2021/11/26 更新

写真a

スギウ ケンジ
杉生 憲志
SUGIU Kenji
所属
岡山大学病院 准教授
職名
准教授
外部リンク

学位

  • 医学博士 ( 岡山大学 )

研究キーワード

  • 脳神経外科学

  • Neurosurgery

研究分野

  • ライフサイエンス / 脳神経外科学

所属学協会

  • 日本脳神経血管内治療学会

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  • 日本脳神経外科学会

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論文

  • Incidence and clinical characteristics of spinal arteriovenous shunts: hospital-based surveillance in Okayama, Japan. 国際誌

    Masafumi Hiramatsu, Ryota Ishibashi, Etsuji Suzuki, Yuko Miyazaki, Satoshi Murai, Hiroki Takai, Yuji Takasugi, Yoko Yamaoka, Kazuhiko Nishi, Yu Takahashi, Jun Haruma, Tomohito Hishikawa, Takao Yasuhara, Masaki Chin, Shunji Matsubara, Masaaki Uno, Koji Tokunaga, Kenji Sugiu, Isao Date

    Journal of neurosurgery. Spine   1 - 8   2021年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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

    DOI: 10.3171/2021.7.SPINE21233

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  • An Evaluation of the Safety and Feasibility of Adenosine-assisted Clipping Surgery for Unruptured Cerebral Aneurysms: Study Protocol.

    Tomohito Hishikawa, Satoshi Murai, Masafumi Hiramatsu, Jun Haruma, Kazuhiko Nishi, Yuki Ebisudani, Yu Sato, Takao Yasuhara, Kenji Sugiu, Kazuyoshi Shimizu, Motomu Kobayashi, Koji Nakagawa, Aya Kimura-Ono, Katsuyuki Hotta, Hiroshi Morimatsu, Isao Date

    Neurologia medico-chirurgica   61 ( 7 )   393 - 396   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    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

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  • Mobile endovascular therapy for acute treatment of ruptured vertebral artery dissecting aneurysm in multiple hospitals. 国際誌

    Naoya Kidani, Kenji Sugiu, Kaoru Terasaka, Hiroyuki Nakashima, Koji Tokunaga, Kazuki Kobayashi, Hirokazu Kambara, Tomohito Hishikawa, Masafumi Hiramatsu, Isao Date

    Acta neurochirurgica   2021年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    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

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  • Clinical trial of carotid artery stenting using dual-layer CASPER stent for carotid endarterectomy in patients at high and normal risk in the Japanese population. 国際誌

    Hirotoshi Imamura, Nobuyuki Sakai, Yasushi Matsumoto, Hiroshi Yamagami, Tomoaki Terada, Toshiyuki Fujinaka, Shinichi Yoshimura, Kenji Sugiu, Akira Ishii, Yuji Matsumaru, Takashi Izumi, Hidenori Oishi, Toshio Higashi, Koji Iihara, Naoya Kuwayama, Yasushi Ito, Masato Nakamura, Akio Hyodo, Kuniaki Ogasawara

    Journal of neurointerventional surgery   13 ( 6 )   524 - 529   2021年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The dual-layer nitinol CASPER stent was designed to prevent plaque prolapse into its strut and periprocedural stroke. OBJECTIVE: To conduct a clinical trial for government approval of the device in patients at either high or normal risk for carotid endarterectomy (CEA). METHODS: Eligible patients had ≥50% symptomatic stenosis or ≥80% asymptomatic stenosis according to the North American Symptomatic Carotid Endarterectomy Trial methods (peak systolic velocity 130 and 230 cm/s on ultrasonography, respectively). The primary endpoint was the lack of major adverse events (MAEs), defined as death, stroke, and myocardial infarction within 30 days, and ipsilateral stroke within 1 year. The performance goal was set at 90.5%. MAE rates were also compared between the CEA high- and normal-risk groups. RESULTS: 140 carotid artery stenting procedures, including 40% of patients at high risk and 60% at normal risk for CEA, were performed in 13 institutes. MAEs occurred in two cases (one intraprocedural and one postprocedural stroke), and the MAE rate was 1.4%. The non-MAE rate was 98.6% according to Kaplan-Meier analysis, which was superior to the previously set performance goal. The deployment success, target lesion revascularization (TLR), in-stent restenosis, and cerebrovascular event rates were 99.3%, 2.4%, 8.5%, and 7.2%, respectively. The MAE rate in patients with normal CEA risk was 1.2%, which was similar to the high-risk CEA group, with no significant difference due to the small number of MAEs. CONCLUSIONS: The MAE rate following use of the CASPER stent was low (1.4%). The MAE, deployment success, TLR, in-stenosis, and cerebrovascular event rates were similar to those of previous reports.

