自治医科大学附属さいたま医療センター

診療科のご案内

冠動脈疾患へのカテーテル治療実績


１．急性心筋梗塞の受け入れ実績


急性心筋梗塞は命に関わる疾患であり、また治療は一刻を争います。当院はさいたま市および周辺地域における急性心筋梗塞を積極的に受け入れており、ここ数年は年間300例前後の急性心筋梗塞患者様を受け入れており、全国でも有数の症例数です

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上記のようにたくさんの急性心筋梗塞患者様を診療しておりますが、残念ながら救命できないこともあります。直近の2024年は1年間で入院中にお亡くなりになった患者様は15名でしたので、2024年急性心筋梗塞院内死亡率は4.8%でした。当院は3次救命センター併設ですので、心肺停止となった最重症の急性心筋梗塞患者様も多く搬入されます。今後もあらゆる重症度の急性心筋梗塞患者様にベストの治療ができるよう、全力を尽くしていきます。
　急性心筋梗塞では閉塞した血管へのカテーテルインターベンションはもちろん重要ですが、その後のリハビリテーションも極めて重要になります。当院では独自のリハビリテーションプログラム(Novel Acute Myocardial Infarction Risk Stratification (nARS) System)を作成し、急性心筋梗塞患者様をそのリスクに応じてリハビリし、退院していただいています




急性心筋梗塞に関する研究実績（2020年～の直近5年間）

  1. Haraguchi Y, Sakakura K, Yamamoto K, Taniguchi Y, Tsukui T, Seguchi M, et al. Determinants of Insufficient Optimal Medical Therapy after Acute Myocardial Infarction. Intern Med. 2020;59(12):1489-95.

  2. Kasahara T, Sakakura K, Yamamoto K, Taniguchi Y, Tsukui T, Seguchi M, et al. Clinical Factors Associated with In-Hospital Mortality in Patients with Acute Myocardial Infarction Who Required Intra-Aortic Balloon Pumping. Int Heart J. 2020;61(2):209-14.

  3. Sawano S, Sakakura K, Taniguchi Y, Yamamoto K, Tsukui T, Seguchi M, et al. Outcomes of Patients With Acute Myocardial Infarction Who Recovered From Severe In-hospital Complications. Am J Cardiol. 2020;135:24-31.

  4. Sawano S, Sakakura K, Yamamoto K, Taniguchi Y, Tsukui T, Seguchi M, et al. Further Validation of a Novel Acute Myocardial Infarction Risk Stratification (nARS) System for Patients with Acute Myocardial Infarction. Int Heart J. 2020;61(3):463-9.

  5. Seguchi M, Sakakura K, Tsukui T, Yamamoto K, Taniguchi Y, Wada H, et al. Determinants of In-Hospital Death Among the Very Elderly with Acute Myocardial Infarction. Int Heart J. 2020;61(5):879-87.

  6. Seguchi M, Sakakura K, Yamamoto K, Taniguchi Y, Wada H, Momomura SI, et al. Comparison of In-Hospital Clinical Outcomes of Acute Myocardial Infarction Between Nonagenarians and Octogenarians. Int Heart J. 2020;61(1):7-14.

  7. Tsukui T, Sakakura K, Taniguchi Y, Yamamoto K, Seguchi M, Jinnouchi H, et al. Factors associated with poor clinical outcomes of ST-elevation myocardial infarction in patients with door-to-balloon time <90 minutes. PLoS One. 2020;15(10):e0241251.

  8. Tsukui T, Sakakura K, Taniguchi Y, Yamamoto K, Seguchi M, Wada H, et al. Association between the Door-to-balloon Time and Mid-term Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction. Intern Med. 2020;59(13):1597-603.

  9. Akashi N, Tsukui T, Yamamoto K, Seguchi M, Taniguchi Y, Sakakura K, et al. Comparison of clinical outcomes and left ventricular remodeling after ST-elevation myocardial infarction between patients with and without diabetes mellitus. Heart Vessels. 2021;36(10):1445-56.

  10. Hatori M, Sakakura K, Taniguchi Y, Jinnouchi H, Tsukui T, Yamamoto K, et al. Factors Associated with In-Hospital Death in Patients with Killip Class 3 Acute Myocardial Infarction. Int Heart J. 2021;62(4):756-63.

