1. Articles from Junya Ako

    1-20 of 20
    1. Very late stent thrombosis lacking findings of the typical causes on optical coherence tomography in a patient with SARS-CoV-2

      Very late stent thrombosis lacking findings of the typical causes on optical coherence tomography in a patient with SARS-CoV-2

      A 50-year-old male was admitted to our hospital with sudden-onset chest pain. He was a current smoker with severe obesity and diabetes. He had a history of drug-eluting stent (DES) implantation in the left anterior descending artery (LAD) and had continuously taken clopidogrel. Eight days prior to admission, polymerase chain reaction testing confirmed that he was positive for severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Emergent coronary angiography revealed total occlusion of previously implanted DES in LAD. Optical coherence tomography (OCT) images demonstrated the presence of large white thrombus within the well-expanded DES with homogenous neointima. There were no ...

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    2. Impact of triglyceride levels on plaque characteristics in patients with coronary artery disease

      Impact of triglyceride levels on plaque characteristics in patients with coronary artery disease

      Background High triglyceride (TG) levels have been demonstrated to be a risk factor for coronary artery disease. This study aimed to clarify the impact of TG levels on the characteristics of coronary plaques. Methods A total of 850 consecutive patients who underwent optical coherence tomography (OCT) imaging of the culprit lesion were included. The morphologies of culprit plaques were compared between the higher TG group (nonfasting TG levels ≥150 mg/dL, n = 337) and the lower TG group (nonfasting TG <150 mg/dL, n = 513). Results The prevalence of lipid-rich plaques (43% vs. 33%, p = 0.005), thin-cap fibroatheromas (TCFAs ...

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    3. Clinical expert consensus document on rotational atherectomy from the Japanese association of cardiovascular intervention and therapeutics

      Clinical expert consensus document on rotational atherectomy from the Japanese association of cardiovascular intervention and therapeutics

      Rotational atherectomy (RA) has been widely used for percutaneous coronary intervention (PCI) to severely calcified lesions. As compared to other countries, RA in Japan has uniquely developed with the aid of greater usage of intravascular imaging devices such as intravascular ultrasound (IVUS) or optical coherence tomography (OCT). IVUS has been used to understand the guidewire bias and to decide appropriate burr sizes during RA, whereas OCT can also provide the thickness of calcification. Owing to such abundant experiences, Japanese RA operators modified RA techniques and reported unique evidences regarding RA. The Task Force on Rotational Atherectomy of the J apanese ...

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    4. Impact of hemodialysis on clinical and angiographic outcomes in in-stent restenotic lesions following optical coherence tomography-guided drug-coated balloon treatment

      Impact of hemodialysis on clinical and angiographic outcomes in in-stent restenotic lesions following optical coherence tomography-guided drug-coated balloon treatment

      Hemodialysis (HD) is associated with a high in-stent restenosis (ISR) rate even in the second-generation era. Drug-coated balloons (DCB) generally provide excellent clinical outcomes in patients with ISR lesions. Nonetheless, safety and efficacy of DCB for ISR lesions in HD patients are largely unknown. A total of 17 centers across Japan participated in this study. Patients were eligible for the study if ISR lesions were treated with DCB. Enrolled patients were divided into 2 groups (HD and non-HD groups). Angiographic, OCT, and clinical outcomes were compared between the HD and the non-HD groups. A total of 210 patients were enrolled ...

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    5. Endothelial glycocalyx and severity and vulnerability of coronary plaque in patients with coronary artery disease

      Endothelial glycocalyx and severity and vulnerability of coronary plaque in patients with coronary artery disease

      Background and aims Endothelial glycocalyx covers the endothelium and maintains vascular integrity. However, its association with the severity and vulnerability of coronary artery disease (CAD) remains to be elucidated. Methods A total of 259 consecutive patients with stable CAD requiring percutaneous coronary intervention (PCI) were prospectively enrolled. Patients were classified into 2 groups according to the median value of serum syndecan-1, which is a core component of the endothelial glycocalyx (lower syndecan-1 group [syndecan-1 <99.0 ng/mL], n = 130; higher syndecan-1 group [syndecan-1 ≥99.0 ng/mL], n = 129). Severity of CAD and focal plaque vulnerability in culprit lesion ...