    DOI: 10.1136/neurintsurg-2020-016250

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  • Trends in Incidence of Intracranial and Spinal Arteriovenous Shunts: Hospital-Based Surveillance in Okayama, Japan. 国際誌

    Satoshi Murai, Masafumi Hiramatsu, Etsuji Suzuki, Ryota Ishibashi, Hiroki Takai, Yuko Miyazaki, Yuji Takasugi, Yoko Yamaoka, Kazuhiko Nishi, Yu Takahashi, Jun Haruma, Tomohito Hishikawa, Takao Yasuhara, Masaki Chin, Shunji Matsubara, Masaaki Uno, Koji Tokunaga, Kenji Sugiu, Isao Date

    Stroke   52 ( 4 )   1455 - 1459   2021年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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

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  • 脳出血 招待

    平松匡文、春間 純、菱川朋人、杉生憲志、伊達 勲

    脳神経外科   49 ( 2 )   284 - 292   2021年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • [Intracerebral Hemorrhage].

    Masafumi Hiramatsu, Jun Haruma, Tomohito Hishikawa, Kenji Sugiu, Isao Date

    No shinkei geka. Neurological surgery   49 ( 2 )   284 - 292   2021年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    CT angiography(CTA)plays a crucial role in the diagnosis of intracerebral hemorrhage(ICH). An 85-year-old woman presented with a disturbance of consciousness and right hemiparesis. Non-contrast CT of the brain revealed intracerebral hemorrhage in the left thalamus spreading to the internal capsule, corona radiata, and midbrain and a "swirl sign." CTA revealed no vascular anomaly. The early and delayed CTA phases revealed the"spot sign" and "leakage sign," respectively. Non-contrast CT three hours after the initial CT showed the enlargement of the hematoma. After the detection of ICH by initial non-contrast CT, CTA should be performed to differentiate between the causes of secondary ICH and detect the imaging markers of hematoma expansion or rebleeding. Previous studies have demonstrated that the "spot sign" detected by CTA is a valid imaging marker for hematoma expansion. In this article, the differential diagnosis of ICH and the detection of the imaging markers of hematoma expansion using non-contrast CT and CTA have been discussed.

    DOI: 10.11477/mf.1436204390

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  • Dural arteriovenous fistulas in the parasellar region other than the cavernous sinus 査読 国際誌

    Hiramatsu M, Sugiu K, Haruma J, Hishikawa T, Takahashi Y, Murai S, Nishi K, Yamaoka Y, Date I

    Journal of Neuroendovascular Therapy   14 ( 12 )   593 - 604   2020年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • 脳血管内治療の知っておきたい最新情報2020 招待

    杉生憲志

    BRAIN NURSING   36 ( 11 )   63 - 66   2020年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Detailed Arterial Anatomy and Its Anastomoses of the Sphenoid Ridge and Olfactory Groove Meningiomas with Special Reference to the Recurrent Branches from the Ophthalmic Artery. 国際誌

    M Hiramatsu, K Sugiu, T Hishikawa, J Haruma, Y Takahashi, S Murai, K Nishi, Y Yamaoka, Y Shimazu, K Fujii, M Kameda, K Kurozumi, I Date

    AJNR. American journal of neuroradiology   2020年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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

    DOI: 10.3174/ajnr.A6790

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  • 頭部外傷の画像読み解きトレーニング─びまん性軸索損傷─

    佐藤 悠、杉生憲志

    BRAIN NURSING   36 ( 10 )   1014 - 1014   2020年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • 脳血管疾患の画像読み解きトレーニング─AVM─ 招待

    西 和彦、杉生憲志

    BRAIN NURSING   36 ( 10 )   982 - 982   2020年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • 脳血管疾患の画像読み解きトレーニング─頚動脈狭窄─ 招待

    胡谷侑貴、杉生憲志

    BRAIN NURSING   36 ( 10 )   978 - 978   2020年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Detection of the common origin of the radiculomedullary artery with the feeder of spinal dural arteriovenous fistula using slab maximum intensity projection image 国際誌

