日本における統計学の発展 第５１巻

昭和55，56，57年度文部省科学研究費総合（A）研究代表者西平重喜による速記録話し手：大橋, 隆憲聞き手：野村, 良樹 | 浦田, 昌計 | 吉田, 忠 | 奈倉, 道隆 | 五十嵐, 光男 | 川口, 清史 | 野沢, 正徳 | 泉, 弘志 | 木下, 滋1982-9-2

A pitfall in selecting promising septal collateral channels in percutaneous coronary intervention with a retrograde approach

Introduction: In percutaneous coronary intervention (PCI) with a retrograde approach, successful guide wire passage through the collateral channels is indispensable. However, success of the procedure depends on the quality of collateral channels, and vascular tortuosity is one of the most common obstacles for successful guidewire passage. Case Presentation: Herein, we present a case of PCI with retrograde approach for chronic total occlusion at the ostium of the left anterior descending coronary artery. A highly tortuous morphology of the right posterior descending artery (PDA) and septal channels bifurcating from the right PDA with marked angulations were recognized in angiographic images from multiple directions. We could advance a guidewire to the optimal route of the septal collateral channel with guidance provided by these images and successfully completed all PCI procedures. Conclusions: To pass a guidewire through collateral arteries in PCI with a retrograde approach, careful inspection of angiographic images for thoroughly understanding the optimal route through the collateral vasculature is of great significance

Successful endovascular treatment for thrombotic in-stent iliac occlusion with in-house-devised optimo®-Like embolic protection system

Introduction: In practical settings of endovascular treatment,wesometimes encounter difficulties in treating lesions with massive thrombi, which may cause distal thromboembolism. Case Presentation: We encountered a case of severe critical limb ischemia involving in-stent iliac occlusion with massive thrombi. We had to overcome the critical issue of how to treat the massive thrombi in the iliac artery while avoiding thromboembolism. Therefore, we devised a very simple but possibly very useful protection system without any special devices based on the concept of the Optimo® balloon-tipped occlusion catheter. Conclusions: Although various endovascular treatment (EVT) devices and techniques have since been developed, little tips and tricks during EVT procedures are sometimes markedly useful

Successful bailout procedure for acute popliteal artery occlusion associated with EXOSEAL® vascular closure device: a case report

Abstract Background Vascular closure devices have been widely used to achieve rapid hemostasis after percutaneous catheterization procedures via the common femoral artery. The EXOSEAL vascular closure device is a device that can deliver a bioabsorbable polyglycolic acid plug to fill the subcutaneous puncture route at the groin for rapid hemostasis, and this device has a lower risk of arterial occlusion than other vascular closure devices. Case presentation An 83-year-old Japanese man underwent percutaneous coronary intervention for a proximal stenosis in his left circumflex artery through a 7-Fr sheath from his right common femoral artery. We encountered acute popliteal artery occlusion associated with EXOSEAL vascular closure device. We detected the plug material of this device at the occluded lesion by intravascular ultrasound, and performed successful bailout stenting after pulling the embolus with an inflated balloon catheter up to the superficial femoral artery from the popliteal artery. Conclusion Acute limb ischemia caused by an EXOSEAL vascular closure device is a very rare complication. Balloon angioplasty and stenting are considered to be effective options to deal with the plug dislodgement of an EXOSEAL vascular closure device. We must be prepared for every rare complication during endovascular treatment