1. Articles from Masamichi Takano

    1-24 of 51 1 2 3 »
    1. Optical coherence tomography in coronary atherosclerosis assessment and intervention

      Optical coherence tomography in coronary atherosclerosis assessment and intervention

      Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in the management of patients with acute coronary syndromes. Detection by OCT of healed coronary plaque has been important in our understanding of the mechanisms involved in plaque destabilization and healing ...

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    2. Optical Coherence Tomography of Coronary Plaque Progression and Destabilization: JACC Focus Seminar Part 3/3

      Optical Coherence Tomography of Coronary Plaque Progression and Destabilization: JACC Focus Seminar Part 3/3

      The development of optical coherence tomography (OCT) has revolutionized our understanding of coronary artery disease. In vivo OCT research has paralleled with advances in computational fluid dynamics, providing additional insights in the various hemodynamic factors influencing plaque growth and stability. Recent OCT studies introduced a new concept of plaque healing in relation to clinical presentation. In addition to known mechanisms of acute coronary syndromes such as plaque rupture and plaque erosion, a new classification of calcified plaque was recently reported. This review will focus on important new insights that OCT has provided in recent years into coronary plaque development, progression ...

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    3. Coronary plaque and clinical characteristics of South Asian (Indian) patients with acute coronary syndromes: An optical coherence tomography study

      Coronary plaque and clinical characteristics of South Asian (Indian) patients with acute coronary syndromes: An optical coherence tomography study

      Background South Asians, and Indians in particular, are known to have a higher incidence of premature atherosclerosis and acute coronary syndromes (ACS) with worse clinical outcomes, compared to populations with different ethnic backgrounds. However, the underlying pathobiology accounting for these differences has not been fully elucidated. Methods ACS patients who had culprit lesion optical coherence tomography (OCT) imaging were enrolled. Culprit plaque characteristics were evaluated using OCT. Results Among 1315 patients, 100 were South Asian, 1009 were East Asian, and 206 were White. South Asian patients were younger (South Asians vs. East Asians vs. Whites: 51.6 ± 13.4 vs ...

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    4. Vulnerable atherosclerotic plaque features: findings from coronary imaging

      Vulnerable atherosclerotic plaque features: findings from coronary imaging

      Pathological studies have suggested that features of vulnerable atherosclerotic plaques likely to progress and lead to acute cardiovascular events have specific characteristics. Given the progress of intravascular coronary imaging technology, some large prospective studies have detected features of vulnerable atherosclerotic plaques using these imaging modalities. However, the rate of cardiovascular events, such as acute coronary syndrome, has been found to be considerably reduced in the limited follow-up period available in the statin era. Additionally, not all disrupted plaques lead to thrombus formation with clinical presentation. If sub-occlusive or occlusive thrombus formation does not occur, a thrombus on a disrupted plaque ...

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    5. Clinical Usefulness of a Novel Optical Coherence Tomography Procedure, “Low Molecular Weight Dextran Infusion Followed by Catheter PUSH (D-PUSH)”

      Clinical Usefulness of a Novel Optical Coherence Tomography Procedure, “Low Molecular Weight Dextran Infusion Followed by Catheter PUSH (D-PUSH)”

      Despite the established usefulness of optical coherence tomography (OCT) guidance in percutaneous coronary intervention (PCI), the quality of the obtained OCT images is sometimes low due to inadequate clearance of blood flow in cases involving extremely tight stenotic lesions. Increasing the volume of contrast media, generally used for blood flow clearance, is also a problem. A novel OCT procedure, “low molecular weight dextran (LMWD) infusion followed by catheter push (D-PUSH)” procedure, in which an OCT catheter is advanced from the proximal to distal target lesion segment after initiating LMWD infusion from a guiding catheter, may improve image quality compared with ...

