1. Articles from Sunao Nakamura

    1-23 of 23
    1. 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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    2. 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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    3. Association of skin autofluorescence with plaque vulnerability evaluated by optical coherence tomography in patients with cardiovascular disease

      Association of skin autofluorescence with plaque vulnerability evaluated by optical coherence tomography in patients with cardiovascular disease

      Background and aims Accumulation of advanced glycation end products (AGEs) can be measured non-invasively by skin autofluorescence (SAF) whose values are elevated in patients with cardiovascular disease (CVD). Optical coherence tomography (OCT) is an intravascular imaging modality that could allow visualization of plaque composition. We aim to examine the relationship between SAF and plaque composition evaluated by frequency-domain OCT in patients with CVD. Methods We prospectively enrolled 108 patients with CVD who underwent OCT images during percutaneous coronary intervention (PCI). We divided the population into two groups: high SAF group (greater than or equal to 2.6) and low SAF ...

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    4. One-year follow-up optical coherence tomography after endovascular treatment with a new-generation zotarolimus-eluting stent for chronic mesenteric ischemia

      One-year follow-up optical coherence tomography after endovascular treatment with a new-generation zotarolimus-eluting stent for chronic mesenteric ischemia

      A 62-year-old man experienced lower abdominal pain triggered by a hypotensive episode during hemodialysis for end-stage renal failure. Computed tomography scan and subsequent angiography revealed a significant calcified stenosis at the proximal part of inferior mesenteric artery (IMA) ( Fig. 1 A-C). Abdominal angina was diagnosed and his symptoms were reproduced during intentional hypotension induced by intravenous administration of calcium channel blocker with drop in the Pd/Pa within the IMA lesion from 0.90 to 0.80. In addition, the balloon occlusion during endovascular treatment as described below also reproduced his symptoms. Pre-procedural optical coherence tomography (OCT) showed a lipid-rich ...

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      Mentions: Yusuke Fujino
    5. Accuracy of computed tomography angiography to identify thin-cap fibroatheroma detected by optical coherence tomography

      Accuracy of computed tomography angiography to identify thin-cap fibroatheroma detected by optical coherence tomography

      Background Thin-cap fibroatheroma (TCFA) is assumed to cause acute coronary syndromes. Objective To compare the accuracy of different models for diagnosing TCFA using parameters derived by CT, validated against optical coherence tomography (OCT). Methods One hundred twenty-nine plaques in 106 patients were analyzed using data acquired by 64-row CT with a reconstruction thickness of 0.67 mm and an increment of 0.33 mm. TCFA was defined by OCT as a plaque with lipid content in ≥2 quadrants and the thinnest part of the fibrous cap measuring ≤65 μm. The following parameters were obtained from CT: remodeling index (RI), proportion ...

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    6. Difference in Vascular Response between Sirolimus-eluting- and Everolimus-eluting Stents in Ostial Left Circumflex Artery after Unprotected Left Main as Observed by

      Difference in Vascular Response between Sirolimus-eluting- and Everolimus-eluting Stents in Ostial Left Circumflex Artery after Unprotected Left Main as Observed by

      Background Kissing-balloon technique (KBT) is commonly performed during percutaneous coronary intervention of distal unprotected left main coronary artery (ULM) aiming at obtaining optimal opening of the side branch (left circumflex artery; LCX) ostium. Nonetheless, detailed evaluation of vascular response to stents in LCX ostium is lacking. We therefore evaluated the vascular response to different drug-eluting stents (DES) in ostial LCX after ULM by means of optical coherence tomography (OCT). Methods We prospectively enrolled 38 consecutive patients with ULM disease, whom were treated with single-stent procedure using DES, crossover the ULM-left anterior descending artery (LAD) following by KBT. Twelve patients were ...

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    7. Association of global and local low endothelial shear stress with high-risk plaque using intracoronary 3D optical coherence tomography: Introduction of ‘shear stress score’

      Association of global and local low endothelial shear stress with high-risk plaque using intracoronary 3D optical coherence tomography: Introduction of ‘shear stress score’

      Aims The association of low endothelial shear stress (ESS) with high-risk plaque (HRP) has not been thoroughly investigated in humans. We investigated the local ESS and lumen remodelling patterns in HRPs using optical coherence tomography (OCT), developed the shear stress score , and explored its association with the prevalence of HRPs and clinical outcomes. Methods and results A total of 35 coronary arteries from 30 patients with stable angina or acute coronary syndrome (ACS) were reconstructed with three dimensional (3D) OCT. ESS was calculated using computational fluid dynamics and classified into low, moderate, and high in 3-mm-long subsegments. In each subsegment ...

