Usefulness of the twin guidewire method during retrieval of the broken tip of a microcatheter entrapped in a heavily calcified coronary artery.

During percutaneous coronary intervention performed for a stenotic lesion with heavy calcification in the left coronary artery, the microcatheter tip became transected in the vessel. The fragment was successfully retrieved using the twin guidewire method after negotiating to cross a chronic total occlusion-dedicated guidewire outside the retained tip.

Examination of the appropriate timing of reperfusion therapy for recent myocardial infarction: a Japanese single-center retrospective study.

Background: The various guidelines clearly mention the treatment strategies for in patient of acute myocardial infarction (MI) presenting more than 24h from symptom onset (recent myocardial infarction, RMI). However, the appropriate timing of reperfusion for RMI is unclear.

Methods: We retrospectively evaluated 525 consecutive MI patients who underwent percutaneous coronary intervention (PCI) in our hospital between January 2008 and December 2012.

Impact of sheath size and hemostasis time on radial artery patency after transradial coronary angiography and intervention in Japanese and non-Japanese patients: A substudy from RAP and BEAT (Radial Artery Patency and Bleeding, Efficacy, Adverse evenT) randomized multicenter trial.

Background: During transradial (TR) access, it remains unclear whether differences in baseline patients characteristics and hemostasis care impact the rate of radial artery occlusion (RAO). We sought to compare the rate of RAO after TR access with the 6 French(Fr) Glidesheath Slender (GSS6Fr, Terumo, Japan) or a standard 5 Fr sheath in Japanese and non-Japanese patients.

Methods And Results: The Radial Artery Patency and Bleeding, Efficacy, Adverse evenT (RAP and BEAT) trial randomized 1,836 patients undergoing TR coronary angiography and/or interventions to receive the GSS6Fr or the standard 5 Fr Glidesheath (GS5Fr, Terumo, Japan).

Spontaneous rotation of the monorail-type guide extension support catheter during advancement of a curved guiding catheter: the potential hazard of twisting with the coronary guidewire.

The extension support guiding catheter has been used to perform complex percutaneous coronary intervention to increase back-up support for the guiding catheter or to ensure deep intubation for device delivery. However, because of its monorail design, advancement of the stent into the distal extension tubing segment is sometimes problematic. Although this problem is considered due to simple collision of the stent, operators have observed tangling between a monorail extension catheter and coronary guidewire in some patients.

Successful treatment of a nonagenarian patient with acute coronary syndrome complicated with chronic total occlusion of the left main coronary artery.

Although chronic total occlusion of the left main coronary artery (LMCA) is considered very rare, this condition could be fatal if it becomes complicated with an acute coronary syndrome lesion in the right coronary artery (RCA) which is usually the only remaining coronary artery for the myocardium. We reported a successfully treated case of a nonagenarian patient with ST-segment elevation myocardial infarction, who had subtotal occlusion of the RCA and total occlusion of the LMCA with Rentrop grade 2 collateral coronary artery supply from the RCA.

Onset-to-device time of patients who arrive at off-hours: Importance of prehospital management and public awareness for patients with ST-segment elevation myocardial infarction.

Aim: The influence of the time of arrival at the hospital on the door-to-device (DTD) time has been investigated; however, the influence on the onset-to-device (OTD) time is unclear in ST-segment elevation myocardial infarction (STEMI) patients. The aim of this study was to investigate the relationship between the time of arrival at the hospital and the OTD time in STEMI patients.

Methods: We evaluated 377 STEMI patients who underwent primary percutaneous coronary intervention (pPCI) between January 2008 and December 2014.

Severe catheter kinking and entrapment during transbrachial angiography: percutaneous retrieval with a slender approach.

A 74-year-old man previously treated with bilateral femoro-popliteal bypass was referred to our hospital for the treatment of a severely tangled 4-Fr diagnostic catheter in the right brachial artery. We inserted a 5-Fr sheath introducer from the proximal right femoral artery and advanced a 5-Fr JR catheter to the right brachial artery. A Sion coronary guidewire was then advanced for the tip of the tangled catheter, and a 4-mm gooseneck snare catheter was inserted through the guidewire.

Percutaneous coronary intervention for nonagenarian patients with ST-segment elevation myocardial infarction: Experience of a single Japanese center.

Background: Old age is a prognostic risk factor for patients with ST elevation acute myocardial infarction (STEMI); however, few data exist describing STEMI patients aged over 90 years.

Methods: We retrospectively evaluated the clinical indices and outcomes of 282 consecutive STEMI patients who underwent primary percutaneous coronary intervention (PCI) in our hospital between January 2008 and December 2012. Patients with acute myocardial infarction complicated by out-of-hospital cardiopulmonary arrest, patients with a left main trunk culprit lesion, and patients diagnosed more than 24h after symptom onset were excluded.

Impact of the Presence of Chronic Total Occlusion in a Non-Infarct-Related Coronary Artery in Acute Myocardial Infarction Patients.

