1. Articles from Masayuki Nakagawa

    1-12 of 12
    1. The impact of in-stent neoatherosclerosis on long-term clinical outcomes: an observational study from the Kobe University Hospital optical coherence tomography registry

      The impact of in-stent neoatherosclerosis on long-term clinical outcomes: an observational study from the Kobe University Hospital optical coherence tomography registry

      Aims: Although pathological studies have indicated the development of neoatherosclerosis (NA) after stenting, its risk factors and impact on future clinical events remain unclear. We aimed to clarify the possible risk factors for NA development and to evaluate the impact of NA in a large Japanese observational OCT database of patients with coronary heart disease. Methods and results: One hundred and seventy-five consecutive patients (314 lesions) who underwent OCT examination >1 year after bare metal or drug-eluting stent implantation were enrolled. We assessed the presence of NA by follow-up OCT and compared adverse clinical events between NA+ and NA– patients ...

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    2. Two-year vessel healing after everolimus-eluting stent implantation: Serial assessment by optical coherence tomography

      Two-year vessel healing after everolimus-eluting stent implantation: Serial assessment by optical coherence tomography

      Background Previous reports have suggested the importance of delayed arterial healing and the development of neoatherosclerosis as major contributors to stent thrombosis and delayed restenosis. The difference of in vivo assessment of long-term vessel healing between first-generation drug-eluting stents and current generation everolimus-eluting stents (EESs) is limited. The aim of this study was to evaluate long-term arterial healing in EES in comparison with the first generation sirolimus-eluting stents (SES). Methods We evaluated 31 EES (23 patients) and 8 SES (7 patients) by serial optical coherence tomography at 12 months (mid-phase) and 24 months (late-phase) after stenting and evaluated the change ...

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    3. Impact of strut-vessel distance and underlying plaque type on the resolution of acute strut malapposition: serial optimal coherence tomography analysis after everolimus-eluting stent implantation

      Impact of strut-vessel distance and underlying plaque type on the resolution of acute strut malapposition: serial optimal coherence tomography analysis after everolimus-eluting stent implantation

      The consequences of acute strut malapposition in everolimus-eluting stents (EES) are unknown. This study investigated the impact of strut–vessel (S–V) distance and plaque type underneath acute strut malapposition on the mid-term vessel response in EES. Twenty-nine patients (35 EES) underwent optical coherence tomography (OCT) immediately after percutaneous coronary intervention and at 8-month follow-up. S–V distance and plaque type (lipid, calcified, or fibrous) underneath acute strut malapposition were evaluated. Follow-up OCT classified acute strut malapposition as persistent or resolved. The S–V cutoff value for predicting resolved strut malapposition and the incidence of intra-stent thrombi were determined. Among ...

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    4. Stabilizing effect of combined eicosapentaenoic acid and statin therapy on coronary thin-cap fibroatheroma

      Stabilizing effect of combined eicosapentaenoic acid and statin therapy on coronary thin-cap fibroatheroma

      Background The addition of highly purified eicosapentaenoic acid (EPA) to statin therapy prevents cardiovascular events. However, the impact of this treatment on vulnerable plaques remains unclear. The aim of this study was to assess the impact of adding EPA to a standard statin therapy on vulnerable plaques by serial optical coherence tomography (OCT). Methods Forty-nine non-culprit thin-cap fibroatheroma (TCFA) lesions in 30 patients with untreated dyslipidemia were included. Patients were randomly assigned to EPA (1800 mg/day) + statin (23 TCFA, 15 patients) or statin only (26 TCFA, 15 patients) treatment. The statin (rosuvastatin) dose was adjusted to achieve a target ...

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    5. Analysis of Long-term Arterial Healing Following Implantation of Different Types of Stents by Optical Coherence Tomography

      Analysis of Long-term Arterial Healing Following Implantation of Different Types of Stents by Optical Coherence Tomography

      Background Although drug-eluting stents have significantly reduced the mid-term incidence of target lesion revascularization, however, in vivo studies on long-term vessel healing of sirolimus-eluting and paclitaxel-eluting stents (SES and PES) are limited. So the aim of this study was to compare long-term arterial healing in SES and PES. Methods We evaluated 27 SES (23 patients) and 21 PES (20 patients) by serial optical coherence tomography (OCT) at 6 months (mid-phase) and ≥3 years (late-phase) after stenting and evaluated the change of neointimal thickness (NIT), the percentages of uncovered and malapposed struts, peri-strut low intensity area (region around stent struts homogenously ...

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    6. Neoatherosclerosis and Mural Thrombus Detection After Sirolimus-Eluting Stent Implantation

      Neoatherosclerosis and Mural Thrombus Detection After Sirolimus-Eluting Stent Implantation

      Background:  Although both optical coherence tomography (OCT) and angioscopy are robust tools for detecting intrastent thrombi and neoatherosclerosis in vivo, whether OCT findings are comparable with angioscopy findings remains unclear. Methods and Results:  22 patients presenting with de novo lesions underwent 26 sirolimus-eluting stent (SES) implantations, with follow-up OCT and angioscopy at 10 months post-implantation for segmental assessment of the proximal, mid-, and distal SES segments (66 segments). The mean signal intensity index (signal intensity of the neointima/signal intensity of fibrous intimal hyperplasia) was quantified for angioscopically detected in-stent yellow and white segments. The detection rate for red thrombi ...

