Problem solving of the coronary bifurcation stenting using 3-dimensional optical coherence tomography and developing the dedicated bioresorbable scaffold

• Project/Area Number: 26461071
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular medicine
• Research Institution: Yamaguchi University
• Principal Investigator: OKAMURA Takayuki 山口大学, 医学部附属病院, 講師 (70380011)
• Co-Investigator(Kenkyū-buntansha): 南 和幸 山口大学, 創成科学研究科, 教授 (00229759)
• Project Period (FY): 2014-04-01 – 2017-03-31
• Project Status: Completed (Fiscal Year 2016)
• Budget Amount: ¥4,940,000 (Direct Cost: ¥3,800,000、Indirect Cost: ¥1,140,000); Fiscal Year 2016: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2015: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000); Fiscal Year 2014: ¥3,250,000 (Direct Cost: ¥2,500,000、Indirect Cost: ¥750,000)
• Keywords: 虚血性心疾患 / 冠動脈ステント / 光干渉断層法 / 動脈硬化 / 画像診断 / ポリマー

Outline of Final Research Achievements

We investigated the serial change of the side branch ostium jailed by drug eluting stent in the coronary artery bifurcation lesion by the three-dimensional optical coherence tomography. The response of the remote phase is different depending on the complexity of the stent covering configuration. The side branch ostial area decreased at the remote period when the stent covering configuration was complicated. In the case of side branch dilatation, when the number of remaining struts was large, the ostial areas often decreased in the remote period. The frequency of the remaining strut after side branch dilatation was higher when the longitudinal stent link was present at the carina. We developed a dedicated bioresorbable scaffold for the bifurcation lesion and evaluate them in the simulated phantom vessel. It was observed the cutting of the longitudinal link of the stent and that the side branch ostium was opened widely.

