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Article: Case 5. Toe stump wound in arterial disease.

Koyama, Akio

2024 Volume 32, Issue Sup12a, Page(s) S16–S17

MeSH term(s)	Humans ; Amputation Stumps ; Toes ; Vascular Diseases
Language	English
Publishing date	2024-01-02
Publishing country	England
Document type	Journal Article
ZDB-ID	1353951-6
ISSN	0969-0700
ISSN	0969-0700
DOI	10.12968/jowc.2023.32.Sup12a.S16
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Zs.A 4572: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Staphylococcus aureus

Takayasu, Mamiko / Hirayama, Kouichi / Shimohata, Homare / Kobayashi, Masaki / Koyama, Akio

International journal of molecular sciences

2022 Volume 23, Issue 13

Abstract: Since 1995, when we reported the case of a patient with glomerulonephritis with IgA deposition that occurred after a methicillin- ... ...

Abstract	Since 1995, when we reported the case of a patient with glomerulonephritis with IgA deposition that occurred after a methicillin-resistant
MeSH term(s)	Glomerulonephritis/pathology ; Glomerulonephritis, IGA/complications ; Glomerulonephritis, IGA/pathology ; Humans ; Immunoglobulin A ; Methicillin-Resistant Staphylococcus aureus ; Staphylococcal Infections ; Staphylococcus aureus
Chemical Substances	Immunoglobulin A
Language	English
Publishing date	2022-07-05
Publishing country	Switzerland
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	2019364-6
ISSN	1422-0067 ; 1422-0067 ; 1661-6596
ISSN (online)	1422-0067
ISSN	1422-0067 ; 1661-6596
DOI	10.3390/ijms23137482
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Article ; Online: Chronic Limb-Threatening Ischemia is a Residual Bleeding Risk Factor among Patients with Lower Extremity Artery Disease.

Tokuda, Takahiro / Yoshioka, Naoki / Koyama, Akio / Yamada, Takehiro / Shimamura, Kiyotaka / Nishikawa, Ryusuke

Journal of atherosclerosis and thrombosis

2023 Volume 31, Issue 1, Page(s) 100–108

Abstract: Aim: Lower-extremity artery disease (LEAD) is a high-risk factor for bleeding. However, the specific risk factors for bleeding in patients with LEAD remain unclear. We aimed to identify risk factors for bleeding in patients with LEAD after endovascular ... ...

Abstract	Aim: Lower-extremity artery disease (LEAD) is a high-risk factor for bleeding. However, the specific risk factors for bleeding in patients with LEAD remain unclear. We aimed to identify risk factors for bleeding in patients with LEAD after endovascular treatment (EVT). Methods: This multicenter, retrospective, observational study included 732 consecutive patients with LEAD who underwent EVT between January 2018 and December 2019. Patient characteristics, laboratory data, target lesions, and medications were compared between patients with and without chronic limb-threatening ischemia (CLTI). Predictive bleeding risk factors were explored using Cox regression analysis with differential models. Results: In model 1, a body mass index (BMI) ＜18.5 kg/m
MeSH term(s)	Humans ; Chronic Limb-Threatening Ischemia ; Warfarin ; Retrospective Studies ; Platelet Aggregation Inhibitors/adverse effects ; Endovascular Procedures/adverse effects ; Peripheral Arterial Disease/surgery ; Treatment Outcome ; Ischemia/surgery ; Risk Factors ; Lower Extremity/blood supply ; Limb Salvage ; Arteries ; Heart Failure/etiology ; Chronic Disease
Chemical Substances	Warfarin (5Q7ZVV76EI) ; Platelet Aggregation Inhibitors
Language	English
Publishing date	2023-08-02
Publishing country	Japan
Document type	Observational Study ; Multicenter Study ; Journal Article
ZDB-ID	2011474-6
ISSN	1880-3873 ; 1340-3478
ISSN (online)	1880-3873
ISSN	1340-3478
DOI	10.5551/jat.64242
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Article ; Online: Predictors of recurrence based on intravascular ultrasound findings after Eluvia placement in symptomatic peripheral arterial disease: A retrospective study.

