Taku Honda

Elution of everolimus and sirolimus from a biodegradable polymer coated stent inhibits neointimal hyperplasia without inflammation or toxicity

Background: Earfy clinical trials with drug eluting stents have suggested limitations including edge restenosis and malaposition. Persistent bio-stable polymer and/or drug may be causal. Biodegradable polymers hold potential advantage if they are metabolized prior to tissue toxicity and deliver drug during the optimal window. Local delivery of active drug from a slowly biodegradable, high molecular weight polylactic acid (PLA) coated stent could lead to inhibition of intimal hyperplasia without impaired healing. Methods: We compared PLA polymer containing 160 or 220 ug of Everolimus(E), 180 ug Sirolimus(S), and bare metal stent. 40 stents were deployed in coronary artehes of 19 pigs with sacrifice at 28 days. Endpoints were assessed by quantitative coronary angiog raphy @CA), histomorphometry, and histology at 28 and 90 days. Results:There was reduction of intimal hyperplasia as assessed by QCA and histomorphometry by both E and S (Table 1). At both 28 and 90 days, there was complete reendothelialization and ho difference in inflammation or fibrin between the bare stent and druglpolymer groups. Conclusion: Everolimus and Sirolimus delivered via stent and thin layer biodegradable polymer are equally effective at inhibition of intimal hyperplasia. At follow-up evaluation. complete healing without toxic or inflammatory reaction was seen. A clinical trial to determine safety and efficacy of the Everolimus coated stent has commenced.

Sheathless guide catheter in transradial percutaneous coronary intervention for ST-segment elevation myocardial infarction.

The aim of this study was to assess the safety and efficacy of sheathless guide catheters in transradial percutaneous coronary intervention (PCI) for ST‐segment elevation myocardial infarction (STEMI).

Three-dimensional relationship between the conus branch and the precordial leads confirmed by 64–multidetector-row computed tomography

A 65-year-old man with effort angina pectoris underwent percutaneous coronary intervention of the proximal right coronary artery. The lesion was dilated with a bare-metal stent under wire protection of the conus branch (CB). However, the jailed CB was occluded. Electrocardiogram with conventional precordial leads (V(1) through V(6)) accompanied with the supplementary leads (V(1) through V(6)) positioned 1 intercostal space higher showed marked ST elevation in V(1) through V(3) that was more prominent in V(1) through V(3). The 64-multidetector-row computed tomographic coronary angiography showed recanalization of the CB located just in the center of the V(1), V(2), V(1), and V(2) electrodes.

“Spaghetti twisting” technique: a novel method of catching pacemaker leads using a needle's eye snare

The needles eye snare has become an indispensable tool in contemporary pacemaker lead extraction techniques. Here, we present a modified method of using the needles eye snare, named “spaghetti twisting” technique, to catch and secure pacemaker leads, which would help operators catch and secure leads much easily.

A “tetra-axial” system in transfemoral lead extraction

Pacemaker lead extractors must become familiar with transfemoral approaches for lead extraction as a bail‐out procedure for a failed superior approach. We presented a “tetra‐axial” system for transfemoral lead extraction. This system would be more widely applicable in cases with difficulties in extraction, resulting in more procedural success.

THE PREDICTORS AND CLINICAL IMPACT OF FAILURE OF TRANSRADIAL APPROACH FOR PRIMARY PERCUTANEOUS CORONARY INTERVENTION IN STEMI PATIENTS IN THE SINGLE-CENTER REGISTRY

Transradial approach (TRA) improves clinical outcomes driven by less hemorrhagic complications in patients with ST-elevation acute myocardial infarction (STEMI), as compared to transfemoral approach (TFA). However, TRA is sometimes avoided in clinical practice due to its procedural complexity, which

TCT-362 Transradial diagnostic and therapeutic coronary catheterization for patients with NSTEMI or UAP using one 4.0-Fr sheath and one Sheathless Eaucathe guide catheter via one puncture site: 1-1-1 Trial

In the treatment of NSTEMI or UAP patients, the primary system of transradial coronary intervention (TRI) may be controversial, because they do not usually undergo immediate revascularization after diagnostic coronary angiography (CAG). A Sheathless Eaucath guide catheter (SH-GC) could be inserted