Publications by authors named "Seung-jun Lee"
Background: Intravascular ultrasound (IVUS) guidance has been shown to yield favorable outcomes for endovascular treatment of femoropopliteal artery (FPA) disease with drug-coated balloon (DCB) angioplasty. However, the specific benefits of IVUS for treatment of complex FPA lesions remain uncertain.
Objectives: In this study, the authors compared the clinical impact of IVUS-guided vs angiography-guided DCB angioplasty in patients with complex or noncomplex FPA lesions.
Endovascular treatment of femoropopliteal artery (FPA) disease with drug-coated balloons (DCBs) may face complications such as arterial recoil, dissection, and residual stenosis. Angiography has limited accuracy for evaluating blood flow through revascularized target lesions. Thus, there is a need for postprocedure hemodynamic assessment in treated limbs.
View Article and Find Full Text PDFIntroduction: During tasks like minimally invasive surgery (MIS), various factors can make working environment not be ergonomic, and those situations will accumulate fatigue in the surgeon's muscles which will inevitably lead to poor surgical performance. Therefore, there has been a need for technical solutions to solve this problem and one of the methods is exoskeleton robots.
Methods: We designed a passive shoulder exoskeleton whose workspace could be used for MIS to assist the surgeon's movements and performed computational and clinical validation.
Objective: We evaluated the pharmacokinetics, tissue concentrations, and toxicities of belotecan during rotational intraperitoneal pressurized aerosol chemotherapy (RIPAC) in pigs.
Methods: We sprayed belotecan in 10% and 30% of doses for intravenous chemotherapy in six pigs (cohort 1, n=3, 0.50 mg/m²; cohort 2, n=3, 1.
Importance: In patients with atherosclerotic cardiovascular disease (ASCVD), intensive lowering of low-density lipoprotein (LDL) cholesterol levels with high-intensity statins is generally recommended. However, alternative approaches considering statin-related adverse effects and intolerance are needed.
Objective: To compare the long-term efficacy and safety of an alternative LDL cholesterol-lowering strategy vs high-intensity statin strategy in patients with ASCVD in randomized clinical trials.
Article Synopsis
- - The study examined the relationship between nutritional intake, physical activity (PA), and handgrip strength (HGS) in individuals over 40 with airflow limitation, using data from the 2014 to 2016 Korean National Health and Nutrition Examination Survey.
- - Results indicated that those who were more physically active and had higher HGS reported greater intakes of food, calories, water, protein, and lipids, with strong correlations found between protein and caloric intake and HGS.
- - Ultimately, while significant connections were observed, the study concluded that nutritional intake did not serve as an independent factor influencing PA and HGS, suggesting potential indirect effects worth exploring further.
Article Synopsis
- - This study developed a machine learning model to personalize the duration of dual antiplatelet therapy (DAPT) after coronary stent implantation, aiming to reduce bleeding risks associated with prolonged therapy.
- - The model, tested on data from several clinical trials, indicated that 84.5% of participants could safely receive a shorter 3-month DAPT without significantly increasing the risk of major adverse cardiovascular events.
- - Validation results showed that patients on abbreviated DAPT had a lower incidence of major bleeding compared to those on the standard 12-month DAPT, highlighting the effectiveness of personalized therapy in improving patient outcomes.
Article Synopsis
- High remnant cholesterol (remnant-C) levels during cholesterol-lowering therapy are linked to an increased risk of cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD).
- A study involving 3,348 ASCVD patients found that individuals in the high remnant-C group experienced the highest rates of cardiovascular death, major events, or non-fatal strokes over three years.
- The findings suggest that monitoring remnant-C levels could help identify patients at higher risk for adverse outcomes, making it a useful tool alongside traditional LDL cholesterol measurements.
Background: Endovascular therapy (EVT) has become the preferred treatment modality for femoropopliteal disease. However, there is limited evidence regarding its procedural and clinical outcomes according to the affected area.
Aims: The aim of this study is to investigate clinical outcomes and device effectiveness according to treatment extent in the superficial femoral artery (SFA), popliteal artery (PA), or both.