    Masafumi Hiramatsu, Kenji Sugiu, Takao Yasuhara, Tomohito Hishikawa, Jun Haruma, Yu Takahashi, Satoshi Murai, Kazuhiko Nishi, Yoko Yamaoka, Isao Date

    NEURORADIOLOGY   62 ( 10 )   1285 - 1292   2020年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    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

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  • Detection of the common origin of the radiculomedullary artery with the feeder of spinal dural arteriovenous fistula using slab maximum intensity projection image 国際誌

    Masafumi Hiramatsu, Kenji Sugiu, Takao Yasuhara, Tomohito Hishikawa, Jun Haruma, Yu Takahashi, Satoshi Murai, Kazuhiko Nishi, Yoko Yamaoka, Isao Date

    Neuroradiology   62 ( 10 )   1285 - 1292   2020年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元: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

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    その他リンク: http://link.springer.com/article/10.1007/s00234-020-02466-0/fulltext.html

  • 脳神経血管内治療領域のインパクトのあった最新論文

    胡谷侑貴、村井 智、杉生憲志

    Rad Fan   18 ( 11 )   52 - 55   2020年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • 脳神経領域の意義とやりがい─神経科学に必要な知識・技術・夢─特別座談会 招待

    阿部康二、伊達 勲、山下 徹、杉生憲志、小笠原邦昭

    脳神経外科速報   30 ( 8 )   808 - 818   2020年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • 【良性脳腫瘍】頭蓋内腫瘍塞栓術の役割と可能性

    杉生 憲志, 菱川 朋人, 平松 匡文, 春間 純, 西廣 真吾, 木谷 尚哉, 高橋 悠, 村井 智, 西 和彦, 山岡 陽子, 胡谷 侑貴, 佐藤 悠, 藤井 謙太郎, 伊達 勲

    脳神経外科ジャーナル   29 ( 8 )   543 - 552   2020年8月

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    記述言語:日本語   出版者・発行元: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)

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    その他リンク: 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

  • Osseous arteriovenous fistulas in the dorsum sellae, clivus, and condyle 国際誌

    Masafumi Hiramatsu, Kenji Sugiu, Jun Haruma, Tomohito Hishikawa, Yu Takahashi, Satoshi Murai, Kazuhiko Nishi, Yoko Yamaoka, Isao Date

    NEURORADIOLOGY   63 ( 1 )   133 - 140   2020年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Purpose Arteriovenous fistulas (AVFs) located in the cavernous sinus (CS), clivus, and condyle can be osseous shunts in nature. Here, we reviewed the angioarchitecture, clinical characteristics, and treatment results of AVFs in these lesions. Methods Twenty-five patients with 27 lesions who underwent rotational angiography in our department between May 2013 and December 2019 were reviewed. We examined 20 CS AVFs, 2 clival AVFs, and 5 condylar AVFs. We divided the anatomical shunted pouches into five locations: the dorsum sellae (posteromedial of the CS), posterolateral wall of the CS, lateral wall of the CS, clivus, and condyle. We divided the AVFs into three categories: intraosseous, transitional, and nonosseous shunts. We analyzed the characteristics and treatment results. Results A total of 33 shunted pouches or points were identified in 27 lesions. The dorsum sellae (n = 16) was the most frequent location. Fourteen AVFs (88%) in the dorsum sellae were osseous (intraosseous or transitional) shunts. All AVFs in the clivus or condyle were also osseous shunts. Eleven lesions (92%) of intraosseous and all lesions of transitional shunts exhibited bilateral external carotid artery involvement as feeders. Ten lesions (83%) of intraosseous shunts were treated with selective transvenous embolization of the shunted pouch with or without additional partial embolization of the sinus. Eleven (92%) intraosseous shunts were completely occluded, and symptom resolution was achieved in all intraosseous shunts. Conclusion Most of the CS AVFs with shunted pouches in the dorsum sellae and all of the AVFs in the clivus and condyle share similar characteristics.

