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

<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

PubMed

researchmap

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1007/s00234-020-02506-9

Web of Science

researchmap

Other Link： https://link.springer.com/article/10.1007/s00234-020-02506-9/fulltext.html

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

PubMed

researchmap

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

PURPOSE: Endovascular therapy to the spinal dural arteriovenous fistula (SDAVF) with a common origin of the radiculomedullary artery and the feeder of the shunt has the risk of spinal cord infarction. This study aimed to retrospectively assess the detection rate of normal spinal arteries from the feeder of SDAVF. METHODS: We retrospectively collected the angiographic and clinical data of SDAVFs. This study included 19 patients with 20 SDAVF lesions admitted to our department between January 2007 and December 2018. We assessed the detection rate of normal radiculomedullary artery branched from the feeder of SDAVF between the period using the image intensifier (II) and flat panel detector (FPD) and evaluated the treatment results. RESULTS: The detection rates of the radiculomedullary artery branched from the feeder of SDAVF were 10% (1/10 lesions) during the II period and 30% (3/10 lesions) during the FPD period. During the FPD period, all normal radiculomedullary arteries branched from the feeder were only detected on slab maximum intensity projection (MIP) images of rotational angiography, and we could not detect them in 2D or 3D digital subtraction angiography. All lesions that had a common origin of a normal radiculomedullary artery and the feeder were completely obliterated without complications. There was no recurrence during the follow-up period. CONCLUSIONS: The flat panel detector and slab MIP images seem to show the common origin of the normal radiculomedullary arteries from the feeder more accurately. With detailed analyses, SDAVF can be safety treated.

DOI： 10.1007/s00234-020-02466-0

Web of Science

PubMed

researchmap

Other Link： http://link.springer.com/article/10.1007/s00234-020-02466-0/fulltext.html

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.

</sec>

DOI： 10.3171/2019.4.jns183458

PubMed

researchmap

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

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

DOI： 10.5797/jnet.ra.2020-0042

researchmap

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

DOI： 10.5797/jnet.oa.2018-0082

researchmap

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ASSOC NEUROLOGICAL SURGEONS  

OBJECTIVE The aim of this retrospective multicenter cohort study was to assess the details of the angioarchitecture of arteriovenous fistulas (AVFs) at the craniocervical junction (CCJ) and to determine the associations between the angiographic characteristics and the clinical presentations and outcomes.METHODS The authors analyzed angiographic and clinical data for patients with CCJ AVFs from 20 participating centers that are members of the Japanese Society for Neuroendovascular Therapy (JSNET). Angiographic findings (feeding artery, location of AV shunt, draining vein) and patient data (age, sex, presentation, treatment modality, outcome) were tabulated and stratified based on the angiographic types of the lesions, as diagnosed by a member of the CCJ AVF study group, which consisted of a panel of 6 neurointerventionalists and 1 spine neurosurgeon.RESULTS The study included 54 patients (median age 65 years, interquartile range 61-75 years) with a total of 59 lesions. Five angiographic types were found among the 59 lesions: Type 1, dural AVF (22 [37%] of 59); Type 2, radicular AVF (17 [29%] of 59); Type 3, epidural AVF (EDAVF) with pial feeders (8 [14%] of 59); Type 4, EDAVF (6 [10%] of 59); and Type 5, perimedullary AVF (6 [10%] of 59). In almost all lesions (98%), AV shunts were fed by radiculomeningeal arteries from the vertebral artery that drained into intradural or epidural veins through AV shunts on the dura mater, on the spinal nerves, in the epidural space, or on the spinal cord. In more than half of the lesions (63%), the AV shunts were also fed by a spinal pial artery from the anterior spinal artery (ASA) and/or the lateral spinal artery. The data also showed that the angiographic characteristics associated with hemorrhagic presentations-the most common presentation of the lesions (73%)-were the inclusion of the ASA as a feeder, the presence of aneurysmal dilatation on the feeder, and CCJ AVF Type 2 (radicular AVF). Treatment outcomes differed among the angiographic types of the lesions.CONCLUSIONS Craniocervical junction AVFs commonly present with hemorrhage and are frequently fed by both radiculomeningeal and spinal pial arteries. The AV shunt develops along the C-1 or C-2 nerve roots and can be located on the spinal cord, on the spinal nerves, and/or on the inner or outer surface of the dura mater.

DOI： 10.3171/2017.3.JNS163048

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Background and Purpose-The purpose of this study is to compare the angiographic and clinical characteristics of spinal epidural arteriovenous fistulas (SEAVFs) and spinal dural arteriovenous fistulas (SDAVFs) of the thoracolumbar spine.Methods-A total of 168 cases diagnosed as spinal dural or extradural arteriovenous fistulas of the thoracolumbar spine were collected from 31 centers. Angiography and clinical findings, including symptoms, sex, and history of spinal surgery/trauma, were retrospectively reviewed. Angiographic images were evaluated, with a special interest in spinal levels, feeders, shunt points, a shunted epidural pouch and its location, and drainage pattern, by 6 readers to reach a consensus.Results-The consensus diagnoses by the 6 readers were SDAVFs in 108 cases, SEAVFs in 59 cases, and paravertebral arteriovenous fistulas in 1 case. Twenty-nine of 59 cases (49%) of SEAVFs were incorrectly diagnosed as SDAVFs at the individual centers. The thoracic spine was involved in SDAVFs (87%) more often than SEAVFs (17%). Both types of arteriovenous fistulas were predominant in men (82% and 73%) and frequently showed progressive myelopathy (97% and 92%). A history of spinal injury/surgery was more frequently found in SEAVFs (36%) than in SDAVFs (12%; P=0.001). The shunt points of SDAVFs were medial to the medial interpedicle line in 77%, suggesting that SDAVFs commonly shunt to the bridging vein. All SEAVFs formed an epidural shunted pouch, which was frequently located in the ventral epidural space (88%) and drained into the perimedullary vein (75%), the paravertebral veins (10%), or both (15%).Conclusions-SDAVFs and SEAVFs showed similar symptoms and male predominance. SDAVFs frequently involve the thoracic spine and shunt into the bridging vein. SEAVFs frequently involve the lumbar spine and form a shunted pouch in the ventral epidural space draining into the perimedullary vein.

DOI： 10.1161/STROKEAHA.117.019131

Web of Science

researchmap

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

We developed the Japanese Registry of Neuroendovascular Therapy 2 (JR-NET2) database and used the information for a retrospective, nation-wide multicenter, observational study to clarify the clinical characteristics, current status of procedures, and outcome of patients treated by neuroendovascular therapy in Japan. In this report, we analyzed the clinical characteristics of dural arteriovenous fistulas (dAVFs) in the JR-NET2 database. All patients with dAVFs treated with endovascular therapy in 150 Japanese hospitals were included. Patient characteristics, clinical presentations, and imaging characteristics were analyzed. A total of 1,075 patients with dAVFs underwent 1,520 endovascular procedures. Of 1,075 patients, 45% were men and 55% were women. The mean age was 65 +/- 13 years. The most frequent location of dAVFs was the cavernous sinus (43.6%), followed by the transverse-sigmoid sinus (TSS) (33.4%). Twelve percent of the patients had intracranial hemorrhage, 9% had venous infarction, and 3% had convulsion. The statistically significant independent risk factors of intracranial hemorrhage were TSS, superior sagittal sinus (SSS), tentorium, anterior cranial fossa, cranio-cervical junction, cortical venous reflux (CVR), and varix. Risk factors of venous infarction were age older than 60 years, male sex, TSS, SSS, and CVR. Risk factors of convulsion were male sex, SSS, and CVR. This is the largest nationwide report, to date, of the clinical characteristics of dAVFs treated by neuroendovascular therapy. CVR was a major risk factor of aggressive symptoms.