Yamada, Takehiro / Tokuda, Takahiro / Yoshioka, Naoki / Koyama, Akio / Nishikawa, Ryusuke / Shimamura, Kiyotaka / Aoyama, Takuma

Health science reports

2023 Volume 6, Issue 8, Page(s) e1481

Abstract: Background and aims: Polymer-coated drug-eluting stents (Eluvia) have shown favorable clinical outcomes in real-world registries. There are no reports on recurrent predictors after Eluvia placement based on intravascular ultrasound (IVUS) findings.: ... ...

Abstract	Background and aims: Polymer-coated drug-eluting stents (Eluvia) have shown favorable clinical outcomes in real-world registries. There are no reports on recurrent predictors after Eluvia placement based on intravascular ultrasound (IVUS) findings. Methods: We analyzed clinical data from the ASIGARU PAD registry, a retrospective, multicenter, observational study that enrolled patients who underwent endovascular therapy for superficial femoral and proximal popliteal arteries lesions using Eluvia or drug-coated balloon. The primary outcome was the identification of recurrent predictors, including IVUS parameters at 12 months. The rate of target lesion recurrence was also assessed. Results: IVUS images were obtained in 54 of 65 cases. Seven recurrent cases (13.0%) were observed within 12 months. The random survival forest method presented eight predictive variables of recurrence: Clinical Frailty Scale (CFS), distal stent edge area, distal plaque burden, age, sex, distal external elastic membrane (EEM) area, minimum stent area (MSA), and distal lumen area. Furthermore, the partial dependence plot showed that frailty (CFS ≥ 6), smaller distal stent edge area, higher and lower distal plaque burden, older and younger age, female sex, smaller distal EEM area, smaller MSA, and smaller and larger distal lumen area predicted recurrence after Eluvia placement within 12 months. Conclusion: CFS, distal stent edge area, distal plaque burden, age, sex, distal EEM area, MSA, and distal lumen area were significant recurrent predictors after Eluvia placement.
Language	English
Publishing date	2023-08-03
Publishing country	United States
Document type	Journal Article
ISSN	2398-8835
ISSN (online)	2398-8835
DOI	10.1002/hsr2.1481
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Article ; Online: Clinical Outcomes Based on High Bleeding Risk in Patients With Lower Extremity Peripheral Artery Disease Who Have Undergone Endovascular Therapy.

Yoshioka, Naoki / Tokuda, Takahiro / Koyama, Akio / Yamada, Takehiro / Shimamura, Kiyotaka / Nishikawa, Ryusuke / Morita, Yasuhiro / Morishima, Itsuro

Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists

2023 , Page(s) 15266028231176953

Abstract: Purpose: Endovascular therapies (EVTs) for symptomatic lower extremity peripheral artery disease (PAD) are efficient and minimally invasive. However, patients with PAD tend to have high bleeding risk (HBR), and there are limited data regarding the HBR ... ...