    DOI: 10.1007/s00234-020-02506-9

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  • Results of 1940 embolizations for dural arteriovenous fistulas: Japanese Registry of Neuroendovascular Therapy (JR-NET3) 国際誌

    Masafumi Hiramatsu, Kenji Sugiu, Tomohito Hishikawa, Shingo Nishihiro, Naoya Kidani, Yu Takahashi, Satoshi Murai, Isao Date, Naoya Kuwayama, Tetsu Satow, Koji Iihara, Nobuyuki Sakai

    Journal of Neurosurgery   133 ( 1 )   166 - 173   2020年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元: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

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  • Cerebellar Blood Flow and Gene Expression in Crossed Cerebellar Diaschisis after Transient Middle Cerebral Artery Occlusion in Rats. 国際誌

    Naoya Kidani, Tomohito Hishikawa, Masafumi Hiramatsu, Shingo Nishihiro, Kyohei Kin, Yu Takahashi, Satoshi Murai, Kenji Sugiu, Takao Yasuhara, Ikuko Miyazaki, Masato Asanuma, Isao Date

    International journal of molecular sciences   21 ( 11 )   2020年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    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

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  • Correction to: High‑Mobility Group Box‑1‑Induced Angiogenesis After Indirect Bypass Surgery in a Chronic Cerebral Hypoperfusion Model. 国際誌

    Shingo Nishihiro, Tomohito Hishikawa, Masafumi Hiramatsu, Naoya Kidani, Yu Takahashi, Satoshi Murai, Kenji Sugiu, Yusuke Higaki, Takao Yasuhara, Cesario V Borlongan, Isao Date

    Neuromolecular medicine   22 ( 2 )   332 - 333   2020年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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

    DOI: 10.1007/s12017-020-08594-3

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  • Safety and efficacy of staged angioplasty for patients at risk of hyperperfusion syndrome: a single-center retrospective study 国際誌

    Satoshi Murai, Kenji Sugiu, Tomohito Hishikawa, Masafumi Hiramatsu, Shingo Nishihiro, Naoya Kidani, Yu Takahashi, Kazuhiko Nishi, Yoko Yamaoka, Isao Date

    NEURORADIOLOGY   62 ( 4 )   503 - 510   2020年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元: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.

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  • 脳血管攣縮に対する薬物療法と髄液管理の治療成績 招待

    菱川朋人、村井 智、高橋 悠、木谷尚哉、平松匡文、杉生憲志、伊達 勲

    脳血管攣縮   35   16 - 19   2020年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • 経時的3DDSA fusion画像で仮性動脈瘤の位置を同定しtarget embolizationを行い得た破裂AVMの1例 査読

    村井 智、杉生憲志、菱川朋人、平松匡文、西廣真吾、木谷尚哉、高橋 悠、伊達 勲

    脳神経外科速報   48 ( 1 )   39 - 45   2020年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Metal artifact reduction algorithm for image quality improvement of cone-beam CT images of medium or large cerebral aneurysms treated with stent-assisted coil embolization 国際誌

    Satoshi Murai, Masafumi Hiramatsu, Yuji Takasugi, Yu Takahashi, Naoya Kidani, Shingo Nishihiro, Yukei Shinji, Jun Haruma, Tomohito Hishikawa, Kenji Sugiu, Isao Date

    NEURORADIOLOGY   62 ( 1 )   89 - 96   2020年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元: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.

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  • [A Case of Ruptured Arteriovenous Malformation Successfully Treated with Target Embolization for Pseudoaneurysm Detected Using Chronological Three-dimensional Digital Subtraction Angiography Fusion Images].

    Satoshi Murai, Kenji Sugiu, Tomohito Hishikawa, Masafumi Hiramatsu, Shingo Nishihiro, Naoya Kidani, Yu Takahashi, Isao Date

    No shinkei geka. Neurological surgery   48 ( 1 )   39 - 45   2020年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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

    DOI: 10.11477/mf.1436204131

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  • High-Mobility Group Box-1-Induced Angiogenesis After Indirect Bypass Surgery in a Chronic Cerebral Hypoperfusion Model 国際誌

    Shingo Nishihiro, Tomohito Hishikawa, Masafumi Hiramatsu, Naoya Kidani, Yu Takahashi, Satoshi Murai, Kenji Sugiu, Yusuke Higaki, Takao Yasuhara, Cesario Borlongan, Isao Date

    NEUROMOLECULAR MEDICINE   21 ( 4 )   391 - 400   2019年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元: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

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  • Intracranial invasive fungal aneurysm due to Aspergillus sinusitis successfully treated by voriconazole plus internal carotid artery ligation therapy in an aged woman

    Mami Takemoto, Yasuyuki Ohta, Koh Tadokoro, Ryo Sasaki, Yoshiaki Takahashi, Kota Sato, Toru Yamashita, Nozomi Hishikawa, Jingwei Shang, Masafumi Hiramatsu, Kenji Sugiu, Tomohito Hishikawa, Isao Date, Koji Abe

    NEUROLOGY ASIA   24 ( 4 )   363 - 367   2019年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元: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.