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    8. Optical coherence tomography assessment of in-stent restenosis after percutaneous coronary intervention with two-stent technique in unprotected left main

      Optical coherence tomography assessment of in-stent restenosis after percutaneous coronary intervention with two-stent technique in unprotected left main

      Background Optical coherence tomography (OCT) has contributed to a better understanding of in-stent restenosis (ISR); however, studies evaluating ISR pattern after two-stent technique in unprotected left main (ULM) are lacking. We aim to evaluate the ISR pattern of proximal LAD and LCX after two-stent technique in ULM. Methods We performed OCT in 26 patients with isolated or combined ISR (identified by angiography as >50%) after two stent implantation in the proximal LCX and LAD. Finally, 13 LAD and 22 LCX ISR lesions underwent OCT assessments. OCT analyses were undertaken in the proximal segments of the LAD and LCX. In addition ...

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    9. Extremely Late Catch-Up Phenomenon After First-Generation Sirolimus-Eluting Stent in the Left Main Stem : Insights From Optical Coherence Tomography

      Extremely Late Catch-Up Phenomenon After First-Generation Sirolimus-Eluting Stent in the Left Main Stem : Insights From Optical Coherence Tomography

      A72-year-old man had undergone angioplasty of the left main stem (LMS) with an implantation of a first-generation drug-eluting stent (DES) (3.5 18-mm Cypher stent, Cordis, Johnson & Johnson, Bridgewater, New Jersey) (Figure 1A). Post-procedural intravascular ultrasound (IVUS) had shown a well-expanded stent (Figures 1A0 and 1Aa–c). Four years later, both angiography and IVUS exhibited no significant in-stent restenosis (ISR) or stent recoil (Figures 1B, 1B0 , and 1Ba0 –c0 ). At 7 years, he presented with acute coronary syndrome (ACS) while still on long-term dual antiplatelet therapy. A subsequently obtained coronary angiogram exhibited severe ISR at the midshaft of LMS (Figure ...

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    10. Extremely Late Catch-Up Phenomenon After First-Generation Sirolimus-Eluting Stent in the Left Main Stem

      Extremely Late Catch-Up Phenomenon After First-Generation Sirolimus-Eluting Stent in the Left Main Stem

      A 72-year-old man had undergone angioplasty of the left main stem (LMS) with an implantation of a first-generation drug-eluting stent (DES) (3.5 × 18-mm Cypher stent, Cordis, Johnson & Johnson, Bridgewater, New Jersey) ( Figure 1A ). Post-procedural intravascular ultrasound (IVUS) had shown a well-expanded stent ( Figures 1A′ and 1Aa–c ). Four years later, both angiography and IVUS exhibited no significant in-stent restenosis (ISR) or stent recoil ( Figures 1B, 1B′, and 1Ba′–c′ ). At 7 years, he presented with acute coronary syndrome (ACS) while still on long-term dual antiplatelet therapy. A subsequently obtained coronary angiogram exhibited severe ISR at the midshaft of LMS ...

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    11. Potential advantages of the GuideLiner® catheter: insights from optical coherence tomography

      Potential advantages of the GuideLiner® catheter: insights from optical coherence tomography

      Optical coherence tomography (OCT) has been reported as promising not only for the evaluation of lesion morphology, but also for better clinical outcomes; however, in some cases with severe vessel tortuosity or angulated bifurcation, it is difficult to advance an intravascular imaging catheter. We report a case in which a GuideLiner ® catheter facilitated obtaining better angiographic and OCT images with the sub-selective injection of minimal contrast medium, even in a case with a tortuous vessel or angulated bifurcation. Furthermore, OCT assessment of a vessel through the catheter may be other potential advantage of this device.