Abstract	Purpose: Endovascular therapies (EVTs) for symptomatic lower extremity peripheral artery disease (PAD) are efficient and minimally invasive. However, patients with PAD tend to have high bleeding risk (HBR), and there are limited data regarding the HBR for patients with PAD after EVT. In this study, we investigated the prevalence and severity of HBR, as well as its association with clinical outcomes in the patients with PAD who underwent EVT. Materials and methods: The Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria were applied to 732 consecutive patients with lower extremity PAD post-EVT to assess the prevalence of HBR, and its association with major bleeding events, all-cause mortality, and ischemic events. The ARC-HBR scores (1 point for each major criterion and 0.5 points for each minor criterion) were obtained and the patients were divided into four groups (score: 0-0.5; low risk, score: 1-1.5; moderate risk, score: 2-2.5; high risk, and score: ≥3; very high risk) according to the score. Major bleeding events were defined as Bleeding Academic Research Consortium type-3 or type-5 bleeding, and ischemic events were defined as the composite of myocardial infarction, ischemic stroke, and acute limb ischemia within 2 years. Results: High bleeding risk occurred in 78.8% of the patients. Major bleeding events, all-cause mortality, and ischemic events occurred in 9.7%, 18.7%, and 6.4% of the study cohort, respectively, within 2 years. During the follow-up period, major bleeding events significantly increased with the ARC-HBR score. The severity of the ARC-HBR score was significantly associated with an increased risk of major bleeding events (high risk: adjusted hazard ratio [HR] 5.62; 95% confidence interval [CI]: [1.28, 24.62]; p=0.022; very high risk: adjusted HR: 10.37; 95% CI: [2.32, 46.30]; p=0.002). All-cause mortality and ischemic events also significantly increased with higher ARC-HBR score. Conclusions: High bleeding risk patients with lower extremity PAD can be at a high risk of bleeding events, mortality, and ischemic events after EVT. The ARC-HBR criteria and its associated scores can successfully stratify HBR patients and assess the bleeding risk in patients with lower extremity PAD who undergo EVT. Clinical impact: Endovascular therapies (EVTs) for symptomatic lower extremity peripheral artery disease (PAD) are efficient and minimally invasive. However, patients with PAD tend to have high bleeding risk (HBR), and there are limited data regarding the HBR for patients with PAD after EVT. Post EVT, most of the patients with PAD were classified as having HBR using the Academic Research Consortium for HBR (ARC-HBR) criteria and the rate of bleeding events as well as mortality and ischemic events within 2 years increased as the ARC-HBR score increased in this retrospective study of 732 participants. HBR patients with PAD can be at high risk of not only bleeding events but also mortality and ischemic events in the mid-term. The ARC-HBR criteria and its associated scores can successfully stratify HBR patients and assess the bleeding risk in patients with PAD who underwent EVT.
Language	English
Publishing date	2023-05-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2006618-1
ISSN	1545-1550 ; 1526-6028
ISSN (online)	1545-1550
ISSN	1526-6028
DOI	10.1177/15266028231176953
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Zs.A 4547: Show issues

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Article ; Online: Association between High Bleeding Risk and 2-Year Mortality in Patients with Chronic Limb-Threatening Ischemia.

Yoshioka, Naoki / Tokuda, Takahiro / Koyama, Akio / Yamada, Takehiro / Shimamura, Kiyotaka / Nishikawa, Ryusuke / Morita, Yasuhiro / Morishima, Itsuro

Journal of atherosclerosis and thrombosis

2023 Volume 30, Issue 11, Page(s) 1674–1686

Abstract: Aim: Patients with chronic limb-threatening ischemia (CLTI) have a high bleeding risk (HBR) and mortality rate. The 2-year life expectancy is an important factor in deciding the appropriate treatment strategy. This study aimed to assess the influence of ...

Abstract	Aim: Patients with chronic limb-threatening ischemia (CLTI) have a high bleeding risk (HBR) and mortality rate. The 2-year life expectancy is an important factor in deciding the appropriate treatment strategy. This study aimed to assess the influence of HBR on the prognosis of patients with CLTI. Methods: A total of 259 patients with CLTI who underwent endovascular therapy (EVT) (mean age, 76.2 years; male, 62.9%) between January 2018 and December 2019 were evaluated. The Academic Research Consortium for HBR (ARC-HBR) criteria were applied to each patient, and the ARC-HBR scores were calculated. The cut-off score for predicting all-cause mortality within two years was derived using a survival classification and regression tree (CART) model. Causes of death and the association between ARC-HBR scores and major bleeding events within two years were also investigated. Results: Based on the CART model, patients were divided into three groups (low HBR score 0-1.0, 48 patients; moderate HBR score 1.5-3.0, 176 patients; and high HBR score ≥ 3.5, 35 patients). During the study period, 82 patients (39.6%) died due to cardiac (n=23) and non-cardiac causes (n=59). All-cause mortality increased significantly with increasing ARC-HBR scores. Cox multivariate analysis revealed a significant association between high ARC-HBR scores and the risk of all-cause mortality within two years. Major bleeding events increased significantly with increasing ARC-HBR scores. Conclusions: The ARC-HBR score could predict 2-year mortality in patients with CLTI who underwent EVT. Thus, this score can help determine the best revascularization strategy for patients with CLTI.
MeSH term(s)	Humans ; Aged ; Chronic Limb-Threatening Ischemia ; Ischemia/surgery ; Treatment Outcome ; Peripheral Arterial Disease/surgery ; Risk Factors ; Hemorrhage/complications ; Risk Assessment ; Retrospective Studies ; Limb Salvage ; Endovascular Procedures/adverse effects
Language	English
Publishing date	2023-03-22
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2011474-6
ISSN	1880-3873 ; 1340-3478
ISSN (online)	1880-3873
ISSN	1340-3478
DOI	10.5551/jat.64157
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Zs.A 5192: Show issues