Because there is a lack of comparative studies assessing drug-coated balloon (DCB) and drug-eluting stent (DES) outcomes with respect to intraluminal (IL) and subintimal (SI) approaches in femoropopliteal (FP) total occlusive lesions, we compared the outcomes between DCB (including bailout stenting) and DES treatments for this lesion. A total of 487 limbs (434 patients) were divided into the IL (n = 344, DCB: n = 268, DES: n = 76) and SI (n = 143, DCB: n = 83, DES: n = 60) approach groups. The primary outcome was a major adverse limb event (MALE), defined as above-ankle amputation or repeat revascularization of the index limb.
View Article and Find Full Text PDFOptical coherence tomography-guided versus angiography-guided percutaneous coronary intervention for patients with complex lesions (OCCUPI): an investigator-initiated, multicentre, randomised, open-label, superiority trial in South Korea.
Lancet
September 2024
Article Synopsis
- The OCCUPI trial aimed to determine if optical coherence tomography (OCT) guidance during percutaneous coronary intervention (PCI) provides better clinical outcomes compared to traditional angiography guidance for complex heart lesions over a year.
- Conducted across 20 hospitals in South Korea, the trial included 1,604 patients aged 19-85 and utilized randomization to assign participants to either OCT or angiography guidance during their PCI procedure.
- The main outcome measured was the rate of major adverse cardiac events, but the effectiveness of OCT guidance in reducing these events compared to angiography guidance remains uncertain, as the study was designed to assess potential clinical benefits.
Background: Patients with ST-elevation myocardial infarction (STEMI) tend to be excluded or under-represented in randomized clinical trials evaluating the effects of potent P2Y12 inhibitor monotherapy after short-term dual antiplatelet therapy (DAPT).
Methods: Individual patient data were pooled from randomized clinical trials that included STEMI patients undergoing drug-eluting stent (DES) implantation and compared ticagrelor monotherapy after short-term (≤3 months) DAPT versus ticagrelor-based 12-month DAPT in terms of centrally adjudicated clinical outcomes. The co-primary outcomes were efficacy outcome (composite of all-cause death, myocardial infarction, or stroke) and safety outcome (Bleeding Academic Research Consortium type 3 or 5 bleeding) at 1 year.
Article Synopsis
- - The study explored the role of sirtuin 4 (SIRT4) in papillary thyroid carcinoma (PTC), using data from The Cancer Genome Atlas (TCGA) and analyzing SIRT4 expression in 205 PTC samples to see its correlation with clinical outcomes.
- - Results showed that lower SIRT4 levels in thyroid cancer are linked to worse survival rates, with SIRT4 overexpression leading to decreased cell survival and invasion in thyroid cancer cell lines, as well as increased apoptosis.
- - The findings suggest SIRT4 acts as a tumor suppressor in PTC, regulating processes like epithelial-mesenchymal transition, and call for further investigation into the underlying molecular mechanisms.
Background: The impact of rosuvastatin versus atorvastatin on new-onset diabetes mellitus (NODM) among patients treated with high-intensity statin therapy for coronary artery disease (CAD) remains to be clarified. This study aimed to evaluate the risk of NODM in patients with CAD treated with rosuvastatin compared to atorvastatin in the randomized LODESTAR trial.
Methods: In the LODESTAR trial, patients with CAD were randomly assigned to receive either rosuvastatin or atorvastatin using a 2-by-2 factorial randomization.
Study Objective: Although the importance of primary percutaneous coronary intervention has been emphasized for ST-segment elevation myocardial infarction (STEMI), the appropriateness of the cardiac catheterization laboratory activation remains suboptimal. This study aimed to develop a precise artificial intelligence (AI) model for the diagnosis of STEMI and accurate cardiac catheterization laboratory activation.
Methods: We used electrocardiography (ECG) waveform data from a prospective percutaneous coronary intervention registry in Korea in this study.
Background And Aims: Drug-coated balloons (DCBs) have demonstrated favourable outcomes following endovascular therapy for femoropopliteal artery (FPA) disease. However, uncertainty remains whether the use of intravascular ultrasound (IVUS) can improve the outcomes of DCBs.