DOI： 10.2176/nmc.st.2013-0172

Web of Science

researchmap

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

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

PubMed

researchmap

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

researchmap

Other Link： https://www.nature.com/articles/s41598-022-14360-1

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

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

PubMed

researchmap

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

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

PubMed

researchmap

Language：English  

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

PubMed

researchmap

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

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

PubMed

researchmap

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

Internal trapping (IT) is a treatment option for intracranial vertebral artery dissecting aneurysms (VADAs). Medullary infarction (MI) is a complication linked to this treatment. This study aims to clarify the outcomes of IT for VADAs and the risk factors for MIs. We retrospectively reviewed the databases from 2010 to 2017 to identify patients with VADAs treated by IT at seven collaborating institutions. Radiological findings, clinical courses, and outcomes were analyzed. Perforating arteries were classified into terminal or longitudinal types using preoperative angiography. IT was completed in 90 patients (74 ruptured and 16 unruptured VADA). Postoperative rebleeding did not occur in any ruptured VADA patients. Postoperative MRI detected MIs in 26 patients (28.9%). The incidence of MIs in the ruptured VADA (32%) was higher compared with that in the unruptured VADA (13%), though it was not significant. In the MI group, the occlusion or blind alley of the terminal-type and longitudinal-type perforator was confirmed in 23 patients (88%) and 11 patients (42%), respectively. The occlusion or blind alley of the terminal-type perforator was an independent risk factor for MIs in the logistic regression analysis (OR 5.81; 95% CI 1.34-25.11; p = 0.018). In ruptured VADA, postoperative MI (OR 12.2; 95% CI 3.19-64.55; p = 0.0001) and high-grade SAH (OR 8.02; 95% CI 2.32-37.70; p = 0.0006) were independent risk factors of an unfavorable clinical outcome. In conclusion, MIs were an independent risk factor for unfavorable outcomes after IT, especially for a ruptured VADA. The occlusion or blind alley of the terminal-type perforator caused by the IT was associated with postoperative MIs.

DOI： 10.1007/s10143-020-01424-x

Web of Science

PubMed

researchmap

Other Link： https://link.springer.com/article/10.1007/s10143-020-01424-x/fulltext.html

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN NEUROSURGICAL SOC  

The effectiveness of adenosine-induced flow arrest in surgical clipping for the cerebral aneurysms with difficulties in temporary clip placement to the proximal main trunk has been reported. This is the first clinical trial to evaluate the safety and feasibility of adenosine-assisted clipping surgery for unruptured cerebral aneurysms (UCAs) in Japan. The inclusion criteria are as follows: patients over 20 years old, patients who agree to be enrolled in this study after providing informed consent, patients who undergo clipping surgery for UCA in our institute, and patients in whom the surgeons (T.H. or I.D.) judge that decompression of the aneurysm is effective. The primary endpoint is a modified Rankin Scale (mRS) score 30 days after surgery. We plan to enroll 10 patients in this study. The original protocol of adenosine administration was established in this trial. Herein, we present the study protocol.

DOI： 10.2176/nmc.st.2021-0018

Web of Science

researchmap

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

BACKGROUND: The patients with ruptured vertebral artery dissecting aneurysm (rVADA) should be treated as early as possible because VADA carries extremely high risk of rebleeding in the acute phase. We have established a mobile endovascular strategy for the patients with rVADA between our flagship center and its affiliated local hospitals. We introduced and reviewed our mobile endovascular therapy in this study. METHODS: We retrospectively evaluated 98 consecutive patients who underwent endovascular surgery for rVADA from 2000 to 2018 at our institution or five affiliated hospitals. When each patient was initially transported to the local affiliated hospitals, neuroendovascular surgeons traveled directly to the affiliated hospital from the flagship center in order to treat the patient there. Clinical outcomes using modified Rankin Scale at 6 months after treatment, radiological results, and procedure-related complications were reviewed to justify our mobile endovascular strategy. RESULTS: All aneurysms were cured successfully by internal trapping. Favorable outcome was achieved in 61 patients (62.2%) even though 53 patients (54.1%) had presented with severe subarachnoid hemorrhage. Overall mortality rate, treatment-related mortality rate, and treatment related complication rate were 18.4% (18/98), 0%, and 16% (16/98), respectively. There were no differences in clinical and radiological outcomes between the patients treated in the flagship center and those who treated in the affiliated hospitals. Treatment in the affiliated hospital was not a predictive factor of unfavorable outcome in our multivariate analysis, and elderly age (≥ 60) was negatively associated with favorable outcome. CONCLUSIONS: Our results prove the efficacy and safety of mobile endovascular therapy for the treatment of rVADA in the ultra-acute stage. Mobile endovascular therapy may work well in the acute treatment of rVADAs in the certain circumstance.

DOI： 10.1007/s00701-021-04885-1

Web of Science

PubMed

researchmap

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

Language：English  

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

PubMed

researchmap

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

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

PubMed

researchmap

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

【目的】経静脈的塞栓術にて治療したposterior condylar canal(PCC)近傍の硬膜動静脈瘻を経験したので報告する.【症例】60代男性.持続的な拍動性耳鳴を主訴に受診.脳血管撮影にて上行咽頭動脈,後頭動脈からのfeederがPCC前方の骨内shunted pouchに流入し,左posterior condylar vein(PCV)に流出していた.局所麻酔下にshunted pouchからPCV内を経静脈的に塞栓し,術後に合併症は認めなかった.【結語】PCC近傍の硬膜動静脈瘻は稀であるが,その診断および治療には解剖学的理解および3次元回転撮影の再構成が非常に有用であった.(著者抄録)

researchmap

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

Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ASSOC NEUROLOGICAL SURGEONS  

OBJECTIVE Spinal arteriovenous shunts are rare vascular lesions and are classified into 4 types (types I-IV). Due to rapid advances in neuroimaging, spinal epidural AVFs (edAVFs), which are similar to type I spinal dural AVFs (dAVFs), have recently been increasingly reported. These 2 entities have several important differences that influence the treatment strategy selected. The purposes of the present study were to compare angiographic and clinical differences between edAVFs and dAVFs and to provide treatment strategies for edAVFs based on a multicenter cohort.METHODS A total of 280 consecutive patients with thoracic and lumbosacral spinal dural arteriovenous fistulas (dAVFs) and edAVFs with intradural venous drainage were collected from 19 centers. After angiographic and clinical comparisons, the treatment failure rate by procedure, risk factors for treatment failure, and neurological outcomes were statistically analyzed in edAVF cases.RESULTS Final diagnoses after an angiographic review included 199 dAVFs and 81 edAVFs. At individual centers, 29 patients (36%) with edAVFs were misdiagnosed with dAVFs. Spinal edAVFs were commonly fed by multiple feeding arteries (54%) shunted into a single or multiple intradural vein(s) (91% and 9%) through a dilated epidural venous plexus. Preoperative modified Rankin Scale (mRS) and Aminoff Logue gait and micturition grades were worse in patients with edAVFs than in those with dAVFs. Among the microsurgical (n = 42), endovascular (n = 36), and combined (n = 3) treat- ment groups of edAVFs, the treatment failure rate was significantly higher in the index endovascular treatment group (7.5%, 31%, and 0%, respectively). Endovascular treatment was found to be associated with significantly higher odds of initial treatment failure (OR 5.72, 95% CI 1.45-22.6). In edAVFs, the independent risk factor for treatment failure after microsurgery was the number of intradural draining veins (OR 17.9, 95% C11.56-207), while that for treatment failure after the endovascular treatment was the number of feeders (OR 4.11, 95% CI 1.23-13.8). Postoperatively, mRS score and Aminoff-Logue gait and micturition grades significantly improved in edAVFs with a median follow-up of 31 months.CONCLUSIONS Spinal epidural AVFs with intradural venous drainage are a distinct entity and may be classified as type V spinal vascular malformations. Based on the largest multicenter cohort, this study showed that primary microsurgery was superior to endovascular treatment for initial treatment success in patients with spinal edAVFs.