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    7. Potential Benefit of Final Kissing Balloon Inflation After Single Stenting for the Treatment of Bifurcation Lesions – Insights From Optical Coherence Tomography Observation

      Potential Benefit of Final Kissing Balloon Inflation After Single Stenting for the Treatment of Bifurcation Lesions – Insights From Optical Coherence Tomography Observation

      Background:  Treatment of coronary bifurcation lesions using a single stenting strategy is preferable over that using a 2-stent technique. The benefit of final kissing inflation (FKI), however, has not been established. Methods and Results:  Seventy-two patients (76 lesions) with true bifurcation lesions treated with a single drug-eluting stent with FKI (n=33 lesions) or without FKI (non-FKI, n=43 lesions) were enrolled in this study. Optical coherence tomography (OCT) was performed at 6–12 months after implantation. Based on the OCT findings, the percentage of jailing struts (number of jailing struts/total number of struts at the bifurcation lesion) was ...

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    8. Natural consequence of post-intervention stent malapposition, thrombus, tissue prolapse, and dissection assessed by optical coherence tomography at mid-term follow-up

      Natural consequence of post-intervention stent malapposition, thrombus, tissue prolapse, and dissection assessed by optical coherence tomography at mid-term follow-up

      Aims We performed this study to clarify natural consequences of abnormal structures (stent malapposition, thrombus, tissue prolapse, and stent edge dissection) after percutaneous coronary intervention (PCI). Methods and results Thirty-five patients treated with 40 drug-eluting stents underwent serial optical coherence tomography (OCT) imaging immediately after PCI and at the 8-month follow-up. Among a total of 73 929 struts in every frame, 431 struts (26 stents) showed malapposition immediately after PCI. Among these, 49 remained malapposed at the follow-up examination. The mean distance between the strut and vessel wall (S–V distance) of persistent malapposed struts on post-stenting OCT images was ...

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    9. Qualitative and Quantitative Assessment of Stent Restenosis by Optical Coherence Tomography

      Qualitative and Quantitative Assessment of Stent Restenosis by Optical Coherence Tomography

      We hypothesized that the tissue components of in-stent restenosis (ISR) might differ between drug-eluting stents (DES) and bare-metal stents (BMS) and that these differences could be distinguished by qualitative and quantitative optical coherence tomography (OCT) analyses. Methods and Results:  One-hundred and twenty-two initial ISR lesions (sirolimus-eluting stents: n=28; paclitaxel-eluting stents: n=51; BMS: n=43) were evaluated with OCT. Based on their OCT appearance, the lesions were classified as homogeneous, layered or heterogeneous. The optical properties of backscatter, attenuation and signal intensity of the neointimal tissue (NIT) were quantified. To evaluate the vascular response after balloon angioplasty (BA), the ...

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    10. Effect of Cytochrome P450 2C19 Polymorphism on Target Lesion Outcome After Drug-Eluting Stent Implantation in Japanese Patients Receiving Clopidogrel

      Effect of Cytochrome P450 2C19 Polymorphism on Target Lesion Outcome After Drug-Eluting Stent Implantation in Japanese Patients Receiving Clopidogrel

      Background: Cytochrome P450 (CYP) 2C19 polymorphism is associated with reduced responsiveness to clopidogrel and poor clinical outcome after drug-eluting stent (DES) implantation, but its contribution to lesion outcome after DES implantation is unclear. Methods and Results: The study included 160 Japanese patients who received clopidogrel and underwent DES implantation with follow-up angiography. Patients were divided into 3 groups by CYP2C19 polymorphism: extensive metabolizers (EM), intermediate metabolizers (IM), and poor metabolizers (PM). The incidence of major adverse cardiac events (MACE) and target lesion revascularization (TLR) were compared among the 3 groups. Optical coherence tomography (OCT) was performed for 120 patients to ...

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    11. Ability of Optical Coherence Tomography to Visualize the Entry Port of Spontaneous Coronary Artery Dissection

      Ability of Optical Coherence Tomography to Visualize the Entry Port of Spontaneous Coronary Artery Dissection
      A 51-year-old man was admitted to a local hospital with sudden onset of severe back pain diagnosed as acute type A aortic dissection on contrast computed tomography (CT). The patient was transferred to Kobe University Hospital and underwent total arch replacement. He had no cardiac risk factors except for obesity, and no connective tissue disorders or clinical features of Marfan syndrome. From the intraoperative findings, the entry of the aortic dissection was confirmed to be in the aortic arch without coronary artery ostium involvement. On the fourth day after the
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    1-12 of 12
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    1. (12 articles) Kobe University Graduate School of Medicine
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    Ability of Optical Coherence Tomography to Visualize the Entry Port of Spontaneous Coronary Artery Dissection Natural Consequence of Stent Malaposition Assessed by Optical Coherence Tomography Effect of Cytochrome P450 2C19 Polymorphism on Target Lesion Outcome After Drug-Eluting Stent Implantation in Japanese Patients Receiving Clopidogrel Qualitative and Quantitative Assessment of Stent Restenosis by Optical Coherence Tomography Natural consequence of post-intervention stent malapposition, thrombus, tissue prolapse, and dissection assessed by optical coherence tomography at mid-term follow-up Potential Benefit of Final Kissing Balloon Inflation After Single Stenting for the Treatment of Bifurcation Lesions – Insights From Optical Coherence Tomography Observation Neoatherosclerosis and Mural Thrombus Detection After Sirolimus-Eluting Stent Implantation Analysis of Long-term Arterial Healing Following Implantation of Different Types of Stents by Optical Coherence Tomography Stabilizing effect of combined eicosapentaenoic acid and statin therapy on coronary thin-cap fibroatheroma Two-year vessel healing after everolimus-eluting stent implantation: Serial assessment by optical coherence tomography Feature Of The Week 07/22/2019: Tsinghua University Demonstrates A “Sparse Sampled” Smart CCD Camera for Compressed Sensing Optical Coherence Tomography. An Unknown Tubular Structure on Optical Coherence Tomography After Revascularization in Chronic Totally Occluded Lesion