| Theme | Interventional Radiology for Dialysis Patients | |
|---|---|---|
| Title | Acute coronary syndrome and interventional cardiology | |
| Publish Date | 2007/01 | |
| Author | Naobumi Mise | Department of Nephrology, Mitsui Memorial Hospital |
| Author | Noriaki Kurita | Department of Nephrology, Mitsui Memorial Hospital |
| Author | Imari Mimura | Department of Nephrology, Mitsui Memorial Hospital |
| Author | Keiko Sai | Department of Nephrology, Mitsui Memorial Hospital |
| Author | Takahiro Nishi | Department of Nephrology, Mitsui Memorial Hospital |
| Author | Yuji Ikari | Department of Cardiology, Tokai University School of Medicine |
| Author | Tokuichiro Sugimoto | Department of Nephrology, Mitsui Memorial Hospital |
| [ Summary ] | Ischemic heart disease (IHD) is common in dialysis patients and is important for patients' survival. Chest pain, arrhythmia and blood pressure changes during or after hemodialysis are sometimes signs leading to a diagnosis of IHD. To treat IHD patients, as is indicated in the guidelines of the Japanese Circulation Society, risk evaluation should be performed and early invasive therapy should be considered for high risk cases. Coronary plaque in dialysis patients is characterized by strong calcification. In interventional cardiology for dialysis patients, the revascularization rate is inferior to that for non-dialysis patients and restenosis rates and the number of complications are both higher. Percutaneous transluminal coronary rotational atherectomy improves the revascularization rates for target lesions which have marked calcification. However, restenosis rates remain high with this modality. It is expected that drug eluting stents, which lower the restenosis rate by 70 % in non-dialysis patients, will also become effective in treating dialysis patients. | |