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    6. Relation of Low-Density Lipoprotein Cholesterol Level to Plaque Rupture

      Relation of Low-Density Lipoprotein Cholesterol Level to Plaque Rupture

      Statin therapy reduces low-density lipoprotein cholesterol (LDL-C), inflammation, and atherosclerotic cardiovascular disease. We investigated the association between LDL-C and statin therapy on the prevalence of plaque rupture (PR). Patients with acute coronary syndromes who underwent optical coherence tomography imaging of the culprit lesion were divided into 4 groups based on LDL-C level and statin use (Group 1: LDL-C ≤ 100 without statin; Group 2; LDL-C ≤ 100 with statin; Group 3: LDL-C >100 with statin; Group 4: LDL-C >100 without statin), and the prevalence of PR was compared between the groups. Among 896 patients, PR was diagnosed in 444 (49.6%) patients ...

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    7. Circadian variations in pathogenesis of ST-segment elevation myocardial infarction: an optical coherence tomography study

      Circadian variations in pathogenesis of ST-segment elevation myocardial infarction: an optical coherence tomography study

      Previous studies have reported a circadian variation in the onset of ST-segment elevation myocardial infarction (STEMI). However, underlying mechanisms for the circadian variation have not been fully elucidated. We investigated the relationship between onset of STEMI and the underlying pathology using optical coherence tomography (OCT). Patients with a diagnosis of STEMI were selected from a multicenter OCT registry. Patients were divided into 4 groups based on the estimated time of onset (00:00–05:59, 06:00–11:59, 12:00–17:59, or 18:00–23:59). Underlying pathologies of MI (plaque rupture, plaque erosion, and calcified plaque) were ...

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    8. Degree of luminal narrowing and composition of thrombus in plaque erosion

      Degree of luminal narrowing and composition of thrombus in plaque erosion

      As the degree of luminal narrowing increases, shear stress increases, and high shear stress is known to activate platelets. However, the relationship between the degree of luminal narrowing and the composition of thrombus in patients with plaque erosion has not been studied. A total of 148 patients with plaque erosion and thrombus detected by optical coherence tomography were divided into tertiles based on the minimum lumen area (MLA) at the culprit lesion. Thrombus was categorized as platelet-rich or fibrin-rich. Among 148 patients, 50 (34%) were in the mild stenosis group, 49 (33%) were in the moderate stenosis group, and 49 ...

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    9. Comparison of post‐stent optical coherence tomography findings: Layered versus non‐layered culprit lesions

      Comparison of post‐stent optical coherence tomography findings: Layered versus non‐layered culprit lesions

      Objectives This study aimed to investigate the vascular response of lesions with a layered phenotype. Background Recent studies have shown that layered plaques at culprit lesions detected by optical coherence tomography (OCT) have greater plaque burden and more inflammatory features than non‐layered plaques. Methods This is a retrospective observational study. A total of 193 target lesions from 193 patients [100 patients with acute coronary syndromes (ACS) and 93 with stable angina pectoris (SAP)] who had undergone OCT imaging of the culprit lesion both before and after stenting were included. Layered plaques were identified by OCT as plaques with layers ...

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    10. COMPARISON OF POST STENT OPTICAL COHERENCE TOMOGRAPHY FINDINGS AMONG THREE SUBTYPES OF CALCIFIED CULPRIT PLAQUES IN PATIENTS WITH ACUTE CORONARY SYNDROME

      COMPARISON OF POST STENT OPTICAL COHERENCE TOMOGRAPHY FINDINGS AMONG THREE SUBTYPES OF CALCIFIED CULPRIT PLAQUES IN PATIENTS WITH ACUTE CORONARY SYNDROME

      Background Recently, three subtypes of calcified plaques at the culprit lesion were reported in patients with acute coronary syndrome (ACS): eruptive calcified nodule, superficial calcific sheet, and calcified protrusion. Methods A total of 157 patients with ACS and calcified plaque at the culprit lesion were selected from our database. Optical coherence tomography (OCT) findings at index procedure and after stent implantation were compared among the three subgroups. Results In the final analysis, 92 cases were included. Pre-procedural OCT showed eruptive calcified nodules in 20 (21.7%) cases, superficial calcific sheets in 66 (71.7%), and calcified protrusion in 6 (6 ...