  11. Ishibashi S, Sakakura K, Asada S, Taniguchi Y, Jinnouchi H, Tsukui T, et al. Factors associated with difficulty in crossing the culprit lesion of acute myocardial infarction. Sci Rep. 2021;11(1):21403.

  12. Ishibashi S, Sakakura K, Asada S, Taniguchi Y, Yamamoto K, Tsukui T, et al. Clinical Factors Associated with Long Fluoroscopy Time in Percutaneous Coronary Interventions to the Culprit Lesion of Non-ST-Segment Elevation Myocardial Infarction. Int Heart J. 2021;62(2):282-9.

  13. Kani K, Sakakura K, Taniguchi Y, Yamamoto K, Tsukui T, Seguchi M, et al. Association of Baseline Anemia with Mid-Term Clinical Outcomes in Patients Who Underwent Trans-Radial Primary Percutaneous Coronary Intervention. Int Heart J. 2021;62(2):256-63.

  14. Ohashi J, Sakakura K, Sasaki W, Taniguchi Y, Kani K, Yamamoto K, et al. Usefulness of 500-m walk electrocardiogram test on clinical outcomes in patients with ST-segment elevation myocardial infarction. Heart Vessels. 2021;36(1):48-57.

  15. Shibata K, Sakakura K, Taniguchi Y, Yamamoto K, Tsukui T, Seguchi M, et al. Comparison of Clinical Outcomes of Acute Myocardial Infarction Between Prasugrel and Clopidogrel. Int Heart J. 2021;62(3):479-86.

  16. Yamamoto K, Sakakura K, Tsukui T, Seguchi M, Taniguchi Y, Wada H, et al. Clinical factors associated with slow flow in left main coronary artery-acute coronary syndrome without cardiogenic shock. Cardiovasc Interv Ther. 2021;36(4):452-61.

  17. Yanase T, Sakakura K, Jinnouchi H, Taniguchi Y, Yamamoto K, Tsukui T, et al. Factors associated with temporary pacing insertion in patients with inferior ST-segment elevation myocardial infarction. PLoS One. 2021;16(5):e0251124.

  18. Yanase T, Sakakura K, Taniguchi Y, Yamamoto K, Tsukui T, Seguchi M, et al. Comparison of Clinical Characteristics of Acute Myocardial Infarction Between Young (< 55 Years) and Older (55 to < 70 Years) Patients. Int Heart J. 2021;62(1):33-41.

  19. Yoshida H, Sakakura K, Yamamoto K, Taniguchi Y, Tsukui T, Seguchi M, et al. Comparison of in-hospital death following ST-elevation myocardial infarction between secondary emergency and tertiary emergency. Cardiovasc Interv Ther. 2021;36(4):444-51.

  20. Ban S, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Association of Asymptomatic Low Ankle-Brachial Index with Long-Term Clinical Outcomes in Patients after Acute Myocardial Infarction. J Atheroscler Thromb. 2022;29(7):992-1000.

  21. Ban S, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Association of Increased Pulse Wave Velocity With Long-Term Clinical Outcomes in Patients With Preserved Ankle-Brachial Index After Acute Myocardial Infarction. Heart Lung Circ. 2022;31(10):1360-8.

  22. Fujimoto Y, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Comparison of Outcomes of Patients With Acute Myocardial Infarction Between Chronic Total Occlusion Versus 90-99% Stenosis in Non-Culprit Arteries. Am J Cardiol. 2022;170:17-24.

  23. Ishibashi S, Sakakura K, Asada S, Taniguchi Y, Jinnouchi H, Tsukui T, et al. Association of collateral flow with clinical outcomes in patients with acute myocardial infarction. Heart Vessels. 2022;37(9):1496-505.

  24. Kobayashi S, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Comparison of door-to-balloon time and in-hospital outcomes in patients with ST-elevation myocardial infarction between before versus after COVID-19 pandemic. Cardiovasc Interv Ther. 2022;37(4):641-50.

  25. Murakami T, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Complications related to veno-arterial extracorporeal membrane oxygenation in patients with acute myocardial infarction: VA-ECMO complications in AMI. J Cardiol. 2022;79(2):170-8.

  26. Murakami T, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Comparison of medical resource use and total admission cost in patients with acute myocardial infarction between on-hours visit versus off-hours visit. Cardiovasc Interv Ther. 2022;37(4):651-9.

