Many studies have shown that a sirolimus-eluting stent (SES) decreases restenosis and target leision revascularization (TLR). We investigated the outcome of SES in a general hospital in Nagano, Japan.
The study group consisted of 99 patients with 127 lesions. We retrospectively evaluated the stent thrombosis and major adverse cardiac events (MACE) in the lesions of the entire study group. For evaluation of the stent and segment restenosis, follow up angiography was performed in 69 patients with 87 leisions.
During follow up, a MACE occurred in 8 patients (cardiac death in 2 and TLR in 6 of 99 patients). One cardiac death was due to coronary spasm just after stent implantation, and the other to very late stent thrombosis. There were 8 segment restenoses, which included 4 stent restenoses.
The outcome of SES in our hospital was comparable to that reported by other Japanese institutes. Additional research is required to avoid coronary spasm after placement of a drug-eluting stent.

View full abstract

We report a case of carcinoid tumor of the ampulla of Vater. A 47-year old woman was admitted to our hospital because of upper abdominal pain. On admission, hypercalcemia (11.6mg/dl [8.7-11.0]) was detected. ERCP revealed tumor of the ampulla of Vater. Biopsy specimen histopathologically revealed a carcinoid tumor. US and CT scan revealed parathyroid tumor and pancreatic tumor. MEN-type 1 was suspected, but pituitary tumor was not detected. Pancreaticoduodenectomy was performed in January 2000. Liver metastasis appeared after surgery, and limited resection of the liver was performed in June 2001. Multiple liver metastasis appeared from January 2004, and although no anti-cancer drug was used, the patient is still alive now.

View full abstract

[in Japanese]

View full abstract