Effect of contact vector direction on achieving cavotricuspid isthmus block.

Cavotricuspid isthmus (CTI) ablation is an important treatment strategy for CTI-dependent atrial flutter (AFL). The location of the catheter contact area is confirmed by the contact vector direction (CVD) through three-dimensional mapping during the procedure. However, the relationship between CVD during radiofrequency ablation and its efficacy in achieving CTI block has not been clarified.

Characteristics, Antithrombotic Patterns, and Prognostic Outcomes in Claudication and Critical Limb-Threatening Ischemia Undergoing Endovascular Therapy.

Purpose: The underlying difference between intermittent claudication (IC) and critical limb-threatening ischemia (CLTI) still remains unclear. This prospective multicenter observational study aimed to clarify differences in clinical features and prognostic outcomes between IC and CLTI, and prognostic factors in patients undergoing endovascular therapy (EVT).

Materials And Methods: A total of 692 patients with 808 limbs were enrolled from 20 institutions in Japan.

Incidence, clinical characteristics, and diagnostic approach in transthyretin amyloid cardiomyopathy: The Kumamoto Cardiac Amyloidosis Survey.

Background: In recent years, transthyretin amyloid cardiomyopathy (ATTR-CM) has received increasing attention; however, the epidemiology of ATTR-CM in Japan is not yet understood. In the Kumamoto Cardiac Amyloid Survey, we evaluated the current incidence, clinical characteristics, diagnostic approaches, and treatment strategies for ATTR-CM and compared tafamidis-prescription hospitals with regional hospitals.

Methods: We conducted a retrospective multicenter observational cohort study.

Risk Factors and Prevalence of Deep Vein Thrombosis After the 2016 Kumamoto Earthquakes.

Background: After previous earthquakes, a high prevalence of deep vein thrombosis (DVT) has been reported. We examined DVT prevalence and risk factors in evacuees of the Kumamoto earthquakes by performing mobile DVT screening at various evacuation centers around the epicenter.

Methods and results: For 1 month after the Kumamoto earthquake on 14 April 2016, mobile DVT screening using portable ultrasonography (US) was performed at 80 evacuation centers.

Low contrast material dose coronary computed tomographic angiography using a dual-layer spectral detector system in patients at risk for contrast-induced nephropathy.

Objective:: To evaluate the effects of virtual monochromatic imaging (VMI) using dual-layer spectral detector CT on the image quality of coronary CT angiography (CCTA) acquired by using a low contrast material (CM) dose.

Methods:: We used a VMI 50keV protocol with a 50%  CM dose (140  mgI kg) to scan 30 patients with renal insufficiency and a 120 kVp with the standard CM dose (280  mgI kg) to scan 30 controls without renal insufficiency. Quantitative parameters, including CT attenuation, image noise, and contrast-to-noise ratio (CNR), were measured.

The Influence of Iterative Reconstruction on Coronary Artery Calcium Scoring-Phantom and Clinical Studies.

Rationale And Objectives: We compared the effect of iterative model reconstruction (IMR), filtered back projection (FBP), and hybrid iterative reconstruction (HIR) on coronary artery calcium (CAC) scoring.

Materials And Methods: CAC scans of 30 consecutive patients (18 men and 12 women, age 70.1 ± 12.

Effect of iterative reconstruction on variability and reproducibility of epicardial fat volume quantification by cardiac CT.

Background: The epicardial fat volume (EFV) measured by cardiac CT has emerged as an important parameter for understanding the pathophysiology of coronary atherosclerosis.

Objective: We investigated the variability and reproducibility of EFV measurements and evaluated the effect of model-based type iterative reconstruction (M-IR) on measurement results.

Methods: Non-contrast cardiac CT data (tube voltage 120-kVp, tube current time product 32 mAs) of 30 consecutive patients were reconstructed with filtered back projection (FBP), hybrid type iterative reconstruction (H-IR), and M-IR using a slice thickness of 3.

256-Slice coronary computed tomographic angiography in patients with atrial fibrillation: optimal reconstruction phase and image quality.

Objectives: To assess the optimal reconstruction phase and the image quality of coronary computed tomographic angiography (CCTA) in patients with atrial fibrillation (AF).

Methods: We performed CCTA in 60 patients with AF and 60 controls with sinus rhythm. The images were reconstructed in multiple phases in all parts of the cardiac cycle, and the optimal reconstruction phase with the fewest motion artefacts was identified.

Improved image quality at 256-slice coronary CT angiography in patients with a high heart rate and coronary artery disease: comparison with 64-slice CT imaging.

Background: The 256-slice computed tomography (CT) scanners with wider detector coverage and faster gantry rotation speed are now available. The performance of scanners that feature a rotation speed of 270 ms at coronary CT angiography (CCTA) has not been evaluated in patients with a higher heart rate.

Purpose: To evaluate the image quality of 256-slice CT with faster gantry rotation speed in patients undergoing CCTA.

A knowledge-based iterative model reconstruction algorithm: can super-low-dose cardiac CT be applicable in clinical settings?

