1. Development of Aortic Stent-Valve
Department of Radiology, Tottori Prefectural Kousei Hospital
Since the 1960s, several trials have described the implantation of aortic valves using transcatheter techniques. Since 1992, with the development of metallic stents, the combination of balloon-expandable metallic stent and pericardial valve (stent-valve) has become a potentially groundbreaking approach. The first implantation of an aortic stent-valve in a patient with severe calcific aortic stenosis was demonstrated in 2002. Since then, transcatheter aortic valve implantation (TAVI) has been under active investigation. Since 1996, we also have been trying to develop a novel aortic stent-valve using our original metallic stent. In this feature article, knowledge obtained through our preliminary experiments was described.
- Aortic valve disease
- Animal experiment
2. Transcatheter Aortic Valve Implantation−The Present State and Future−
Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine
Recently, transcatheter aortic valve implantation (TAVI) is attracting increasing attention across the globe. Aortic valve replacement for aortic valve stenosis has commonly achieved safety and excellent durability over a few decades. But this conventional surgery is still extremely invasive for elderly and high-risk patients. So less invasive surgical techniques are necessary, and we believe TAVI serves such a purpose. TAVI was started in 2002, mainly in Europe and Canada, and over 20000 cases have received TAVI worldwide until now. In 2009, we performed the first case of TAVI in Japan, and 22 cases have since received TAVI in our institution. The data of clinical trials are prohibited to be shown to the public, so in this session, we elucidated the results of four TAVI cases (transfemoral: 3, transapical: 1) by clinical research. In addition, several new devices for TAVI have already been launched in US and Europe. I will show you these new devices and discuss the future picture of TAVI.
- Transcatheter aortic valve implantation
- Aortic valve
3. Stent Graft Treatment for Aortic Dissection
Department of Cardiovascular Surgery, Morinomiya Hospital
Endovascular stent graft treatment for aortic dissection was started from in 1993 in Japan and then spread all over the world. Although preliminary data using home-made device to close the entry site of aortic dissection was reported before the millennium, company-made devices have promoted the expert consensus of endovascular treatment for acute complicated type B dissection. For patient with uncomplicated type B dissection, endovascular treatment promises a better result for reverse remodeling of the false lumen. Stent graft treatment will be a promising therapeutic modality for aortic dissection.
- Acute type B aortic dissection
- Complicated case
- Stent graft
4. The Chimney Graft Technique in the Aortic Branches for Thoracic Endovascular Aortic Repair in Patients with an Inadequate Proximal Fixation Zone
Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University
Kimihiko Sugiura, Toshio Kaminou, Masayuki Hashimoto, Ouchi Yasufumi, Toshihide Ogawa
Thoracic endovascular aortic repair (TEVAR) is often done by proximal fixation, and the aortic stent graft may need to be extended beyond the origin of the aortic branches. Until recently, TEVAR has been limited to aneurysms not involving critical aortic branches due to the complex nature of designing a repair that would preserve important end-organ flow. We describe the chimney graft technique, which is an alternative to the fenestrated stent-graft and has been proposed to preserve flow into the branches during TEVAR. The indications included acute complicated type B dissection, ruptured aneurysms of the aortic arch, traumatic aortic transection, aortoesophageal fistula, and accidental over stenting of the left carotid artery during TEVAR. Chimney grafts were implanted into the innominate, left carotid, and left subclavian arteries. Use of a chimney graft makes it possible to use standard off-the-shelf stent-grafts to instantly treat lesions with inadequate fixation zones, providing an alternative to fenestrated stent-grafts in urgent cases. Our initial experience with this technique suggests that it is feasible in the aortic branches and may facilitate TEVAR in patients with an inadequate proximal fixation zone.
- Chimney stent
- Stent graft
5. About Patents Which are Necessary for the Development of New Medical Devices (from Ideas to Commercialization)
Planning & Research Office / Central Research Laboratory, JMS Co.,Ltd.
This paper describes the points you should know when you file patent applications for doctors’ ideas and inventions. It also summarizes the key points of patent application.
Furthermore, as the necessary information for productization and commercialization of doctors’ invention and patents, the following topics are explained; the way to find appropriate business partners, the points for negotiation with other companies, and the organizations which promote Japanese medical industry.
- Medical devices
- Patent application