Koji Hozawa

Difference in vascular response between sirolimus-eluting- and everolimus-eluting stents in ostial left circumflex artery after unprotected left main as observed by optical coherence tomography

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, who were treated with single-stent procedure using DES, crossover the ULM-left anterior descending artery (LAD) followed by KBT. Twelve patients were treated with sirolimus-eluting stents (SES) and 26 patients were treated with everolimus-eluting stents (EES). OCT was conducted at post-PCI and 9-month follow-up. We evaluated the DES-vessel interactions and number of stent struts at the side branch (LCX) ostium (SO) at post-PCI, and compared the narrowing of ostial area at LCX between SES and EES. RESULTS Post-procedure, the number of stent struts at SO was significantly higher in SES compared to EES (median 14.47% vs 0.19%, p<0.001). The narrowing of LCX ostial area at follow-up was more pronounced in SES compared with EES (29.16% vs 2.46%, respectively, p<0.001). Linear regression analysis showed a high correlation between the number of stent struts in LCX ostium and ostial area narrowing (r=0.771, p<0.001). CONCLUSIONS OCT showed differences between EES- and SES-vessel interactions at ULM bifurcation PCI. Number of LCX ostium struts at post-PCI impacted the narrowing of ostial area at 9-month follow-up.

5-Year Follow-Up After Stenting for Iatrogenic Coronary Stenosis Due to Mitral Annuloplasty: Insights With Multiple Imaging Modalities.

A 59-year-old woman with severe mitral regurgitation underwent mitral annuloplasty (MAP) with a 28-mm Carpentier-Edwards Physio II annuloplasty ring (Edwards Lifesciences, Irvine, California). On post-operative day 10, the patient complained of chest oppression with ischemic changes on an

TCT-27 The Impact of Second Generation Drug-eluting Stent on Mid-term Clinical Outcome in Patients with Unprotected Left Main, Milan and New-Tokyo Registry

Niels R. Holm, Kari Kervinen, Matti J. Niemela, Andrejs Erglis, Indulis Kumsars, Terje Steigen, Evald H. Christiansen, Markku Eskola, Hannu Romppanen, Andis Dombrovskis, Ole Frobert, Lars Åberge, Pål Gunnes, Juhani Airaksinen, Anders Hervold, Sanda Jegere, Thor Trovik, Lisette Okkels Jensen, Michael Maeng, Timo Makikallio, Mikko Pietila, Iwar Sjögren, Per Thayssen, Saila Vikman, Jens F. Lassen, Leif Thuesen Aarhus University Hospital, Skejby, Aarhus N, Denmark, Oulo University Hospital, Oulo, Finland, University of Oulo, Oulo, Finland, Pauls Stradins Clinical University Hospital, Riga, Latvia, Latvian Cardiology Center, Riga, Latvia, University Hospital of Northern Norway, Tromso, Norway, Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus N, Denmark, Tampere Heart Center, Tampere, Finland, Latvian center of cardiology, Paul Stradins Clinical Hospital, Riga, Latvia, Örebro University Hospital, Örebro, Sweden, Rikshospitalet, Oslo, Norway, Feiringklinikken, Feiring, Norway, Turku University Hospital, Turku, Finland, Pauls Stradins Clinical University Hospital, Riga, Not applicable, University Hospital of Tromsoe, Tromsoe, Norway, Odense University Hospital, Odense, Denmark, Aarhus University Hospital, Aarhus, Denmark, Falun Hospital, Falun, Sweden, Department of Cardiology, Odense University Hospital, Odense, Denmark, Tampere University Hospital, Tampere, Finland, Department of Cardiology, Aarhus University Hospital, Skejby, Denmark, Aarhus, Denmark

1003-90 Successful embolization protection using guardWire system for acute myocardial infarction: Multicenter registry in Japan

Background: Distal embolism is one of the major complications during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). These complications may be potentially mitigated by distal protection. The GuardWire system (GS) consists of an occlusion balloon which is inflated distally allowing ‘protected’ PCI has recently become available. Aim: To evaluate the efficacy and safety of this device, we studied a total of 212 patients (male 69.8%) of AMI who underwent PCI using GS. The GS was successfully placed in all of the cases. Gross inspection of the filter after retrieval demonstrated macroscopic emboli including thrombus in 93.9% of patients. Results: See table. Conclusion: The preliminary results suggest that PCI for AMI using GS is technically feasible, safe and early clinical outcomes appear to be favorable. 6 months and 1 year follow-up clinical outcome will be available at time of presentation.

Nicorandil, a KATPchannel opener, facilities the recovery of ventricular contraction after reperfusion therapy in acute myocardial infarction: Multicenter registry in Japan

observed: there were no arrhythmias, no conduction disturbances and no ST-segment modifications. Cardiac enzymes remained unchanged. Conclusion: Gadolinium enhanced coronary angiography is safe and well tolerated. The mixture of Gadolinium with non-ionic contrast allowed us to obtain diagnostic angiograms of excellent quality in all cases. In patients at high-risk for renal failure, Gadolinium constitutes an interesting adjunct to contrast agents for coronary artery imaging.