DOI： 10.3171/2020.2.SPINE191432

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Background and Purpose Endovascular trapping of the vertebral artery dissecting aneurysms (VADAs) carries a risk of medullary infarction due to the occlusion of the perforating arteries. We evaluated the detectability and anatomical variations of perforating arteries arising from the vertebral artery (VA) using three-dimensional DSA. Methods In 120 patients without VA lesions who underwent rotational vertebral arteriography, the anatomical configurations of perforating arteries from the VA were retrospectively evaluated on the bi-plane DSA and reconstructed images to reach the consensus between two experienced reviewers. The images were interpreted by focusing on the numbers and types of perforating arteries, the relationships between the number of perforators and the anatomy of the VA and its branches. Results Zero, 1, 2, 3, 4, and 6 perforators were detected in 2, 51, 56, 9, 1, and 1 patient, respectively (median of 2 perforators per VA). The 200 perforators were classified into 146 terminal and 54 longitudinal course types and into 32 ventral, 151 lateral, and 17 dorsolateral distribution types. All ventral type perforators were also terminal type. In contrast, the longitudinal type was seen in 28.5% of lateral types and in 65% of dorsolateral types. Regarding the difference in the origin of the posterior inferior cerebellar artery (PICA), non-PICA type VAs gave off larger number of perforators than the other types of VAs. Conclusions Non-PICA type VAs give off a significantly larger number of perforators than other types, indicating that the trapping of non-PICA type VAs is associated with a risk of ischemic complications.

DOI： 10.1007/s00234-020-02549-y

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI  

Crossed cerebellar diaschisis (CCD) is a state of hypoperfusion and hypometabolism in the contralesional cerebellar hemisphere caused by a supratentorial lesion, but its pathophysiology is not fully understood. We evaluated chronological changes in cerebellar blood flow (CbBF) and gene expressions in the cerebellum using a rat model of transient middle cerebral artery occlusion (MCAO). CbBF was analyzed at two and seven days after MCAO using single photon emission computed tomography (SPECT). DNA microarray analysis and western blotting of the cerebellar cortex were performed and apoptotic cells in the cerebellar cortex were stained. CbBF in the contralesional hemisphere was significantly decreased and this lateral imbalance recovered over one week. Gene set enrichment analysis revealed that a gene set for "oxidative phosphorylation" was significantly upregulated while fourteen other gene sets including "apoptosis", "hypoxia" and "reactive oxygen species" showed a tendency toward upregulation in the contralesional cerebellum. MCAO upregulated the expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) in the contralesional cerebellar cortex. The number of apoptotic cells increased in the molecular layer of the contralesional cerebellum. Focal cerebral ischemia in our rat MCAO model caused CCD along with enhanced expression of genes related to oxidative stress and apoptosis.

DOI： 10.3390/ijms21114137

Web of Science

researchmap

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

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

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Purpose Intracranial hemorrhage following hyperperfusion syndrome (HPS) is a rare but potentially fatal complication after carotid artery stenting (CAS). Staged angioplasty (SAP) is a two-stage form of CAS that can prevent the abrupt increase of cerebral blood flow. In this study, we investigated the safety and efficacy of SAP. Methods One hundred thirty-four patients who underwent CAS for high-grade carotid artery stenosis between January 2010 and December 2018 were enrolled. Patients who showed severe impairment of hemodynamic reserve in I-123-IMP SPECT with acetazolamide received SAP (SAP group), while the others received regular CAS (RS group). Results Twenty-six (19.4%) patients at risk for HPS received SAP. HPS was not observed in either group. Diffusion-weighted image (DWI)-positive lesions on postoperative MRI were observed in 56 (52.3%) cases in the RS group and 16 (64.0%) cases in the SAP group. Symptomatic procedure-related complications occurred in 5 (4.6%) cases in the RS group and 1 (3.8%) case in the SAP group. These differences were not statistically significant. Modified Rankin Scale score had declined 30 days after discharge in 4 (3.0%) cases. Distal filter protection was significantly correlated to the occurrence of new DWI-positive lesions. Conclusions For patients at high risk of HPS, SAP was a reasonable treatment strategy to prevent HPS. SAP did not increase the rate of DWI-positive lesions or procedure-related complications compared with regular CAS.

DOI： 10.1007/s00234-019-02343-5

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

Although temporary clipping of the parent artery is an indispensable technique in clipping surgery for intracranial aneurysms, the permissive duration of temporary clipping is still not well known. The aim of this study is to confirm the safety of precise motor evoked potential (MEP) monitoring and to estimate the permissive duration of temporary clipping for middle cerebral artery (MCA) aneurysm based on precise MEP monitoring results. Under precise MEP monitoring via direct cortical stimulation every 30 seconds to 1 minute, surgeons released a temporary clip and waited for MEP amplitude to recover following severe (>50%) reduction of MEP amplitude during temporary clipping. Precise MEP monitoring was safely performed. Twenty-eight instances of temporary clipping were performed in 42 MCA aneurysm clipping surgeries. Because precise MEP monitoring could be used to determine when to release a temporary clip even with a severe reduction in MEP amplitude due to lengthy temporary clipping, no patients experienced permanent postoperative hemiparesis. Based on logistic regression analysis, if a temporary clip is applied for 312 seconds or more, there is a higher probability of a severe reduction in MEP amplitude. We should therefore release temporary clips after 5 minutes in order to avoid permanent postoperative hemiparesis.

DOI： 10.1038/s41598-020-60377-9

Web of Science

researchmap

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。

researchmap

Authorship：Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

PurposeThe aim of the present study was to assess image quality improvement using a metal artifact reduction (MAR) algorithm in cases of medium or large cerebral aneurysms treated with stent-assisted coil embolization (SAC), and to analyze factors associated with the usefulness of the MAR algorithm.MethodsWe retrospectively evaluated the cone-beam computed tomography (CBCT) data sets of 18 patients with cerebral aneurysms treated with SAC. For subjective analysis, images of all cases with and without MAR processing were evaluated by five neurosurgeons based on four criteria using a five-point scale. For objective analysis, the CT values of all cases with and without MAR processing were calculated. In addition, we assessed factors associated with the usefulness of the MAR by analyzing the nine cases in which the median score for criterion 1 improved by more than two points.ResultsMAR processing improved the median scores for all four criteria in 17/18 cases (94.4%). Mean CT values of the region of interest at the site influenced by metal artifacts were significantly reduced after MAR processing. The maximum diameter of the coil mass (<17 mm; odds ratio [OR], 4.0; 95% confidence interval [CI], 1.2-13.9; p=0.02) and vessel length covered by metal artifacts (<24 mm; OR, 2.3; 95% CI, 1.1-4.7; p=0.03) was significantly associated with the usefulness of the MAR.ConclusionsThis study suggests the feasibility of a MAR algorithm to improve the image quality of CBCT images in patients who have undergone SAC for medium or large aneurysms.

DOI： 10.1007/s00234-019-02297-8

Web of Science

researchmap

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

PubMed

researchmap

Publishing type：Research paper (scientific journal)  

Purpose：Embolization for intracranial tumors currently plays a supporting role to open surgery. The reasons for embo-lization include：1）tumor necrosis resulting in a safer operation and more aggressive surgery, 2）reduction in intraoperative bleeding and avoidance of blood transfusion, and 3）decrease in operative time. Functional vascular anatomy and endovascular technique are the most important issues for safe embolization. Herein we report our standard techniques for tumor emboliza-tion and compare our results with those of the Japanese Registry of NeuroEndovascular Therapy（JR‒NET）. Methods：Our standard procedure is as follows：1）embolization is performed several days before open surgery, 2）in cases with strong peritumoral edema, steroid administration or embolization may be performed immediately before surgery, 3）patients undergo the procedure under local anesthesia, 4）insertion of the microcatheter is as close as possible to the tumor, 5）particulate emboli are the first line material, 6）embolization is occasionally performed with N‒butyl cyanoacrylate （NBCA）glue, and 7）if possible, additional proximal feeder occlusion with coils is performed. Results：During the past 12 years, 169 intra‒cranial tumor embolization procedures were performed in our department. Meningioma was the main target of embolization（154 of 169 patients, 91.1%）. Seven procedure‒related complications were observed, with one permanent complication（0.6%）of hearing loss after anterior inferior cerebellar artery embolization for hemangioblastoma with NBCA. Transient complications included three middle meningeal arterio‒venous fistulas, two cranial nerve paresis, and a pseudoaneurysm of the femoral artery（puncture site）. We conducted the JR‒NET 2（2007‒2009）and JR‒NET 3（2010‒2014）in Japan. Complications of tumor embolization occurred in 57 of 1,544 JR‒NET 3 patients（3.69%）, although the complication rate for JR‒NET 2 was only 1.48%（15 of 1,012 patients）. Tumors other than meningioma were a significant risk factor for the occurrence of JR‒NET 2 complications. Further, embolization of vessels other than the external carotid artery（ECA）and use of liquid embolic material were significantly associated with the development of JR‒NET 3 complications. We suggest that more aggressive embolization targeted to vessels other than the ECA and increased applica-tion of liquid embolic materials might worsen the risk of complications. Conclusions：Although embolization was safe for extra‒axial tumors such as meningiomas fed by the ECA, embolization of vessels other than the ECA as occurs in hemangioblastomas was a significant risk factor for complications. Use of liquid embolic material increased the risk for complications. Endovascular neurosurgeons should fully discuss the indications and strategies for preoperative embolization with tumor neurosurgeons to perform safe and effective procedures.

