Different Patterns of Vascular Response Between Patients With or Without Diabetes Mellitus After Drug-Eluting Stent Implantation Optical Coherence Tomographic Analysis

ObjectivesWe performed this study to investigate with optical coherence tomography (OCT) the vascular response after sirolimus-eluting stent (SES) implantation between patients with and those without diabetes mellitus (DM).BackgroundThe difference in vascular response after SES implantation between patients with and those without DM has not been fully evaluated with OCT.MethodsOptical coherence tomography was performed to examine 74 nonrestenotic SES implanted in 63 patients (32 with DM and 31 without DM) at 9 months after SES implantation. For struts showing neointimal coverage, the neointimal thickness on the luminal side of each strut section was measured, and neointimal characteristics were classified into high, low, and layered signal pattern.ResultsBaseline patient characteristics and lesion and procedural characteristics data were similar between the 2 groups. In total, 11,422 struts were analyzed. High signal neointima was observed in 90.2 ± 13.9%, low signal neointima in 7.3 ± 10.0%, and layered neointima in 2.7 ± 5.8%/stents. There was higher incidence of low signal neointima (10.5 ± 10.3% vs. 4.5 ± 5.6%, p = 0.003), neointimal thickness was larger (median: 106.8 μm, interquartile range: 79.3 to 130.4 μm vs. median: 83.5 μm, interquartile range: 62.3 to 89.3 μm; p < 0.0001), and neointimal coverage of stent struts was higher (92.1 ± 6.2% vs. 87.2 ± 11.9%; p = 0.03) in DM patients.ConclusionsHigh signal neointimal pattern was predominantly observed, and low or layered signal pattern was observed in some cases. In DM patients, low signal neointima was observed with high frequency. Neointimal coverage and neointimal thickness was also higher in DM patients as compared with non-DM patients

The stenting strategy of drug-eluting stents for coronary artery disease in patients on dialysis

Background: Reports regarding the relationship between the length and diameter of implanted drug-eluting stents and clinical and angiographic outcomes in dialysis patients are limited. Aim: We investigated the efficiency of drug-eluting stents for coronary artery disease in patients on dialysis from the viewpoint of stent sizing. Methods: Sirolimus-eluting stents were implanted in 88 lesions and bare metal stents were implanted in 43 lesions. We compared stenting strategy, major adverse cardiac events, and angiographic results between sirolimus-eluting stent and bare metal stent groups. Results: Stent diameter was smaller and stent length was longer in the sirolimus-eluting stent group than in the bare metal stent group in our routine practices. There was no significant between-group difference in late diameter loss. Rates of angiographic restenosis and target lesion revascularization were significantly higher in the sirolimus-eluting stent group than in the bare metal stent group. Although stent length was significantly longer and stent diameter was smaller in the sirolimus-eluting stent group, sirolimus-eluting stents did not improve the subsequent clinical and angiographic results compared with bare metal stents in dialysis patients. Conclusion: In dialysis patients, a longer length and/or smaller diameter sirolimus-eluting stent implantation was associated with high rates of restenosis and target lesion revascularization compared with bare metal stents

Archaeological Application of Airborne LiDAR with Object-Based Vegetation Classification and Visualization Techniques at the Lowland Maya Site of Ceibal, Guatemala

The successful analysis of LiDAR data for archaeological research requires an evaluation of effects of different vegetation types and the use of adequate visualization techniques for the identification of archaeological features. The Ceibal-Petexbatun Archaeological Project conducted a LiDAR survey of an area of 20 x 20 km around the Maya site of Ceibal, Guatemala, which comprises diverse vegetation classes, including rainforest, secondary vegetation, agricultural fields, and pastures. We developed a classification of vegetation through object-based image analysis (OBIA), primarily using LiDAR-derived datasets, and evaluated various visualization techniques of LiDAR data. We then compared probable archaeological features identified in the LiDAR data with the archaeological map produced by Harvard University in the 1960s and conducted ground-truthing in sample areas. This study demonstrates the effectiveness of the OBIA approach to vegetation classification in archaeological applications, and suggests that the Red Relief Image Map (RRIM) aids the efficient identification of subtle archaeological features. LiDAR functioned reasonably well for the thick rainforest in this high precipitation region, but the densest parts of foliage appear to create patches with no or few ground points, which make the identification of small structures problematic.JSPS KAKENHI [26101002, 26101003]; Alphawood Foundation; Dumbarton Oaks fellowship; University of Arizona Agnese Nelms Haury programThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]