SUMMARYThe aim of this study was to compare the initial and long-term outcomes of sirolimuseluting stents (SES) and bare-metal stents (BMS) in patients with calcified lesions without performing rotational atherectomy.The subjects were 79 consecutive lesions (38 in the SES group and 41 in the BMS group) which were confirmed to have superficially calcified lesions by intravascular ultrasound. In all lesions, the stent was implanted after predilatation with a balloon.The patient characteristics were not different between the 2 groups. All procedures were successfully performed in both groups. Vessel area was significantly smaller in the SES group than in the BMS group (11.01 ± 3.88 mm 2 versus 13.08 ± 3.49 mm 2 , P < 0.005), as was the lumen area (5.41 ± 2.31mm 2 versus 6.48 ± 2.04 mm 2 , P < 0.005). Minimum stent area was significantly smaller in the SES group than in the BMS group (5.61 ± 1.54 mm 2 versus 6.69 ± 1.74 mm 2 , P < 0.01). In cases in whom angiographic follow-ups were performed, the late loss was significantly smaller in the SES group than in the BMS group (0.19 ± 0.49 mm versus 0.76 ± 0.48 mm, P < 0.001). The restenosis rate was significantly lower in the SES group than in the BMS group (8.8% versus 33.3%, P < 0.05) and the TLR rate tended to be lower in the SES group (7.9% versus 19.5%). Stent thrombosis was not observed in either group.The results suggest that SES are more effective than BMS and can be used safely when treating calcified lesions if predilatation with a balloon is possible. (Int Heart J 2007; 48: 137-147)

Hyperuricemia has recently been recognized to not only be a predictor of cardiovascular disease but also a marker of metabolic syndrome. We examined the association between uric acid levels and various clinical parameters, including the components of metabolic syndrome, in essential hypertension. One hundred forty-six untreated Japanese hypertensive patients (mean 58.3 years) without overt cardiovascular disease were divided into low and high uric acid groups by the median uric acid value (cut-off: 6.3 for men and 4.4 mg/dL for women). The high uric acid group had higher serum creatinine (0.74 vs. 0.67 mg/dL, p = 0.019) and a larger body mass index (BMI) (25.2 vs. 23.6 kg/m(2), p = 0.018) compared to the low group. Men from the high uric acid group were younger and had higher blood pressure (BP) than men from the low group. Uric acid levels were correlated with creatinine in both genders, with blood pressure, triglycerides in men only, and with BMI, fasting glucose in women only. Multiple regression analysis also indicated a significant correlation of uric acid with creatinine in both genders, with triglycerides in men, and with glucose in women. Metabolic syndrome (modified NCEP-ATPIII definition) was found in 37.0% of the high uric acid group (men 45.0, women 27.3%) and 20.8% of the low group. Results suggest that an increase of uric acid is associated with impaired renal function and constitutes a risk factor for metabolic syndrome. Uric acid may also be a useful index for initial risk stratification of untreated patients with essential hypertension.

ABSTRACT. Recently popularised, the combined angiography and CT (angio-CT) system is useful for correctly identifying the feeding arteries and their perfusion in various organs. We applied this system for advanced maxillary cancer to expose its feeding arteries and their supplying territories. In addition to the maxillary artery, extramaxillary feeding arteries were usually observed, including the ophthalmic, accessory meningeal, facial, transverse facial and ascending palatine arteries. These extramaxillary feeding arteries exhibited uniform tendencies, depending on the site of extramaxillary tumour extension. Combined therapy with radiotherapy and superselective intra-arterial chemotherapy for advanced maxillary sinus carcinoma has recently been attempted at many institutions to preserve the organ and improve prognosis [1][2][3]. Although the maxillary artery is the usual main feeder, we frequently encounter extramaxillary supplying arteries when tumours grow exophytically or invade adjacent organs. Therefore, interventional radiologists should be familiar with the imaging findings of the supplying arteries associated with maxillary cancer. In this pictorial review, we illustrate the feeding arteries (and their supplying territories) of advanced maxillary cancer using a combined angiography and CT (angio-CT) system, which provides more accurate vascular anatomy than digital subtraction angiography (DSA). Patients and techniquesFrom January 2006 to July 2008, 56 sessions of superselective transarterial chemotherapy were performed in 14 patients with advanced maxillary cancer at our institutions. The patients comprised 10 men and 4 women, ranging in age from 42 to 80 years (mean, 60 years). The clinical T factors for these patients were T3 (n54) and T4 (n510).All catheterisations were performed via a transfemoral approach, and systemic heparinisation was accomplished by intravenous administration of 3000 IU of heparin. Catheterisation of the external or internal carotid artery was performed using a 5-French standard headhunter catheter. Superselective catheterisation of external carotid branches was performed with a coaxial catheter system using a 5-French catheter and 2.2-French microcatheter (SIRABE Piolax, Yokohama, Japan). DSA and angio-CT were performed using CT with a DSA system (Infinix VC; Toshiba, Tokyo, Japan). For DSA of internal or external carotid arteries, 6 ml of non-ionic contrast material (Iopamiron300, ,300 mg iodine per mm; Bayer-Schering Pharma, Osaka, Japan) was injected at a rate of 4 ml s 21. For the branches of the external carotid artery, 2-4 ml of non-ionic contrast material was injected at a rate of 0.7-1.5 ml s 21. For the angio-CT study of the external or internal carotid arteries, 30 ml of Iopamiron-150 (,150 mg iodine per mm) was injected at a rate of 3 ml s 21. For the external carotid branches, a total 10-20 ml of contrast medium was injected at a rate of 0.8-1.5 ml s 21. Feeding arteriesThe feeding arteries are summarised in Figure 1. For all of the tumours, the maxillary artery...

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