DOI： 10.7887/jcns.29.543

Scopus

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：HUMANA PRESS INC  

High-mobility group box-1 (HMGB1) is a nuclear protein that promotes inflammation during the acute phase post-stroke, and enhances angiogenesis during the delayed phase. Here, we evaluated whether indirect revascularization surgery with HMGB1 accelerates brain angiogenesis in a chronic cerebral hypoperfusion model. Seven days after hypoperfusion induction, encephalo-myo-synangiosis (EMS) was performed with or without HMGB1 treatment into the temporal muscle. We detected significant increments in cortical vasculature (p<0.01), vascular endothelial growth factor (VEGF) expression in the temporal muscle (p<0.05), and ratio of radiation intensity on the operated side compared with the non-operated side after EMS in the HMGB1-treated group than in the control group (p<0.01). Altogether, HMGB1 with EMS in a chronic hypoperfusion model promoted brain angiogenesis in a VEGF-dependent manner, resulting in cerebral blood flow improvement. This treatment may be an effective therapy for patients with moyamoya disease.

DOI： 10.1007/s12017-019-08541-x

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASEAN NEUROLOGICAL ASSOC  

A fungal carotid aneurysm is an infrequently occurring infectious aneurysm that is usually treated by antifungal therapy plus surgical debridement of the infected vessel. We herein report an extremely rare case involving a patient with a medical history of bladder cancer treated by Bacillus Calmette-Guerin (BCG) who developed a fungal aneurysm of the internal carotid artery and thrombosis of the superior ophthalmic vein caused by maxillary Aspergillus sinusitis. The patient was successfully treated by antifungal, anticoagulant, and antiplatelet drugs combined with internal carotid artery ligation therapy. Internal carotid artery fungal aneurysm is associated with a high mortality rate, but the present case suggests that it can be successfully treated by antifungal therapy combined with a less invasive endovascular therapy.

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER WIEN  

BackgroundThe Japanese Registry of NeuroEndovascular Therapy 2 (JR-NET2) and 3 (JR-NET3) were nationwide surveys that evaluated clinical outcomes after neuroendovascular therapy in Japan. The aim of this study was to compare the prevalence and risk factors of complications of intracranial tumor embolization between JR-NET2 and JR-NET3.MethodsA total of 1018 and 1545 consecutive patients with intracranial tumors treated with embolization were enrolled in JR-NET2 and JR-NET3, respectively. The prevalence of complications in intracranial tumor embolization and related risk factors were compared between JR-NET2 and JR-NET3.ResultsThe prevalence of complications in JR-NET3 (3.69%) was significantly higher than that in JR-NET2 (1.48%) (p=0.002). The multivariate analysis in JR-NET2 showed that embolization for tumors other than meningioma was the only significant risk factor for complication (odds ratio [OR], 3.88; 95% confidence interval [CI], 1.13-12.10; p=0.032), and that in JR-NET3 revealed that embolization for feeders other than external carotid artery (ECA) (OR, 3.56; 95% CI, 2.03-6.25; p<0.001) and use of liquid materials (OR, 2.65; 95% CI, 1.50-4.68; p<0.001) were significant risks for complications. The frequency of embolization for feeders other than ECA in JR-NET3 (15.3%) was significantly higher than that in JR-NET2 (9.2%) (p<0.001). Also, there was a significant difference in the frequency of use of liquid materials between JR-NET2 (21.2%) and JR-NET3 (41.2%) (p<0.001).ConclusionsEmbolization for feeders other than ECA and use of liquid materials could increase the complication rate in intracranial tumor embolization.

DOI： 10.1007/s00701-019-03970-w

Web of Science

researchmap

Language：English   Publisher：WOLTERS KLUWER MEDKNOW PUBLICATIONS  

Angiogenesis involves new blood vessels sprouting from preexisting blood vessels. This process may serve to improve brain circulation. Moyamoya disease (MMD) is a cerebrovascular disorder causing intracranial stenosis which significantly reduces the blood supply to the brain. Mainly stroke is the first symptom of the disorder, so treatments that reduce the risk of stroke are used for patients with MMD. To prevent stroke for those with chronic cerebral hypoperfusion, more blood needs to flow to the brain, which was thought to be achieved by enhancing angiogenesis. Indirect bypass surgery, such as encephalo-myo-synangiosis (EMS), is used for revascularization. However, EMS alone sometimes cannot provide enough circulation to avoid ischemic strokes. The current study examined if EMS combined with high-mobility group box-1 (HMGB1) and vascular endothelial growth factor (VEGF) enhanced angiogenesis and increased cerebral circulation. The results indicated that HMGB1 administered with EMS increased angiogenesis through a VEGF-dependent mechanism. In addition, exercising and stem cell transplantation possess possible means to increase angiogenesis. Overall, EMS with gene therapy, maintaining fitness, and stem cell utilization may prevent or help one recover from stroke by enhancing brain angiogenesis. Thus, these treatments may be applicable for patients with MMD. This paper is a review article. Referred literature in this paper has been listed in the references section. The datasets supporting the conclusions of this article are available online by searching various databases, including PubMed.

DOI： 10.4103/bc.bc_33_19

Web of Science

researchmap

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

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

PubMed

researchmap

Language：English   Publisher：SPRINGER WIEN  

The persistent primitive trigeminal artery (PPTA) is the most common carotid-basilar anastomosis, and the incidence of cerebral aneurysms associated with the PPTA is approximately 4%. Since PPTA aneurysms often have a wide neck and other vascular anomalies, endovascular treatment using an adjunctive technique is the current first-line therapy. Here, we report a case of PPTA aneurysm treated by coil embolization with a stent-assisted technique. A detailed evaluation of the size and course of all vessels and collateral flow, including the Allcock test and balloon test occlusion, is necessary when deciding on the treatment strategy.

DOI： 10.1007/s00701-018-3767-6

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN NEUROSURGICAL SOC  

Embolization for intracranial tumor is performed as a standard endovascular treatment. A retrospective, multicenter, observational study was conducted to clarify the nature, frequency, and risk factors of complications in intracranial tumor embolization. Patients were derived from the Japanese Registry of NeuroEndovascular Therapy (JR-NET3) using data taken from January 2010 through December 2014 in Japan. A total of 40,169 patients were enrolled in JR-NET3, of which, 1,545 patients (3.85%) with intracranial tumors underwent embolization. The primary end point was the proportion of patients with a modified Rankin scale (mRS) score of 0-2 (independency) at 30 days after embolization. The secondary end point was the occurrence of complications related to the procedures. The risk factors of the development of complications were analyzed. The proportion of patients with mRS scores <= 2 at 30 days after procedure was 89.5%. Complications occurred in 57 of the 1544 patients (3.7%). Multivariate analysis showed that target vessels other than external carotid artery (ECA) (OR, 3.56; 95% CI, 2.03-6.25; P < 0.001) and use of liquid material (OR, 2.65; 95% CI, 1.50-4.68; P < 0.001) were significantly associated with the development of complications. In JR-NET3, the primary end point was 89.5%, and the procedure-related complication rate was 3.7%. Embolization from other than ECA was significant risk factor of the complications. In addition, increasing usage of liquid embolic material worsened the risk of complications.

