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<h4>Background</h4>Endovascular treatment is the mainstay of treatment for carotid-cavernous fistulas, but endovascular approaches vary widely. The authors report a rare case of a direct carotid-cavernous fistula with cranial nerve symptoms caused by rupture of a giant aneurysm in which selective transvenous embolization via the pterygoid plexus was performed.<h4>Observations</h4>An 81-year-old man presented with headache and various progressive cranial nerve symptoms due to a direct carotid-cavernous fistula caused by a ruptured giant aneurysm. All the draining veins visualized on preoperative examination immediately before the treatment were occluded except for the pterygoid plexus. Therefore, the authors chose the dilated pterygoid plexus to approach the shunted pouch at the cavernous sinus and achieve shunt obliteration by selective embolization with coils and n-butyl cyanoacrylate.<h4>Lessons</h4>Careful study of the three-dimensional rotational images in the preoperative examination is important when considering the various approaches to surgery. The pterygoid plexus can be an effective venous approach route to reach the cavernous sinus area.

DOI： 10.3171/case22558

DOI： 10.3171/CASE22558

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DOI： 10.1007/s00062-022-01218-2

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OBJECTIVE There have been no accurate surveillance data regarding the incidence rate of spinal arteriovenous shunts (SAVSs). Here, the authors investigate the epidemiology and clinical characteristics of SAVSs.
METHODS The authors conducted multicenter hospital-based surveillance as an inventory survey at 8 core hospitals in Okayama Prefecture between April 1, 2009, and March 31, 2019. Consecutive patients who lived in Okayama and were diagnosed with SAVSs on angiographic studies were enrolled. The clinical characteristics and the incidence rates of each form of SAVS and the differences between SAVSs at different spinal levels were analyzed.
RESULTS The authors identified a total of 45 patients with SAVSs, including 2 cases of spinal arteriovenous malformation, 5 cases of perimedullary arteriovenous fistula (AVF), 31 cases of spinal dural AVF (SDAVF), and 7 cases of spinal epidural AVF (SEAVF). The crude incidence rate was 0.234 per 100,000 person-years for all SAVSs including those at the craniocervical junction (CCJ) level. The incidence rate of SDAVF and SEAVF combined increased with advanc- ing age in men only. In a comparative analysis between upper and lower spinal SDAVF/SEAVF, hemorrhage occurred in 7/14 cases (50%) at the CCJ/cervical level and in 0/24 cases (0%) at the thoracolumbar level (p = 0.0003). Venous congestion appeared in 1/14 cases (7%) at the CCJ/cervical level and in 23/24 cases (96%) at the thoracolumbar level (p < 0.0001).
CONCLUSIONS The authors reported detailed incidence rates of SAVSs in Japan. There were some differences in clinical characteristics of SAVSs in the upper spinal levels and those in the lower spinal levels.

DOI： 10.3171/2021.7.SPINE21233

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<h4>Background and purpose</h4>To date, the incidence of intracranial and spinal arteriovenous shunts has not been thoroughly investigated. We aimed to clarify recent trends in the rates of intracranial and spinal arteriovenous shunts in Japan.<h4>Methods</h4>We conducted multicenter hospital-based surveillance at 8 core hospitals in Okayama Prefecture between April 1, 2009 and March 31, 2019. Patients who lived in Okayama and were diagnosed with cerebral arteriovenous malformations, dural arteriovenous fistulas (DAVFs), or spinal arteriovenous shunts (SAVSs) were enrolled. The incidence and temporal trends of each disease were calculated.<h4>Results</h4>Among a total of 393 cranial and spinal arteriovenous shunts, 201 (51.1%) cases of DAVF, 155 (39.4%) cases of cerebral arteriovenous malformation, and 34 (8.7%) cases of SAVS were identified. The crude incidence rates between 2009 and 2019 were 2.040 per 100 000 person-years for all arteriovenous shunts, 0.805 for cerebral arteriovenous malformation, 1.044 for DAVF, and 0.177 for SAVS. The incidence of all types tended to increase over the decade, with a notable increase in incidence starting in 2012. Even after adjusting for population aging, the incidence of nonaggressive DAVF increased 6.0-fold while that of SAVS increased 4.4-fold from 2010 to 2018.<h4>Conclusions</h4>In contrast to previous studies, we found that the incidence of DAVF is higher than that of cerebral arteriovenous malformation. Even after adjusting for population aging, all of the disease types tended to increase in incidence over the last decade, with an especially prominent increase in SAVSs and nonaggressive DAVFs. Various factors including population aging may affect an increase in DAVF and SAVS.

DOI： 10.1161/strokeaha.120.032052

DOI： 10.1161/STROKEAHA.120.032052

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DOI： 10.1007/s00234-020-02506-9

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：American Society of Neuroradiology (ASNR)  

BACKGROUND AND PURPOSE: Detailed arterial anatomy of the sphenoid ridge and olfactory groove meningiomas is complicated due to the fine angioarchitecture and anastomoses between each feeder. Herein, we present details of the arterial anatomy and the relationships of feeders in these lesions. MATERIALS AND METHODS: This study included 20 patients admitted to our department between April 2015 and March 2020. Conditions of subjects consisted of 16 sphenoid ridge meningiomas and 4 olfactory groove meningiomas. We mainly analyzed arterial anatomy using 3D rotational angiography and slab MIP images of these lesions. We also analyzed the anastomoses of each feeder. RESULTS: We found that 19 (95%), 15 (75%), and 15 (75%) lesions had feeders from the ophthalmic, internal carotid, and external carotid arteries, respectively. As feeders from the ophthalmic artery, recurrent meningeal arteries were involved in 18 lesions (90%). Fifteen lesions (75%) had anastomoses between each feeder. CONCLUSIONS: Most of the meningiomas in the sphenoid ridge and olfactory groove had feeders from the ophthalmic and internal carotid arteries. There were various anastomoses between each feeder. This is the first report to demonstrate the detailed arterial anatomy and frequency of recurrent branches from the ophthalmic artery and their anastomoses using detailed imaging techniques.

DOI： 10.3174/ajnr.a6790

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DOI： 10.1007/s00234-020-02466-0

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Journal of Neurosurgery Publishing Group (JNSPG)  

<sec><title>OBJECTIVE</title>Embolization is the most common treatment for dural arteriovenous fistulas (dAVFs). A retrospective, multicenter observational study was conducted in Japan to clarify the nature, frequency, and risk factors for complications of dAVF embolization.

</sec><sec><title>METHODS</title>Patient data were derived from the Japanese Registry of Neuroendovascular Therapy 3 (JR-NET3). A total of 40,169 procedures were registered in JR-NET3, including 2121 procedures (5.28%) in which dAVFs were treated with embolization. After data extraction, the authors analyzed complication details and risk factors in 1940 procedures performed in 1458 patients with cranial dAVFs treated with successful or attempted embolization.

</sec><sec><title>RESULTS</title>Transarterial embolization (TAE) alone was performed in 858 cases (44%), and transvenous embolization (TVE) alone was performed in 910 cases (47%). Both TAE and TVE were performed in one session in 172 cases (9%). Complications occurred in 149 cases (7.7%). Thirty-day morbidity and mortality occurred in 55 cases (2.8%) and 16 cases (0.8%), respectively. Non–sinus-type locations, radical embolization as the strategy, procedure done at a hospital that performed dAVF embolization in fewer than 10 cases during the study period, and emergency procedures were independent risk factors for overall complications.

</sec><sec><title>CONCLUSIONS</title>Complication rates of dAVF embolization in Japan were acceptable. For better results, the risk factors identified in this study should be considered in treatment decisions.

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DOI： 10.3171/2019.4.jns183458

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Other Link： https://thejns.org/downloadpdf/journals/j-neurosurg/133/1/article-p166.xml

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DOI： 10.5797/jnet.ra.2020-0042

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DOI： 10.5797/jnet.oa.2018-0082

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DOI： 10.3171/2017.3.JNS163048

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DOI： 10.1161/STROKEAHA.117.019131

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DOI： 10.2176/nmc.st.2013-0172

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Trigonal meningiomas are rare and pose surgical challenges due to their deep location and proximity to critical neuroanatomical structures. We present the case of a 67-year-old woman with a growing trigonal meningioma successfully resected with guidance by a preoperative 3D imaging analysis system. Integration of CT and MRI including diffusion tensor imaging (DTI) enabled precise mapping of the optic radiation, guiding a middle temporal gyrus approach. Preoperative embolization reduced tumor vascularity, facilitating gross total resection with minimal blood loss. This case highlights the effectiveness of preoperative 3D imaging systems in optimizing surgical planning and improving outcomes in complex neurosurgical cases.

DOI： 10.18926/AMO/69440

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BACKGROUND: Peripheral ophthalmic artery aneurysms (POAAs) arising from the main trunk or branches of the ophthalmic artery (OphA) are extremely rare. However, their epidemiology and optimal management remain poorly understood. The authors report a rare case of a symptomatic POAA caused by arterial dissection that was successfully treated using endovascular therapy, leading to favorable visual recovery. OBSERVATIONS: A 77-year-old woman presented with sudden-onset visual impairment in the right eye. Ophthalmological examination revealed a defect in the right visual field. CT angiography revealed a fusiform aneurysm in the right intraorbital OphA. Digital subtraction angiography revealed a pearl and string sign, consistent with a dissecting aneurysm. A balloon test occlusion (BTO) of the OphA origin confirmed collateral circulation from the external carotid artery. Internal trapping of the OphA was performed under general anesthesia. Postoperatively, the patient's visual function gradually improved, and complete recovery was achieved within 3 months. LESSONS: Although POAAs are exceptionally rare, they may lead to significant visual dysfunction owing to optic nerve compression. When visual symptoms are present, prompt intervention may reverse the symptoms. Preoperative assessment of collateral circulation using BTO is essential for treatment planning. Internal trapping may be an effective strategy when sufficient collateral flow is confirmed. https://thejns.org/doi/10.3171/CASE25483.

