Publications by authors named "Akihiro Ikuta"
Background: The effect of the location of calcification in the left main coronary artery (LMCA) bifurcation on cardiovascular events remains unclear.
Methods And Results: This retrospective study included 498 patients who underwent LMCA stenting at a single center between 2014 and 2018. Moderate or severe calcification was visually assessed by coronary angiography.
Coronary computed tomography angiography-derived fractional flow reserve (FFR) is useful for noninvasively detecting coronary artery disease. This procedure has been covered by health insurance reimbursement in the United Kingdom, the United States of America, and Japan. This is the first study to investigate the 1-year outcomes of the FFR, with management covered by health insurance from the DiscoverY of Novel Assessment Myocardial IsChemia by FFR (DYNAMIC-FFR) registry.
View Article and Find Full Text PDFBackground: Hemodialysis (HD) is associated with adverse cardiovascular events after percutaneous coronary intervention (PCI). Although the ultrathin strut biodegradable polymer sirolimus-eluting stent (ultrathin strut BP-SES) has had better results in patients undergoing PCI compared with other drug-eluting stents (DES), its usefulness in HD patients is unknown.
Methods And Results: This study involved 286 lesions in 162 HD patients who underwent PCI with a DES between January 2018 and June 2022.
Background: Owing to the advent of new generation drug-eluting stents, percutaneous coronary intervention (PCI) outcomes are improving. However, the polymers, which have been the most common type of coatings used in drug-eluting stents, have some issues. The study aim was to evaluate the clinical outcomes of patients undergoing PCI with polymer-free sirolimus- and probucol-eluting stents (NP023).
View Article and Find Full Text PDFBackground: Intravascular imaging (IVI) complements coronary angiography and may help prevent coronary artery perforation (CAP) during percutaneous coronary intervention (PCI).
Objectives: The authors evaluated whether IVI-guided PCI is associated with a lower risk of PCI-related CAP in a real-world cohort.
Methods: This observational study analyzed consecutive PCI procedures from January 2006 to October 2023.
Background: Transcatheter aortic valve replacement (TAVR) is a well-established treatment option for patients with severe aortic valve stenosis; however, clinical valve thrombosis is a major challenge.
Case Summary: A 92-year-old woman underwent TAVR for severe aortic stenosis. One month later, the patient developed acute heart failure.
Background: Reversing heparin when managing coronary artery perforation (CAP) during percutaneous coronary intervention (PCI) can provide hemostasis but may cause coronary thrombosis if a device is still present in a coronary artery.
Aims: To assess the impact of heparin reversal while an intracoronary artery device is in place for CAP.
Methods: This study analyzed CAP cases during PCI from January 2006 to October 2023.
Chronic total occlusion (CTO) lesions of the femoropopliteal artery have been shown to benefit from drug-coated balloon (DCB) angioplasty. However, because bailout stenting is often performed, the outcome of DCB angioplasty alone remains unknown, particularly the differences in outcomes between low-dose DCB (LD-DCB) and high-dose DCB (HD-DCB). To address these issues, we conducted a single-center, retrospective cohort study and enrolled 66 consecutive patients undergoing initial endovascular therapy with DCBs for femoropopliteal CTO lesions from June 2018 to February 2023.
View Article and Find Full Text PDFAn aspirin-free strategy for percutaneous coronary intervention in patients with diabetes: a pre-specified subgroup analysis of the STOPDAPT-3 trial.
Eur Heart J Cardiovasc Pharmacother
February 2025
Aims: Safety of aspirin-free strategy immediately after percutaneous coronary intervention (PCI) for cardiovascular events in patients with diabetes was unknown.
Methods And Results: We conducted the prespecified subgroup analysis on diabetes in the STOPDAPT-3 trial, which randomly compared prasugrel (3.75 mg/day) monotherapy (2984 patients) to dual antiplatelet therapy (DAPT) with prasugrel and aspirin (2982 patients) in patients with acute coronary syndrome or high bleeding risk.
Article Synopsis
- The Academic Research Consortium (ARC) has established criteria for identifying patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention, but the impact of these criteria on endovascular therapy (EVT) for femoropopliteal lesions is not well understood.
- A study involving 165 patients undergoing EVT found that 75.8% were classified as HBR, and these patients had significantly higher rates of adverse outcomes, including all-cause death, major bleeding, and target lesion revascularization within two years.
- The findings indicate that most patients with peripheral artery disease are considered HBR, and being classified as HBR increases the risk of serious complications compared to non-HBR patients.
Background: Clinical outcomes after percutaneous coronary intervention have improved with the use of drug-eluting stents, but data beyond 10 years are limited. The purpose of this study was to evaluate the clinical outcomes of patients undergoing sirolimus-eluting stent implantation with follow-up beyond 10 years and to determine the impact of clinical and angiographic characteristics on long-term prognosis.
Methods and results: The clinical outcomes of 885 patients who had undergone sirolimus-eluting stent implantation at a single institution were retrospectively reviewed.
Objective: The association between a combined anaemia and renal failure index and 1-year prognosis of patients undergoing transcatheter aortic valve implantation (TAVI) is unexplored. We aimed to investigate a simple risk score in patients undergoing TAVI.
