Even after the introduction of revolutionary new devices, the conventional guidewire techniques, are essential, and mastering of these techniques is the key to improving the success rate in PCI for CTO lesions. The main handling techniques for conventional guidewires are classified into either "drilling," "penetrating," or "microchannel tracking." When using these different techniques, the most important point is how clearly the distal vessel anatomy can be identified. Even in the era of retrograde approach for CTO lesions, the antegrade approach is essential. It requires a lot of expertise. All operators must be familiar with these guidewire handling techniques.
Important issues in noise problems for current helicopters are described. An active tab (AT) was developed as a new active device for noise/vibration reduction under research cooperation between Japan Aerospace Exploration Agency (JAXA) and Kawada Industries, Inc. The wind tunnel test was conducted in order to investigate the effectiveness of the AT on the aeroacoustic characteristics of a helicopter. From the wind tunnel test, the capability of reducing blade vortex interaction (BVI) noise by an AT was verified. A new control law using instantaneous pressure change on a blade during BVI phenomena was introduced and applied to the wind tunnel testing. This new control law shows reasonable controllability for helicopter noise reduction. Furthermore, in order to analyze noise characteristics, the advanced computational fluid dynamics (CFD) code named JAXA_ov3d was developed in JAXA and extended to include CFD–CSD (computational structure dynamics) coupling by using the beam theory for blade deformation.
The BIOFLOW-IV clinical trial was designed for regulatory submission in Japan. It assessed the safety and efficacy of a new third-generation sirolimus-eluting stent system with bioresorbable polymer (Orsiro, BP-SES) compared with an everolimus-eluting stent system with permanent polymer (XIENCE Prime/Xpedition, PP-EES).This prospective, international, multicentre, 2:1 randomised, non-inferiority trial enrolled 575 patients (385 BP-SES and 190 PP-EES) with 659 stenotic de novo lesions. Of these, 137 patients (23.8%) were Japanese. Follow-up until five years is ongoing. We herein report outcomes at 12 months. Baseline parameters were well balanced. Device success was 98.9% for BP-SES versus 99.6% for PP-EES, p=0.670. Non-inferiority related to 12-month target vessel failure was met (pnon-inferiority <0.001). Further, there was no significant difference in clinical outcomes between the groups. The target vessel failure rate was 5.5% for BP-SES and 7.5% for PP-EES, the target lesion failure rate was 4.2% versus 5.4%, and the definite or probable stent thrombosis rate was 0.8% versus 0%.The randomised BIOFLOW-IV trial provides further evidence on the safety and efficacy of the Orsiro BP-SES and its non-inferiority to the current benchmark, an everolimus-eluting permanent polymer stent. ClinicalTrials.gov: NCT01939249.
Background:The MitraClip®system is a transcatheter-based therapeutic option for patients with chronic mitral regurgitation (MR) who are at high risk for surgery. A prospective, multicenter, single-arm study was initiated to confirm the transferability of this system to Japan.
To create awareness of, to summarise and to classify "Slender TRI": any technique associated with less trauma to the radial artery compared to traditional, established or recommended procedures, predominantly by reduction of French (Fr) size.A literature search was conducted to identify publications on Slender transradial coronary interventions. Based on this search the following techniques will be described: miniaturisation of materials, sheathless coronary intervention, guideless coronary intervention and back-up-improving techniques. The European perspectives will be discussed.Slender TRI is a new challenge to maximise patient value by improving outcome and reducing costs during TRI. Materials and techniques are continuously being refined and miniaturised to the highest standards. Whether outcome improves while reducing costs remains to be validated.