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    11. Comparison of post‐stent optical coherence tomography findings among three subtypes of calcified culprit plaques in patients with acute coronary syndrome

      Comparison of post‐stent optical coherence tomography findings among three subtypes of calcified culprit plaques in patients with acute coronary syndrome

      Objectives To compare the postprocedural optical coherence tomography (OCT) findings and in‐hospital outcomes among the three subtypes of calcified plaques: eruptive calcified nodules, superficial calcific sheet, and calcified protrusion. Background Recently, three subtypes of calcified culprit plaques were reported in patients with acute coronary syndrome (ACS). How these subtypes respond to stenting is unknown. Methods ACS patients with calcified plaque at the culprit lesion were selected from our database. OCT findings at baseline and after stent implantation were compared. Results In the final analysis, 87 cases were included. Preprocedural OCT showed eruptive calcified nodules in 19 (21.8%) cases ...

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    12. Comparison of Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Relation to Outcomes in Patients Diagnosed with Acute Coronary Syndrome During Winter –vs– Other Season

      Comparison of Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Relation to Outcomes in Patients Diagnosed with Acute Coronary Syndrome During Winter –vs– Other Season

      Patients diagnosed with acute coronary syndrome (ACS) during winter have worse outcomes; however, mechanisms driving this trend are unclear. We examined coronary culprit lesion morphologies using optical coherence tomography (OCT). Features and outcomes were retrospectively compared between patients admitted with ACS in winter (W-ACS; n=390) and in other seasons (O-ACS; n=1027). Angiography and OCT results were analyzed in patients who underwent OCT examination (173 patients in W-ACS and 450 in O-ACS). On initial angiography, minimum lumen diameter was smaller (median; 0.12 mm vs. 0.25 mm, p=0.021) and Thrombolysis in Myocardial Infarction (TIMI) flow grade ...

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    13. Comparison of Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Relation to Outcomes in Patients Diagnosed with Acute Coronary Syndrome During Winter –vs– Other Seasons

      Comparison of Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Relation to Outcomes in Patients Diagnosed with Acute Coronary Syndrome During Winter –vs– Other Seasons

      Patients diagnosed with acute coronary syndrome (ACS) during winter have worse outcomes; however, mechanisms driving this trend are unclear. We examined coronary culprit lesion morphologies using optical coherence tomography (OCT). Features and outcomes were retrospectively compared between patients admitted with ACS in winter (W-ACS; n=390) and in other seasons (O-ACS; n=1027). Angiography and OCT results were analyzed in patients who underwent OCT examination (173 patients in W-ACS and 450 in O-ACS). On initial angiography, minimum lumen diameter was smaller (median; 0.12 mm vs. 0.25 mm, p=0.021) and Thrombolysis in Myocardial Infarction (TIMI) flow grade ...

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    14. Relation of coronary culprit lesion morphology determined by optical coherence tomography and cardiac outcomes to preinfarction angina in patients with acute myocardial infarction

      Relation of coronary culprit lesion morphology determined by optical coherence tomography and cardiac outcomes to preinfarction angina in patients with acute myocardial infarction

      Background While preinfarction angina pectoris (pre-IA) is recognized as favorable effects on acute myocardial infarction (AMI), the detail has not been fully investigated. The aims of the current study were to clarify patient characteristics, lesion morphologies determined by optical coherence tomography (OCT), and cardiac outcomes related to pre-IA in patients with AMI. Methods Clinical data and outcomes were compared between AMI patients with pre-IA (pre-IA group, n = 507) and without pre-IA (non-pre-IA group, n = 653). Angiography and OCT findings were analyzed in patients with pre-intervention OCT and compared between groups of pre-IA ( n = 219) and non-pre-IA ( n = 269). Results ST-segment ...