DOI： 10.3171/CASE25483

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Embolization of intracranial tumors is predominantly performed in Japan, primarily before neurosurgical resection. The Japanese Registry of NeuroEndovascular Therapy (JR-NET) Study Group, established in 2005, aims to clarify the factors influencing the outcomes of neuroendovascular treatment. Japanese Registry of NeuroEndovascular Therapy 4 is a nationwide, multicenter retrospective observational study that evaluates real-world data on intracranial tumor embolization in Japan. Japanese Registry of NeuroEndovascular Therapy 4 is based on data collected from 166 neurosurgical centers in Japan between January 2015 and December 2019. Of 63,230 patients, 2,664 (4.2%) with intracranial tumors underwent embolization. The primary endpoint was the proportion of patients with a modified Rankin scale (mRS) score of 0-2 at 30 days post-procedure. Secondary endpoints included procedure-related complications. Among the 2,664 patients, 61 records lacked sufficient data, leaving 2,603 patients (1,612 females, median age: 61 years [interquartile range 51-71]). The proportion of patients with mRS scores ≤2 at 30 days after the procedure was 86.9%. The overall incidence of procedure-related complications was 4.8%, with 1.8% hemorrhagic, 2.0% ischemic, and 1.0% classified as other complications. In the multivariate analysis, general anesthesia and embolization of vessels other than the external carotid artery were identified as risk factors for the development of complications. Meningioma cases had a complication rate of 4.3%, with major complications occurring in 3.5%. Hemangioblastoma cases had a 14.9% complication rate, with major complications at 9.9%. Japanese Registry of NeuroEndovascular Therapy 4 provides comprehensive real-world data on intracranial tumor embolization in Japan, identifying risk factors to inform and improve the safe practice of intracranial tumor embolization in neuroendovascular therapy.

DOI： 10.2176/jns-nmc.2025-0081

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Middle meningeal artery embolization has increasingly been used to treat chronic subdural hematoma. However, the current state of its application and outcomes in Japan remains unclear. We conducted a multicenter observational study involving facilities affiliated with the Japanese Society for Neuroendovascular Therapy to assess current practices and clarify the usefulness and safety of middle meningeal artery embolization for chronic subdural hematoma. A total of 466 patients from 40 facilities were included. The mean age of the patients was 78.0 ± 10.5 years, and bleeding risks, including antithrombotic therapy or bleeding predisposition, were present in 36.1% of patients. The most common timing for middle meningeal artery embolization was after the second burr hole surgery, accounting for 34.8% of cases. N-butyl-2-cyanoacrylate was used as the embolic material in 67% of cases. The complication rate was 5.2%, with complication-related morbidity at 0.9%. Hematomas were stable in 91.5% of cases at 30 days post-middle meningeal artery embolization. The symptomatic recurrence rate was 8.9%. Cases that underwent middle meningeal artery embolization after the second or subsequent burr hole surgeries were significantly associated with symptomatic recurrence. This study is the first nationwide survey investigating the real-world clinical practice of middle meningeal artery embolization for chronic subdural hematoma in Japan. While it included many elderly patients, recurrent cases, and those with bleeding risks, the safety and usefulness of middle meningeal artery embolization were deemed acceptable. However, symptomatic recurrence was common even in cases with middle meningeal artery embolization when performed after the second or subsequent burr hole surgeries. A further prospective study will be warranted to clarify treatment indications, optimal timing, and treatment techniques of middle meningeal artery embolization.

DOI： 10.2176/jns-nmc.2025-0003

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The aim of this single-center, single-arm study was to evaluate the safety of adenosine-assisted clipping surgery for unruptured cerebral aneurysms. Five patients underwent aneurysmal clipping during adenosine-induced hypotension at ≤60 mmHg. The mean age of patients was 63.4±8.5 years, and the mean aneurysm size was 5.3±1.1 mm. The prevalence of patients with modified Rankin Scale scores of zero 30 days after surgery was 100%. The degree of aneurysm obliteration was complete in 4 patients and residual dome in 1 patient. The mean total dosage of adenosine was 37.4±18.8 mg. The mean duration of systolic blood pressure at ≤60 mmHg was 64.2±28.3 secs. No patients exhibited paroxysmal atrial fibrillation within 24 hours after adenosine administration or elevation of high-sensitivity cardiac troponin T on postoperative day 1. There was no reduction in either motor-evoked or somatosensory-evoked potential amplitude during surgery. Adenosine-induced hypotension is a safe procedure in clipping surgery for unruptured cerebral aneurysms.

DOI： 10.2176/jns-nmc.2024-0331

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Extracorporeal membrane oxygenation is utilized in the treatment of severe acute cardiac failure and respiratory failure. While it provides the advantage of oxygenating blood through extracorporeal circulation, it also carries risks of intracranial ischemic and hemorrhagic complications due to the continuous presence of artificial materials within the body. We encountered a case in which venoarterial extracorporeal membrane oxygenation was initiated for fulminant myocarditis, and the patient subsequently developed a large vessel occlusion. The diagnosis was confirmed using perfusion computed tomography. A visible thrombus was observed on the arterial cannula of the extracorporeal membrane oxygenation circuit, and the large vessel occlusion was determined to have been caused by thromboembolism. An immediate extracorporeal membrane oxygenation circuit exchange was performed, followed by endovascular thrombectomy. The patient experienced no perioperative complications and achieved a favorable neurological outcome. Endovascular thrombectomy in extracorporeal membrane oxygenation patients requires careful perioperative management and should be promptly performed in eligible cases of thromboembolic events. Furthermore, because patients on extracorporeal membrane oxygenation are often sedated and under intensive systemic management, regular neurological assessments and intracranial monitoring are essential for the early detection of intracranial pathologies.

DOI： 10.2176/jns-nmc.2025-0120

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The clinical imaging features of photon-counting detector (PCD) computed tomography (CT) are mainly known as dose reduction, improvement of spatial resolution, and reduction of artifacts compared to energy-integrating detector CT (EID-CT). The utility of cranial and spinal PCD-CT and PCD-CT angiography (CTA) has been previously reported. CTA is a widely used technique for noninvasive evaluation. Cranial CTA is important in brain tumors, especially glioblastoma; it evaluates whether the tumor is highly vascularized prior to an operation and helps in the diagnosis and assessment of bleeding risk. Spinal CTA has an important role in the estimation of feeders and drainers prior to selective angiography in the cases of spinal epidural arteriovenous fistulas and spinal tumors, especially in hemangioblastoma. So far, EID-CTA is commonly performed in an adjunctive role prior to selective angiography; PCD-CTA with high spatial resolution can be an alternative to selective angiography. In the cases of cerebral aneurysms, flow diverters are important tools for the treatment of intracranial aneurysms, and postoperative evaluation with cone beam CT with angiography using diluted contrast media is performed to evaluate stent adhesion and in-stent thrombosis. If CTA can replace selective angiography, it will be less invasive for the patient. In this review, we present representative cases with PCD-CT. We also show how well the cranial and spinal PCD-CTA approaches the accuracy of angiographic and intraoperative findings.

DOI： 10.1007/s11604-024-01661-w

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BACKGROUND: Silent magnetic resonance angiography (MRA) mitigates metal artifacts, facilitating clear visualization of neck remnants after stent and coil embolization of cerebral aneurysms. This study aims to scrutinize hemodynamics at the neck remnant by employing silent MRA and computational fluid dynamics. OBSERVATIONS: The authors longitudinally tracked images of a partially thrombosed anterior communicating artery aneurysm's neck remnant, which had been treated with stent-assisted coil embolization, using silent MRA over a decade. Computational fluid dynamics delineated the neck remnant's reduction process, evaluating hemodynamic parameters such as flow rate, wall shear stress magnitude and vector, and streamlines. The neck remnant exhibited diminishing surface area, volume, neck size, dome depth, and aspect ratio. Its reduction correlated with a decline in the flow rate ratio of the remnant dome to the inflow parent artery. Analysis delineated regions within the contracting neck remnant characterized by consistently low average wall shear stress magnitude and variation, accompanied by notable variations in wall shear stress vector directionality. LESSONS: Evaluation of neck remnants after stent-coil embolization is possible through silent MRA and computational fluid dynamics. Predicting the neck remnant reduction may be achievable through hemodynamic parameter analysis.

DOI： 10.3171/CASE24141

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We analyzed the correlation between the duration of electroencephalogram (EEG) recovery and histological outcome in rats in the acute stage of subarachnoid hemorrhage (SAH) to find a new predictor of the subsequent outcome. SAH was induced in eight rats by cisternal blood injection, and the duration of cortical depolarization was measured. EEG power spectrums were given by time frequency analysis, and histology was evaluated. The appropriate frequency band and recovery percentage of EEG (defined as EEG recovery time) to predict the neuronal damage were determined from 25 patterns (5 bands × 5 recovery rates) of receiver operating characteristic (ROC) curves. Probit regression curves were depicted to evaluate the relationships between neuronal injury and duration of depolarization and EEG recovery. The optimal values of the EEG band and the EEG recovery time to predict neuronal damage were 10-15 Hz and 40%, respectively (area under the curve [AUC]: 0.97). There was a close relationship between the percentage of damaged neurons and the duration of depolarization or EEG recovery time. These results suggest that EEG recovery time, under the above frequency band and recovery rate, may be a novel marker to predict the outcome after SAH.