  27. Murakami T, Sakakura K, Taniguchi Y, Yamamoto K, Tsukui T, Seguchi M, et al. Comparison of the cost in percutaneous coronary intervention between ST-segment elevation myocardial infarction vs. non-ST-segment elevation myocardial infarction. Cardiovasc Interv Ther. 2022;37(2):293-303.

  28. Ohashi J, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Comparison of Long-Term Clinical Outcomes in Patients Stratified by a Novel Acute Myocardial Infarction Risk Stratification (nARS) System. Circ J. 2022;86(10):1519-26.

  29. Watanabe Y, Sakakura K, Taniguchi Y, Yamamoto K, Seguchi M, Tsukui T, et al. Long-term outcomes of the modest stent expansion strategy for the culprit lesion of acute myocardial infarction. Cardiovasc Interv Ther. 2022;37(4):660-9.

  30. Aono-Setoguchi H, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Factors associated with intensive care unit delirium in patients with acute myocardial infarction. Heart Vessels. 2023;38(4):478-87.

  31. Hori Y, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Association of peak C-reactive protein with long-term clinical outcomes in patients with ST-segment elevation myocardial infarction. Heart Vessels. 2023;38(6):764-72.

  32. Ishibashi S, Sakakura K, Asada S, Taniguchi Y, Jinnouchi H, Tsukui T, et al. Angiographic Coronary Calcification: A Simple Predictor of Long-Term Clinical Outcomes in Patients with Acute Myocardial Infarction. J Atheroscler Thromb. 2023;30(8):990-1001.

  33. Ishibashi S, Sakakura K, Ikeda T, Taniguchi Y, Jinnouchi H, Tsukui T, et al. Appetite Predicts Long-Term Clinical Outcomes in Patients with Acute Myocardial Infarction. J Clin Med. 2023;12(19).

  34. Kasahara T, Sakakura K, Hori N, Jinnouchi H, Taniguchi Y, Tsukui T, et al. Comparison of in-hospital outcomes of acute myocardial infarction between patients with cardiogenic shock and with cardiac arrest. Heart Vessels. 2023;38(2):139-46.

  35. Kobayashi S, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Influence of daily temperature on the occurrence of ST-elevation myocardial infarction. J Cardiol. 2023;81(6):544-52.

  36. Murakami T, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Acute Ischemic Stroke and Transient Ischemic Attack in ST-Segment Elevation Myocardial Infarction Patients Who Underwent Primary Percutaneous Coronary Intervention. J Clin Med. 2023;12(3).

  37. Yamashita T, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Hatori M, et al. Impact of Excessive Increase in Systolic Blood Pressure after Exercise on Clinical Outcomes in Patients with ST-Segment Elevation Myocardial Infarction. J Clin Med. 2023;12(21).

  38. Ban S, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Hatori M, et al. Association of Increased Inter-arm Blood Pressure Difference with Long-term Clinical Outcomes in Patients with Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention. Intern Med. 2024;63(8):1043-51.

  39. Hai Y, Sakakura K, Jinnouchi H, Taniguchi Y, Yamamoto K, Tsukui T, et al. Comparison of clinical outcomes between direct and indirect transfer in patients with ST-segment elevation myocardial infarction. Cardiovasc Interv Ther. 2024;10.1007/s12928-024-01075-5.

  40. Hamaguchi K, Sakakura K, Jinnouchi H, Taniguchi Y, Yamamoto K, Tsukui T, et al. Comparison of clinical outcomes between proximal and non-proximal right coronary artery occlusion in patients with inferior ST-segment elevation myocardial infarction. J Cardiol. 2024;10.1016/j.jjcc.2024.07.007.

  41. Hori Y, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Hatori M, et al. Determinants of serious in-hospital complications in patients with Killip class 1/2 ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention. Heart Vessels. 2024;10.1007/s00380-024-02382-w.

  42. Kobayashi S, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Hatori M, et al. Impact of controlled blood pressure and pulse rate at discharge on clinical outcomes in patients with ST-segment elevation myocardial infarction. J Cardiol. 2024;83(6):394-400.

  43. Konoma S, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Hatori M, et al. Impact of the Japanese Version of High Bleeding Risk Criteria on Clinical Outcomes in Patients with ST-segment Elevation Myocardial Infarction. J Atheroscler Thromb. 2024;31(6):917-30.

