PubMed Health⌕ Search

Biomedical subjects

Jun Tanabe

Publications and source records attributed to Jun Tanabe.

10 recordsLinked to original sources

Use of an air ambulance system improves time to treatment of patients with acute myocardial infarction.

OBJECTIVE: The aim of this study was to clarify whether a helicopter ambulance system (doctor helicopter system; DHS) could shorten the time interval to coronary intervention in the treatment of patients with acute myocardial infarction (AMI), in comparison with ground ambulance (GA). METHODS: The time from the emergency call to coronary angiography (CAG time) or to percutaneous coronary intervention (PCI time), and the inhospital outcome were evaluated in 76 AMI patients. Twenty patients were transported by DHS, and the other 56 were by GA. RESULTS: Both CAG time and PCI time were significantly shorter in the DHS (98.8+/-29.2 min, and 169.6+/-57.4 min) than those of the GA (126.6+/-48.7 min, and 203.2+/-57.0 min; p<0.05) group. Inhospital mortality was lower in the DHS (5.0%) versus the GA (10.7%) group. CONCLUSION: Use of DHS shortened the time interval to coronary intervention and also improved the inhospital prognosis of AMI patients.

Aged↗

Impact of histological plaque characteristics on intravascular ultrasound parameters at culprit lesions in coronary artery disease.

Prior intravascular ultrasound (IVUS) studies have demonstrated that a positive remodeling pattern of a culprit lesion is observed more frequently in acute coronary syndrome (ACS) than stable angina (SA). However, the relationship between the plaque morphology detected by IVUS and the histological type of atherosclerotic plaque has not been well defined. This is a prospective study on 37 consecutive patients who underwent directional coronary atherectomy. The 37 patients were divided into 2 groups; 21 patients with SA and 16 with ACS. Vessel and plaque cross sectional area were measured at the culprit lesion and the remodeling index (RI) was calculated by IVUS. The plaque tissue was assessed for the presence of inflammatory cells and lipids, and the presence of each was scored as 0 (absent), 1 (sparse), 2 (dense), or 3 (predominant). The RI of the patients with ACS was higher than that of SA. Inflammatory cells were present to a greater extent in patients with ACS. Inflammatory cells and lipids were significantly correlated with the RI (Inflammatory cell score grade > or = 2 patients; 1.14 +/- 0.13 versus grade 0 patients; 0.87 +/- 0.24, and grade 1 patients; 0.93 +/- 0.17, P < 0.01 and lipid score grade > or = 2 patients; 1.13 +/- 0.17 versus grade 0 patients; 0.85 +/- 0.18, P < 0.001 and grade 1 patients; 0.95 +/- 0.19, P < 0.05). The results clearly indicate that the evaluation of vessel morphology by vascular imaging is an important indicator of plaque instability.

Aged↗

Morphologic changes in infarct-related plaque after coronary stent placement: a serial angioscopy study.

OBJECTIVES: The aim of this study was to investigate the morphologic changes in infarct-related lesions after stenting in acute or recent myocardial infarction (MI) with coronary angioscopy. BACKGROUND: There is no information on the serial morphologic changes, which occur after stenting, and the time course of neointimal coverage of stents for disrupted unstable plaques. METHODS: Forty-three patients with MI within seven days of onset were examined. Angioscopy was serially performed for the infarct-related lesions at baseline (n = 43), after balloon angioplasty (n = 35), and after stenting following balloon angioplasty (n = 39) and at one (n = 36) and six months (n = 30) after stenting. RESULTS: At baseline, most of the lesions had complex morphology, yellow plaque color, and protruding thrombus (96%, 96%, and 74%, respectively). Although balloon angioplasty reduced the protruding thrombus, it remained in 37%, and an intimal flap was observed in 89% of the lesions. After stenting, the protruding thrombus and intimal flap disappeared, with an increased luminal size obtained in all lesions. At one-month follow-up, an irregular and yellow surface, along with a lining thrombus, was still observed, with partial neointimal stent coverage in most of the lesions. At six-month follow-up, the neointima was found to have sufficiently formed over the stent. The plaque shape and color were almost all classified as smooth (97%) and white (93%). CONCLUSIONS: These results suggest that a stent not only compressed and covered a disrupted plaque with a protruding thrombus and intimal flap, leading to a wide vessel lumen, but also helped to seal the unstable plaque through neointimal proliferation.

Aged↗