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Article ; Online: Validation of the Usefulness of the Diameter Reduction, Spiral Shape, Flow Impairment, or Adverse Morphology Classification System in Real-World Clinical Practice.

Yamada, Takehiro / Tokuda, Takahiro / Yoshioka, Naoki / Koyama, Akio / Nishikawa, Ryusuke / Shimamura, Kiyotaka / Tsuruoka, Takuya / Mitsuoka, Hiroki / Aoyama, Takuma

Journal of atherosclerosis and thrombosis

2023 Volume 31, Issue 2, Page(s) 148–157

Abstract: Aim: The accuracy of the DISFORM (diameter reduction, spiral shape, flow impairment, or adverse morphology) classification system has not been validated.: Methods: This retrospective multicenter observational study enrolled 288 consecutive patients ... ...

Abstract	Aim: The accuracy of the DISFORM (diameter reduction, spiral shape, flow impairment, or adverse morphology) classification system has not been validated. Methods: This retrospective multicenter observational study enrolled 288 consecutive patients with lower extremity artery disease who underwent endovascular therapy with drug-coated balloons for femoropopliteal lesions between January 2018 and December 2021. Patients were classified into DISFORM I-IV groups. Primary patency (PP) and freedom from clinically driven target lesion revascularization (CD-TLR) at 12 months, and recurrence predictors at 12 months were investigated. Results: In total, 183, 66, 11, and 28 patients were classified into DISFORM I, II, III, and IV groups, respectively. In the DISFORM I, II, III, and IV groups, the PP rates were 75.3%, 91.1%, 87.5%, and 50.0%, respectively, and freedom from CD-TLR rates were 86.0%, 91.6%, 88.9%, and 76.7%, respectively, at 12 months. In the DISFORM I-III and IV groups, the PP rates were 79.4% and 50.0%, respectively, and freedom from CD-TLR rates were 87.5% and 76.7%, respectively, at 12 months. Multivariate analysis showed that chronic limb-threatening ischemia, DISFORM IV, and Lutonix™ use were independent predictors of PP loss at 12 months. Conclusion: DISFORM IV had a lower PP rate than DISFORM I-III in midterm phase.
MeSH term(s)	Humans ; Femoral Artery ; Popliteal Artery ; Peripheral Arterial Disease ; Treatment Outcome ; Ischemia/therapy ; Time Factors ; Angioplasty, Balloon/adverse effects ; Cardiovascular Agents/adverse effects ; Coated Materials, Biocompatible ; Vascular Patency
Chemical Substances	Cardiovascular Agents ; Coated Materials, Biocompatible
Language	English
Publishing date	2023-08-09
Publishing country	Japan
Document type	Observational Study ; Multicenter Study ; Journal Article
ZDB-ID	2011474-6
ISSN	1880-3873 ; 1340-3478
ISSN (online)	1880-3873
ISSN	1340-3478
DOI	10.5551/jat.64335
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Article: Recurrent Mural Thrombosis of the Ascending Aorta in a Patient with Antiphospholipid Syndrome.