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    15. Postprandial Hyperchylomicronemia and Thin-Cap Fibroatheroma in Nonculprit Lesions A Multivessel Optical Coherence Tomography Study

      Postprandial Hyperchylomicronemia and Thin-Cap Fibroatheroma in Nonculprit Lesions A Multivessel Optical Coherence Tomography Study

      Objective— Although postprandial hypertriglyceridemia can be a risk factor for coronary artery disease, the extent of its significance remains unknown. This study aimed to investigate the correlation between the postprandial lipid profiles rigorously estimated with the meal tolerance test and the presence of lipid-rich plaque, such as thin-cap fibroatheroma (TCFA), in the nonculprit lesion. Approach and Results— A total of 30 patients with stable coronary artery disease who underwent a multivessel examination using optical coherence tomography during catheter intervention for the culprit lesion were enrolled. Patients were divided into 2 groups: patients with TCFA (fibrous cap thickness ≤65 µm) in ...

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    16. Postprandial Hyperchylomicronemia and Thin-Cap Fibroatheroma in Non-culprit Lesions: a Multivessel Optical Coherence Tomography Study

      Postprandial Hyperchylomicronemia and Thin-Cap Fibroatheroma in Non-culprit Lesions: a Multivessel Optical Coherence Tomography Study

      Objective: Although postprandial hypertriglyceridemia potentially plays a role as a risk factor for coronary artery disease (CAD), details of its significance remain unknown. This study aimed to investigate the correlation between the postprandial lipid profiles rigorously estimated with the meal tolerance test and the presence of lipid-rich plaque, such as thin-cap fibroatheroma (TCFA), in the non-culprit lesion. Methods: Thirty patients with stable CAD who underwent a multivessel study using optical coherence tomography during catheter intervention for the culprit lesion were enrolled. Patients were divided into two groups: those with or without TCFA (fibrous cap thickness ≤65 μm) in the non-culprit ...

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    17. Relation of Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Cardiac Outcomes to Serum Uric Acid Levels in Patients with Acute Coronary Syndrome

      Relation of Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Cardiac Outcomes to Serum Uric Acid Levels in Patients with Acute Coronary Syndrome

      The aims of the current study were to elucidate features of culprit lesion plaque morphology using optical coherence tomography (OCT) in relation to elevated serum uric acid (sUA) levels and to clarify the impact of sUA levels on adverse clinical outcomes in patients with acute coronary syndrome (ACS). Clinical data and outcomes were compared between ACS patients with sUA ≥6 mg/dL (high-sUA; n=506) and sUA <6.0 mg/dL (low-sUA; n=608). Angiography and OCT findings were analyzed in patients with pre-intervention OCT and compared between groups of high-sUA (n=206) and low-sUA (n=273). Patients with high-sUA ...

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    18. Clinical Significance of Lipid-Rich Plaque Detected by Optical Coherence Tomography : A 4-Year Follow-Up Study

      Clinical Significance of Lipid-Rich Plaque Detected by Optical Coherence Tomography : A 4-Year Follow-Up Study

      Background Lipid-rich plaque (LRP) is thought to be a precursor to cardiac events. However, its clinical significance in coronary arteries has never been systematically investigated. Objectives This study investigated the prevalence and clinical significance of LRP in the nonculprit region of the target vessel in patients undergoing percutaneous coronary intervention (PCI). Methods The study included 1,474 patients from 20 sites across 6 countries undergoing PCI, who had optical coherence tomography (OCT) imaging of the target vessel. Major adverse cardiac events (MACE) were defined as a composite of cardiac death, acute myocardial infarction, and ischemia-driven revascularization. Patients were followed for ...