DOI： 10.2176/nmc.st.2018-0220

Web of Science

researchmap

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

DOI： 10.2335/scs.47.167

researchmap

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

DOI： 10.5797/jnet.oa.2018-0089

researchmap

Publishing type：Research paper (scientific journal)  

In this article, we present cutting-edge knowledge on the natural course, risk scores, treatment results of unruptured cerebral aneurysms (UCAs), and characteristics of UCAs in elderly patients. Data from the Unruptured Cerebral Aneurysm Study of Japan (UCAS Japan) are important for understanding the natural course of UCAs in Japanese patients. The prediction model for 3-year rupture risk of UCAs based on UCAS Japan data is reliable and useful in the clinical setting. Both surgical clipping and coil embolization for UCAs have favorable outcomes in Japan. The annual rupture rate of UCAs in elderly patients in Japan has been reported to be 1.6%. Age, size and location of aneurysms are significant risks for UCA rupture in elderly patients. The outcomes of surgical clipping and coil embolization for UCAs in elderly patients were equal in Okayama University Hospital. Numerous foreign studies have, however, demonstrated that the results of coil embolization are superior to those of surgical clipping in elderly patients. In the future, the establishment of treatment risk scores for UCAs and guidelines for UCAs in elderly patients in Japan are warranted.

DOI： 10.7887/jcns.28.120

Scopus

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

DOI： 10.1016/j.jstrokecerebrovasdis.2018.04.036

Web of Science

researchmap

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

researchmap

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

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ASSOC NEUROLOGICAL SURGEONS  

OBJECTIVE Although cortical spreading depolarization (CSD) has been observed during the early phase of subarachnoid hemorrhage (SAH) in clinical settings, the pathogenicity of CSD is unclear. The aim of this study is to elucidate the effects of loss of membrane potential on neuronal damage during the acute phase of SAH.METHODS Twenty-four rats were subjected to SAH by the perforation method. The propagation of depolarization in the brain cortex was examined by using electrodes to monitor 2 direct-current (DC) potentials and obtaining NADH (reduced nicotinamide adenine dinucleotide) fluorescence images while exposing the parietal-temporal cortex to ultraviolet light. Cerebral blood flow (CBF) was monitored in the vicinity of the lateral electrode. Twenty-four hours after onset of SAH, histological damage was evaluated at the DC potential recording sites.RESULTS Changes in DC potentials (n = 48 in total) were sorted into 3 types according to the appearance of ischemic depolarization in the entire hemisphere following induction of SAH. In Type 1 changes (n = 21), ischemic depolarization was not observed during a 1-hour observation period. In Type 2 changes (n = 13), the DC potential demonstrated ischemic depolarization on initiation of SAH and recovered 80% from the maximal DC deflection during a 1-hour observation period (33.3 +/- 15.8 minutes). In Type 3 changes (n = 14), the DC potential displayed ischemic depolarization and did not recover during a 1-hour observation period. Histological evaluations at DC potential recording sites showed intact tissue at all sites in the Type 1 group, whereas in the Type 2 and Type 3 groups neuronal damage of varying severity was observed depending on the duration of ischemic depolarization. The duration of depolarization that causes injury to 50% of neurons (P-50) was estimated to be 22.4 minutes (95% confidence intervals 17.0-30.3 minutes). CSD was observed in 3 rats at 6 sites in the Type 1 group 5.1 +/- 2.2 minutes after initiation of SAH. On NADH fluorescence images CSD was initially observed in the anterior cortex; it propagated through the entire hemisphere in the direction of the occipital cortex at a rate of 3 mm/minute, with repolarization in 2.3 +/- 1.2 minutes. DC potential recording sites that had undergone CSD were found to have intact tissue 24 hours later. Compared with depolarization that caused 50% neuronal damage, the duration of CSD was too short to cause histological damage.CONCLUSIONS CSD was successfully visualized using NADH fluorescence. It propagated from the anterior to the posterior cortex along with an increase in CBF. The duration of depolarization in CSD (2.3 +/- 1.2 minutes) was far shorter than that causing 50% neuronal damage (22.4 minutes) and was not associated with histological damage in the current experimental setting.

DOI： 10.3171/2016.9.JNS161385

Web of Science

researchmap

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

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

PubMed

researchmap

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

もやもや病(Moyamoya disease)に対する間接血行再建術の有効性は多く報告されている一方、効果が不十分な症例も存在する。われわれは慢性脳虚血モデル(両側総頸動脈結紮ラット)に間接血行再建術(encephalo-myo-synangiosis:EMS)を加えることにより、もやもや病手術モデルとし、さらに血管新生を促進させるような遺伝子治療を加える血管新生増強療法の研究を行ってきた。最近ではapelinという新規血管新生因子とvascular endothelial growth factor(VEGF)を併用することで成熟した血管新生を生じ得ることを報告した。今後は血管新生増強療法として蛋白製剤を用い、さらに脳血流の評価も行っていくことにより、臨床応用につなげていきたいと考えている。(著者抄録)

researchmap

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。

researchmap

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J02079&link_issn=&doc_id=20171211180009&doc_link_id=%2Fcp4strok%2F2017%2F004506%2F009%2F0476-0482%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcp4strok%2F2017%2F004506%2F009%2F0476-0482%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ASSOC NEUROLOGICAL SURGEONS  

OBJECTIVE The aim of this study was to evaluate whether combined gene therapy with vascular endothelial growth factor (VEGF) plus apelin during indirect vasoreconstructive surgery enhances brain angiogenesis in a chronic cerebral hypoperfusion model in rats.METHODS A chronic cerebral hypoperfusion model induced by the permanent ligation of bilateral common carotid arteries (CCAs; a procedure herein referred to as "CCA occlusion" [CCAO]) in rats was employed in this study. Seven days after the CCAO procedure, the authors performed encephalo-myo-synangiosis (EMS) and injected plasmid(s) into each rat's temporal muscle. Rats were divided into 4 groups based on which plasmid was received (i.e., LacZ group, VEGF group, apelin group, and VEGF+apelin group). Protein levels in the cortex and attached muscle were assessed with enzyme-linked immunosorbent assay (ELISA) on Day 7 after EMS, while immunofluorescent analysis of cortical vessels was performed on Day 14 after EMS.RESULTS The total number of blood vessels in the cortex on Day 14 after EMS was significantly larger in the VEGF group and the VEGF+apelin group than in the LacZ group (p < 0.05, respectively). Larger vessels appeared in the VEGF+apelin group than in the other groups (p < 0.05, respectively). Apelin protein on Day 7 after EMS was not detected in the cortex for any of the groups. In the attached muscle, apelin protein was detected only in the apelin group and the VEGF+apelin group. Immunofluorescent analysis revealed that apelin and its receptor, APJ, were expressed on endothelial cells (ECs) 7 days after the CCAO.CONCLUSIONS Combined gene therapy (VEGF plus apelin) during EMS in a chronic cerebral hypoperfusion model can enhance angiogenesis in rats. This treatment has the potential to be a feasible option in a clinical setting for patients with moyamoya disease.

DOI： 10.3171/2016.8.JNS16366

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

Dementia and parkinsonism are rarely observed in dural arteriovenous fistula. Here, we report a case of a 63-year-old man with recurrent dural arteriovenous fistula, who developed progressive dementia and parkinsonism as a result of a dural arteriovenous fistula at the torcular herophili. A sinus thrombosis induced the abnormal cortical venous reflux from the isolated straight sinus, resulting in the deep venous congestion of the thalamus and basal ganglia, which led to dementia and parkinsonism. However, the third endovascular embolization ameliorated memory disturbance and apathy with a slight improvement of parkinsonism. Although recoveries from dural arteriovenous fistula-associated neurological deficits are variable depending on the severity, duration and, furthermore, selective vulnerability of the responsible ischemic lesions, early treatment should be essential for better recovery.