  44. Murakami T, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Hatori M, et al. Development of a simple prediction model for mechanical complication in ST-segment elevation myocardial infarction patients after primary percutaneous coronary intervention. Heart Vessels. 2024;39(4):288-98.

  45. Sato H, Sakakura K, Jinnouchi H, Taniguchi Y, Yamamoto K, Tsukui T, et al. The Impact of the Coronary Artery Calcium Score on the Clinical Outcomes in Patients with Acute Myocardial Infarction. J Clin Med. 2024;13(23).

  46. Tokunaga Y, Sakakura K, Jinnouchi H, Taniguchi Y, Yamamoto K, Tsukui T, et al. Determinants of In-hospital Death in Non-ST-segment Elevation Myocardial Infarction with Triple-vessel Disease. Intern Med. 2024;10.2169/internalmedicine.3949-24.

  47. Yamashita T, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Hatori M, et al. Creatinine kinase-myocardial band (CK-MB) to creatinine kinase (CK) ratio for ST-segment elevation myocardial infarction in the era of the universal definition. Heart Vessels. 2024;10.1007/s00380-024-02424-3.

  48. Ban S, Sakakura K, Jinnouchi H, Taniguchi Y, Yamamoto K, Tsukui T, et al. The Association Between Peripheral Arterial Disease and Long-Term Bleeding Events in Patients with Acute Myocardial Infarction. Journal of Clinical Medicine. 2025;14(9).

  49. Nanri K, Sakakura K, Jinnouchi H, Taniguchi Y, Yamamoto K, Tsukui T, et al. Comparison of clinical outcomes in patients with ST-segment elevation myocardial infarction among preserved, mid-range, and reduced ejection fraction. Heart and Vessels. 2025;10.1007/s00380-025-02558-y.

  50. Ota Y, Sakakura K, Jinnouchi H, Taniguchi Y, Yamamoto K, Tsukui T, et al. Comparison of Clinical Outcomes Between Early and Delayed Percutaneous Coronary Intervention for the Culprit Lesion in Patients with Non-ST-Segment Elevation Myocardial Infarction. Intern Med. 2025;10.2169/internalmedicine.4805-24.

  51. Watanabe Y, Sakakura K, Jinnouchi H, Taniguchi Y, Yamamoto K, Seguchi M, et al. Impact of coronary flow restoration just before stent deployment in primary percutaneous coronary intervention. Cardiovasc Interv Ther. 2025;10.1007/s12928-025-01088-8.



２．経皮的冠動脈形成術（Percutaneous coronary intervention：PCI）治療実績


経皮的冠動脈形成術（PCI）は年間800例前後であり、大学病院附属施設としては全国で最も多い症例数となっています。

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尚、PCIを緊急、非緊急で分けると緊急PCIは172件、非緊急PCIは595件でした。急性心筋梗塞の件数に比べて緊急PCIが少ないのは、欧米のガイドラインに準拠して、ST上昇型急性心筋梗塞以外の急性心筋梗塞については必ずしも緊急PCIをしていないからです。ST上昇型急性心筋梗塞以外の急性心筋梗塞については、冠動脈バイパス手術（CABG）も含めて選択肢になるため、各病変に最適な治療をカンファレンス等で議論して決めています。また、高度石灰化病変が非ST上昇型急性心筋梗塞の責任病変であった場合には、薬物療法で安定化させてから、後日ロータブレーターを含めた治療を行っています。




経皮的冠動脈形成術に関する研究実績（2020年～の直近5年間）

  1. Asada S, Sakakura K, Taniguchi Y, Yamamoto K, Tsukui T, Seguchi M, et al. Association of the long fluoroscopy time with factors in contemporary primary percutaneous coronary interventions. PLoS One. 2020;15(8):e0237362.

  2. Asada S, Sakakura K, Yamamoto K, Momomura S, Fujita H. An alternative strategy for coronary artery lesions with an extra-large reference diameter using a perfusion balloon. Postepy Kardiol Interwencyjnej. 2020;16(2):219-20.

  3. Hasegawa H, Sakakura K, Hamamoto K, Yamamoto K, Taniguchi Y, Tsukui T, et al. Determinants of Greater Peak Radiation Skin Dose in Contemporary Percutaneous Coronary Interventions. Cardiovasc Revasc Med. 2020;21(1):6-11.