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    12. A Honeycomb-Like Structure in Chronic Total Occlusion Demonstrated by Frequency-Domain Optical Coherence Tomography

      A Honeycomb-Like Structure in Chronic Total Occlusion Demonstrated by Frequency-Domain Optical Coherence Tomography

      A 68 year-old male with a history of hypertension and current smoking was admitted due to exertional chest pain. Coronary angiography (CAG) showed a chronic total occlusion (CTO) in the left circumflex artery with collateral supply from the right coronary artery (Fig. 1). PCI was performed in this lesion as patient has normal left ventricular function. After crossing the lesion with guide wire (Gaia 2nd) and micro catheter, frequency-domain optical coherence tomography (FD-OCT) (ILUMIEN™ OCT Imaging System, St Jude Medical, Inc, St Paul, Minnesota) was performed

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    13. One-Year Follow-Up Optical Coherence Tomography After Implantation of Bioresorbable Vascular Scaffolds for a Chronic Coronary Total Occlusion

      One-Year Follow-Up Optical Coherence Tomography After Implantation of Bioresorbable Vascular Scaffolds for a Chronic Coronary Total Occlusion

      A 70-year-old male underwent coronary angiography because of worsening angina, which demonstrated proximal left anterior descending coronary artery (LAD) chronic total occlusion (CTO) collateralized by septal branches from the right coronary and antegrade bridge (Figure 1A).

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    14. Impact of Main-Branch Calcified Plaque on Side-Branch Stenosis in Bifurcation Stenting: An Optical Coherence Tomography Study

      Impact of Main-Branch Calcified Plaque on Side-Branch Stenosis in Bifurcation Stenting: An Optical Coherence Tomography Study

      Percutaneous coronary intervention (PCI) in bifurcations is routinely performed, however this procedure is associated with higher rates of adverse events compared non-bifurcation PCI [1,2]. While bifurcation PCI per se leads to progressively higher rates of periprocedural myocardial infarction as its complexity increases (i.e., 1- vs. 2-stent technique) [3], side-branch (SB) stenosis (SBS) after main-branch (MB) stenting may further contribute to myocardial ischemia and necrosis; in addition, it might require additional intervention and resource utilization.

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    15. Serial optical coherence tomography images of trapped balloon catheter after bailout stenting

      Serial optical coherence tomography images of trapped balloon catheter after bailout stenting

      The increased use of endovascular interventions has resulted in a growing number of complications pertaining to unretrievable devices. We report a case of balloon dislodgement in a coronary artery during percutaneous coronary intervention (PCI) with bailout stenting used bare metal stent (BMS). We could not retrieve the remnant despite several attempts and techniques. Thereafter, we deployed BMS to bail out thrombus to recover the coronary flow. Emergency surgery was not considered because of high perioperative mortality (EuroSCORE II 55.91%). We did careful follow up with frequency domain optical coherence tomography (FD-OCT) images, which revealed thick neointima hyperplasia that completely ...

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    16. Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque

      Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque

      Patients with Kawasaki disease (KD) not treated with immunoglobulin therapy have a 25% risk of developing coronary aneurysms, which lead to adverse cardiovascular events such as myocardial infarction and death . In addition, these individuals frequently present significant calcium deposits in regions of previous inflammation in the coronaries . OCT assessment of stent-vessel interactions seems to be more accurate than IVUS' in patients with highly calcified plaques .

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    17. Frequency-Domain Optical Coherence Tomography Assessment of Unfavorable Kissing-Balloon Result in Unprotected Left Main Intervention

      Frequency-Domain Optical Coherence Tomography Assessment of Unfavorable Kissing-Balloon Result in Unprotected Left Main Intervention

      A 67-year-old man with a history of hypertension and dyslipidemia was admitted because of angina symptoms. Coronary angiography (CAG) showed an eccentric lesion of the distal unprotected left main coronary artery (ULMCA) involving the ostium of the left anterior descending coronary artery (LAD) (Figure 1 A). ULMCA/LAD crossover stent implantation was conducted with a 3.5 × 18-mm everolimus-eluting stent (EES) (XIENCE PRIME, Abbott Vascular, Santa Clara, California) at 12 atm, followed by the kissing-balloon technique (KBT). Despite a favorable CAG result (Figure 2 A), frequency-domain optical coherence tomography (FD-OCT) revealed stent strut deformation towards the LAD, leading to a ...

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    18. Serial assessment of vessel interactions after drug-eluting stent implantation in unprotected distal left main coronary artery disease using frequency-domain optical coherence tomography

      Serial assessment of vessel interactions after drug-eluting stent implantation in unprotected distal left main coronary artery disease using frequency-domain optical coherence tomography

      Objectives This study sought to assess stent-vessel interactions after drug-eluting stent (DES) implantation in unprotected left main coronary artery (ULM) by frequency-domain optical coherence tomography (FD-OCT). Background Percutaneous coronary intervention using DES in ULM has been increasingly performed in routine practice. Recently, FD-OCT assessments of DES-vessel interactions have been used as surrogates for DES safety; however, there are no FD-OCT studies in ULM. Methods We prospectively enrolled 33 consecutive patients with ULM disease treated with sirolimus- (n = 11) and everolimus-eluting stents (n = 22). FD-OCT assessments were performed post-percutaneous coronary intervention and at 9-month follow-up. Three different segments of ULM were ...