DOI： 10.1038/s41598-024-52527-0

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Intracranial artery dissections (IADs), although uncommon, are an important cause of cerebral infarction and subarachnoid hemorrhage (SAH). Some IADs can heal spontaneously after reconstitution of the vessel lumen with excellent prognosis. Meanwhile, others can progress to stroke that requires treatment. The incidence of IAD in the posterior circulation is higher than that in the anterior circulation. Anterior circulation dissections are more likely to develop into ischemia and posterior circulation lesions into hemorrhage. The mortality rate after IAD among patients with SAH is 19%-83%. Further, the mortality rate of IAD without SAH is 0%-3%. Patients with SAH commonly undergo surgery or receive neuroendovascular treatment (EVT) to prevent rebleeding. However, the treatment of IADs is empirical in the absence of data from randomized controlled trials. Recently, EVT has emerged and is considered for IADs because of its less invasiveness and perceived low rates of procedure-related morbidity with good efficacy. EVT strategies can be classified into deconstructive (involving sacrifice of the parent artery) and reconstructive (preserving blood flow via the parent vessel) techniques. In particular, the number of reports on reconstructive techniques is increasing. However, a reconstructive technique for ruptured IADs has not yet been established. This review aimed to provide an overview of IADs in the posterior circulation managed with EVT by performing a literature search.

DOI： 10.5797/jnet.ra.2023-0068

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AIM: Vertebral artery dissection (VAD) is a rare cause of non-traumatic subarachnoid hemorrhage (SAH) with significant clinical implications. This study compared the clinical characteristics and outcomes of SAH from intracranial VAD rupture to those from other etiologies, primarily aneurysmal rupture. METHODS: This single-center retrospective cohort study at Okayama University Hospital included patients with non-traumatic SAH diagnosed between 2019 and 2023. Patients were categorized into "VAD rupture" and "other etiologies" groups. The main outcome was clinical presentation and symptoms. Additional outcomes included ICU mortality, in-hospital mortality, and unfavorable outcomes at discharge and 6 months, defined as a modified Rankin Scale score of 3-6. RESULTS: A total of 66 patients were included, with 14 in the VAD rupture group and 52 in the other etiologies group. The VAD rupture group was younger (median age 49 vs. 64 years, p = 0.003) and had a higher incidence of out-of-hospital cardiac arrest (42.9% vs. 9.6%, p = 0.011). Preceding headache was more common in the VAD rupture group (78.6% vs. 11.5%, p < 0.001), with a median duration of 36 h before presentation. ICU and in-hospital mortality was higher in the VAD rupture group (both 50.0% vs. 19.3%, p = 0.019). No significant differences were found in unfavorable neurological outcomes at hospital discharge and 6 months. CONCLUSIONS: VAD-related SAH often presents with prodromal headaches, severe symptoms like out-of-hospital cardiac arrest, and higher ICU and in-hospital mortality than other SAH causes, though long-term outcomes are similar. Larger, prospective studies are needed to refine interventions.

DOI： 10.1002/ams2.70031

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OBJECTIVE: Simulation training has focused on education and practical training. However, the adoption rate of neurointerventional simulation training in Japan is unknown. Therefore, we sent a questionnaire survey form to consulting specialists from the Japanese Society for Neuroendovascular Therapy (JSNET) to clarify the actual simulation training situation and compare the differences between university hospitals and general hospitals in Japan. METHODS: The questionnaire survey was conducted in 243 neurosurgical training facilities that had JSNET consulting specialists between May 31, 2021 and July 31, 2021. The questionnaire survey forms were distributed by Google Forms. RESULTS: A total of 162 facilities responded to the survey (response rate: 66.7%; 35.2% from university hospitals and 64.8% from general hospitals). The adoption rate for simulation training was 53.7%, and it was significantly higher in the university hospitals than in the general hospitals (64.9% vs. 47.6%, p = 0.035). On the simulation effectiveness survey, more than 80% of respondents answered that the simulation training was a useful tool for upskill training. The open-ended question on interventional simulation training showed that there are limiting factors such as financial constraints. Additionally, respondents expressed a desire for a standard neurointerventional simulation training and education program. CONCLUSION: The adoption rate for simulation training was 53.7% in the training facilities of JSNET, and it was higher in the university hospitals than in the general hospitals. Most of the respondents answered that simulation training is an effective tool to improve neurointerventional skills. They also requested the establishment of simulation training programs and simulation tools.

DOI： 10.5797/jnet.ra.2022-0062

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Early brain injury after aneurysmal subarachnoid hemorrhage (SAH) worsens the neurological outcome. We hypothesize that a longer duration of depolarization and excessive release of glutamate aggravate neurological outcomes after SAH, and that brain hypothermia can accelerate repolarization and inhibit the excessive release of extracellular glutamate and subsequent neuronal damage. So, we investigated the influence of depolarization time and extracellular glutamate levels on the neurological outcome in the ultra-early phase of SAH using a rat injection model as Experiment 1 and then evaluated the efficacy of brain hypothermia targeting ultra-early brain injury as Experiment 2. Dynamic changes in membrane potentials, intracranial pressure, cerebral perfusion pressure, cerebral blood flow, and extracellular glutamate levels were observed within 30 min after SAH. A prolonged duration of depolarization correlated with peak extracellular glutamate levels, and these two factors worsened the neuronal injury. Under brain hypothermia using pharyngeal cooling after SAH, cerebral perfusion pressure in the hypothermia group recovered earlier than that in the normothermia group. Extracellular glutamate levels in the hypothermia group were significantly lower than those in the normothermia group. The early induction of brain hypothermia could facilitate faster recovery of cerebral perfusion pressure, repolarization, and the inhibition of excessive glutamate release, which would prevent ultra-early brain injury following SAH.

DOI： 10.1038/s41598-022-14360-1

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OBJECTIVE: In recent years, endovascular treatment has become the treatment of choice for distal anterior cerebral artery (DACA) aneurysms. In this study, we report the outcomes of coil embolization for DACA aneurysms. METHODS: Eighteen DACA aneurysms in 16 patients treated with endovascular treatment between January 2010 and December 2020 were included in this study. We retrospectively analyzed patient characteristics, data on aneurysms, the reason for the selection of endovascular treatment, treatment technique, and treatment outcomes. RESULTS: There were 18 procedures in 16 patients. The average age was 65.7 years and 56% of patients were male. The average diameter of the dome was 5.5 mm, and the location of aneurysm was A3 in 83% and A4 in 17%. We mainly selected endovascular treatment for patients with a past history of craniotomy and head trauma, or with systemic comorbidities. The technical success rate was 94%, and adequate obliteration immediately after treatment was achieved in 72%. There were no symptomatic periprocedural complications. The retreatment rate was 11.1%. CONCLUSION: Coil embolization for DACA aneurysms yielded good treatment outcomes. Endovascular treatment for DACA aneurysms will become more common with advances in endovascular devices and the establishment of stable perioperative antiplatelet therapy.

DOI： 10.1016/j.jstrokecerebrovasdis.2022.106811

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OBJECTIVE: The morphological changes of the pipeline embolization device (PED; Medtronic, Minneapolis, MN, USA), such as delayed migration or foreshortening, can relate to the incomplete occlusion of aneurysms. CASE PRESENTATION: A 30-year-old man with a giant cavernous carotid artery aneurysm was treated with two PEDs using the overlapping technique. Six months after treatment, follow-up angiography showed morphological changes of the PEDs and residual flow into the aneurysm. Chronological cone-beam computed tomography fusion imaging clearly revealed the dynamic foreshortening of the first PED and the disconnection of both PEDs, so we decided to implant an additional PED. CONCLUSION: This case illustrates that a three-dimensional understanding can be useful for assessing the cause of treatment failure or recurrence.

DOI： 10.1007/s00701-022-05245-3

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BACKGROUND: Hemifacial spasm (HFS) due to vertebral artery (VA) dissecting aneurysm (VADA) is rare and endovascular treatment has been performed in selected cases. CASE DESCRIPTION: We encountered a case of HFS caused by VADA that was managed with endovascular stent placement and additional stent-in-stent placement. Therapeutic strategies and benefits based on pre- and post-treatment evaluation by 3D multifusion imaging using silent MRA were discussed. CONCLUSION: This is the first case report of stent-in-stent placement in successful treatment of HFS caused by VADA, in which relief of neurovascular contact was demonstrated by multifusion imaging.

DOI： 10.25259/SNI_253_2022

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PURPOSE: To assess the ability of the "wall-carving (WC) image technique," which uses vascular images from three-dimensional digital subtraction angiograms (3DDSAs). Also, to verify the accuracy of the resulting 3D-printed hollow models of intracranial aneurysms. METHODS: The 3DDSA data from nine aneurysms were processed to obtain volumetric models suitable for the stereolithography apparatus. The resulting models were filled with iodinated contrast media. 3D rotational angiography of the models was carried out, and the aneurysm geometry was compared with the original patient data. The accuracy of the 3D-printed hollow models' sizes and shapes was evaluated using the nonparametric Wilcoxon signed-rank test and the Dice coefficient index. RESULTS: The aneurysm volumes ranged from 34.1 to 4609.8 mm3 (maximum diameters 5.1-30.1 mm), and no statistically significant differences were noted between the patient data and the 3D-printed models (p = 0.4). Shape analysis of the aneurysms and related arteries indicated a high level of accuracy (Dice coefficient index value, 88.7-97.3%; mean [± standard deviation (SD)], 93.6% ± 2.5%). The vessel wall thickness of the 3D-printed hollow models was 0.4 mm for the parent and 0.2 mm for small branches and aneurysms, almost the same as the patient data. CONCLUSION: The WC technique, which involves volume rendering of 3DDSAs, can provide a detailed description of the contrast enhancement of intracranial vessels and aneurysms at arbitrary depths. These models can provide precise anatomic information and be used for simulations of endovascular treatment.