  4. Kasahara T, Sakakura K, Momomura SI, Fujita H. A modified reverse guidewire technique for a Crusade-uncrossable bifurcation lesion. J Cardiol Cases. 2020;21(1):32-4.

  5. Kubota M, Sakakura K, Yamamoto K, Taniguchi Y, Tsukui T, Seguchi M, et al. Mid-term Clinical Outcomes of Immediate Protamine Use Following Elective Percutaneous Coronary Interventions. Int Heart J. 2020;61(5):865-71.

  6. Mizuno Y, Sakakura K, Yamamoto K, Taniguchi Y, Tsukui T, Seguchi M, et al. Determinants of Periprocedural Myocardial Infarction in Current Elective Percutaneous Coronary Interventions. Int Heart J. 2020;61(6):1121-8.

  7. Mukai Y, Sakakura K, Yamamoto K, Taniguchi Y, Tsukui T, Seguchi M, et al. Association of less-contrast media with clinical factors in elective percutaneous coronary intervention. Heart Vessels. 2020;35(2):143-52.

  8. Sasaki W, Wada H, Sakakura K, Matsuda J, Ibe T, Hayashi T, et al. Coronary vasospasm induced by cisplatin for seminoma. Clin Case Rep. 2020;8(1):190-3.

  9. Tsukui T, Sakakura K, Momomura SI, Fujita H. A novel method for prevention of intravascular ultrasound catheter entrapment using soft guide extension catheter. Cardiovasc Interv Ther. 2020;35(4):405-6.

  10. Jinnouchi H, Sakakura K, Yanase T, Ugata Y, Tsukui T, Taniguchi Y, et al. Impact of stent edge dissection detected by optical coherence tomography after current-generation drug-eluting stent implantation. PLoS One. 2021;16(11):e0259693.

  11. Mizuno Y, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Yamamoto K, et al. Comparison of the incidence of periprocedural myocardial infarction between percutaneous coronary intervention with versus without rotational atherectomy using propensity score-matching. Sci Rep. 2021;11(1):11140.

  12. Narita M, Sakakura K, Taniguchi Y, Yamamoto K, Tsukui T, Seguchi M, et al. Factors associated with aorto-ostial stent coverage during intravascular ultrasound-guided percutaneous coronary intervention to severely narrowed non-ostial right coronary artery lesions. Postepy Kardiol Interwencyjnej. 2021;17(2):163-9.

  13. Sakakura K. Lesion Preparation for Severely Calcified Coronary Artery Disease　- Intravascular Lithotripsy as a New Option. Circ J. 2021;85(6):834-6.

  14. Sawano S, Sakakura K, Tsurumaki Y, Fujita H. Entrapment of a completely radiolucent fragment of balloon catheter: should we try to retrieve or knock the invisible fragment? Cardiovasc Interv Ther. 2021;36(3):386-8.

  15. Taniguchi Y, Sakakura K, Tsukui T, Yamamoto K, Jinnouchi H, Seguchi M, et al. Association of Ankle Brachial Index with Clinical Outcomes Following Percutaneous Coronary Intervention in Patients with Aortic Aneurysm. Intern Med. 2021;60(17):2733-40.

  16. Yamamoto K, Sakakura K, Ishibashi S, Shibata K, Tsukui T, Taniguchi Y, et al. Perfusion Balloon for the Treatment of Very Late Stent Thrombosis. Int Heart J. 2021;62(2):422-6.

  17. Ishibashi S, Sakakura K, Okazaki Y, Fujita H. A unique bailout strategy for coronary artery dissection accompanying longitudinal hematoma. Postepy Kardiol Interwencyjnej. 2022;18(3):306-8.

  18. Mizuno Y, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Comparison of the Incidence of Periprocedural Myocardial Infarction in Bifurcation Lesions Between Medina (1,1,1) and (0,1,1) in Elective Percutaneous Coronary Intervention. Int Heart J. 2022;63(3):459-65.

  19. Fujimoto Y, Sakakura K, Fujita H. Complex and high-risk intervention in indicated patients (CHIP) in contemporary clinical practice. Cardiovasc Interv Ther. 2023;38(3):269-74.

  20. Fujimoto Y, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Comparison of Outcomes of Elective Percutaneous Coronary Intervention between Complex and High-Risk Intervention in Indicated Patients (CHIP) versus Non-CHIP. J Atheroscler Thromb. 2023;30(9):1229-41.