Methods: A total of 469 consecutive patients undergoing TAVI between 2015 and 2021 were enrolled.
Article Synopsis
- - The study reviews the impact of computed tomography-derived fractional flow reserve (FFR) on the treatment of coronary artery disease in Japan, where it is reimbursed by insurance, assessing its clinical effectiveness and economic benefits.
- - In a multicenter registry involving 410 patients, results showed that FFR usage significantly reduced the need for invasive coronary angiography (ICA) in 39.5% of cases and avoided unnecessary additional tests in patients with FFR values above 0.80.
- - Overall, the introduction of FFR not only minimized unnecessary procedures but also led to an estimated 35% reduction in medical costs, highlighting its potential value in everyday clinical practice.
An aspiration catheter stuck in a patient with acute coronary syndrome: an unanticipated complication.
Cardiovasc Interv Ther
July 2023
A 62-year-old man presented with ST-elevation myocardial infarction. Thrombectomy using an aspiration catheter was performed, but the wire lumen of the catheter had been torn during the catheter was removed. The aspiration catheter could not be retrieved into the guide catheter, and the entire system along with the guide catheter was removed.
View Article and Find Full Text PDFThe Bending of a Frame in a Balloon-Expandable Valve During Transcatheter Aortic Valve Replacement.
JACC Cardiovasc Interv
February 2023
Objective: Postprocedural ischaemic and bleeding risks after transcatheter aortic valve replacement (TAVR) remain a major concern. Nevertheless, no reliable risk models incorporating both possibilities are currently available. We aimed to assess the accuracy of percutaneous coronary intervention (PCI)-derived models and the performance of a recalibrated model that included variables more applicable to TAVR.
View Article and Find Full Text PDFBackground: Data on long-term outcomes of transcatheter aortic valve replacement (TAVR) in Japanese patients beyond 5 years are limited.
Methods: Between June 2010 and December 2014, 55 consecutive inoperable or high surgical risk patients underwent TAVR with SAPIEN XT valves (Edwards Lifesciences, Irvine, CA, USA) for severe aortic stenosis at our institution. Among them, 2 patients were excluded from the analysis because one was converted to open surgery during the TAVR procedure and the other could not undergo TAVR due to device delivery failure.
Predictors of success and puncture site complications in the distal radial approach.
Heart Vessels
February 2023
The distal radial approach (DRA) has been proposed as an alternative approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI); however, the predictors of DRA failure and puncture site complications are unclear. Among 7153 consecutive patients undergoing CAG or PCI between November 2018 and January 2021, 3610 patients undergoing CAG or PCI with DRA were analyzed. The primary endpoint of this study was the procedural success, and the secondary endpoint of this study was puncture site complications during procedure.
View Article and Find Full Text PDFArticle Synopsis
- * Researchers analyzed data from 3,410 PCI patients between 2010 and 2013, tracking incidences of significant bleeding events (Types 3 or 5) through various bleeding risk scores, including ARC-HBR, PRECISE-DAPT, PARIS, and CREDO-Kyoto.
- * Results showed that as bleeding risk scores increased, the incidence of bleeding events rose, with ARC-HBR demonstrating greater sensitivity in identifying patients at risk for long-term bleeding compared to the other scores.
Background: The distal radial approach (DRA) has been proposed as an alternative approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI). However, its outcomes in hemodialysis (HD) patients have not been well studied in detail. We aimed to determine the feasibility and safety of coronary intervention with the DRA for HD patients.
View Article and Find Full Text PDFArticle Synopsis
- The study evaluates different high bleeding risk (HBR) definitions (ARC-HBR, S-HBR, and J-HBR) in patients receiving drug-eluting stents, focusing on their effectiveness over time.
- It found that S-HBR was just as effective as ARC-HBR for predicting short- and long-term bleeding risks, while J-HBR was better for long-term predictions but not as strong for short-term.
- A total of 3,430 patients were analyzed, and major bleeding occurrences were recorded at 1 and 7 years, revealing slight variations among the definitions' predictive values.
Background: Gastrointestinal bleeding (GIB) and intracranial bleeding (ICB) are frequently observed as major bleeding events after percutaneous coronary intervention (PCI); however, there are few reports on these predictors and their association with the Academic Research Consortium for High Bleeding Risk (ARC-HBR).
Methods and results: The study included 3,453 patients who underwent PCI with second-generation drug-eluting stents between 2010 and 2013. Mean follow up was 2,663±596 days.
Background: Drug-coated balloon (DCB) angioplasty for side branches with main branch stenting is effective for bifurcation lesions and reduces late lumen loss (LLL) in side branches. However, the predictors and clinical implications of LLL after DCB angioplasty are largely unexplored.
Methods: Among 181 patients undergoing DCB angioplasty for side branches with drug-eluting stent implantation for main branches between 2016 and 2018, we enrolled 138 patients (138 lesions) undergoing follow-up coronary angiography within 1 year.
Background: The association between renal morphological findings and changes in renal function in patients undergoing transcatheter aortic valve implantation (TAVI) is unexplored.
Aims: We aimed to investigate the association between renal morphological findings and changes in renal function in patients undergoing TAVI.
Methods: Among 283 consecutive patients undergoing TAVI between 2018 and 2021, the study sample included 224 patients.