DOI： 10.1111/ncn3.12138

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER WIEN  

We present the case of a de novo vertebral artery dissecting aneurysm (VADA) after endovascular trapping of a ruptured VADA on the contralateral side. The first ruptured VADA involved the posterior inferior cerebellar artery, which was successfully treated by endovascular internal trapping using a stent. A follow-up study at 3 months revealed a de novo VADA on the contralateral side. The second VADA was successfully embolized using coils while normal arterial flow in the vertebral artery was preserved using a stent. Increased hemodynamic stress may cause the development of a de novo VADA on the contralateral side.

DOI： 10.1007/s00701-017-3204-2

Web of Science

researchmap

Authorship：Lead author,　Corresponding author   Language：Japanese  

researchmap

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

PubMed

researchmap

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

当科では医学生やメディカルスタッフに対して、血管内治療シミュレーターVascular Intervention Simulator Trainer(VIST)を用いたシミュレーション教育を行っており、その有効性について検討した。実習は3名1組となり、VISTを用いてデバイスの選択、血管造影、カテーテル操作、コイル塞栓術の手技を行った。実習終了後に行った筆記試験やアンケートでは血管内治療への理解度向上の効果が得られた。VISTを用いた血管内治療シミュレーション教育は血管内治療や血管解剖の理解度向上に効果があり、医学生に対して脳神経外科や脳血管内治療への興味喚起につながり、メディカルスタッフに対してより良いチーム医療の形成に役立つと考えられた。(著者抄録)

researchmap

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J03120&link_issn=&doc_id=20170705170012&doc_link_id=issn%3D0917-1495%26volume%3D27%26issue%3D7%26spage%3D751&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0917-1495%26volume%3D27%26issue%3D7%26spage%3D751&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

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

CiNii Article

researchmap

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

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

PubMed

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN NEUROSURGICAL SOC  

Perioperative management is critical for positive neurosurgical outcomes. In order to maintain safe and authentic perioperative management, a perioperative management center (PERIO) was introduced to patients of our Neurosurgery Department beginning in June 2014. PERIO involves a multidisciplinary team consisting of anesthesiologists, dentists/dental hygienists/technicians, nurses, physical therapists, pharmacists, and nutritionists. After neurosurgeons decide on the course of surgery, a preoperative evaluation consisting of blood sampling, electrocardiogram, chest X-ray, and lung function test was performed. The patients then visited the PERIO clinic 7-14 days before surgery. One or two days before surgery, the patients without particular issues enter the hospital and receive a mouth cleaning one day before surgery. After surgery, postoperative support involving eating/swallowing evaluation, rehabilitation, and pain control is provided. The differences in duration from admission to surgery, cancellation of surgery, and postoperative complications between PERIO and non-PERIO groups were examined. Eighty-five patients were enrolled in the PERIO group and 131 patients in the non-PERIO group. The duration from admission to surgery was significantly decreased in the PERIO group (3.6 +/- 0.3 days), compared to that in the non-PERIO group (4.7 +/- 0.2 days). There was one cancelled surgery in the PERIO group and six in the non-PERIO group. Postoperative complications and the overall hospital stay did not differ between the two groups. The PERIO system decreased the duration from admission to surgery, and it is useful in providing high-quality medical service, although the system should be improved so as not to increase the burden on medical staff.

DOI： 10.2176/nmc.oa.2016-0085

Web of Science

researchmap

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

CiNii Article

researchmap

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。

researchmap

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

CiNii Article

researchmap

Other Link： http://search.jamas.or.jp/link/ui/2015281939

Publishing type：Research paper (scientific journal)  

In this article, we introduce cutting-edge knowledge pertaining to the pathophysiology of moyamoya disease from the viewpoint of angioarchitecture and genetic analysis. A complementary relationship among the anterior circulation(AC), the posterior circulation(PC)and the external carotid artery(ECA)system is involved in the pathophysiology of moyamoya disease. Suzuki’s grading is representative of the interaction between the AC and ECA, and it has traditionally played a leading role in evaluating disease progression. The interaction between the AC and PC is related to hemodynamic ischemia. There is a difference between pediatric and adult moyamoya patients in the interaction between the AC and PC. The analysis of the RNF213 gene is noteworthy as a new approach to understanding the pathophysiology of moyamoya disease. The prognosis and responsiveness to revascularization surgery can be predicted on the basis of genetic analysis. Although gene therapy for moyamoya disease is only now just in the basic experimental studies stage, it can be expected to emerge as an assisting modality for indirect revascularization surgery.

DOI： 10.7887/jcns.24.239

Scopus

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Embolization of intracranial tumor is widely performed in Japan, mainly before neurosurgical resection. A retrospective, multicenter, observational study in Japan was conducted to clarify the nature, frequency, and risk factors of complications in intracranial tumor embolization.Patients were derived from the Japanese Registry of NeuroEndovascular Therapy 2 (JR-NET2). A total of 20,854 patients were enrolled in JR-NET2, of which 1,018 patients (4.88 %) with intracranial tumors underwent embolization. The primary end point was the proportion of patients with a modified Rankin scale (mRS) score of 0-2 (independency) at 30 days. The secondary end point was the occurrence of complications related to the procedures. The risk factors of the occurrence of complications were studied.The proportion of patients with mRS scores a parts per thousand currency sign2 at 30 days after procedure was 91.3 %. Complications occurred in 15 of the 1,012 patients (1.48 %). Multivariate analysis showed that embolization for tumors other than meningioma (OR, 4.626; 95 % CI, 1.347-14.59; p = 0.0105) was significantly associated with the development of complications.The frequency of complications after intracranial tumor embolization was relatively low in this large Japanese cohort. Embolization for tumors other than meningioma was the only significant risk factor for the occurrence of complications.

DOI： 10.1007/s00234-013-1300-4

Web of Science

researchmap

Language：English   Publishing type：Research paper (scientific journal)   Publisher：HINDAWI LTD  

Object. The effect on clinical outcomes of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage (SAH) in patients over 80 years who underwent coil embolization was evaluated. Methods. Forty-four cases were reviewed and divided into two groups according to patient age: Group A, 79 years or younger, and Group B, 80 or older. Patient characteristics, prevalence of symptomatic vasospasm, modified Rankin Scale (mRS) scores at discharge and frequency of symptomatic vasospasm in patients with mRS scores of 3-6 were analyzed. Results. Thirty-two (73%) of the 44 cases were categorized as Group A and 12 (27%) as Group B. Group B had a significantly higher prevalence of symptomatic vasospasm compared to Group A (P = 0.0040). mRS scores at discharge were significantly higher in Group B than in Group A (P = 0.0494). Among cases with mRS scores of 3-6, there was a significantly higher frequency of symptomatic vasospasm in Group B than in Group A (P = 0.0223). Conclusions. In our cohort of aneurysmal SAH patients treated by coil embolization, patients over 80 years of age were more likely to suffer symptomatic vasospasm, which significantly correlated with worse clinical outcomes, than those 79 years and under.

DOI： 10.1155/2014/253867

Web of Science

researchmap

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

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.

PubMed

researchmap

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.

PubMed

researchmap

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

researchmap

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

researchmap

Language：Japanese  

CiNii Article

CiNii Books

researchmap

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

researchmap

Language：Japanese  

CiNii Article

CiNii Books

researchmap

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

researchmap

Language：Japanese  

CiNii Article

CiNii Books

researchmap

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

researchmap

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

researchmap

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

Language：Japanese

researchmap

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

researchmap

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

J-GLOBAL

researchmap

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

＜文献概要＞Point ・脳出血急性期にCTAを撮影する意義は大きい.・CTAで二次的な脳出血を鑑別し,出血源が明らかであれば外科的治療を検討する.・単純CTやCTAで,血腫増大・再出血の危険因子となる所見を検出する必要がある.