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    6. Novel volumetric analysis for stent expansion after drug‐eluting stent implantation: An optical coherence tomography study

      Novel volumetric analysis for stent expansion after drug‐eluting stent implantation: An optical coherence tomography study

      Objectives To assess the clinical significance of a novel optical coherence tomography (OCT)‐derived volumetric parameter of stent expansion by comparing it with the conventional parameters in real‐world practice. Background The clinical significance of novel parameters in real‐world practice including longer and smaller stents remains to be elucidated. Methods A total of 226 de novo lesion treated with drug‐eluting stents in 208 consecutive patients were enrolled. Stent expansion was retrospectively assessed on the final OCT images after stent implantation. The novel parameter was the minimum expansion index (MEI) calculated using a novel algorithm that yields the ideal ...

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    7. Lipoprotein (a) level is associated with plaque vulnerability in patients with coronary artery disease: An optical coherence tomography study

      Lipoprotein (a) level is associated with plaque vulnerability in patients with coronary artery disease: An optical coherence tomography study

      Background High lipoprotein (a) [Lp(a)] levels are an independent factor for worse prognosis in patients with coronary artery disease (CAD). However, the association between serum Lp(a) level and coronary plaque vulnerability remains to be determined. Methods A total of 255 consecutive patients with CAD who underwent optical coherence tomography imaging of culprit lesions were included. Patients were divided into 2 groups according to their Lp(a) levels (the higher Lp(a) group [≥25 mg/dL], n = 87; or the lower Lp(a) group [<25 mg/dL], n = 168). Results The prevalence of thin-cap fibroatheroma (TCFA) was significantly higher ...

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    8. Zero-Contrast Optical Coherence Tomography- and Physiology-Guided Percutaneous Coronary Intervention for Severely Calcified Lesion

      Zero-Contrast Optical Coherence Tomography- and Physiology-Guided Percutaneous Coronary Intervention for Severely Calcified Lesion

      An 80-year-old man with severe kidney dysfunction (estimated glomerular filtration rate, 26 mL/min/1.73 m 2 ) not requiring hemodialysis presented with effort angina. Diagnostic angiography with minimum contrast showed a diffuse lesion in the proximal right coronary artery (RCA; Figure A ). On a later day, optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) with dextran injection was performed. Because multiple cracks were seen in the severely calcified lesion after pre-dilation ( Figure B,C ; Supplementary Movie 1 ), an everolimus-eluting stent (3.25–33 mm) was implanted ( Figure D ). The final OCT showed sufficient luminal expansion (minimum stent area ...

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    9. Incidence, factors, and clinical significance of cholesterol crystals in coronary plaque: An optical coherence tomography study

      Incidence, factors, and clinical significance of cholesterol crystals in coronary plaque: An optical coherence tomography study

      Background and aims Intraplaque cholesterol crystal (CC) is recognized as a component of vulnerable plaques. However, the clinical characteristics of patients with CC and the impact of CC on clinical events remain unknown. Methods A total of 340 consecutive patients who underwent optical coherence tomography (OCT) imaging of culprit lesions were included in the study. CC was defined as a thin linear structure with high reflectivity and low signal attenuation on OCT images. The incidence of major adverse cardiovascular events (MACE) at 1-year was compared between patients with CC (CC group) and those without CC (non-CC group). MACE included cardiac ...

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    10. Achilles tendon thickening is associated with disease severity and plaque vulnerability in patients with coronary artery disease

      Achilles tendon thickening is associated with disease severity and plaque vulnerability in patients with coronary artery disease

      Background Tendon xanthomas are accumulations of collagen and macrophages which contain cholesterol esters and a marker of high risk for coronary artery disease (CAD). Objective To clarify whether the presence of Achilles tendon thickening (ATT) was associated with disease severity and plaque vulnerability in patients with CAD. Methods A total of 241 consecutive patients who underwent percutaneous coronary intervention and ATT assessment were analyzed. ATT was defined as Achilles tendon thickness of 9 mm or more on radiograph. The severity of CAD and plaque vulnerability were assessed by the findings on angiogram and optical coherence tomography, respectively. Results ATT was ...

