Taishi Hirai

Electronic cardiac arrest triage score best predicts mortality after intervention in patients with massive and submassive pulmonary embolism

To determine if the cardiac arrest triage (CART) Score would better predict poor outcomes after pharmacomechanical therapy (PMT) for massive and submassive pulmonary embolism (PE) than traditional risk scores

Subscapular Bursitis and Calcinosis in a Patient With Dermatomyositis

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Impact of subintimal plaque modification procedures on health status after unsuccessful chronic total occlusion angioplasty

We sought to determine the impact of subintimal plaque modification (SPM) on early health status following unsuccessful chronic total occlusion (CTO) PCI.

Broken arrow: Successful retrieval of a dislodged coronary orbital atherectomy microtip

A 68‐year‐old female with a history of coronary artery disease and prior bypass surgery presented for staged percutaneous coronary intervention (PCI) to a calcified and angulated ostial left circumflex (LCX) artery lesion after PCI of the anastomosis of the left internal mammary artery ‐ to left anterior descending artery. Orbital atherectomy of the LCX was performed at a speed of 80,000 RPM with multiple passes, and was complicated by device microtip dislodgement and entrapment within the vessel. After advancing a “buddy” wire beyond the microtip, a tapered microcatheter was advanced over the ViperWire and into the edge of the broken microtip and torqued into the microtip with forward pressure using the 0.014 in ViperWire tip as a “backstop.” The guidewire, microcatheter, and microtip were then successfully removed as a unit and the intervention with stent placement was completed over the “buddy” wire. Scanning electron microscopy of the shaft revealed evidence of cyclic fatigue, indicating that the fracture occurred while spinning. The fracture when performing atherectomy in a model coronary artery with a radius of approximately 6 mm. This represents a first case of microtip dislodgement and entrapment during the use of a coronary orbital atherctomy device.short

Classification Systems for Acute and Chronic Limb Ischemia

The treatment for peripheral artery disease include medical, endovascular, and surgical. When deciding treatment options, the risk of the intervention should be weighed against the benefit the patient will gain. Grading the lesions and symptoms of peripheral artery disease is very important in deciding the treatment strategy and assessing clinical outcome. In this chapter, we will discuss different classification systems for acute and chronic limb ischemia.

Economic Burden of Chronic Critical Limb Ischemia

Managing patients with chronic limb ischemia is costly and laborious. Multiple treatment strategy including wound care, revascularization (percutaneous or open surgery), and amputation is performed in the USA. It is important to consider cost-effectiveness of each strategy when selecting the treatment plan, to optimize use of medical resources. In this chapter, we review the cost and cost-effectiveness of the various treatment strategies.

Syncope from radiation-induced baroreceptor failure

Orthostatic hypotension has a vast differential that has been previously described throughout the literature. However, baroreceptor failure as a sequela of head and neck radiation is not often recognised as an important cause of dramatic haemodynamic variability. As a result, individuals suffering from baroreceptor failure likely have been undertreated. Herein, we report a case of a patient with a history of radiation to the neck for squamous cell carcinoma of the tongue and resultant baroreceptor failure resulting in syncope.

TCT-790 Cardiac Arrest Triage score best predicts mortality after intervention in patients with massive and submassive pulmonary embolism

Medical Centers, AMAGASAKI, Japan; Kansai Rosai Hospital, Cardiovascular Center, Amagasaki city, Japan; Kokura Memorial Hospital; Morinomiya Hospital, Osaka, Japan; Minneapolis Heart Institute Foundation; Saiseikai Central Hospital, Kyoto, Japan; Saiseikai Yokohama-city Eastern Hospital; AstraZeneca; Nagoya Kyoritsu Hospital, Nagoya, Japan; Kyoto university Hospital, Kyoto, Japan; University of North Carolina Hospital; Fukuoka, Japan; Sant’Eugenio Hospital, Rome, Italy; Juntendo University Nerima Hp., Tokyo, Japan; Hospital of León; Kanazawa Cardiovascular Hospital, Ishikawa, Japan; shinshu university hospital, Matsumoto, Japan; Tokai University, Isehara, Japan; Sant’Eugenio Hospital, Rome, Italy; Hofstra Northwell School of Medicine