Methods: This prospective, multicentre, randomized trial, conducted at seven centres in South Korea, compared the outcomes of IVUS-guided vs.
Background: The optimal statin treatment strategy that is balanced for both efficacy and safety has not been clearly determined in older adults with coronary artery disease (CAD).
Methods: In the post hoc analysis of the LODESTAR (low-density lipoprotein cholesterol-targeting statin therapy versus intensity-based statin therapy in patients with coronary artery disease) trial, the impact between a treat-to-target strategy versus a high-intensity statin therapy strategy was compared in older adults (aged 75 years or older). The goal of treat-to-target low-density lipoprotein cholesterol (LDL-C) level was 50-70 mg/dl.
The asymmetric division of stem cells permits the maintenance of the cell population and differentiation for harmonious progress. Developing mouse incisors allows inspection of the role of the stem cell niche to provide specific insights into essential developmental phases. Microtubule-associated serine/threonine kinase family member 4 (Mast4) knockout (KO) mice showed abnormal incisor development with low hardness, as the size of the apical bud was decreased and preameloblasts were shifted to the apical side, resulting in amelogenesis imperfecta.
View Article and Find Full Text PDFBackground And Objectives: The K-ELUVIA study aimed to investigate the clinical effectiveness and safety of Eluvia™, a polymer-coated, paclitaxel-eluting stent, for femoropopliteal artery disease using data from a prospective Korean multicenter registry.
Methods: A total of 105 patients with femoropopliteal artery disease who received endovascular treatment (EVT) with Eluvia™ stents at 7 Korean sites were enrolled in a prospective cohort and followed for 2 years. The primary endpoint was the 2-year clinical patency.
Background And Objectives: The popliteal artery is generally regarded as a "no-stent zone." Limited data are available on the outcomes of drug-coated balloons (DCBs) for popliteal artery disease. This study aimed to evaluate the 12-month clinical outcomes among patients who received DCB treatment for atherosclerotic popliteal artery disease.
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- The study evaluated the impact of genetic variations on clinical outcomes in older patients (≥75 years) undergoing percutaneous coronary intervention (PCI) with clopidogrel-based therapy.
- Patients were categorized into normal, intermediate, and poor metabolizers based on their genotypes, revealing significant differences in 3-year major adverse cardiac events among these groups.
- The findings indicated that older patients with loss-of-function alleles experienced higher rates of cardiac events and mortality, highlighting the need for tailored antiplatelet strategies in this population.
Background And Aims: In patients with acute coronary syndrome (ACS), dual antiplatelet therapy (DAPT) with aspirin and a potent P2Y12 inhibitor is recommended for 12 months after drug-eluting stent (DES) implantation. Monotherapy with a potent P2Y12 inhibitor after short-term DAPT is an attractive option to better balance the risks of ischaemia and bleeding. Therefore, this study evaluated the efficacy and safety of ticagrelor monotherapy after short-term DAPT, especially in patients with ACS.
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- * It involved 159 patients with 339 lesions, all of whom had noninvasive coronary computed tomography angiography (CTA) prior to angiography, where FFR and OCT were used to identify ischemic lesions.
- * Findings showed that certain plaque characteristics from CTA and OCT, like low attenuation plaque and thrombus, significantly predicted which lesions were likely causing ischemia, suggesting a detailed anatomical evaluation could enhance diagnostic accuracy.
Background: Although age and body mass index (BMI) significantly affect platelet reactivity units and clinical outcomes after percutaneous coronary intervention, there are limited data on the relationship between high on-treatment platelet reactivity (HPR) and clinical outcomes on age and BMI differences. Thus, we investigated the association of HPR with clinical outcomes according to age and BMI.
Methods And Results: The study analyzed 11 714 patients who underwent platelet function tests after percutaneous coronary intervention.
Background: Endobronchial valve (EBV) therapy, a validated method for bronchoscopic lung volume reduction (BLVR) in severe emphysema, has been explored for persistent air-leak (PAL) management. However, its effectiveness and safety in the Asian population require further real-world evaluation. In this study, we assessed the outcomes of treatment with EBV within this demographic.
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