Rationale And Objectives: To investigate whether "full" iterative reconstruction, a knowledge-based iterative model reconstruction (IMR), enables radiation dose reduction by 80% at cardiac computed tomography (CT).

Materials And Methods: A total of 23 patients (15 men, eight women; mean age 64.3 ± 13.

Improved coronary in-stent visualization using a combined high-resolution kernel and a hybrid iterative reconstruction technique at 256-slice cardiac CT-Pilot study.

Objectives: To investigate the diagnostic performance of 256-slice cardiac CT for the evaluation of the in-stent lumen by using a hybrid iterative reconstruction (HIR) algorithm combined with a high-resolution kernel.

Methods: This study included 28 patients with 28 stents who underwent cardiac CT. Three different reconstruction images were obtained with: (1) a standard filtered back projection (FBP) algorithm with a standard cardiac kernel (CB), (2) an FBP algorithm with a high-resolution cardiac kernel (CD), and (3) an HIR algorithm with the CD kernel.

Incidence and risk factors of vascular complications following endovascular treatment of peripheral arterial disease via the popliteal artery.

To evaluate vascular complications associated with endovascular treatment (EVT) of peripheral arterial disease (PAD) through the popliteal artery and to identify the risk factors for these complications. Between November 2005 and January 2009, 63 patients with PAD received EVT via the popliteal artery. Retrograde (n = 58) and antegrade (n = 5) transpopliteal procedures were performed to target 77 lesions, including 12 distal to the trifurcation.

PCI using a 4-Fr "child" guide catheter in a "mother" guide catheter: Kyushu KIWAMI® ST registry.

Objectives: With the development of PCI techniques, the indications for stents have been expanding as well. On the other hand, we often encounter the situations where deploying a stent/stents by the conventional method is technically challenging. We report a novel stent delivery system using a newly developed 4Fr.

Low responsiveness to thienopyridine in hemodialysis patients.

We sought to evaluate whether thienopyridine low responsiveness, a predictor of stent thrombosis, is found in hemodialysis patients. We measured platelet aggregation at the site of implantation of drug-eluting stents in 333 patients with angina pectoris undergoing dual anti-platelet therapy. Thirty-one patients were on hemodialysis (HD group), and 302 were not (N-HD group).

Sorafenib-induced acute myocardial infarction due to coronary artery spasm.

A 65-year-old man with advanced renal cell carcinoma was admitted due to continuing chest pain at rest. Two weeks before his admission, sorafenib had been started. He was diagnosed with non-ST-elevation myocardial infarction by laboratory data and electrocardiogram.

Effects of gastric medicines on gastroduodenal injury in patients with stable angina during antiplatelet therapy.

Background: The aim of this study was to examine the effects of gastric medicines on gastroduodenal injury during antiplatelet therapy after coronary intervention.

Methods: A total of 501 patients were enrolled and as dual antiplatelet therapy, aspirin and thienopyridine were administered. Patients were divided into four groups: histamine H2-receptor antagonists (H2RA); proton pump inhibitors (PPI); other gastromucosal protective agents (GMP); or nothing (None), and follow-up lasted 8-20 months.

Metal allergic reaction in chronic refractory in-stent restenosis.

Objectives: This study examined the relationship between chronic refractory (CR) in-stent restenosis (ISR) and metal allergic reaction.

Background: Although drug-eluting stent reduced the restenotic event compared with bare-metal stent, the mechanism of neointimal proliferation is not clear yet; however, bare-metal stent still remains as one of the choices.

Methods: Of 128 bare-metal stent implanted patients who experienced target lesion revascularization at least once, 60 patients with the second ISR (study group) and 68 patients without the second ISR (control group) were compared in terms of result from the skin patch test for metal allergic reaction.

Subacute thrombosis after coronary stenting occurring with resistance to ticlopidine.

A 79-year-old man underwent stent implantation from the proximal site to the left main trunk with one bare metal stent after rotation atherectomy. He received 200 mg/day ticlopidine and 200 mg/day aspirin from 2 days pre-stenting. Subacute thrombosis occurred 5 days after coronary stenting.

Increased expression of monocyte chemoattractant protein-1 in atherectomy specimens from patients with restenosis after percutaneous transluminal coronary angioplasty.

The plasma concentration of monocyte chemoattractant protein-1 (MCP-1) antigen is higher in patients with restenosis after coronary angioplasty than in those who do not restenose. In this study the MCP-1 expression of coronary atherectomy specimens was investigated by immunohistochemistry. Samples were obtained from 12 patients with restenosis and 15 with de novo lesions by directional coronary atherectomy.

Challenging case of pulse infusion thrombolysis using a unique pump system for a patient with deep vein thrombosis: a case report.

A 69-year-old man presented with chronic deep vein thrombosis due to massive thrombi extending from the inferior vena cava to both femoral veins. He had undergone surgery for prostatic cancer in 1991, and since then he had been taking an artificial estrogen agent. He was successfully treated by pulse infusion thrombolysis using a unique pump system, which we have developed, without complication.