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    11. Impact of underlying plaque type on strut coverage in the early phase after drug-eluting stent implantation

      Impact of underlying plaque type on strut coverage in the early phase after drug-eluting stent implantation

      Background The aim of this study was to investigate whether the underlying plaque type affects the neointimal coverage after drug-eluting stent implantation. Methods A total of 1793 struts in 22 zotarolimus-eluting stents were assessed using optical coherence tomography imaging within 3 months of implantation. Neointimal coverage was evaluated within 5 mm from each stent edge on cross-sectional optical coherence tomography images at every 1-mm interval. The percentage of struts covered by neointima was compared among the normal segment group, the fibrous plaque group, and the lipid plaque group on the basis of the underlying plaque type. Results The percentage of ...

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    12. Early Phase Arterial Reaction Following Drug-Eluting and Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction Optical Coherence Tomography Assessment at 2 Weeks

      Early Phase Arterial Reaction Following Drug-Eluting and Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction Optical Coherence Tomography Assessment at 2 Weeks

      The early phase arterial reaction after implantation of second-generation drug-eluting stents (2nd DES) and baremetal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. The MECHANISM pilot study is a multi-center prospective registry that enrolled 24 STEMI patients (from 11 centers) who had undergone implantation of everolimus-eluting ( n = 6), biolimus A9-eluting ( n = 6) or zotarolimus-eluting stents ( n = 6), or BMS ( n = 6). Scheduled optical coherence tomography (OCT) was performed 2 weeks after implantation, and images were independently analyzed at a core laboratory in a blinded fashion. Intra-stent thrombus was quantitatively analyzed in terms of the maximal area ...

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    13. Low eicosapentaenoic acid to arachidonic acid ratio is associated with thin-cap fibroatheroma determined by optical coherence tomography

      Low eicosapentaenoic acid to arachidonic acid ratio is associated with thin-cap fibroatheroma determined by optical coherence tomography

      Background A low eicosapentaenoic acid (EPA)/arachidonic acid (AA) ratio is known to be associated with cardiovascular events. However, the relationship between the EPA/AA ratio and coronary plaque vulnerability assessed by optical coherence tomography (OCT) has not been examined thoroughly. This study examined the relationship between the EPA/AA ratio and coronary plaque vulnerability assessed by OCT in patients with acute coronary syndrome (ACS). Methods We evaluated 59 ACS patients who had undergone percutaneous coronary intervention using OCT. We divided them into 2 groups according to OCT findings—those with and without thin-cap fibroatheroma (TCFA)—and compared the EPA ...

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    14. Neointimal coverage of zotarolimus-eluting stent at 1, 2, and 3 months' follow-up: an optical coherence tomography study

      Neointimal coverage of zotarolimus-eluting stent at 1, 2, and 3 months' follow-up: an optical coherence tomography study

      Incomplete neointimal coverage and malapposed struts after stenting are associated with increased risk of stent thrombosis. We aimed to evaluate neointimal coverage early after Resolute zotarolimus-eluting stent (R-ZES) implantation using optical coherence tomography (OCT). A total of 20 patients with de novo native coronary lesions with R-ZES were enrolled. Among these patients, 20 stented lesions in 19 patients were evaluated at 1, 2, and 3 months after R-ZES implantation. The strut apposition and neointimal coverage were evaluated by OCT. Neointimal hyperplasia (NIH) thickness and percentage of covered struts and the proportion of incompletely apposed struts were measured at 1-mm intervals ...

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    15. Neoatherosclerosis 16 years following bare-metal stent implantation: Different tissue components in different underlying lesions observed with optical coherence tomography

      Neoatherosclerosis 16 years following bare-metal stent implantation: Different tissue components in different underlying lesions observed with optical coherence tomography

      A 61 years old male with a history of multiple treatments of percutaneous coronary intervention (PCI) with bare-metal stents (BMS) was admitted for the treatment of acute coronary syndrome (ACS). Sixteen years prior to this admission when he was 45years old, he experienced inferior ST-elevation myocardial infarction. He received one Palmaz-Schatz Stent (PS) for the treatment of lesion in distal right coronary artery (RCA).