DOI： 10.11477/mf.1436204390.

researchmap

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)  

researchmap

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

脳腫瘍塞栓術は多くの場合開頭術前の補助療法であり安全性が重要である。当科での過去12年間169塞栓術で、恒久的合併症は1例(0.6%)であった。外頸動脈を主栄養血管とする髄外腫瘍(髄膜腫)の塞栓術は安全だが、血管芽腫などの髄内腫瘍では合併症の危険性は高くなる。合併症として、術後腫瘍内出血、塞栓物質の神経栄養血管への迷入による脳神経麻痺や視障害、および脳梗塞などがあるが、十分な血管機能解剖の知識と技術をもってすればその多くは回避できる。術前塞栓術の有用性は知られているが、摘出術への貢献を科学的に証明することは困難である。当科では一貫して開頭術者が術前塞栓を依頼しており、有効性の表れと感じている。(著者抄録)

researchmap

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  

脳動脈瘤に対する脳血管内コイリング治療後や開頭ネック・クリッピング手術後のネックやドームの解剖学的形態の描出に、Silent MRAとfast spin-echo(FSE)MR cisternography(MRC)の3D融合画像を新しく考案した。これまでのtime-of-flight(TOF)MRAでは、金属による磁化率アーチファクトやRF遮断効果の影響で、コイルやクリップ近傍のネック形態を描出することは困難であった。Silent MRAでは、金属による磁化率アーチファクトの影響を受け難く、コイリング治療後やクリッピング手術後のネックや母血管の形態が良好に描出された。また、FSE MRCでは、コイリング治療後のドームやネック部の形態、クリッピング処理されたネックの形態が詳細に描出された。Silent MRAとFSE MRC、それぞれの3D画像を重量描画する、Silent MRAとFSE MRCの3D融合画像を、コイリング治療後の15例、クリッピング手術後の19例に応用した結果、脳動脈瘤治療後のネック・ドームの画像評価に有用であった。本稿では、Silent MRAとFSE MRCの3D融合画像の作成技術と臨床応用につき報告する。(著者抄録)

researchmap

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  

未破裂脳動脈瘤における自然歴、リスクスコア、治療成績、高齢者未破裂脳動脈瘤に関する最新の知見を紹介する。本邦の自然歴の理解はUCAS Japanが基本となる。UCAS Japanのデータから構築された3年間の破裂リスク予測スコアは信頼性が高く有用である。本邦の未破裂脳動脈瘤の治療成績はクリッピング術、コイル塞栓術ともに良好である。本邦での高齢者未破裂脳動脈瘤は年間破裂率1.6%で年齢、サイズ、部位が破裂に関与する。当科の治療成績はクリッピング術とコイル塞栓術でほぼ同等であったが、海外からの報告ではコイル塞栓術がより良好とするものが多い。本邦独自の治療リスクスコアの確立や高齢者未破裂脳動脈瘤に対するガイドライン策定が望ましい。(著者抄録)

researchmap

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  

researchmap

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

researchmap

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

もやもや病の病態解析において血管構築と遺伝子の観点から最新の知見を紹介する。血管構築においては前方循環と外頸動脈系、前方循環と後方循環の間にそれぞれinteractionが存在する。前者のinteractionは「鈴木の分類」に代表され、病態解析の中心的役割を担ってきた。後者のinteractionは虚血重症化に関与し、小児と成人で異なるパターンが存在する。遺伝的要因においてはRNF213を中心とした遺伝子解析はもやもや病の病態解析に新たな局面を提供しており、予後や治療効果の予測に応用できる可能性がある。遺伝子治療は基礎実験の段階であるが、血行再建術を補助する方法として期待される。(著者抄録)

researchmap

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  

FPD装置の登場により、脳血管撮影装置の性能や機能は飛躍的に進歩してきた。本稿では、最近の性能に関する改善点、さらに、FPD装置に備わっているさまざまな革新的機能を概説する。(著者抄録)

researchmap

Language：Japanese   Publisher：(株)医学出版  

＜POINT＞(1)硬膜動静脈瘻の症状や重症度は、部位と周囲の静脈の状態によって大きく変わってくることを理解しておきましょう。(2)発生部位は海綿静脈洞部が最多で、次に横・S状静脈洞部に多くみられます。(3)TAEとTVEそれぞれで、治療目的や塞栓物質は異なります。(4)TAEとTVEに分けて、出現する可能性のある合併症を知っておきましょう。(著者抄録)

researchmap

Language：Japanese  

CiNii Article

CiNii Books

researchmap

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。

researchmap

Event date： 2023.3.16 - 2023.3.18

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

Venue：横浜  

researchmap

Event date： 2022.11.10 - 2022.11.12

Presentation type：Symposium, workshop panel (public)  

researchmap

Event date： 2022.11.10 - 2022.11.12

Presentation type：Symposium, workshop panel (nominated)  

researchmap

Event date： 2022.9.28 - 2022.10.1

Presentation type：Symposium, workshop panel (public)  

Venue：横浜  

researchmap

Event date： 2022.8.21 - 2022.8.25

Language：English   Presentation type：Oral presentation (general)  

Venue：Kyoto  

researchmap

Event date： 2022.8.21 - 2022.8.25

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

Venue：Kyoto  

researchmap

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.

researchmap

Event date： 2021.11.25 - 2021.11.27

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

researchmap

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.

researchmap

Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Event date： 2021.6.3 - 2021.6.4

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

researchmap

Event date： 2021.6.3 - 2021.6.4

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

researchmap

Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Event date： 2020.9.29 - 2020.9.30

Presentation type：Oral presentation (general)  

researchmap

Event date： 2020.8.23 - 2020.8.25

Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2020.8.23 - 2020.8.25

Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2019.11.21 - 2019.11.23

Presentation type：Oral presentation (general)  

researchmap

Event date： 2019.11.21 - 2019.11.23

Presentation type：Oral presentation (general)  

researchmap

Event date： 2019.10.9 - 2019.10.12

Presentation type：Oral presentation (general)  

Venue：大阪  

researchmap

Event date： 2018.11.22 - 2018.11.24

Presentation type：Symposium, workshop panel (nominated)  

researchmap

Event date： 2018.11.22 - 2018.11.24

Presentation type：Symposium, workshop panel (public)  

researchmap

Event date： 2018.10.10 - 2018.10.12

Presentation type：Symposium, workshop panel (public)  

researchmap

Event date： 2017.11.23 - 2017.11.25

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

researchmap

Event date： 2017.10

Presentation type：Oral presentation (general)  

researchmap

Event date： 2023.3.16 - 2023.3.18

Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2023.1.20 - 2023.1.21

Presentation type：Symposium, workshop panel (public)  

Venue：幕張メッセ  

researchmap

Event date： 2022.4.8 - 2022.4.9

Presentation type：Symposium, workshop panel (public)  

Venue：web  

researchmap

Event date： 2022.3.17 - 2022.3.19

Presentation type：Poster presentation  

Venue：大阪  

researchmap

Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

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

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

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

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

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

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

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

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

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

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

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

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

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

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Poster presentation  

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

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

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Poster presentation  

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

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

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Poster presentation  

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Poster presentation  

Venue：福岡  

researchmap

Event date： 2021.11.25 - 2021.11.27

Language：Japanese   Presentation type：Poster presentation  

Venue：福岡  

researchmap

Event date： 2021.11.12 - 2021.11.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岐阜  

researchmap

Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2021.10.27 - 2021.10.30

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2021.9.28

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

Venue：岡山  

researchmap

Event date： 2021.9.25

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2021.9.25

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2021.9.25

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2021.9.25

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2021.9.25

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2021.9.25

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2021.9.3 - 2021.9.4

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：京都  

researchmap

Event date： 2021.8.21

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：富山  

researchmap

Event date： 2021.8.7

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

Venue：岡山  

researchmap

Event date： 2021.6.30

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

researchmap

Event date： 2021.6.4 - 2021.6.5

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福島  

researchmap

Event date： 2021.5.28

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

researchmap

Event date： 2021.5.22

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

Venue：博多  

researchmap

Event date： 2021.5.21

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

researchmap

Event date： 2021.5.13 - 2021.5.16

Language：Japanese   Presentation type：Oral presentation (keynote)  

Venue：横浜  

researchmap

Event date： 2021.5.1

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

Venue：博多  

researchmap

Event date： 2021.4.23 - 2021.4.24

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

Venue：札幌  

researchmap

Event date： 2021.4.17

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

Venue：秋田  

researchmap

Event date： 2021.4.9 - 2021.4.24

Language：Japanese   Presentation type：Oral presentation (general)  

researchmap

Event date： 2021.4.3 - 2021.4.4

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：松江  

researchmap

Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Oral presentation (keynote)  