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    19. Optical coherence tomography visualisation of burst balloon catheter trapped by coronary stent

      Optical coherence tomography visualisation of burst balloon catheter trapped by coronary stent

      A 69-year-old man with prior anterior myocardial infarction underwent percutaneous coronary intervention for significant stenosis of the left anterior descending (LAD) artery. High-pressure inflation by non-compliant balloon was required because of severe calcification in the culprit lesion. The balloon ruptured during inflation and an angiographic filling defect appeared in the LAD. The balloon catheter was pulled out of the body and the tip and membranous part of the catheter was lost ( Panel A , black arrowhead). Although we attempted to retrieve…

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    20. Flow-limiting thrombosis after intracoronary coil embolisation: optical coherence tomography during acute myocardial infarction

      Flow-limiting thrombosis after intracoronary coil embolisation: optical coherence tomography during acute myocardial infarction

      A 75-year-old female was transferred to our hospital with sudden onset chest pain radiating to the left arm. She had a history of hypertension, chronic kidney disease treated with regular haemodialysis, and a prior anterior myocardial infarction. Electrocardiography upon admission showed ST-segment elevation in broad anterior leads. Previous coronary angiography had illustrated chronic total occlusion (CTO) at the mid-left anterior descending artery (LAD) and collateral flow from the 2nd diagonal branch (DB) to the distal LAD through the 3rd DB. Percutaneous

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    21. The Role of Multiple Imaging Modalities to Disclose the Mechanism of ACS Angioscopy in Comparison to Other Imaging Modalities Including OCT, IVUS and CTA (Book Chapter)

      The Role of Multiple Imaging Modalities to Disclose the Mechanism of ACS Angioscopy in Comparison to Other Imaging Modalities Including OCT, IVUS and CTA (Book Chapter)

      This book presents a thorough review of coronary angioscopy, ranging from instructions on its use to the latest advances. Starting with the structure and fundamental principles of angioscopy, it shows readers how to apply the image to comprehensive care of coronary-artery patients. Plentiful color photos and illustrations will enable readers to investigate and classify plaques and thrombi and to evaluate coronary stent- and drug-based therapies. The authors are leading researchers on angioscopy. This book offers the perfect guide not only for new clinicians but also for cardiologists who have already adopted this technique for medical examination and treatment. Angioscopy is ...

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    22. Assessment of vascular response after drug-eluting stents implantation in patients with diabetes mellitus: an optical coherence tomography sub-study of the J-DESsERT

      Assessment of vascular response after drug-eluting stents implantation in patients with diabetes mellitus: an optical coherence tomography sub-study of the J-DESsERT

      Even in the drug-eluting stent era, diabetes mellitus (DM) patients have high incidences of restenosis and repeat revascularization after percutaneous coronary intervention. The aim of this study was to compare vascular response after stent implantation between sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) by using optical coherence tomography (OCT) in DM patients as well as in non-DM patients. In the Japan-Drug Eluting Stents Evaluation; a Randomized Trial (J-DESsERT), the OCT sub-study enrolled 75 patients who underwent 8 months follow-up imaging after SES or PES implantation. Mean neointimal hyperplasia (NIH) thickness was significantly thinner in SES than PES in the DM ...

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    23. Relationship between cholesterol crystals and culprit lesion characteristics in patients with stable coronary artery disease: an optical coherence tomography study

      Relationship between cholesterol crystals and culprit lesion characteristics in patients with stable coronary artery disease: an optical coherence tomography study

      Aims Some recent studies have reported the role of cholesterol crystals (ChCs) in plaque rupture in patients with coronary artery disease. We used optical coherence tomography (OCT) to investigate the characteristics of coronary plaques that were associated with derived ChCs. Methods We evaluated 101 subjects with stable coronary artery disease who underwent OCT. We compared the OCT findings of the culprit lesions with ChCs to those without ChCs and investigated the background characteristics. Results ChCs were observed in culprit lesions of 39 patients. The frequencies of spotty calcification, microchannel structure, and lipid-rich plaque were significantly higher in patients with ChCs ...

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