  21. Fujimoto Y, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Comparison of Long-Term Clinical Outcomes of Elective Percutaneous Coronary Intervention Between Complex and High-risk Intervention in Indicated Patients (CHIP) versus Non-CHIP. Am J Cardiol. 2023;194:1-8.

  22. Jinnouchi H, Sakakura K, Taniguchi Y, Yamamoto K, Hatori M, Tsukui T, et al. Clinical Impact of In-Stent Calcification in Coronary Arteries: Optical Coherence Tomography Study. Am J Cardiol. 2024;214:115-24.

  23. Seguchi M, Sakakura K, Taniguchi Y, Fujita H. Current situation and overview of resorbable magnesium scaffolds: a perspective for overcoming the remaining issues of polymeric bioresorbable scaffold. Cardiovasc Interv Ther. 2024;10.1007/s12928-024-01070-w.

  24. Watanabe Y, Sakakura K, Jinnouchi H, Fujita H. Complicated coronary artery dissection in which a guidewire was pushed out from the true lumen to the false lumen behind calcified plaque. Journal of Cardiology Cases. 2024;10.1016/j.jccase.2024.11.007.

  25. Ishibashi S, Sakakura K, Fujita H. Intravascular ultrasound can distinguish between thrombus formation and coronary vasospasm during primary percutaneous coronary intervention. Cardiovasc Interv Ther. 2025;10.1007/s12928-025-01098-6.

  26. Ishibashi S, Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, et al. Association between the long-term dialysis due to diabetic nephropathy and clinical outcomes in patients with coronary artery disease and chronic renal failure. Cardiovascular Intervention and Therapeutics. 2025;10.1007/s12928-025-01109-6.

  27. Jinnouchi H, Sakakura K, Fujita H. Deep dive into intravascular coronary imaging in calcified lesions. Cardiovasc Interv Ther. 2025;10.1007/s12928-025-01096-8.



３．冠動脈複雑症例へのPCI(Complex PCI)について


１．冠動脈慢性完全閉塞（CTO）


冠動脈慢性完全閉塞（Chronic total occlusion：CTO）へのPCIは高難度とされており、
一般的なカテーテル治療の成功率は70％前後と報告されています。
当院での2017以降の治療成功率の推移を以下に示します。

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2017年以降、毎年90%前後と高い成功率で推移しています。逆行性アプローチ（Retrograde approach）、
IVUSガイドワイヤリングなど様々な技術を用いて成功を目指して一例一例取り組んでいます。




慢性完全閉塞（CTO）に関する研究実績（2020年～の直近5年間）

  1. Yamamoto K, Sakakura K, Hamamoto K, Hasegawa H, Tsukui T, Seguchi M, et al. Determinants of Greater Peak radiation skin dose in percutaneous coronary intervention for chronic total occlusion. J Cardiol. 2020;76(2):217-23.

  2. Yamamoto K, Sakakura K, Tsukui T, Seguchi M, Taniguchi Y, Wada H, et al. Factors associated with antegrade true-sub-true phenomenon in percutaneous coronary intervention for chronic total occlusion. PLoS One. 2020;15(4):e0232158.

  3. Taniguchi Y, Sakakura K, Ban S, Fujita H. IVUS-assisted parallel wiring for coronary chronic total occlusion. Postepy Kardiol Interwencyjnej. 2022;18(1):79-80.

  4. Taniguchi Y, Sakakura K, Jinnouchi H, Tsukui T, Hatori M, Tamanaha Y, et al. Determinants of successful parallel wire technique in percutaneous coronary intervention to coronary chronic total occlusion. Cardiovasc Revasc Med. 2024;59:48-52.



２．石灰化病変に対するロータブレーター治療について


当院では石灰化病変に対して積極的にロータブレーターを用いています。
年間100例前後の国内有数のロータブレーター使用実績があります。
ロータブレーターを安全に行うために、これまでHalfway Rotational Atherectomy、
Halftime Rotational Atherectomyという概念を提唱し、安全性を報告してきました。

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Halfway Rotational Atherectomy (Sakakura K, et al. PLos One 2019; 14(7):e0219289より引用)



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Halftime Rotational Atherectomy (Sakakura K, et al. Cardiovasc Interv Ther　2024;39:18-27.より引用)。



ロータブレーターに関する研究実績（2020年～の直近5年間）

  1. Sakakura K, Taniguchi Y, Yamamoto K, Tsukui T, Jinnouchi H, Fujita H. Excessive Rotational Speed May Be Associated With the Transection of Guidewires in Rotational Atherectomy. Am J Cardiol. 2020;132:172-3.