DOI： 10.1016/j.wneu.2021.12.018

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DOI： 10.1007/s10143-020-01424-x

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DOI： 10.2176/nmc.st.2021-0018

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DOI： 10.1007/s00701-021-04885-1

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Other Link： https://link.springer.com/article/10.1007/s00701-021-04885-1/fulltext.html

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Ossification of the posterior longitudinal ligament (OPLL) is common in East Asia. Arteriovenous fistula at the craniocervical junction (CCJ-AVF), in contrast, is rare. As OPLL occurs most often in the cervical region, these 2 conditions can coexist in the cervical spinal canal of a single patient. We report a case of CCJ-AVF found after cervical laminoplasty (CLP) for OPLL. A 68-year-old man experienced progressive myelopathy due to cervical OPLL. Magnetic resonance imaging (MRI) revealed a high-intensity area inside the spinal cord. CLP was performed and his symptoms immediately improved. Three months after CLP, however, myelopathy recurred. MRI revealed an exacerbated and enlarged high-intensity area inside the cord from the medulla oblongata to the C4/5 level with a flow void around the cord. Left vertebral artery angiography revealed CCJ-AVF with ascending and descending draining veins. Direct surgery was performed to interrupt shunt flow into the draining veins. The patient's symptoms improved to a limited degree. In this case, increased pressure inside the spinal canal due to OPLL might have decreased the shunt flow of the CCJ-AVF. Thus, the venous congestion induced by CCJ-AVF might have been exacerbated after the pressure was removed by CLP. Magnetic resonance angiography screening could help detect concurrent CCJ-AVF and OPLL.

DOI： 10.14245/ns.2040200.100

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OBJECTIVE: The purpose of the present study was to compare the treatment success rates of primary neurosurgical and endovascular treatments in patients with spinal dural arteriovenous fistulas (dAVFs). METHODS: Data from 199 consecutive patients with thoracic and lumbosacral spinal dAVFs were collected from 18 centers. Angiographic and clinical findings, the rate of initial treatment failure or recurrence by procedures, risk factors for treatment failure, complications, and neurological outcomes were statistically analyzed. RESULTS: Spinal dAVFs were frequently detected in the thoracic region (81%), fed by a single feeder (86%), and shunted into an intradural vein via the dura mater. The fistulous connection between the feeder(s) and intradural vein was located at a single spinal level in 195 patients (98%) and at 2 independent levels in 4 patients (2%). Among the neurosurgical (n = 145), and endovascular (n = 50) treatment groups of single dAVFs (n = 195), the rate of initial treatment failure or recurrence was significantly higher in the index endovascular treatment group (0.68% and 36%). A multivariate analysis identified endovascular treatment as an independent risk factor with significantly higher odds of initial treatment failure or recurrence (OR 69; 95% CI 8.7-546). The rate of complications did not significantly differ between the two treatment groups (4.1% for neurosurgical vs 4.0% for endovascular treatment). With a median follow-up of 26 months, improvements of ≥ 1 point in the modified Rankin Scale (mRS) score and Aminoff-Logue gait and Aminoff-Logue micturition grades were observed in 111 (56%), 121 (61%), and 79 (40%) patients, respectively. Independent risk factors for lack of improvement in the Aminoff-Logue gait grades were multiple treatments due to initial treatment failure or recurrence (OR 3.1) and symptom duration (OR 1.02). CONCLUSIONS: Based on data obtained from the largest and most recently assessed multicenter cohort, the present study shows that primary neurosurgery is superior to endovascular treatment for the complete obliteration of spinal dAVFs by a single procedure.

DOI： 10.3171/2020.6.SPINE20309

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Authorship：Corresponding author   Language：Japanese   Publisher：(NPO)日本脳神経血管内治療学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J06751&link_issn=&doc_id=20201127220001&doc_link_id=%2Fcf5nokec%2F2020%2F000504%2F001%2F0155-0160%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcf5nokec%2F2020%2F000504%2F001%2F0155-0160%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

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DOI： 10.1007/s00234-020-02549-y

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DOI： 10.3171/2020.2.SPINE191432

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DOI： 10.3390/ijms21114137

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The original version of this article unfortunately contained a mistake. Figure 5a, b were incorrect. The correct figures are given below.

DOI： 10.1007/s12017-020-08594-3

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DOI： 10.1007/s00234-019-02343-5

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DOI： 10.1038/s41598-020-60377-9

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：スパズム・シンポジウム事務局  

2003年1月〜2018年9月に発症72時間以内に外科治療を行った脳動脈瘤破裂によるくも膜下出血115例(男48例、女67例、年齢中央値65歳)を対象とした。2003〜2009年の53例(前期)は動脈瘤の部位・重症度・年齢でクリップとコイルを選択していたが、2010〜2018年の62例(後期)はコイルファーストの治療を行った。症候性脳血管攣縮を27例(24%)に、脳血管攣縮による脳梗塞を14例(12%)に認めた。症候性脳血管攣縮のリスク評価を多変量解析した結果、75歳以上が有意なリスク因子であり、腰椎ドレナージは有意に症候性脳血管攣縮の発生を抑制した。症候性脳血管攣縮の頻度は前期38%、後期11%であり、後期で有意に少なかった。各期の多変量解析で前期では75歳以上が有意なリスクであり、後期は腰椎ドレナージが有意に症候性脳血管攣縮の発生を抑制していた。脳動脈瘤破裂によるくも膜下出血に対する外科治療の基本管理は腰椎ドレナージが推奨されることが示唆された。

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DOI： 10.1007/s00234-019-02297-8

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Language：Japanese   Publishing type：Research paper (scientific journal)  

We herein report a case of ruptured arterio-venous malformation(AVM)detected using three-dimensional digital subtraction angiography(3DDSA)fusion images and successfully treated with target embolization for pseudoaneurysm. A 50-year-old man with a history of AVM was admitted to our department for the treatment of ruptured high-grade AVM in the right parietal lobe. Although a bleeding point was not evident on DSA, the patient had re-rupture in the right ventricle, one month after admission. Chronological 3DDSA fusion images generated from 3DDSA images taken on admission and after re-rupture revealed a newly visualized intranidal pseudoaneurysm near a hematoma. Contrast-enhanced magnetic resonance imaging showed vessel wall enhancement along the posterior horn of the right ventricle;this enhancement corresponded to the location of the pseudoaneurysm. We planned target embolization for the intranidal pseudoaneurysm to prevent re-bleeding. The origin of the feeder was so steep that a microcatheter could not be advanced deeply, and embolization with 20% n-butyl-2-cyanoacrylate resulted in proximal occlusion. Follow-up angiography 1 week after embolization showed complete disappearance of the pseudoaneurysm, and the patient had no recurrence of aneurysm until one year.

DOI： 10.11477/mf.1436204131

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DOI： 10.7887/jcns.29.543

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DOI： 10.1007/s12017-019-08541-x

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DOI： 10.1007/s00701-019-03970-w

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DOI： 10.4103/bc.bc_33_19

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BACKGROUND AND PURPOSE: Our aim was to visualize the precise configuration of the aneurysmal neck and dome with/without remnants combined with a coiled dome after coiling treatment for cerebral aneurysms. We developed 3D multifusion imaging of silent MRA and FSE-MR cisternography. MATERIALS AND METHODS: We examined 12 patients with 3D multifusion imaging by composing 3D images reconstructed from TOF-MRA, silent MRA, and FSE-MR cisternography. The influence of magnetic susceptibility artifacts caused by metal materials affecting the configuration of the aneurysmal complex with coiling was assessed in a single 3D image. RESULTS: In all cases, TOF-MRA failed to depict the aneurysmal neck complex precisely due to metal artifacts, whereas silent MRA delineated the neck and parent arteries at the coiled regions without serious metal artifacts. FSE-MR cisternography depicted the shape of the coiled aneurysmal dome and parent artery complex together with the brain parenchyma. With the 3D multifusion images of silent MRA and FSE-MR cisternography, the morphologic status of the coiled neck and parent arteries was clearly visualized with the shape of the dome in a single 3D image. CONCLUSIONS: Silent MRA is a non-contrast-enhanced form of MRA. It depicts the coiled neck complex without serious metal artifacts. FSE-MR cisternography can delineate the shape of the coiled dome. In this small feasibility study, 3D multifusion imaging of silent MRA and FSE-MR cisternography allowed good visualization of key features of coiled aneurysms. This technique may be useful in the follow-up of coiled aneurysms.

