Yoshinobu Ogino

Scedosporium aurantiacum brain abscess after near-drowning in a survivor of a tsunami in Japan

Many victims of the tsunami that occurred following the Great East Japan Earthquake on March 11, 2011 developed systemic disorders owing to aspiration pneumonia. Herein, we report a case of tsunami lung wherein Scedosporium aurantiacum was detected in the respiratory tract. A magnetic resonance image of the patients head confirmed multiple brain abscesses and lateral right ventricle enlargement. In this case report, we describe a potential refractory multidrug-resistant infection following a tsunami disaster.

Angioscopy and OCT in repeated in-stent restenosis in saphenous vein graft.

The morphological characteristics of in-stent restenosis (ISR) that occur in multiple layers of stents (stent in stent) are not well described. We used multimodality imaging in a 69-year-old man in whom repeated episodes of restenosis developed in a 9-year-old saphenous vein graft (SVG) to the left

“Intracoronary Whirling Current Phenomenon” and Thrombus Formation After Sirolimus-Eluting Stent Implantation Visualized by Optical Coherence Tomography

We present a case of imaged “intracoronary whirling current phenomenon.” A 60-year-old Japanese man was treated with 2 sirolimus-eluting stents (SES; 3.0×18 and 3.5×33 mm) in the right coronary artery (RCA) for chronic total occlusion in October 2007. After percutaneous coronary intervention, he was taking 200 mg of aspirin and 200 mg of ticlopidine. However, he had recurrent transient ischemic chest pain beginning at 7 months. A second coronary angiography at 8 months after SES implantation showed reocclusion at a site just proximal to the SES. A repeat percutaneous coronary intervention was performed for RCA chronic total occlusion (Figure 1). After crossing the guide wire to the distal portion of the RCA, the target lesion was dilated using a 1.25×10 mm balloon catheter. After minimum balloon dilatation, optical coherence tomography (OCT) was performed to evaluate in-stent reocclusion from the distal portion to the proximal portion (Figure 2). Two different types of tissue coverage (may be consistent with thrombus formations of different ages) were observed in the stent reocclusion.1 Moreover, in the patent distal portion of the RCA, an intracoronary whirling current …

Late stent thrombosis after discontinuation of dual anti-platelet therapy in off-label use of paclitaxel-eluting stent visualized by optical coherence tomography—3-vessel OCT study

We observed late stent thrombosis image by optical coherence tomography (OCT) in vessels with off-label paclitaxel-eluting stents (PES) implantation. A 59-year-old Japanese man was treated with a single on-label PES for chronic coronary artery disease in the left circumflex artery. After 9 months, he was implanted with two linked PESs in the left anterior descending artery (LAD) and a single PES in the right coronary artery (RCA). He was examined for suspicion of a colon tumor by fiberscope after discontinuation of dual anti-platelet therapy without consultation. He complained of chest pain and was transferred to our center. Emergency coronary angiography demonstrated thrombotic total occlusion of the proximal LAD in the two linked PESs. After thrombus aspiration therapy, OCT was performed to evaluate the stents in the 3 vessels. The off-label two linked PESs demonstrated the same average neo-intimal hyperplasia (NIH) thickness and percentage of uncovered stent struts compared with the on-label PES in the RCA by visualized OCT image. However, the heterogeneity of NIH in the LAD stent was significantly higher than the stents in the other two vessels. The implantation of the two linked off-label and the heterogeneity of NIH may increase hyperplatelet coagulability more than on-label single PES use.