Research Products

• [Journal Article] Serial changes in the three-dimensional aspect of the side-branch ostium jailed by a drug-eluting stent assessed by optical coherence tomography. (2017)
  • Author(s): Nakamura T, Okamura T, Fujimura T, Yamada J, Nao T, Tateishi H, Maeda T, Oda T, Shiraishi K, Nakashima T, Nishimura S, Miura T, Matsuzaki M, Yano M.
  • Journal Title: Int J Cardiovasc Imaging Volume: 33 Issue: 6 Pages: 797-806
  • DOI: 10.1007/s10554-017-1080-8
  • Peer Reviewed
• [Journal Article] Differences of side branch jailing between left main-left anterior descending artery stenting and left main-left circumflex artery stenting with Nobori biolimus-eluting stent. (2016)
  • Author(s): Nakao F, Okamura T, Suetomi T, Yamada J, Nakamura T, Ueda T, Oda T, Kanemoto M, Ikeda Y, Fujii T, Yano M.
  • Journal Title: Heart Vessels Volume: 31 Issue: 12 Pages: 1895-1903
  • DOI: 10.1007/s00380-016-0812-3
  • Peer Reviewed
• [Journal Article] New implication of three-dimensional optical coherence tomography in optimising bifurcation PCI. (2015)
  • Author(s): Onuma Y, Okamura T, Muramatsu T, Uemura S, Serruys PW.
  • Journal Title: EuroIntervention Volume: 11 Issue: V Pages: V71-V74
  • DOI: 10.4244/eijv11sva15
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] New quantitative method to diagnose coronary in-stent restenosis by 64-multislice computed tomography (2015)
  • Author(s): Yoshimura M, Nao T, Miura T, Okada M, Nakashima Y, Fujimura T, Okamura T, Yamada J, Matsunaga N, Matsuzaki M, Yano M.
  • Journal Title: J Cardiol Volume: 65 Issue: 1 Pages: 57-62
  • DOI: 10.1016/j.jjcc.2014.03.013
  • Peer Reviewed / Open Access
• [Journal Article] Impact of angiographic peri-stent contrast staining (PSS) on late adverse events after sirolimus-eluting stent implantation: an observation from the multicenter j-Cypher registry PSS substudy. (2014)
  • Author(s): Imai M, Kimura T, Morimoto T, Saito N, Shiomi H, Kawaguchi R, Kan H, Mukawa H, Fujita H, Ishise T, Hayashi F, Nagao K, Take S, Taniguchi H, Sakamoto H, Yamane T, Shirota K, Tamekiyo H, Okamura T, Kishi K, Miyazaki S, Yamamoto S, Yamaji K, Kawasaki T, Taguchi E, Nakajima H, Kosedo I, Tada T, Kadota K, Mitsudo K.
  • Journal Title: Cardiovasc Interv Ther. Volume: 29 Issue: 3 Pages: 226-36
  • DOI: 10.1007/s12928-014-0248-6
  • NAID: 40020134714
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] 3D optical coherence tomography: new insights into the process of optimal rewiring of side branches during bifurcational stenting (2014)
  • Author(s): Okamura T, Onuma Y, Yamada J, Iqbal J, Tateishi H, Nao T, Oda T, Maeda T, Nakamura T, Miura T, Yano M, Serruys PW.
  • Journal Title: EuroIntervention Volume: 10 Issue: 8 Pages: 907-15
  • DOI: 10.4244/eijv10i8a157
  • Peer Reviewed
• [Journal Article] Sequel of jailed side branch (2014)
  • Author(s): Tateishi H, Okamura T, Yamada J, Nao T, Maeda T, Oda T, Nakamura T, Miura T, Matsuzaki M, Yano M
  • Journal Title: Circ J Volume: 78 Pages: 772-4
  • Peer Reviewed
• [Journal Article] Serial three-dimensional optical coherence tomography assessment of strut coverage and intraluminal structures after drug-eluting stent implantation (2014)
  • Author(s): Maeda T, Okamura T, Yamada J, Nao T, Tateishi H, Yoshimura M, Oda T, Shiraishi K, Nakashima T, Nakamura T, Miura T, Yano M
  • Journal Title: Cardiovasc Interv Ther Volume: 29(1) Issue: 1 Pages: 31-9
  • DOI: 10.1007/s12928-013-0209-5
  • Peer Reviewed
• [Journal Article] Dual-source computed tomography coronary angiography in patients with high heart rate. (2013)
  • Author(s): Fujimura T, Miura T, Nao T, Yoshimura M, Nakashima Y, Okada M, Okamura T, Yamada J, Ohshita C, Wada Y, Matsunaga N, Matsuzaki M, Yano M.
  • Journal Title: Heart Vessels Volume: 29 Issue: 4 Pages: 443-8
  • DOI: 10.1007/s00380-013-0383-5
  • Peer Reviewed
• [Presentation] 3D-OCT Bifurcation Registry : Impact of Optimal Side Branch Dilation on Residual Jailed Struts and Clinical Outcome at 9 Month (2017)