DOI： 10.3174/ajnr.A6026

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DOI： 10.1007/s00701-018-3767-6

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DOI： 10.2176/nmc.st.2018-0220

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.2335/scs.47.167

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society for Neuroendovascular Therapy  

DOI： 10.5797/jnet.oa.2018-0089

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DOI： 10.7887/jcns.28.120

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DOI： 10.1016/j.jstrokecerebrovasdis.2018.04.036

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Authorship：Last author   Language：Japanese   Publishing type：Research paper (scientific journal)  

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DOI： 10.3171/2016.9.JNS161385

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Background: Surgeries for deep-seated lesions are challenging because making a corridor and observing the interface between lesions and normal brain tissue are difficult. The ViewSite Brain Access System, which is a clear plastic tubular retractor system, is used for resection of deep-seated lesions. However, the tapered shape of this system may result in limitation of the surgical field and cause brain injury to observe the interface between lesions and normal tissue. In this study, we evaluated the usefulness of the combination of ViewSite and brain spatulas. Methods: Nine patients were retrospectively identified who underwent resection of deep-seated lesions with the combination of Viewsite and brain spatulas. We assessed the extent of resection, prognosis, and quantitative brain injury from postoperative diffusion-weighed imaging (DWI). Results: There were four total radiographically confirmed resections. Subtotal resection in four patients and partial resection in one with central neurocytoma were achieved because these tumors were strongly adherent to the choroid plexus and ependymal veins. Only one case of metastatic tumor relapsed 6 months after surgery. The mean postoperative high signal on DWI was 3.68 ± 0.80 cm3. Conclusions: The combination of ViewSite and brain spatulas provides wide and adequate operative fields to observe the interface between lesions and normal tissue, and to prevent brain injury from excessive retraction pressure on the brain derived from repositioning of the ViewSite. Postoperative 3D volumetric analysis shows minimal damage to normal brain tissue. This report may provide new insight into the use of the ViewSite tubular retractor.

DOI： 10.4103/sni.sni_62_18

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：(株)メディカ出版  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J03120&link_issn=&doc_id=20171204180003&doc_link_id=issn%3D0917-1495%26volume%3D27%26issue%3D12%26spage%3D1251&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0917-1495%26volume%3D27%26issue%3D12%26spage%3D1251&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Language：Japanese   Publisher：(一社)日本脳卒中の外科学会  

症例1:9歳女児。左片麻痺で発症し、右内包後脚脳梗塞と診断された。aspirin内服を行い、24ヵ月再発なく外来加療中である。症例2:13歳男児。けいれん発作、意識障害、左片麻痺が生じ、動脈炎として加療開始された。右中大脳動脈領域に脳梗塞を認めたため外減圧術を施行したが、第62病日に頭蓋骨形成術を施行後に意識障害が生じ、けいれん重積状態となった。barbitalを用いた2週間にわたる鎮静・呼吸循環管理にて徐々に改善したが、左不全麻痺の悪化、右不全麻痺を生じた。17ヵ月経過現在、両杖をついた歩行訓練を行っている。症例3:10ヵ月女児。左不全片麻痺で発症し、3日後に意識障害が生じた。右側の血栓性脳梗塞と考えaspirin内服を開始したが、脳梗塞の再発、左側に新規の脳梗塞を来たした。warfarinとaspirinの内科加療を開始し、16ヵ月再発なく経過している。症例4:2歳女児。Klippel-Trenaunay症候群として経過観察されていた。繰り返す左片麻痺とけいれん発作が生じ、右内頸動脈の閉塞ないし狭窄に伴う脳虚血と診断し、aspirin内服加療を開始した。16ヵ月間再発なく経過している。

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DOI： 10.1111/ncn3.12138

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.3171/2016.8.JNS16366

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DOI： 10.1007/s00701-017-3204-2

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Authorship：Lead author,　Corresponding author   Language：Japanese  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J02079&link_issn=&doc_id=20170810180005&doc_link_id=%2Fcp4strok%2F2017%2F004504%2F005%2F0270-0275%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcp4strok%2F2017%2F004504%2F005%2F0270-0275%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publishing type：Research paper (scientific journal)  

Surgical resection of solid cerebellar hemangioblastomas can be challenging because of the profuse blood supply and tight space. We report two cases of solid cerebellar hemangioblastomas treated via surgical resection with the aid of preoperative endovascular embolization on the day of surgery. Case 1: A 36-year-old woman presented with a two-month history of headache and vomiting. Magnetic resonance imaging(MRI)revealed a right cerebellar solid mass, mild hydrocephalus, and apparent peritumoral edema. Angiogram showed a highly vascularized mass, three feeding arteries from the superior cerebellar artery(SCA), and a dilated vein draining into the confluence. We performed preoperative embolization of the three feeders with 15% n-butyl-2-cyanoacrylate(NBCA). Final angiogram showed an absence of tumor staining. Tumor resection was performed on the same day, and gross total resection was achieved with no complications. Case 2: A 36-year-old man presented with a four-month history of headache and numbness in the left upper extremity. MRI revealed a right cerebellar solid mass with peritumoral edema. Angiogram showed a highly vascularized mass with two feeding arteries from the right SCA, one from the left posterior inferior cerebellar artery(PICA), and a dilated vein draining into the confluence. Preoperative embolization was performed with 15% NBCA, and complete devascularization was achieved. Tumor resection was performed on the same day, and gross total resection was achieved with no complications. In conclusion, preoperative embolization with NBCA on the day of surgery is a safe and effective adjunctive treatment for solid cerebellar hemangioblastoma.

DOI： 10.11477/mf.1436203560

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Language：Japanese   Publisher：(株)メディカ出版  

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Language：English   Publisher：The Japanese Society for Neuroendovascular Therapy  

<p>Purpose: We examined the outcome of coil embolization for symptomatic unruptured cerebral aneurysms, and investigated factors contributing to symptom relief after surgery.</p><p>Methods: We retrospectively reviewed 19 patients who underwent coil embolization between January 2008 and April 2016.</p><p>Results: After surgery, symptoms reduced in 13 patients (68%), but not in 6 (32%). In the improved group, the mean duration of disease was significantly shorter than in the unimproved group (1.3 vs. 16.2 months, respectively, p <0.05). There was a significant reduction in the aneurysmal size in the former (mean rate of reduction: 3.51 mm), whereas there was an increase in the latter (mean increase: 1.63 mm) (p <0.05).</p><p>Conclusion: Early therapeutic intervention and a postoperative reduction in the aneurysmal size may be important to achieve the relief of symptoms of symptomatic unruptured cerebral aneurysms after surgery.</p>

DOI： 10.5797/jnet.oa.2017-0045

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BACKGROUND: Traumatic vertebral arteriovenous fistula (TVAVF) is an uncommon disease that occurs after traumatic injury. Here we report a case of TVAVF presenting with cervical bruit successfully treated by internal trapping using coils. CASE PRESENTATION: A 66-year-old man was transferred to our hospital after falling into a ditch. Initial CT revealed a C2 fracture into the right transverse foramen, and the patient had been treated with conservative management. A vascular abnormality was suspected because the patient exhibited cervical bruit on admission. CT angiography revealed right TVAVF at the V2 segment of the right vertebral artery (VA) near the C2 fracture. Digital subtraction angiography also revealed right TVAVF between the V2 segment of the right VA and the vertebral venous plexus, draining into the right internal jugular vein and the deep cervical vein as well as the intracranial venous system. The fistula was also opacified by retrograde flow from the contralateral VA through the union, while the flow in the basilar artery was antegrade. The patient was diagnosed with TVAVF with large transection of the right VA, and underwent endovascular treatment with internal trapping of the right VA using coils starting distal to the transection and proceeding in a proximal direction. After treatment, the right VAVF and right VA were completely occluded. The patient achieved clinical symptom resolution with no neurological deficits. CONCLUSION: Endovascular treatment with internal trapping of the VA using coils is safe and effective against TVAVF.

DOI： 10.11477/mf.1436203245

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DOI： 10.2176/nmc.oa.2016-0085

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Language：English   Publisher：The Japanese Society for Neuroendovascular Therapy  

<p>Objective: Unidentified fever, headache, and gastrointestinal symptoms after endosaccular coil embolization are occasionally observed in patients with unruptured cerebral aneurysms. We defined these symptoms as post coiling syndrome (PCS) and analyzed the clinical risk factors involved.</p><p>Methods: We applied the PCS diagnostic criteria based on the scoring of symptoms, which include fever, headache, nausea, and/or vomiting. Thirty-six consecutive patients were included in this retrospective study. Systematic follow-up included clinical and blood examinations.</p><p>Results: Based on our criteria, 11 of 36 patients were diagnosed with PCS. Between patients in the PCS group and patients in the non-PCS group, we recognized significant differences in age (63.4 ± 12.5 vs. 53.8 ± 12.9, respectively; p <0.029) as patient background and in aneurysmal diameter (9.96 ± 4.24 vs. 6.48 ± 3.06, respectively; p <0.049), aneurysmal volume (242 ± 254 vs. 87.9 ± 70.1, respectively; p <0.015), total coil length (122 ± 106 vs. 39.1 ± 25.7, respectively; p <0.0021), and volume embolization ratio as aneurysmal data (41.9 ± 8.1 vs. 30.7 ± 8.5, respectively; p <0.0019). In addition, we recognized a significant difference in postoperative leukocytosis as an inflammatory factor.</p><p>Conclusions: Patient age, aneurysmal diameter, aneurysmal volume, total coil length, and volume embolization may enable the prediction of PCS.</p>

DOI： 10.5797/jnet.oa.2016-0036

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Language：Japanese   Publisher：(一社)日本血管内治療学会  

コイル塞栓術を施行した破裂脳動脈瘤の連続46例を80歳以上(A群)と80歳未満(B群)に分類し、治療成績と予後に関する因子について検討した。その結果、A群は12例、B群は34例であった。A群はB群に比べ症候性脳血管攣縮の発生頻度が有意に高く、腰椎ドレナージ挿入の頻度が有意に低かった。退院時のmodified Rankin Scaleが0-2を予後良好例、3-6を予後不良例としたところ、予後良好例は10例、予後不良例は36例であった。予後良好例はA群0/12例(0%)、B群10/34例(29%)で、A群で有意に少なかった。症候性脳血管攣縮が予後不良に関与する割合はA群4/12例(33%)、B群1/24例(4%)で、A群で有意に高かった。

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Language：Japanese   Publisher：The Japanese Society of Spinal Surgery  

Spinal hemangioblastomas are benign, and total surgical resection is the standard treatment method used. However, hypervascular tumors may have excessive operative blood loss if the tumors are divided. We encountered a case of cauda equina hemangioblastoma with extraordinary blood supply, which was treated with preoperative embolization. A 49-year-old woman with von Hippel-Lindau disease who had undergone multiple surgeries for intracranial/extracranial hemangioblastomas had lumbago and leg pain. Magnetic resonance images revealed intradural spinal tumors at the L4-S1 vertebral level, with remarkable gadolinium enhancement. The patient was referred to our hospital, after a plan of total resection had been abandoned elsewhere because of the high flow feeders and high pressure of the tumors. Preoperative embolization was performed with consequent disappearance of the arterial blood supply to the tumor. Two days later, the tumor was resected subtotally with reduced tension and a little blood loss. The patient's symptoms resolved soon after surgery. Selective preoperative embolization for a spinal hemangioblastoma with a rich blood supply is a valid option as an adjuvant to the complete surgical resection of a tumor.

