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Highlights This study aimed to evaluate the characteristics of lipid-rich plaque (LRP) in Japanese. The maxLCBI 4mm significantly predicted acute coronary syndrome culprit lesion. Almost 20% of patients had at least one high-risk LRP in non-culprit lesion segment in same vessel. No surrogate maker (lipids and inflammation) for a high-risk LRP was found. Direct intravascular evaluation of plaque characteristics remains important.

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Aims Living alone is reported as an independent risk factor for cardiovascular disease. However, little is known about the association between clinical outcomes and living alone in patients with acute coronary syndrome (ACS). The aim of this study was to determine whether living alone is an independent prognostic risk factor for long-term mortality stratified by age in patients with ACS who were treated with primary percutaneous coronary intervention (PCI). Methods and results We conducted an observational cohort study of ACS patients who underwent PCI between January 1999 and May 2015 at Juntendo University Shizuoka Hospital, Japan. The primary endpoint was all-cause death. Among 2547 ACS patients, 381 (15.0%) patients were living alone at the onset of ACS. The cumulative incidence of all-cause death was comparable between living alone and living together (34.8% vs. 34.4%, log-rank P = 0.63). However, among younger population (aged <65 years), the incidence of all-cause death was significantly higher in the living alone group (log-rank P = 0.01). Multivariate Cox hazard analysis revealed a significant association between living alone and all-cause death, even after adjusting for other risk factors (hazard ratio 2.30, 95% confidence interval 1.38–3.84, P = 0.001). Conclusion Although living alone was not significantly associated with long-term clinical outcomes in patients with ACS, it was a predictive risk factor among younger ACS patients. Careful attention should be paid to patients’ lifestyle, especially younger patients with ACS.

A 37-year-old woman presented at 37 weeks of gestation with a history of heaviness in her left leg. Enhanced computed tomography revealed a left extensive ileofemoral thrombus, and we employed a transient inferior vena cava (IVC) filter (t-IVCF) before delivery. Although we attempted to remove the t-IVCF on the day after delivery, a large thrombus was captured in the filter. We therefore performed thrombolytic therapy for one week, but a few small clots remained within the t-IVCF. We were ultimately able to remove the t-IVCF under constant negative pressure by aspiration from a side-hole of the sheath. We herein describe the effectiveness of this aspiration technique in our case.