  2. Sakakura K, Taniguchi Y, Yamamoto K, Tsukui T, Seguchi M, Wada H, et al. Comparison of complications with a 1.25-mm versus a 1.5-mm burr for severely calcified lesions that could not be crossed by an intravascular ultrasound catheter. Cardiovasc Interv Ther. 2020;35(3):227-33.

  3. Sakakura K, Taniguchi Y, Yamamoto K, Tsukui T, Seguchi M, Wada H, et al. Comparison of the incidence of slow flow after rotational atherectomy with IVUS-crossable versus IVUS-uncrossable calcified lesions. Sci Rep. 2020;10(1):11362.

  4. Sakakura K, Taniguchi Y, Yamamoto K, Wada H, Momomura SI, Fujita H. Association of Excessive Speed Reduction with Clinical Factors During Rotational Atherectomy. Cardiovasc Revasc Med. 2020;21(3):314-9.

  5. Sakakura K, Ito Y, Shibata Y, Okamura A, Kashima Y, Nakamura S, et al. Clinical expert consensus document on rotational atherectomy from the Japanese association of cardiovascular intervention and therapeutics. Cardiovasc Interv Ther. 2021;36(1):1-18.

  6. Sakakura K, Taniguchi Y, Yamamoto K, Tsukui T, Jinnouchi H, Seguchi M, et al. Modifiable and unmodifiable factors associated with slow flow following rotational atherectomy. PLoS One. 2021;16(4):e0250757.

  7. Jinnouchi H, Sakakura K, Taniguchi Y, Tsukui T, Watanabe Y, Yamamoto K, et al. Intravascular ultrasound-factors associated with slow flow following rotational atherectomy in heavily calcified coronary artery. Sci Rep. 2022;12(1):5674.

  8. Jinnouchi H, Sakakura K, Taniguchi Y, Tsukui T, Watanabe Y, Yamamoto K, et al. Impact of ultrasound reverberation in calcified coronary arteries: Intravascular ultrasound study. Atherosclerosis. 2022;363:1-7.

  9. Jinnouchi H, Sakakura K, Taniguchi Y, Tsukui T, Watanabe Y, Yamamoto K, et al. Clinical Outcomes and Unique Restenosis of Calcified Nodule in Heavily Calcified Coronary Artery. J Atheroscler Thromb. 2023;30(6):649-62.

  10. Sakakura K, Ito Y, Shibata Y, Okamura A, Kashima Y, Nakamura S, et al. Clinical expert consensus document on rotational atherectomy from the Japanese association of cardiovascular intervention and therapeutics: update 2023. Cardiovasc Interv Ther. 2023;38(2):141-62.

  11. Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, Yamamoto K, et al. Study design and rationale for comparison of the incidence of slow flow following rotational atherectomy to severely calcified coronary artery lesions between short single session and long single session: The randomized ROTASOLO trial. Cardiol J. 2023;30(3):483-8.

  12. Sakakura K, Jinnouchi H, Taniguchi Y, Yamamoto K, Fujita H. Lifetime management of severely calcified coronary lesions: the treatment algorithm focused on the shape of calcification. Cardiovasc Interv Ther. 2023;38(4):375-80.

  13. Taniguchi Y, Sakakura K, Jinnouchi H, Tsukui T, Fujita H. Rotational atherectomy to left circumflex ostial lesions: tips and tricks. Cardiovasc Interv Ther. 2023;38(4):367-74.

  14. Sakakura K, Jinnouchi H, Taniguchi Y, Tsukui T, Watanabe Y, Yamamoto K, et al. Halftime rotational atherectomy: a unique concept for diffuse long severely calcified lesions. Cardiovasc Interv Ther. 2024;39(1):18-27.

  15. Watanabe Y, Sakakura K, Fujita H. Simple bailout method for burr entrapment in rotational atherectomy. Cardiovascular Intervention and Therapeutics. 2025;10.1007/s12928-025-01107-8.



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