DOI： 10.2531/spinalsurg.29.53

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DOI： 10.7887/jcns.24.239

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DOI： 10.1007/s00234-013-1300-4

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DOI： 10.1155/2014/253867

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Aneurysms at the vertebrobasilar junction are often found with basilar artery(BA)fenestration. We encountered 10 consecutive cases of aneurysms associated with BA fenestration. The purpose of this study is to describe the frequency, clinical features, and outcome of these aneurysms treated by endovascular procedure. The incidence of these aneurysms in our series was 1.9%. All aneurysms were successfully treated by coil embolization. Half of them were treated by using simple technique, and the other half were treated by using adjunctive techniques such as balloon remodeling technique. 70% of these cases were ruptured, and all except one case showed good recovery at the time of discharge. We found 63 reported cases of this aneurysm in the literature between 2000 and 2012. 57 out of 63 aneurysms were treated by endovascular means with good clinical results. The usefulness of endovascular procedure is reported to be superior to surgical clipping because of their anatomical complexity and the difficulty of surgical exposure for clipping. We conclude that outcome of these aneurysms is favorable and endovascular procedure has become their standard treatment for these aneurysms.

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Language：Japanese   Publishing type：Research paper (scientific journal)  

We report a rare case of a paraspinal arteriovenous fistula(AVF)treated by combined transarterial and transvenous embolization(TAE/TVE). A 72-year-old woman was admitted after a traffic accident. Abdominal enhanced CT disclosed pre-existing large varices at the L3-L4 level in the right retroperitoneum with multiple feeding arteries and veins draining into the extradural venous plexus in the spinal canal. The lesion was diagnosed as a paraspinal AVF. Four days later, the patient went into a state of shock. Emergency abdominal CT showed retroperitoneal hemorrhage due to rupture of the varix. TAE of the feeders from the right L1-L4 arteries was performed, and rebleeding from the varix was prevented. Three months later, follow-up CTA showed regrowth of the AVF, and TVE was performed. Two microcatheters were navigated transvenously into the varix, and detachable coils were delivered into the small compartment just downstream to the shunts, leading to complete obliteration. We conclude that transarterial flow reduction followed by occlusion of the venous side of the shunts is effective to achieve cure of a complex and high-flow paraspinal AVF.

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Language：Japanese   Publisher：The Japanese Society for Neuroendovascular Therapy  

Objective: The "Sheep technique" is a special technique for navigating a balloon catheter that is difficult to navigate because of the steep angle of the branching vessel.<br>Case presentation: We treated two patients having intracranial aneurysms by endovascular therapy with the sheep technique. In both cases, initial balloon catheter navigation failed because the branch near the aneurysm was steep. With the aid of the sheep technique, the balloon catheter was successfully delivered into the target vessel. Coil embolization was then performed using a balloon remodeling technique.<br>Conclusion: The sheep technique is effective when balloon catheter delivery is difficult because the branch near the aneurysm is steep.

DOI： 10.5797/jnet.7.3

CiNii Article

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Language：Japanese   Publishing type：Research paper (scientific journal)  

Recent advances in endovascular techniques greatly improved the ability to treat complex cerebral aneurysms. However, patients with wide-necked cerebral aneurysms have posed a special challenge to conventional endovascular therapy. We report a novel method of embolizing wide-necked basilar apex aneurysms by employing a Y-configuration, double stent technique. A 40-year-old woman with a partially thrombosed basilar apex aneurysm transferred to our hospital after diagnosis of subarachnoid hemorrhage. Cerebral angiography revealed a wide-necked aneurysm which neck was incorporating the origins of both the posterior cerebral arteries. In treatment procedure, a microcatheter was inserted into the aneurysm followed by coiling of the upper half of the dome. Next, the first stent was deployed in the right P2 segment extending down to the mid basilar artery and the second stent was then deployed with half of the stent in the left P2 and the other half within the lumen of the previously placed stent. Finally, the microcatheter was withdrawn near the neck, and the rest of the aneurysmal dome was packed by additional coils. The result was favorable. Successful coil embolization of a wide-necked bifurcation aneurysm can be achieved by using the double stenting Y-configuration in this case. This result continues to provide highly encouraging support of this novel technique to treat a subset of complex, wide-necked aneurysms that until recently were considered poor candidates for endovascular therapies.

PubMed

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Language：Japanese  

CiNii Article

CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2013228402

Language：Japanese   Publishing type：Research paper (scientific journal)  

The aim of this study was to analyze the effect of endovascular treatment of basilar (BA) tip aneurysms. The authors performed a retrospective analysis of 79 aneurysms of the BA tip that had been treated using endovascular coil embolization for the last 11 years. Fifty-six patients were women, and 23 were men. The average age of the patients was 63.7 years (range, 35-83 year). The average maximum diameter of the aneurysms was 8.0 mm (range, 2-30 mm). Forty-seven patients (60%) presented with acute subarachnoid hemorrhage (SAH), 1 patient (1%) had an unruptured aneurysm with mass effect, and 31 patients (39%) had incidental aneurysms. Immediate anatomic outcomes demonstrated complete occlusion (CO) in 53 aneurysms (67%), residual neck (RN) in 22 aneurysms (28%), and residual aneurysm (RA) in 4 aneurysms (5%). One patient died from rebleeding 6 hours after the embolization. Another patient suffered from rebleeding 6 years after the initial embolization, and was successfully treated with re-embolization. Four patients suffered from asymptomatic P1 occlusion. No symptomatic complication was observed in the unruptured group. Retreatment was performed in 5 patients, including 4 broad-neck large ruptured aneurysms and 1 giant thrombosed aneurysm. Angiographic and clinical results have been improving in recent cases in this study. Technical advances such as highly compliant balloon remodeling microcatheter and 3D-reconstructed digital angiography contributed to this improvement. Our results indicate that endovascular treatment of BA tip aneurysm is safe and effective. The long-term stability after coil embolization is still a matter of concern. Further improvement is expected.

PubMed

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Language：Japanese  

CiNii Article

CiNii Books

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Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)  

INTRODUCTION: Percutaneous transvenous embolization (TVE) using coils is a well-established treatment of cavernous sinus dural arteriovenous fistula (CSdAVF). However, it is sometimes difficult to achieve complete occlusion by coil embolization. In these two cases, we were able to obtain complete angiographic obliteration of the fistulas without complications by means of percutaneous TVE using n-butyl-cyanoacrylate (NBCA) after we failed when TVE using coils. Case 1: An 89-year-old woman presented with double vision. She was diagnosed as Barrow type D right CSdAVF draining only to the cortical vein. We treated the patient by TVE using coils, but the microcatheter was withdrawn before complete occlusion was attained. The repositioning of the microcatheter was difficult, so we used 30% NBCA for TVE, and obtained complete obliteration of the fistula. Case 2: An 87-year-old woman presented with right exophthalmos, and chemosis. She was diagnosed as Barrow type C right CSdAVF draining only to the right superior ophthalmic vein with very slow flow. We planned to treat her, using TVE with coils, but we could place only 3 coils and obtained only partial obliteration of the fistula. So we additionally used 25% NBCA for TVE, and obtained complete obliteration of the fistula. CONCLUSION: Compared to TVE using coils, TVE using NBCA gives rise to many problems, but, we can use NBCA as a second option if TVE using coils results in only partial obliteration as in these cases.

PubMed

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Language：Japanese  

CiNii Article

CiNii Books

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Authorship：Lead author   Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society for Neuroendovascular Therapy  

Objective: Percutaneous transvenous embolization (TVE) of a transverse/sigmoid sinus dural arteriovenous fistula (TS/SS dAVF) through the mastoid emissary vein (MEV) is reported.Case presentation: A 46-year-old man was admitted to our hospital for cerebral venous infarction. Angiography revealed left TS/SS dAVF with isolated sinus and retrograde cortical venous reflux. Transarterial embolization resulted in successful reduction of the shunt flow and improvement of the clinical symptoms. Transvenous approach through the occluded dural sinus into the affected sinus failed. Direct puncture of the dilated occipital vein was then performed, and TVE using coils was performed successfully through the MEV. This procedure resulted in complete disappearance of the dAVF.Conclusion: This technique is a simple and good alternative treatment in patients for whom conventional approach to the isolated sinus is difficult to adopt, if there is the drainage of the dilated mastoid emissary vein.

