clinical outcomes in patients with acute coronary syndrome (ACS). We hypothesized that percutaneous coronary intervention (PCI) for thin-cap fibroatheroma (TCFA) could easily disrupt the fibrous cap and expose the contents of plaque to coronary flow, possibly resulting in microvascular obstruction (MVO). The purpose of this study was to investigate whether TCFA was associated with MVO following PCI in patients with ACS. Methods and Results—We enrolled 115 patients with ACS who were successfully recanalized with PCI. The patients were divided into a ruptured plaque group (n=59 ...
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    9. Intracoronary Optical Frequency Domain Imaging for Identifying Stent-Related Complications

      Intracoronary Optical Frequency Domain Imaging for Identifying Stent-Related Complications
      Percutaneous coronary intervention is the most common treatment of coronary artery disease with the majority of cases undergoing stent implantation. Furthermore, adequate stent deployment is of primary importance to avoid late stent thrombosis and achieve a favorable clinical outcome. Optical coherence tomography (OCT) is a new imaging modality that utilizes advanced photonics and fiberoptics to obtain intravascular images on a microscopic scale. Today, many new drug-eluting stents (DES) are now undergoing clinical trials. Moreover, the intricacies of stent design, local pharmacology, tissue biology, and rheology preclude an intuitive understanding of usability of DES. After stent implantation, assessment should include both ...
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    10. Difference of Culprit Lesion Morphologies Between ST-Segment Elevation Myocardial Infarction and Non-ST-Segment Elevation Acute Coronary Syndrome: An Optical Coherence Tomography Study

      Difference of Culprit Lesion Morphologies Between ST-Segment Elevation Myocardial Infarction and Non-ST-Segment Elevation Acute Coronary Syndrome: An Optical Coherence Tomography Study
      Objectives The aim of this study was to investigate the difference of culprit lesion morphologies assessed by optical coherence tomography (OCT) between ST-segment elevation myocardial infarction (STEMI) and non–ST-segment elevation acute coronary syndrome (NSTEACS). Background Autopsy studies have reported that rupture of a thin-cap fibroatheroma and subsequent thrombus formation is the most important mechanism leading to acute coronary syndrome (ACS). Optical coherence tomography is a high-resolution imaging modality that is capable of investigating detailed coronary plaque morphology in vivo. Methods We examined the culprit lesion morphologies by OCT in 89 consecutive patients with acute coronary syndrome (STEMI = 40; NSTEACS ...
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    11. Clinical Classification and Plaque Morphology Determined by Optical Coherence Tomography in Unstable Angina Pectoris

      Clinical Classification and Plaque Morphology Determined by Optical Coherence Tomography in Unstable Angina Pectoris
      Unstable angina pectoris (UAP) is categorized with the Braunwald classification. However, the association of clinical presentation and plaque structure/function has not yet been elucidated in relation to cause. We used optical coherence tomography to investigate this relation. One hundred fifteen patients with primary UAP were categorized according to the Braunwald classification. Patients with class I UAP had the highest frequency of ulcers without fibrous cap disruption (p = 0.003) and the smallest minimum lumen area (class I, median 0.70 mm2, quartiles 1 to 3 0.42 to 1.00; class II, 1.80 mm2, 1.50 to 2 ...
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    12. The Effect of Lipid and Inflammatory Profiles on the Morphological Changes of Lipid-Rich Plaques in Patients With Non-ST-Segment Elevated Acute Coronary Syndrome: Follow-Up Study by Optical Coherence Tomography and Intravascular Ultrasound

      The Effect of Lipid and Inflammatory Profiles on the Morphological Changes of Lipid-Rich Plaques in Patients With Non-ST-Segment Elevated Acute Coronary Syndrome: Follow-Up Study by Optical Coherence Tomography and Intravascular Ultrasound
      Objectives The aim of this study was to determine the relationship between the morphological changes of nonculprit lipid-rich plaques and several clinical profiles in patients with non–ST-segment elevated acute coronary syndrome (NSTEACS). Background Identification of coronary lesion with morphological characteristics of rupture-prone plaques is still difficult. Methods Eighty-two consecutive patients with NSTEACS who underwent percutaneous coronary intervention were enrolled. The changes in total atheroma volume (TAV) of residual nonculprit lipid-rich plaques and the changes in the corresponding fibrous cap thickness (FCT) were assessed by intravascular ultrasound and optical coherence tomography, respectively, at baseline and after 9 months. Results The ...
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    13. Relation of Microchannel Structure Identified by Optical Coherence Tomography to Plaque Vulnerability in Patients With Coronary Artery Disease

      Relation of Microchannel Structure Identified by Optical Coherence Tomography to Plaque Vulnerability in Patients With Coronary Artery Disease
      Increased neovascularization in atherosclerotic plaques is associated with plaque vulnerability. The high resolution of optical coherence tomography (OCT) might provide a chance to directly visualize plaque neovascularization in vivo. The aim of the present study was to investigate the relation between microchannels in culprit plaques identified by OCT and plaque vulnerability in patients with coronary artery disease. A total of 63 consecutive patients with coronary artery disease who had undergone both OCT and intravascular ultrasound before any interventions to examine culprit lesion morphologies were enrolled. Microchannel was defined as a no-signal tubuloluminal structure on the cross-sectional optical coherence tomographic image ...
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    14. Multiple Coronary Lesion Instability in Patients With Acute Myocardial Infarction as Determined by Optical Coherence Tomography