Chronic total occlusion (CTO) in a non-infarcted-related artery was reported to worsen immediate clinical outcome in acute myocardial infarction (AMI) patients. However, the prognosis of such patients with preserved left ventricular function after successful primary percutaneous coronary intervention (PCI) has not yet been clarified. The aim of the present study was to evaluate whether the presence of CTO contributes to a worse prognosis even in patients with preserved left ventricular function after primary PCI.

Minimally invasive atherectomy with a virtual 3-Fr sheathless guiding catheter and a 0.9-mm excimer laser catheter for the treatment of coronary in-stent restenosis: a case report.

A 50-year-old man underwent percutaneous coronary intervention for stent restenosis in his left anterior descending artery. After insertion of a 5-Fr sheathless guiding catheter through the right radial artery, optical coherence tomography (OCT) revealed a circumferential dense fibrotic plaque in the distal part of the stent. Therefore, we performed excimer laser coronary atherectomy using a 0.

Virtual 5-French intra-aortic pumping using a Glidesheath Slender and 6-French intra-aortic balloon catheter.

Objectives: The aim of this study was to evaluate the feasibility and safety of the 6-Fr Glidesheath Slender, which has equivalent outer size to the conventional 5-Fr sheath, for use with the 6-Fr intra-aortic balloon pump (IABP) catheter.

Methods: Between May 2014 and March 2015, 24 patients with acute coronary syndrome underwent percutaneous coronary intervention using a 6-Fr IABP catheter through a 6-Fr Glidesheath Slender for support. The adverse events, including access site complications, kinking of the sheath during the procedure, and any evidence of balloon pump failure, were retrospectively investigated.

Urgent Balloon Aortic Valvuloplasty for Worsening Heart Failure in a Patient with Acute Myocardial Infarction and Critical Aortic Stenosis.

Unlabelled: A 91-year-old man was admitted to our hospital with dyspnea and chest pain. His electrocardiogram showed ST-segment elevation in the V1-4 leads, and an emergency coronary angiogram revealed subtotal occlusion in the left descending coronary artery. A successful primary percutaneous coronary intervention was subsequently performed using aspiration thrombectomy and bare metal stent implantation.

The novel 4.5F CoKatte catheter for stent delivery facilitation in complex coronary artery lesions.

Background: The mother and child technique with a deep-seated 4F Kiwami catheter has been reported to be effective for delivering stents to complex lesions.

Objectives: To assess the feasibility and efficacy of a novel 4.5F child catheter for deep insertion and stent deployment into the distal coronary artery for the treatment of complex lesions.

Successful rescue from cardiac arrest in a patient with postinfarction left ventricular blow-out rupture: "extra-pericardial aortic cannulation" for establishment total cardiopulmonary bypass.

We report a quick and simple technique to establish cardiopulmonary bypass (CPB) in a left ventricular (LV) blow-out rupture. A 74-year-old woman with a diagnosis of acute myocardial infarction suddenly collapsed and lost consciousness. A venous-arterial extracorporeal membrane oxygenation (ECMO) device was inserted by femoral cannulation.

Mother-child aspiration technique.

A 94-year-old woman underwent primary percutaneous coronary intervention for a total occlusion of the right coronary artery. A 6-Fr Ikari-left guiding catheter was inserted through the right radial artery. Initially, thrombectomy was performed with a conventional thrombus aspiration catheter.

Longitudinal stent elongation during retraction of entrapped jailed guidewire in a side branch with balloon catheter support: a case report.

A 72-year-old man underwent primary percutaneous coronary intervention for a subtotal occlusion in the mid-portion of the left anterior descending artery involving a large diagonal branch. After successful stenting with a 3.0/24 mm bare metal stent, during which, the diagonal branch was protected with a coronary guidewire, conventional retrieval of the jailed guide wire was impossible.

Successful recanalization of a left circumflex artery jailed with a polytetrafluoroethylene-covered stent after coronary perforation during stent implantation in the left main bifurcation.

An 88-year-old woman underwent emergency percutaneous coronary intervention (PCI) to treat circulatory collapse with severe stenosis in the distal left main coronary artery (LMCA). After 3.5/18-mm stent deployment from the LMCA to the left anterior descending artery (LAD), coronary perforation occurred in the LAD ostium.

Clinical and angiographic outcomes of patients undergoing entrapped guidewire retrieval in stent-jailed side branch using a balloon catheter.

Objective: The purpose of this study was to examine the efficacy and safety of method for retrieval of entrapped guidewire in stent-jailed side branch using a balloon catheter.

Background: Guidewire entrapment in the side branch after main vessel stenting is an infrequent but potentially serious complication of bifurcation lesion treatment. Entrapped wire retrieval with device advancement over the wire is a previously reported bail-out method, but its efficacy and impact on the proximal edge of the stent are unknown.

Use of novel 6 French intra-aortic balloon pump catheter for patients undergoing percutaneous coronary intervention.

This study aimed to evaluate the feasibility and safety of a new 6 French (6 Fr) intra-aortic balloon pumping (IABP) catheter for patients undergoing percutaneous coronary intervention (PCI). Sixty-nine consecutive patients who received a 6 Fr IABP catheter were retrospectively evaluated. Patients with height <162 cm were primary selected for the 6 Fr IABP catheter treatment because of limited balloon size (30 ml).