DOI： 10.5797/jnet.3.112

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2009351823

Language：Japanese   Publisher：The Japanese Society for Neuroendovascular Therapy  

Objective: To compare clinical results of carotid artery stenting (CAS) under distal protection with the use of Angioguard XP and PercuSurge GuardWire.Methods: 138 patients treated by CAS under distal protection from September 2002 to November 2008 were included in this study. 85 patients treated with GuardWire were divided into 2 sequential groups, the early GW group (n=42) and the late GW group (n=43). Angioguard XP was used in 53 patients (the AG group) from November 2007. Treatment results from the 3 groups were investigated.Results: A stent was successfully deployed in all patients. 1 patient in the early GW group died of intracerebral hemorrhage which developed 5 days after CAS. In the late GW group, 1 patient died of multiple organ failure after intraoperative abdominal wall hemorrhage and another patient showed persistent hemiparesis due to intracerebral hemorrhage which occurred 1 week after CAS. Procedure-associated learning curve was not demonstrated between the 2 groups. In the AG group, postoperative MRI diffusion-weighted imaging disclosed new high-intensity lesions in the area of the treated carotid artery in 7 patients, in which 2 patients suffered from thromboembolic strokes.Conclusion: Hemorrhagic complications were causes of disability for patients treated with GuardWire. Thromboembolic events were more frequently encountered in patients undergoing CAS with Angioguard XP.

DOI： 10.5797/jnet.3.79

CiNii Article

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Other Link： http://search.jamas.or.jp/link/ui/2009351818

Language：Japanese

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Total pages：70   Responsible for pages：13-15   Language：Japanese

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：(株)中外医学社  

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Language：Japanese   Publisher：日本脳神経外科コングレス  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J02632&link_issn=&doc_id=20130107430005&doc_link_id=10.7887%2Fjcns.22.37&url=https%3A%2F%2Fdoi.org%2F10.7887%2Fjcns.22.37&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(株)メディカ出版  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2025&ichushi_jid=J03120&link_issn=&doc_id=20250509200015&doc_link_id=issn%3D0917-1495%26volume%3D35%26issue%3D3%26spage%3D380&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0917-1495%26volume%3D35%26issue%3D3%26spage%3D380&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Language：Japanese   Publisher：(一社)日本脳卒中の外科学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2025&ichushi_jid=J02079&link_issn=&doc_id=20250611180001&doc_link_id=%2Fcp4strok%2F2025%2F005303%2F001%2F0143-0150%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcp4strok%2F2025%2F005303%2F001%2F0143-0150%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：(一社)日本脊髄外科学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2025&ichushi_jid=J02943&link_issn=&doc_id=20250516260016&doc_link_id=10.2531%2Fspinalsurg.39.77&url=https%3A%2F%2Fdoi.org%2F10.2531%2Fspinalsurg.39.77&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：(株)メディカ出版  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2025&ichushi_jid=J03120&link_issn=&doc_id=20250110170017&doc_link_id=issn%3D0917-1495%26volume%3D35%26issue%3D1%26spage%3D103&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0917-1495%26volume%3D35%26issue%3D1%26spage%3D103&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Language：Japanese   Publisher：(株)医学書院  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2025&ichushi_jid=J01228&link_issn=&doc_id=20250203180022&doc_link_id=10.11477%2Fmf.030126030530010199&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.030126030530010199&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：医歯薬出版(株)  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J00060&link_issn=&doc_id=20241126030012&doc_link_id=issn%3D0039-2359%26volume%3D291%26issue%3D8%26spage%3D619&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0039-2359%26volume%3D291%26issue%3D8%26spage%3D619&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Language：Japanese   Publisher：(株)医学書院  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J01228&link_issn=&doc_id=20240725160016&doc_link_id=10.11477%2Fmf.1436204978&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1436204978&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：(株)医学書院  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J01228&link_issn=&doc_id=20240325230012&doc_link_id=10.11477%2Fmf.1436204914&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1436204914&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：(株)メディカ出版  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2024&ichushi_jid=J03120&link_issn=&doc_id=20231228250013&doc_link_id=issn%3D0917-1495%26volume%3D34%26issue%3D1%26spage%3D68&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0917-1495%26volume%3D34%26issue%3D1%26spage%3D68&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：(株)三輪書店  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J02317&link_issn=&doc_id=20240111060007&doc_link_id=10.11477%2Fmf.5002202195&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.5002202195&type=%E5%8C%BB%E6%9B%B8.jp_%E3%82%AA%E3%83%BC%E3%83%AB%E3%82%A2%E3%82%AF%E3%82%BB%E3%82%B9&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Language：Japanese   Publisher：(一社)日本脳卒中の外科学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J02079&link_issn=&doc_id=20231212130006&doc_link_id=%2Fcp4strok%2F2023%2F005106%2F006%2F0503-0507%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcp4strok%2F2023%2F005106%2F006%2F0503-0507%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Language：Japanese   Publisher：SAH  

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Language：Japanese   Publisher：(一社)日本小児神経外科学会  

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J00650&link_issn=&doc_id=20230622280003&doc_link_id=%2Fco2socie%2F2023%2F004801%2F003%2F0015-0020%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fco2socie%2F2023%2F004801%2F003%2F0015-0020%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

J-GLOBAL

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Authorship：Lead author,　Corresponding author   Language：Japanese  

In this paper, we will discuss the relationship between neuroendovascular therapy and infection in two parts: the risk of infectious complications in neuroendovascular therapy and neuroendovascular therapy for infectious diseases. The risk of infectious complications associated with neuroendovascular therapy is rare but should not be ignored. We must comply with clean procedures and consider prophylactic antibiotic administration in selected cases. Neuroendovascular therapy for infectious diseases is a high-risk treatment, and a safer treatment strategy should be considered for each case.

DOI： 10.11477/mf.1436204656

PubMed

J-GLOBAL

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Language：Japanese   Publisher：(株)中外医学社  

J-GLOBAL

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publisher：(株)医学書院  

DOI： 10.11477/mf.1436204390.

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01228&link_issn=&doc_id=20210406190012&doc_link_id=10.11477%2Fmf.1436204390&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1436204390&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

Authorship：Lead author   Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (trade magazine, newspaper, online media)  

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Language：Japanese   Publisher：日本脳神経外科コングレス  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J02632&link_issn=&doc_id=20200803230002&doc_link_id=130007890362&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130007890362&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

Language：Japanese   Publisher：(株)メディカ出版  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J03120&link_issn=&doc_id=20190703140011&doc_link_id=issn%3D0917-1495%26volume%3D29%26issue%3D7%26spage%3D762&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0917-1495%26volume%3D29%26issue%3D7%26spage%3D762&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Language：Japanese   Publisher：日本脳神経外科コングレス  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J02632&link_issn=&doc_id=20190524170001&doc_link_id=130007618622&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130007618622&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

Language：Japanese   Publisher：(一社)日本内科学会  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01159&link_issn=&doc_id=20170822110015&doc_link_id=10.2169%2Fnaika.106.1646&url=https%3A%2F%2Fdoi.org%2F10.2169%2Fnaika.106.1646&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

DOI： 10.5797/jnet.oa.2016-0092

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Language：Japanese   Publisher：日本脳神経外科コングレス  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J02632&link_issn=&doc_id=20150519230004&doc_link_id=10.7887%2Fjcns.24.239&url=https%3A%2F%2Fdoi.org%2F10.7887%2Fjcns.24.239&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

Language：Japanese   Publisher：(株)エムイー振興協会  

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Language：Japanese   Publisher：(株)医学出版  

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Language：Japanese  

CiNii Article

CiNii Books

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Language：Japanese   Publisher：(株)医薬情報研究所  

頸動脈ステント留置術(CAS)の初期治療成績と、周術期の抗血小板療法の実際について報告した。頸動脈狭窄症に対して、脳保護フィルターを使用して自己拡張型ステントを留置した50例を対象とした。術前狭窄率はNASCET法で60〜95(平均83)%であったが、術後狭窄率は0〜30(平均8)%に改善した。mRSは、術直後に悪化した症例は5例あったが、24時間後も悪化した状態が継続した症例は1例のみであった。CASの周術期における抗血小板剤の投与については、アスピリン、クロピドグレル、チクロピジン、シロスタゾールの中から、複数の抗血小板剤をCAS施行3日以上前から投与された。

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Event date： 2024.11.21 - 2024.11.23

Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2024.11.21 - 2024.11.23

Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2024.6.8

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Other Link： https://www.nicheneuroangio.com/17nnac.html

Event date： 2024.5.9 - 2024.5.12

Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2024.3.7 - 2024.3.9

Presentation type：Symposium, workshop panel (public)  

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Event date： 2023.11.22 - 2023.11.25

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

Venue：京都  

皮質静脈逆流（cortical venous reflux: CVR）を伴わないbenign typeの硬膜動静脈瘻（dural arteriovenous fistula: dAVF）の自然歴は良好であり、CVRを伴うaggressive typeに変化するリスクは1-2%程度であると報告されている。生活に支障を来すレベルの自覚症状を呈するbenign typeのdAVFに対しては治療が行われることがあるが、罹患静脈洞が正常静脈還流に関与していることも多く、静脈洞の温存が必要となる。以前はtransarterial embolization (TAE)でのflow reductionが治療の主体であったが、近年ではballoon catheterによるsinus protection下にOnyxを注入して根治を狙うTAEが、積極的に行われるようになっている。治療により自覚症状の改善は得られやすいが、治療に伴う合併症リスクは無視できない。また、定位放射線治療の報告も増えてきている。本発表では、過去の文献をもとにBorden type 1 dAVFの自然歴と、合併症リスクを含めた治療成績を論じる。

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Event date： 2023.11.22 - 2023.11.25