Venue：福岡  

researchmap

Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

researchmap

Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

researchmap

Event date： 2021.3.11 - 2021.3.13

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

Venue：福岡  

researchmap

Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

researchmap

Event date： 2021.3.11 - 2021.3.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡  

researchmap

Event date： 2021.3.11 - 2021.3.13

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

Venue：福岡  

researchmap

Event date： 2020.12.25

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

researchmap

Event date： 2020.11.19 - 2020.11.21

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

Venue：京都  

researchmap

Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：京都  

researchmap

Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

researchmap

Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

researchmap

Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Oral presentation (keynote)  

Venue：京都  

researchmap

Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

researchmap

Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

researchmap

Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

researchmap

Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：京都  

researchmap

Event date： 2020.11.19 - 2020.11.21

Language：Japanese   Presentation type：Poster presentation  

Venue：京都  

researchmap

Event date： 2020.11.13 - 2020.11.14

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2020.11.13 - 2020.11.14

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2020.11.9 - 2020.11.10

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

Venue：Tokyo  

researchmap

Event date： 2020.11.9 - 2020.11.10

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京  

researchmap

Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Poster presentation  

Venue：岡山  

researchmap

Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Poster presentation  

Venue：岡山  

researchmap

Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Poster presentation  

Venue：岡山  

researchmap

Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Poster presentation  

Venue：岡山  

researchmap

Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Poster presentation  

Venue：岡山  

researchmap

Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2020.10.15 - 2020.10.17

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

Venue：岡山  

researchmap

Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Poster presentation  

Venue：岡山  

researchmap

Event date： 2020.10.15 - 2020.10.17

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2020.9.5

Presentation type：Oral presentation (general)  

researchmap

Event date： 2020.8.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2020.8.23

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

Venue：横浜  

researchmap

Event date： 2020.8.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2020.8.23

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

Venue：横浜  

researchmap

Event date： 2020.8.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2020.8.23

Language：Japanese   Presentation type：Oral presentation (keynote)  

Venue：横浜  

researchmap

Event date： 2020.8.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2020.8.23

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2020.8.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2020.8.23

Language：Japanese   Presentation type：Oral presentation (keynote)  

Venue：横浜  

researchmap

Event date： 2020.8.23

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

Venue：横浜  

researchmap

Event date： 2020.8.23

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

Venue：横浜  

researchmap

Event date： 2020.8.23

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

Venue：横浜  

researchmap

Event date： 2020.8.23

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2020.8.23

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

Venue：横浜  

researchmap

Event date： 2020.8.8

Presentation type：Oral presentation (general)  

researchmap

Event date： 2020.8.8

Presentation type：Oral presentation (general)  

researchmap

Event date： 2020.8.1

Presentation type：Oral presentation (invited, special)  

researchmap

Event date： 2020.1.24 - 2020.1.25

Presentation type：Symposium, workshop panel (nominated)  

researchmap

Event date： 2019.12.7

Presentation type：Oral presentation (general)  

researchmap

Event date： 2019.8.17

Presentation type：Oral presentation (general)  

researchmap

Event date： 2019.7.20 - 2019.7.21

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

Venue：岡山  

researchmap

Event date： 2019.7.20 - 2019.7.21

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2019.7.20 - 2019.7.21

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2019.7.20 - 2019.7.21

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

Venue：岡山  

researchmap

Event date： 2019.7.13

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：仙台  

researchmap

Event date： 2019.7.11 - 2019.7.12

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：神戸  

researchmap

Event date： 2019.7.6

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

researchmap

Event date： 2019.7.4 - 2019.7.7

Language：English   Presentation type：Poster presentation  

Venue：Yokohama  

researchmap

Event date： 2019.7.1 - 2019.7.3

Language：English   Presentation type：Oral presentation (general)  

Venue：Yokohama  

researchmap

Event date： 2019.6.28 - 2019.6.29

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京  

researchmap

Event date： 2019.6.28 - 2019.6.29

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

Venue：東京  

researchmap

Event date： 2019.6.25 - 2019.6.28

Language：English   Presentation type：Poster presentation  

Venue：Amsterdam  

researchmap

Event date： 2019.6.19

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：岡山  

researchmap

Event date： 2019.5.16 - 2019.5.19

Language：Japanese   Presentation type：Oral presentation (keynote)  

Venue：横浜  

researchmap

Event date： 2019.4.27 - 2019.4.28

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

Venue：Sapporo  

researchmap

Event date： 2019.4.20

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

researchmap

Event date： 2019.4.12 - 2019.4.13

Presentation type：Symposium, workshop panel (nominated)  

researchmap

Event date： 2019.4.12 - 2019.4.13

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

Venue：岡山  

researchmap

Event date： 2019.3.29

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：久留米  

researchmap

Event date： 2019.3.21 - 2019.3.23

Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2019.3.21 - 2019.3.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2019.3.21 - 2019.3.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2019.3.21 - 2019.3.23

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

Venue：横浜  

researchmap

Event date： 2019.3.21 - 2019.3.23

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2019.3.21 - 2019.3.23

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2019.3.21 - 2019.3.23

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2019.3.21 - 2019.3.23

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

Venue：横浜  

researchmap

Event date： 2019.3.21 - 2019.3.23

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2019.3.21 - 2019.3.23

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：横浜  

researchmap

Event date： 2019.3.21 - 2019.3.23

Language：Japanese   Presentation type：Poster presentation  

Venue：横浜  

researchmap

Event date： 2019.3.1 - 2019.3.2

Presentation type：Symposium, workshop panel (public)  

Venue：東京  

researchmap

Event date： 2019.3.1 - 2019.3.2

Language：Japanese   Presentation type：Poster presentation  

Venue：東京  

researchmap

Event date： 2019.2.14 - 2019.2.15

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：久留米  

researchmap

Event date： 2019.2.2

Presentation type：Oral presentation (general)  

researchmap

Event date： 2019.2.1 - 2019.2.2

Language：Japanese   Presentation type：Oral presentation (keynote)  

Venue：大阪  

researchmap

Event date： 2018.12.1

Presentation type：Oral presentation (general)  

researchmap

Event date： 2018.11.10

Presentation type：Oral presentation (general)  

researchmap

Event date： 2018.6.30

Presentation type：Oral presentation (general)  

researchmap

Event date： 2018.6.23 - 2018.6.26

Language：English   Presentation type：Poster presentation  

researchmap

Event date： 2018.6.20

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

researchmap

Event date： 2018.4.13 - 2018.4.14

Presentation type：Oral presentation (general)  

researchmap

Event date： 2018.4.8

Presentation type：Oral presentation (general)  

researchmap

Event date： 2018.3.15 - 2018.3.18

Presentation type：Oral presentation (general)  

researchmap

Event date： 2018.3.15 - 2018.3.18

Presentation type：Oral presentation (general)  

researchmap

Event date： 2018.3.2 - 2018.3.3

Presentation type：Symposium, workshop panel (public)  

researchmap

Event date： 2017.12.2

Presentation type：Oral presentation (general)  

researchmap

Event date： 2017.11.23 - 2017.11.25

Presentation type：Oral presentation (general)  

researchmap

Event date： 2017.9.2

Presentation type：Oral presentation (general)  

researchmap

Event date： 2017.8.19

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

researchmap

Event date： 2017.5.27

Presentation type：Oral presentation (invited, special)  

researchmap

Event date： 2017.5.27

Presentation type：Oral presentation (general)  

researchmap

Event date： 2017.4.22

Presentation type：Oral presentation (general)  

researchmap

Event date： 2017.4.7

Presentation type：Symposium, workshop panel (nominated)  

researchmap

Event date： 2017.3.16 - 2017.3.19

Presentation type：Oral presentation (general)  

researchmap

Event date： 2017.1.19

Presentation type：Symposium, workshop panel (nominated)  

researchmap

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

researchmap

researchmap

Presentation type：Oral presentation (general)  

researchmap

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

researchmap

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

researchmap

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

researchmap

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