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    16. Evaluation of the Peri-strut Low Intensity Area Following Sirolimus- and Paclitaxel-Eluting Stents Implantation: Insights From an Optical Coherence Tomography Study in Humans

      Evaluation of the Peri-strut Low Intensity Area Following Sirolimus- and Paclitaxel-Eluting Stents Implantation: Insights From an Optical Coherence Tomography Study in Humans
      Background: In previous pathological studies, paclitaxel-eluting stents (PES) showed greater fibrin deposition around stent struts, while sirolimus-eluting stent (SES) showed predominance of inflammatory cells with less fibrin deposition than PES. However, there are limited in-vivo data clarifying those qualitative differences in the process of vascular healing after 1st-generation drug-eluting stents (DES) implantation. A recent animal study has shown that peri-strut low intensity area (PLIA) seen in optical coherence tomography (OCT) imaging might represent the process of hyaluronic acid and proteoglycan replacing fibrin. Methods: A total of 60 patients who underwent 6-month follow-up OCT after SES (n=34) and PES (n ...
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    17. Local Determinants of Thrombus Formation Following Sirolimus-Eluting Stent Implantation Assessed by Optical Coherence Tomography

      Objectives We conducted this study to assess the prevalence and determinants of subclinical thrombus after sirolimus-eluting stent (SES) implantation. Background Angioscopic analyses have demonstrated the presence of thrombus is more common than the clinical incidence of SES thrombosis. Methods Fifty-three patients (53 lesions) underwent 6-month follow-up optical coherence tomography. A stent eccentricity index ([SEI] minimum/maximum stent diameter) was determined in each cross section. To evaluate unevenness of neointimal thickness, a neointimal unevenness score ([NUS] maximum neointimal thickness in the cross section/average neointimal thickness of the same cross section) was calculated for each cross section. Average SEI and NUS ...
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    18. Local Determinants and Clinical Significance of Thrombus Formation Following Sirolimus-Eluting Stent Implantation: Insights from Optical Coherence Tomography Analysis

      Angioscopic analyses have shown the presence of subclinical thrombus in sirolimus-eluting stents (SES) is more common than the clinical incidence of stent thrombosis. However, the determinants and long term significance of subclinical thrombus remain unknown. Thirty five patients (44 stents) who received SES underwent 6 months follow-up optical coherence tomography (OCT). Patients were divided into 2 groups according to the presence of thrombus by OCT. Cross-sectional images were analyzed every 1mm. Stent eccentricity index (SEI; minimum stent diameter divided by maximum stent diameter) was determined in each cross section (CS). To assess the unevenness of neointimal thickness (NIT), a neointimal ...
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    1-20 of 20
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    Evaluation of the Peri-strut Low Intensity Area Following Sirolimus- and Paclitaxel-Eluting Stents Implantation: Insights From an Optical Coherence Tomography Study in Humans Neoatherosclerosis 16 years following bare-metal stent implantation: Different tissue components in different underlying lesions observed with optical coherence tomography Neointimal coverage of zotarolimus-eluting stent at 1, 2, and 3 months' follow-up: an optical coherence tomography study Low eicosapentaenoic acid to arachidonic acid ratio is associated with thin-cap fibroatheroma determined by optical coherence tomography Early Phase Arterial Reaction Following Drug-Eluting and Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction Optical Coherence Tomography Assessment at 2 Weeks Successful Retrieval of Entrapped Balloon With Optical Coherence Tomography Guidance Impact of underlying plaque type on strut coverage in the early phase after drug-eluting stent implantation Incidence, factors, and clinical significance of cholesterol crystals in coronary plaque: An optical coherence tomography study Intraoperative Optical Coherence Tomography in Idiopathic Macular Epiretinal Membrane Surgery Quantitative approaches in multimodal fundus imaging: State of the art and future perspectives Non-cystic macular thickening on optical coherence tomography as an alternative to fluorescein angiography for predicting retinal vascular leakage in early stages of uveitis Self-supervised patient-specific features learning for OCT image classification