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Venue：京都  

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Event date： 2023.11.20 - 2023.11.25

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

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Event date： 2023.10.25 - 2023.10.27

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2023.5.18 - 2023.5.21

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Venue：Osaka  

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Event date： 2023.3.16 - 2023.3.18

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Venue：横浜  

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Event date： 2022.11.10 - 2022.11.12

Presentation type：Symposium, workshop panel (public)  

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Event date： 2022.11.10 - 2022.11.12

Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2022.9.28 - 2022.10.1

Presentation type：Symposium, workshop panel (public)  

Venue：横浜  

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Event date： 2022.8.21 - 2022.8.25

Language：English   Presentation type：Oral presentation (general)  

Venue：Kyoto  

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Event date： 2022.8.21 - 2022.8.25

Language：English   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Venue：Kyoto  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

[Background] The lateral spinal artery (LSA) perfuses the dorsolateral part of the spinal cord at the craniocervical junction (CCJ). We analyze the angioarchitecture of normal LSA and CCJ arteriovenous fistula (AVF).
[Methods 1] This study included 26 patients with vertebral artery or posterior inferior cerebellar artery (PICA) aneurysm treated in our department between 2016 and 2021. Using slab maximum intensity projection (MIP) images of 3D-RA and cone-beam CT (CBCT), we analyzed the origin of LSA, anastomosis with PICA, reaching point to the spinal cord, and perfused range of craniocaudal direction.
[Methods 2] We analyzed angioarchitecture and treatment results of four patients with seven lesions of CCJAVF treated in our department between 2016 and 2021.
[Results 1] We could visualize the LSA using CBCT in all cases. The LSA originated from C1 and C2 segmental arteries in 22 (85%) and 6 (23%) cases. LSA had anastomosis with the PICA in 11 patients (42%). The LSA reached the dorsolateral part of the spinal cord in all cases. The mean visualized range of the LSA was 27.4mm (range: 6.2-41.6mm).
[Results 2] There were three perimedullary AVFs, two radicular AVFs, one dural AVF, and one epidural AVF. The anterior spinal artery (ASA) and LSA were involved in 3 (43%) and 5 lesions (71%). All cases other than the epidural AVF had a pial arterial supply from the ASA or LSA. There was one case with lateral part of spinal cord infarction after embolization of the LSA. Other lesions were treated with direct interruption of the AVF, and we could preserve the ASA and LSA.
[Conclusions] We could visualize the LSA using the slab MIP images of 3D-RA and CBCT. Most cases of the CCJAVF involve the LSA, and we need the treatment strategy with preservation of the LSA.

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

[Background] Spinal epidural arteriovenous fistulas (SEDAVFs) are rare diseases and include osseous AVFs, which develop in the vertebral body or arch. We summarize our case series of SEDAVF with osseous involvement and review past literature.
[Methods] This study included four patients of SEDAVF with osseous involvement treated in our department between 2011 and 2021. We analyze the clinical characteristics, angioarchitecture, and treatment results.
[Results] Of the four patients, three were women, and the mean age was 58 years. Three cases had a history of spinal surgery, and another had a spinal compressed fracture before our treatment. One patient suffered from congestive myelopathy due to reflux to the medullary vein, and two patients had symptoms of lumbar canal stenosis due to dilated venous pouch. Another case had not only osseous and epidural AVF but also dural, perimedullary, and paraspinal AVFs, and suffered from progressive paraparesis. All cases had numerous feeders from four or more segmental arteries, and shunt levels were included between Th12-L3. All cases had dilated venous pouch in the bone and spinal canal and drainage route from epidural space to the paravertebral vein. One patient with intradural reflux was treated by surgical interruption of the intradural vein. The other three cases were treated with transarterial venous embolization or transvenous embolization using coils and glue and achieved good angiographical results. All patients had no procedural complication, and all cases other than the case with multiple AVFs achieved symptom resolution.
[Conclusion] Our case series of SEDAVF with osseous involvement has numerous feeders and diffuse shunt, different from usual SEDAVFs. We need to treat the venous side using coils and glue.

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Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Oral presentation (general)  

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Event date： 2021.6.3 - 2021.6.4

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2021.6.3 - 2021.6.4

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Oral presentation (general)  

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Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Oral presentation (general)  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Oral presentation (general)  

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Event date： 2020.9.29 - 2020.9.30

Presentation type：Oral presentation (general)  

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Event date： 2020.8.23 - 2020.8.25

Presentation type：Oral presentation (general)  

Venue：横浜  

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Event date： 2020.8.23 - 2020.8.25

Presentation type：Oral presentation (general)  

Venue：横浜  

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Event date： 2019.11.21 - 2019.11.23

Presentation type：Oral presentation (general)  

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Event date： 2019.11.21 - 2019.11.23

Presentation type：Oral presentation (general)  

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Event date： 2019.10.9 - 2019.10.12

Presentation type：Oral presentation (general)  

Venue：大阪  

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Event date： 2018.11.22 - 2018.11.24

Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2018.11.22 - 2018.11.24

Presentation type：Symposium, workshop panel (public)  

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Event date： 2018.10.10 - 2018.10.12

Presentation type：Symposium, workshop panel (public)  

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Event date： 2017.11.23 - 2017.11.25

Language：English   Presentation type：Symposium, workshop panel (public)  

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Event date： 2017.10

Presentation type：Oral presentation (general)  

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Event date： 2025.11.13 - 2025.11.15

Presentation type：Poster presentation  

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Event date： 2025.7.15

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Event date： 2025.6.21

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Venue：博多  

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Event date： 2025.6.12 - 2025.6.13

Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2025.3.21 - 2025.3.22

Presentation type：Oral presentation (general)  

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Event date： 2025.1.24

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Event date： 2024.11.21 - 2024.11.23

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Event date： 2024.11.21 - 2024.11.23

Presentation type：Oral presentation (general)  

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Event date： 2024.11.21 - 2024.11.23

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Event date： 2024.8.24

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Event date： 2024.7.12 - 2024.7.13

Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2024.4.19 - 2024.4.20

Presentation type：Oral presentation (general)  

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Event date： 2023.3.16 - 2023.3.18

Presentation type：Oral presentation (general)  

Venue：横浜  

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Event date： 2023.1.20 - 2023.1.21

Presentation type：Symposium, workshop panel (public)  

Venue：幕張メッセ  

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Event date： 2022.4.8 - 2022.4.9

Presentation type：Symposium, workshop panel (public)  

Venue：web  

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Event date： 2022.3.17 - 2022.3.19

Presentation type：Poster presentation  

Venue：大阪  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Poster presentation  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Poster presentation  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Poster presentation  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Poster presentation  

Venue：福岡  

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Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Poster presentation  

Venue：福岡  

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Event date： 2021.11.12 - 2021.11.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岐阜  

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Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

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Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

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Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

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Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

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Event date： 2021.9.28

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：岡山  

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Event date： 2021.9.25

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2021.9.25

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2021.9.25

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2021.9.25

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2021.9.25

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2021.9.25

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2021.9.3 - 2021.9.4

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：京都  

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Event date： 2021.8.21

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：富山  

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Event date： 2021.8.7

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：岡山  

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Event date： 2021.6.30

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Event date： 2021.6.4 - 2021.6.5

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福島  

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Event date： 2021.5.28

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Event date： 2021.5.22

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：博多  

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Event date： 2021.5.21

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Event date： 2021.5.13 - 2021.5.16

Language：Japanese   Presentation type：Oral presentation (keynote)  

Venue：横浜  

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Event date： 2021.5.1

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：博多  

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Event date： 2021.4.23 - 2021.4.24

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：札幌  

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Event date： 2021.4.17

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：秋田  

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Event date： 2021.4.9 - 2021.4.24

Language：Japanese   Presentation type：Oral presentation (general)  

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Event date： 2021.4.3 - 2021.4.4

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：松江  

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Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Oral presentation (keynote)  

Venue：福岡  

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Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

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Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

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Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：福岡  

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Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

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Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

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Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：福岡  

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Event date： 2020.12.25

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：京都  

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Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：京都  

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Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

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Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

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Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Oral presentation (keynote)  

Venue：京都  

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Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

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Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

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Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

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Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：京都  

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Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

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Event date： 2020.11.13 - 2020.11.14

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2020.11.13 - 2020.11.14

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2020.11.9 - 2020.11.10

Language：English   Presentation type：Symposium, workshop panel (public)  

Venue：Tokyo  

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Event date： 2020.11.9 - 2020.11.10

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Poster presentation  

Venue：岡山  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Poster presentation  

Venue：岡山  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Poster presentation  

Venue：岡山  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Poster presentation  

Venue：岡山  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

Venue：岡山  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Poster presentation  

Venue：岡山  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Poster presentation  

Venue：岡山  

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Event date： 2020.9.5

Presentation type：Oral presentation (general)  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Oral presentation (keynote)  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：横浜  

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Event date： 2020.8.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

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Event date： 2020.8.8

Presentation type：Oral presentation (general)  

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Event date： 2020.8.8

Presentation type：Oral presentation (general)  

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Event date： 2020.8.1

Presentation type：Oral presentation (invited, special)  

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Event date： 2020.1.24 - 2020.1.25

Presentation type：Symposium, workshop panel (nominated)  

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Event date： 2019.12.7

Presentation type：Oral presentation (general)  

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Event date： 2019.8.17

Presentation type：Oral presentation (general)  

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Event date： 2019.7.20 - 2019.7.21

Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Venue：岡山  

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Event date： 2019.7.20 - 2019.7.21

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2019.7.20 - 2019.7.21

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

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Event date： 2019.7.20 - 2019.7.21

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

Venue：岡山  

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Event date： 2019.7.13