Otsuka, Ryohei / Saito, Shunei / Yamamoto, Toshikuni / Ohno, Tsukasa / Koyama, Akio / Morimae, Hirofumi / Matsushita, Masahiro / Yokota, Kaori / Miyahara, Ken / Matsuura, Akio

Annals of vascular diseases

2022 Volume 15, Issue 1, Page(s) 77–80

Abstract: A 38-year-old man presented with embolic occlusion of the brachial artery. As per his computed tomography results, a pedunculated mass in the proximal ascending aorta was detected. Since discrimination between a thrombus and a tumor was deemed difficult, ...

Abstract	A 38-year-old man presented with embolic occlusion of the brachial artery. As per his computed tomography results, a pedunculated mass in the proximal ascending aorta was detected. Since discrimination between a thrombus and a tumor was deemed difficult, the patient underwent replacement of the ascending aorta. Histopathology revealed the mass to be a thrombus. The diagnosis of antiphospholipid syndrome was then confirmed postoperatively. Six months post-surgery, a new thrombus was detected in the vascular prosthesis. The thrombus resolved after treatment with edoxaban and aspirin. To the best of our knowledge, this is the first report on graft thrombosis in antiphospholipid syndrome, highlighting the importance of seamless anticoagulation therapy.
Language	English
Publishing date	2022-04-06
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2394256-3
ISSN	1881-6428 ; 1881-641X
ISSN (online)	1881-6428
ISSN	1881-641X
DOI	10.3400/avd.cr.21-00138
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Article ; Online: Comparison of clinical outcomes, including the wound healing rate, between inframalleolar bypass to the pedal artery and that to the pedal branch artery in the modern endovascular era.

Kodama, Akio / Kobayashi, Taira / Guntani, Atsushi / Yamada, Tetsuya / Koyama, Akio / Mii, Shinsuke / Ishibashi, Hiroyuki / Matsushita, Masahiro / Komori, Kimihiro

Journal of vascular surgery

2022 Volume 75, Issue 6, Page(s) 2019–2029.e2

Abstract: Objective: Inframalleolar (IM) bypass has been reported to demonstrate acceptable patency and limb salvage in patients with chronic limb-threatening ischemia. However, wound healing after IM bypass and comparisons between pedal artery (PA) bypass and ... ...

Abstract	Objective: Inframalleolar (IM) bypass has been reported to demonstrate acceptable patency and limb salvage in patients with chronic limb-threatening ischemia. However, wound healing after IM bypass and comparisons between pedal artery (PA) bypass and pedal branch artery (PBA) bypass are lacking. Methods: We reviewed prospectively collected data from 208 consecutive patients after IM bypass performed over a period of 6 years. Patients were divided into two groups based on the distal anastomotic artery: the PA group (dorsal pedis artery or common plantar artery) and the PBA group (medial tarsal, lateral tarsal, medial plantar, and lateral plantar artery). The primary outcome was wound healing, and secondary outcomes included loss of patency and limb and life prognosis. Results: Of the 208 patients, 174 (74%) had PA bypass, whereas 34 (16%) had PBA bypass. Patients in the PBA group were significantly younger than those in the PA group (69 ± 7 vs 73 ± 9; P = .03). Although early (30-day) graft failure was more common in the PBA group, late clinical outcomes, including the wound healing rate (79% in the PA group and 84% in the PBA group; P = .74), were similar between the two groups. The Global Limb Anatomic Staging System IM grade (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.58-0.93; P = .006); wound, ischemia, and foot infection wound grade (HR, 0.67; 95% CI, 0.51-0.89; P < .01); and wound, ischemia, and foot infection foot infection grade (HR, 0.79; 95% CI, 0.65-0.96; P = .02) were independent predictors of wound healing. Conclusions: The current study revealed that wound healing in patients after PBA bypass was acceptable and comparable with that after PA bypass. In the modern era, including a high prevalence of infrapopliteal angioplasty, our results could provide useful information to clinicians in actual clinical settings. Moreover, PBA bypass may be an alternative revascularization procedure to avoid major amputation when the PA is occluded, such as in the global vascular guideline IM P2 grade. Prospective multicenter larger studies are warranted to confirm the findings of this study and to compare PBA bypass and IM endovascular treatment in patients with anatomical no-option chronic limb-threatening ischemia.
MeSH term(s)	Amputation ; Humans ; Ischemia/diagnostic imaging ; Ischemia/surgery ; Limb Salvage ; Multicenter Studies as Topic ; Prospective Studies ; Risk Factors ; Tibial Arteries ; Treatment Outcome ; Vascular Patency ; Wound Healing
Language	English
Publishing date	2022-02-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2022.01.138
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Article ; Online: Two-year clinical outcomes and predictors of restenosis following the use of polymer-coated paclitaxel-eluting stents or drug-coated balloons in patients with femoropopliteal artery disease.

