Diamond-like carbon coating to inner surface of polyurethane tube reduces Staphylococcus aureus bacterial adhesion and biofilm formation

Staphylococcus aureus is one of the main causative bacteria for polyurethane catheter and artificial graft infection. Recently, we developed a unique technique for coating diamond-like carbon (DLC) inside the luminal resin structure of polyurethane tubes. This study aimed to elucidate the infection-preventing effects of diamond-like carbon (DLC) coating on a polyurethane surface against S. aureus. We applied DLC to polyurethane tubes and rolled polyurethane sheets with our newly developed DLC coating technique for resin tubes. The DLC-coated and uncoated polyurethane surfaces were tested in smoothness, hydrophilicity, zeta-potential, and anti-bacterial properties against S. aureus (biofilm formation and bacterial attachment) by contact with bacterial fluids under static and flow conditions. The DLC-coated polyurethane surface was significantly smoother, more hydrophilic, and had a more negative zeta-potential than did the uncoated polyurethane surface. Upon exposure to bacterial fluid under both static and flow conditions, DLC-coated polyurethane exhibited significantly less biofilm formation than uncoated polyurethane, based on absorbance measurements. In addition, the adherence of S. aureus was significantly lower for DLC-coated polyurethane than for uncoated polyurethane under both conditions, based on scanning electron microscopy. These results show that applying DLC coating to the luminal resin of polyurethane tubes may impart antimicrobial effects against S. aureus to implantable medical polyurethane devices, such as vascular grafts and central venous catheters

2つの瘤を形成した冠動脈-肺動脈瘻に対する1手術例

症例は77歳男性.2ヶ月前より夜間の息苦しさと胸の締め付けを感じていた.冠動脈CTを施行したところ主肺動脈前面及び上行大動脈と主肺動脈の間に冠動脈・肺動脈瘻を伴った2個の瘤を認め,右冠動脈#2に90%狭窄を認めた.On pump beating下に瘤を切開し,冠動脈側からの入口部及び肺動脈瘻を閉鎖した.また,右冠動脈の狭窄病変に対して大伏在静脈をグラフトとして用い冠動脈バイパス術を行った.術後経過良好にて退院となった.今回我々は瘤を形成した冠動脈-肺動脈瘻に対して人工心肺下に手術を施行した1手術例を経験したので報告する.We will report on one surgically treated case of coronary-pulmonary artery fistula with two aneurysms. A 77-year-old male suffering from chest pain and respiratory discomfort underwent coronary CT and angiography. Both revealed a fistula between the coronary artery and the pulmonary artery along with two aneurysms. Surgery was performed utilizing the on-pump beating heart technique. We extracted all fistulous vessels and performed a coronary bypass to #3 segment using the great saphenous vein grafting. We believe, that for complete treatment in such a case direct inspection of the internal wall of the aneurysm through incision is necessary, as opposed to simple ligation of the feeding vessel

Use of the Outback re-entry device for occluded abdominal aortic aneurysms with bilateral common iliac artery aneurysms

Background: Extensive juxtarenal aortoiliac occlusion (JRO) is difficult to treat and has severe outcomes. However, recent treatments have involved endovascular approaches. We encountered a rare case of successful occlusion penetration using the Outback Elite Re-entry Catheter (Cordis, Miami, FL, USA). Case presentation: A 75-year-old man was referred to our department for treatment of an enlarged aneurysm. The patient presented with intermittent claudication and underwent computed tomography, which revealed thoracic aortic, abdominal aortic (AAA), bilateral common iliac artery (CIAA), and right external iliac artery (EIAA) aneurysms of 51.8, 47.4, 71.5/31.9 (right/left), and 26.3 mm in diameter, respectively. The AAA, bilateral CIAA, and right EIAA were extensively occluded and treated with a re-entry device (outback® Elite Re-entry Catheter). The patient's symptoms improved significantly, and he was discharged with no serious complications. Conclusion: The Outback Elite Re-entry Catheter may be a promising endovascular treatment option for patients with extensive JRO

Comprehensive hemocompatibility analysis on the application of diamond-like carbon to ePTFE artificial vascular prosthesis

Abstract The aim of this study was to obtain comprehensive data regarding the hemocompatibility of diamond-like carbon (DLC)-coated expanded polytetrafluoroethylene (ePTFE). DLC increased the hydrophilicity and smoothened the surface and fibrillar structure, respectively, of the ePTFE. DLC-coated ePTFE had more albumin and fibrinogen adsorption and less platelet adhesion than uncoated ePTFE. There were scarce red cell attachments in in vitro human and in vivo animal (rat and swine) whole blood contact tests in both DLC-coated and uncoated ePTFE. DLC-coated ePTFE had a similar but marginally thicker band movement than uncoated-ePTFE with SDS-PAGE after human whole blood contact test. In addition, survival studies of aortic graft replacement in rats (1.5 mm graft) and arteriovenous shunt in goats (4 mm graft) were performed to compare the patency and clot formation between DLC-coated and uncoated ePTFE grafts. Comparable patency was observed in both animal models. However, clots were observed in the luminal surface of the patent 1.5 mm DLC-coated ePTFE grafts, but not in that of uncoated ePTFE grafts. In conclusions, hemocompatibility of DLC-coated ePTFE was high and comparable to that of uncoated ePTFE. However, it failed to improve the hemocompatibility of 1.5 mm ePTFE graft probably because increased fibrinogen adsorption canceled the other beneficial effects of DLC