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    19. Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention

      Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention

      We compared intravascular ultrasound (IVUS) and 2 different generations of optical coherence tomography (OCT)—time-domain OCT (TD-OCT) and frequency-domain OCT (FD-OCT)—for the assessment of coronary disease and percutaneous coronary intervention (PCI) using stents. Background OCT is a promising light-based intravascular imaging modality with higher resolution than IVUS. However, the paucity of data on OCT image quantification has limited its application in clinical practice. Methods A total of 227 matched OCT and IVUS pull backs were studied. One hundred FD-OCT and IVUS pull backs in nonstented (n = 56) and stented (n = 44) vessels were compared. Additionally, 127 matched TD-OCT and ...

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    20. Frequency-Domain Optical Coherence Tomography Assessment of Stent Constriction 9 Months After Sirolimus-Eluting Stent Implantation in a Highly Calcified Plaque

      Frequency-Domain Optical Coherence Tomography Assessment of Stent Constriction 9 Months After Sirolimus-Eluting Stent Implantation in a Highly Calcified Plaque

      A 60-year-old man with a history of chronic renal failure in hemodialysis was admitted due to angina symptoms. Coronary angiography showed an eccentric lesion of distal unprotected left main coronary artery involving the ostium of left anterior descending artery (Figure 22_gr1 A). Frequency-domain optical coherence tomography (FD-OCT) revealed a calcified plaque protruding to the lumen (Figure 22_gr1 -a). Rotational atherectomy with a 2.0-mm burr (Figure 22_gr1 -b) was conducted before the implantation of a 3.5 × 18 mm sirolimus-eluting stent at 12 atm., which was followed by intra-stent post-dilation with a noncompliant 4.0 × 12 mm balloon at 18 ...

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    21. Frequency-domain optical coherence tomography assessment of unprotected left main coronary artery disease - a comparison with intravascular ultrasound

      Frequency-domain optical coherence tomography assessment of unprotected left main coronary artery disease - a comparison with intravascular ultrasound

      Objectives: To investigate safety and feasibility of imaging unprotected left main (ULM) using frequency-domain optical coherence tomography (FD-OCT) compared with intravascular ultrasound (IVUS). Background: IVUS has been used to assess and guide percutaneous coronary intervention (PCI) of ULM disease. FD-OCT offers 10-fold higher axial resolution than IVUS and its high-speed image acquisition obviates the need for proximal balloon occlusion. Methods: We prospectively enrolled 35 consecutive patients with ULM disease. FD-OCT and IVUS assessments were attempted pre- and post-PCI and compared in regards to safety, ability to image the region of interest (ROI), number of pullbacks, volume of contrast and ability ...

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    1-23 of 23
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    Frequency-domain optical coherence tomography assessment of unprotected left main coronary artery disease - a comparison with intravascular ultrasound Frequency-Domain Optical Coherence Tomography Assessment of Stent Constriction 9 Months After Sirolimus-Eluting Stent Implantation in a Highly Calcified Plaque Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention Serial assessment of vessel interactions after drug-eluting stent implantation in unprotected distal left main coronary artery disease using frequency-domain optical coherence tomography Frequency-Domain Optical Coherence Tomography Assessment of Unfavorable Kissing-Balloon Result in Unprotected Left Main Intervention Frequency-domain optical coherence tomography evaluation of a patient with Kawasaki disease and severely calcified plaque Impact of Main-Branch Calcified Plaque on Side-Branch Stenosis in Bifurcation Stenting: An Optical Coherence Tomography Study One-Year Follow-Up Optical Coherence Tomography After Implantation of Bioresorbable Vascular Scaffolds for a Chronic Coronary Total Occlusion A Honeycomb-Like Structure in Chronic Total Occlusion Demonstrated by Frequency-Domain Optical Coherence Tomography Potential advantages of the GuideLiner® catheter: insights from optical coherence tomography Correlation between optical coherence tomography, multifocal electroretinogram findings and visual acuity in diabetic macular edema Ciliary body length revisited by anterior segment optical coherence tomography: implications for safe access to the pars plana for intravitreal injections