Hiroshi Yamasaki

Detroit Medical Center, Detroit, Michigan, United States

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Publications (2)4.65 Total impact

  • Arshad Rehan · Yassar Almanaseer · Devang M Desai · Arshad Ali · Hiroshi Yamasaki ·
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    ABSTRACT: A 25-year-old female, 17 weeks pregnant presented to our hospital with complaints of progressively increasing dyspnea. She was hypertensive with creatine of 1.0; she was transferred to ICU with multiple medications to control her blood pressure, without success. The patient continued to decompensate, which required intubation. The patient developed acute renal failure, part of her work-up suggested bilateral renal artery stenosis. She was taken to the catheterization lab and was found to have bilateral total renal artery occlusion. The left renal artery was successfully opened. The patient recovered and her blood pressure was controlled after the procedure. In the past, surgery was the preferred treatment in cases of acute renal artery occlusion. This approach has been replaced increasingly by renal artery angioplasty, which is less invasive and is at least as effective as surgical reconstruction. Our case demonstrates a percutaneous approach can be tried for totally occluded renal artery with a successful outcome.
    Cardiology 02/2007; 108(1):51-4. DOI:10.1159/000095832 · 2.18 Impact Factor
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    ABSTRACT: The safety of glycoprotein (GP) IIb/IIIa inhibitors has been well documented in clinical trials. Although these trials have included a broad patient population, the strict enrollment criteria may have resulted in exclusion of patients at a higher risk of bleeding complications. The authors conducted a retrospective chart review of 1020 consecutive patients who received GP IIb/IIIa inhibitors and underwent percutaneous coronary intervention in a large community hospital. They used Thrombolysis in Myocardial Infarction (TIMI) criteria to define major or minor bleeding complications. Bleeding complications developed in 214 (21%) patients, with major bleeding in 89 (9%). Univariate predictors of bleeding were older age, lower body weight, elevated serum creatinine, higher activated partial thromboplastin time (aPTT) level, history of diabetes mellitus (DM), peripheral vascular disease (PVD), congestive heart failure (CHF), and emergency procedure for acute myocardial infarction (AMI). Multivariate predictors of major bleeding were PVD (20% in bleeding group vs 11% in nonbleeders, odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1.2-2.6, P < .004), age (68 +/- 2 years, 95% CI = 66-70 in bleeding group vs 63 +/- 13 years, 95% CI = 61.2-63 in nonbleeders, P < .001), and higher aPTT level (66 +/- 27 seconds, 95% CI = 63-70 in bleeding group vs 53 +/- 28 seconds, 95% CI = 51-56 in nonbleeders, P < .001). The risk of bleeding in the large community hospital setting may be higher than in randomized clinical trials. This increased risk is associated with higher hospitalization costs. Recognition of predictors of bleeding should further enhance the safety of these antiplatelet agents.
    The Journal of Clinical Pharmacology 12/2004; 44(11):1328-32. DOI:10.1177/0091270004269559 · 2.48 Impact Factor