  • Author(s): Takayuki Okamura
  • Organizer: 第８１回日本循環器学会学術集会
  • Place of Presentation: KKRホテル金沢等（石川県金沢市）
  • Year and Date: 2017-03-19
• [Presentation] Serial change of side branch ostial areas after single crossover stenting with kissing balloon dilatation assessed by three-dimensional Optical Coherence Tomography (2016)
  • Author(s): Tatsuhiro Fujimura, Takayuki Okamura
  • Organizer: TCT 2016
  • Place of Presentation: ワシントン、 アメリカ
  • Year and Date: 2016-10-29
  • Int'l Joint Research
• [Presentation] Clinical usefulness of 3D-OCT for bifurcation stenting (2016)
  • Author(s): 岡村誉之
  • Organizer: CCT 2016
  • Place of Presentation: 神戸国際会議場（兵庫県神戸市）
  • Year and Date: 2016-10-21
  • Invited
• [Presentation] Serial change of side branch ostial areas after single crossover stenting with KBD assessed by 3D OCT (2016)
  • Author(s): Tatsuhiro Fujimura, Takayuki Okamura, Jutaro Yamada, Tetsuro Oda, Mamoru Mochizuki, Yousuke Miyazaki, Takeshi Suetomi, Akihiro Hino, Shigehiko Nishimura, Takashi Nishimura, Masafumi Yano
  • Organizer: 第６４回日本心臓病学会学術集会
  • Place of Presentation: 東京国際フォーラム（東京都千代田区）
  • Year and Date: 2016-09-24
• [Presentation] 3D OCT Bifurcation Registry : 側枝入口部のステント形状とリワイヤリング位置がKBD 後のISA に及ぼす影響 (2016)
  • Author(s): 岡村誉之
  • Organizer: CVIT 2016
  • Place of Presentation: 東京国際フォーラム（東京都千代田区）
  • Year and Date: 2016-07-08
  • Invited
• [Presentation] 左主幹部分岐部病変における ｓｉｎｇｌｅ ｓｔｅｎｔ治療とｔｗｏ ｓｔｅｎｔ治療の治療成績比較 ―分岐角度を踏まえた検討－ (2015)
  • Author(s): 宮崎 要介, 岡村 誉之, 山田 寿太郎, 西村 傑, 西村 滋彦, 日野 昭宏, 末冨 建, 藤村 達大, 望月 守, 小田 哲朗, 矢野 雅文
  • Organizer: 日本心臓病学会学術集会
  • Place of Presentation: 横浜（パシフィコ横浜）
  • Year and Date: 2015-09-18
• [Presentation] Fate of jailed side branch (2015)
  • Author(s): Takayuki Okamura, Yoshinobu Onuma, Patrick W Serruys
  • Organizer: 日本心血管カテーテル治療学会学術集会
  • Place of Presentation: 福岡（ヤフオク！ドーム）
  • Year and Date: 2015-07-30
  • Int'l Joint Research
• [Presentation] Appropriate stent selection and rewiring control in the treatment of bifurcation with steep side branch - Insights from the bench test - (2015)
  • Author(s): Takayuki Okamura, Tatsuhiro Fujimura
  • Organizer: 日本心血管カテーテル治療学会学術集会
  • Place of Presentation: 福岡（ヤフオク！ドーム）
  • Year and Date: 2015-07-30
  • Int'l Joint Research
• [Presentation] Impact of jailing configuration and bifurcation angle on incomplete stent apposition after single crossover stenting with final kissing balloon dilatation, assessed by Three-Dimensional OCT (2015)
  • Author(s): Takeshi Suetomi, Takayuki Okamura, Fumiaki Nakao, Jutaro Yamada, Tetsuro Oda, Mamoru Mochizuki, Yosuke Miyazaki, Takeshi Nakamura, Masafumi Yano.
  • Organizer: EuroPCR 2015
  • Place of Presentation: パリ、フランス
  • Year and Date: 2015-05-19
  • Int'l Joint Research
• [Presentation] 3D-OCTによるステント留置後の側枝入口部のストラット形状評価と慢性期への影響 (2014)
  • Author(s): 中村武史、岡村誉之、山田寿太郎、名尾朋子、小田哲郎、望月守、末冨建、中島唯光、西村滋彦、西村傑、矢野雅文
  • Organizer: 日本心臓病学会学術集会
  • Place of Presentation: 仙台（仙台国際センター）
  • Year and Date: 2014-09-26 – 2014-09-27
• [Presentation] Impact of the jailing configuration after bifurcational stenting on the side branch ostial stenosis at follow up (2014)
  • Author(s): Takeshi Nakamura, Takayuki Okamura, Jutaro Yamada, Hiroki Tateishi, Takao Maeda, Tomoko Nao, Tetsuro Oda, Mamoru Mochizuki, Kozo Shiraishi, Masafumi Yano
  • Organizer: European Society of Cardiology, Congress 2014
  • Place of Presentation: バルセロナ、スペイン
  • Year and Date: 2014-08-30 – 2014-09-03
• [Presentation] New Insights into Two-stent technique in bifurcation PCI (2014)
  • Author(s): 岡村誉之
  • Organizer: 第23回日本心血管インターベンション治療学会
  • Place of Presentation: 名古屋（名古屋国際会議場）
  • Year and Date: 2014-07-24 – 2014-07-26
  • Invited
• [Presentation] Usefulness of 3D reconstruction of OCT image (2014)
  • Author(s): 岡村誉之
  • Organizer: 第23回日本心血管インターベンション治療学会
  • Place of Presentation: 名古屋（名古屋国際会議場）
  • Year and Date: 2014-07-24 – 2014-07-26
  • Invited