      Autopsy studies have suggested that acute myocardial infarction (AMI) represents a pan-coronary process of vulnerable plaque development. We performed multifocal optical coherence tomographic (OCT) examination to compare coronary lesion instability between AMI and stable angina pectoris (SAP). A total of 42 patients with AMI (n = 26) or SAP (n = 16) who had multivessel disease and underwent multivessel coronary intervention were enrolled in the present study. The OCT examination was performed not only in the infarct-related/target lesions, but also in the noninfarct-related/nontarget lesions. OCT-derived thin-cap fibroatheroma (TCFA) was defined as a lesion with a fibrous cap thickness of
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    15. Feasibility of Noninvasive Assessment of Thin-Cap Fibroatheroma by Multidetector Computed Tomography

      Objectives The purpose of this study was to investigate whether multidetector computed tomography (MDCT) can noninvasively help assess thin-cap fibroatheroma (TCFA). Background Plaque rupture and thrombus formation play key roles in the onset of acute coronary syndrome. TCFA is recognized as a precursor lesion for plaque rupture, and MDCT angiography can potentially help identify plaques prone to rupture. Methods We enrolled 105 patients with coronary artery disease (acute coronary syndromes, n = 31; stable angina pectoris, n = 74). Culprit lesions were assessed by both MDCT and optical coherence tomography (OCT). Patients were divided into a TCFA and a non-TCFA group according ...
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    16. Activated Platelet is Associated With Subclinical Stent Thrombosis Detected by Optical Coherence Tomography

      Activated Platelet is Associated With Subclinical Stent Thrombosis Detected by Optical Coherence Tomography

      Backgrounds: While stent thrombosis is a critical issue in the drug-eluting stent era, there are few monitoring markers for stent thrombosis. Optical coherence tomography (OCT) introducing as a high-resolution modality allows us to assess plaque characteristics, including in-stent micro-thrombus. We hypothesized that in vivo activated platelet was associated with in-stent thrombus formation. The aim of this study was to investigate the relationship between in vivo platelet activity and in-stent thrombus formation assessed by OCT. Methods: We enrolled 54 patients who were treated with coronary stent. OCT was performed at a 8-month follow-up angiography. The frequency of uncovered struts was assessed ...

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    17. Impact of Culprit Lesion Characteristics on Microvascular Obstruction in Patients With Acute Coronary Syndrome: An Optical Coherence Tomography and Cardiac Magnetic Resonance Imaging Study

      Background: The degree of myocardial damage is an important determinant of clinical outcomes in patients with acute coronary syndrome (ACS). We have reported that lesion characteristics are associated with slow flow phenomenon. The aim of this study was to investigate whether culprit lesion characteristics identified by optical coherence tomography (OCT) were associated with microvascular obstruction (MVO) assessed by contrast-enhanced magnetic resonance imaging (ce-MRI) in patients with ACS. Methods: We enrolled 46 patients with ACS who were successfully recanalized with primary percutaneous coronary intervention (PCI). They were divided into a thin-cap fibroatheroma (TCFA) group (n=17) and a non-TCFA group (n ...
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    18. Advantage of next-generation frequency-domain optical coherence tomography compared with conventional time-domain system in the assessment of coronary lesion

      Background: Intracoronary optical coherence tomography (OCT) is a high-resolution imaging modality used for evaluation of coronary lesion morphology. However, current time-domain OCT (TD-OCT) have a number of limitations with regard to both procedural usage and safety in the clinical setting. The next-generation frequency-domain OCT (FD-OCT), which has a much faster frame rate and pullback speed than TD-OCT, is expected to overcome these limitations. The aim of this study was to evaluate the feasibility and usability of next generation FD-OCT in the assessment of coronary lesions. Methods: A comparison study was performed between FD-OCT and TD-OCT from the aspect of usability ...
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    19. Head to head comparison between the conventional balloon occlusion method and the non-occlusion method for optical coherence tomography

      Abstract: Background: Optical coherence tomography (OCT) has been introduced as a high-resolution imaging modality for the coronary arteries. The current OCT system, however, has a serious limitation in that the image acquisition method requires a soft balloon occlusion to avoid signal scattering from red blood cells.Purpose: The purpose of this study was to compare OCT images from the conventional balloon occlusion method and a non-occlusion image acquisition method, the continuous-flushing method, in the clinical setting.Methods: OCT was performed with the conventional balloon occlusion method and the continuous-flushing method sequentially in 23 patients with stable angina. The image quality ...
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    20. Relationship Between Coronary Arterial Remodeling, Fibrous Cap Thickness and High-Sensitivity C-Reactive Protein Levels in Patients With Acute Coronary Syndrome

      Thin-capped fibroatheroma (TCFA) is a recognized precursor lesion for acute coronary syndrome (ACS). Positive remodeling (PR) is the predominant pattern of arterial remodeling in patients with ACS. The aim of this study was to evaluate the relationship between coronary arterial remodeling, fibrous cap thickness and high-sensitivity C-reactive protein (hs-CRP) concentration in patients with ACS. Methods and Results: The 47 consecutive ACS patients were enrolled in this study. Arterial remodeling of culprit plaque was assessed by intravascular ultrasound, and fibrous cap thickness was measured by optical coherence tomography. The remodeling index (RI) was calculated as lesion divided by the reference external ...
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    21. Lipid-rich plaque and myocardial perfusion after successful stenting in patients with non-ST-segment elevation acute coronary syndrome: an optical coherence tomography study

      Aims: Although some recent guidelines recommend an early invasive strategy for non-ST-segment elevation acute coronary syndrome (NSTEACS), several studies have failed to identify any benefit for very early intervention for NSTEACS. The no-reflow phenomenon may inhibit the expected benefit from very early recanalization for NSTEACS subjects. The aim of this study was to investigate whether optical coherence tomography (OCT) could predict no-reflow in patients with NSTEACS. Methods and results: This study comprised 83 consecutive patients with NSTEACS who underwent OCT and successful emergent primary stenting. On the basis of post-stent TIMI flow, patients were divided into two groups: no-reflow group ...
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