Yoshioka, Naoki / Tokuda, Takahiro / Koyama, Akio / Yamada, Takehiro / Shimamura, Kiyotaka / Nishikawa, Ryusuke / Morita, Yasuhiro / Morishima, Itsuro

Heart and vessels

2022 Volume 38, Issue 3, Page(s) 429–437

Abstract: We aimed to assess the clinical performance and risk factors for patency loss within 2 years following the use of polymer-coated paclitaxel-eluting stents (PC-PESs) and drug-coated balloons (DCBs) in patients with lower extremity artery disease. Multi- ... ...

Abstract	We aimed to assess the clinical performance and risk factors for patency loss within 2 years following the use of polymer-coated paclitaxel-eluting stents (PC-PESs) and drug-coated balloons (DCBs) in patients with lower extremity artery disease. Multi-center registry data from 151 patients (65 and 86 treated with PC-PES and DCB, respectively) were retrospectively investigated. Two-year primary patency (PP) and clinically driven target lesion revascularization (CD-TLR) were evaluated using Kaplan-Meier analysis. Predictors of restenosis within 2 years of the procedures were analyzed using the random survival forest method. The consistent predictors of restenosis within 1 and 2 years were assessed and validated using Kaplan-Meier analysis. Two-year PP was 77.2 and 57.2% (log rank p = 0.047) and freedom from CD-TLR was 84.4 and 84.8% in the PC-PES and DCB groups, respectively (log rank p = 0.89). In the DCB group, most of the patients (n = 77, 89.5%) were treated with high-dose DCB. Consistent predictors of restenosis were lower vessel diameter and severity of Clinical Frailty Scale in the PC-PES group, and severity of peripheral artery calcification scoring system grade, severity of post dissection pattern, and smaller vessel diameter in the DCB group. The validation analysis revealed that patients with consistent predictors had significantly worse PP values than that of those without in the PC-PES (87.9% vs. 55.3%, log rank p = 0.003) and DCB groups (75.9% vs. 35.2%, log rank p = 0.001). The 2-year PP of DCBs was lower than that of PC-PESs. A smaller vessel diameter could predict restenosis in both devices. Vessel calcification and dissection should be considered when using DCB to ensure longer term patency.
MeSH term(s)	Humans ; Popliteal Artery/diagnostic imaging ; Drug-Eluting Stents ; Paclitaxel/pharmacology ; Retrospective Studies ; Peripheral Arterial Disease/diagnosis ; Peripheral Arterial Disease/therapy ; Peripheral Arterial Disease/etiology ; Treatment Outcome ; Angioplasty, Balloon/adverse effects ; Femoral Artery ; Stents ; Constriction, Pathologic/chemically induced ; Coated Materials, Biocompatible ; Vascular Patency
Chemical Substances	Paclitaxel (P88XT4IS4D) ; Coated Materials, Biocompatible
Language	English
Publishing date	2022-09-28
Publishing country	Japan
Document type	Journal Article
ZDB-ID	89678-0
ISSN	1615-2573 ; 0910-8327 ; 0935-736X
ISSN (online)	1615-2573
ISSN	0910-8327 ; 0935-736X
DOI	10.1007/s00380-022-02182-0
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