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  • 蝶形骨縁および前頭蓋底髄膜腫の動脈解剖

    平松 匡文, 杉生 憲志, 菱川 朋人, 木谷 尚哉, 村井 智, 西 和彦, 山岡 陽子, 藤井 謙太郎, 黒住 和彦, 伊達 勲

    脳血管内治療   4 ( Suppl. )   S239 - S239   2019年11月

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    記述言語:日本語   出版者・発行元:(NPO)日本脳神経血管内治療学会  

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  • 血栓回収機器の種類─閉塞性疾患─ 査読

    高橋 悠、杉生憲志

    Clinical Neuroscience   37 ( 10 )   1244 - 1247   2019年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • A comparison of the prevalence and risk factors of complications in intracranial tumor embolization between the Japanese Registry of NeuroEndovascular Therapy 2 (JR-NET2) and JR-NET3 国際誌

    Tomohito Hishikawa, Kenji Sugiu, Satoshi Murai, Yu Takahashi, Naoya Kidani, Shingo Nishihiro, Masafumi Hiramatsu, Isao Date, Tetsu Satow, Koji Iihara, Nobuyuki Sakai, Akio Hyodo, Shigeru Miyachi, Yoji Nagai, Chiaki Sakai, Tetsu Satoh, Waro Taki, Tomoaki Terada, Masayuki Ezura, Toshio Hyogo, Shunji Matsubara, Kentaro Hayashi, Toshiyuki Fujinaka, Yasushi Ito, Shigeki Kobayashi, Masaki Komiyama, Naoya Kuwayama, Yuji Matsumaru, Yasushi Matsumoto, Yuichi Murayama, Ichiro Nokahara, Shigeru Nemoto, Koichi Sato, Shinichi Yoshimura, Susumu Miyamoto, Kunihiro Nishimura, Kazunori Toyoda, Masaru Hirohata, Akira Ishii, Hirotoshi Imamura, Hidenori Oishi

    ACTA NEUROCHIRURGICA   161 ( 8 )   1675 - 1682   2019年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元: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

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  • 脳動脈瘤コイリング・クリッピング治療後のネック・ドームの新しい画像評価─Silent MRAとFSE MRCの3D 融合画像 の応用─ 査読

    佐藤 透、菱川朋人、杉生憲志、平松匡文、伊達 勲

    脳神経外科速報   29 ( 7 )   762 - 772   2019年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • 内頚動脈後交通動脈分岐部瘤に対する後交通動脈を温存した塞栓術後の再発リスク 査読

    平松匡文、杉生憲志、菱川朋人、西廣真吾、木谷尚哉、高橋 悠、村井 智、伊達 勲

    脳卒中の外科   47 ( 3 )   167 - 173   2019年5月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Visualization of Aneurysmal Neck and Dome after Coiling with 3D Multifusion Imaging of Silent MRA and FSE-MR Cisternography. 国際誌

    T Satoh, T Hishikawa, M Hiramatsu, K Sugiu, I Date

    AJNR. American journal of neuroradiology   40 ( 5 )   802 - 807   2019年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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

    DOI: 10.3174/ajnr.A6026

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  • [Endovascular therapy for acute stroke-An important role of neurologists].

    Kenji Sugiu

    Rinsho shinkeigaku = Clinical neurology   59 ( 4 )   173 - 176   2019年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Previous randomized clinical trials have revealed significant benefit of the endovascular thrombectomy for the patients with acute ischemic stroke. In this short communication, I would like to introduce the history of endovascular treatment for acute ischemic stroke in Japan, and give a positive message to the neurologists who might contribute to the treatment for acute ischemic stroke.

    DOI: 10.5692/clinicalneurol.cn-001257

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  • Comparison between spinal dural arteriovenous fistula and spinal epidural arteriovenous fistula 査読 国際誌

    Hiramatsu M, Sugiu K, Yasuhara T, Hishikawa T, Nishihiro S, Kidani N, Takahashi Y, Murai S, Date I

    Journal of Neuroendovascular Therapy   13 ( 3 )   114 - 119   2019年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • 【出血性脳血管障害】未破裂脳動脈瘤の自然歴 最新の知識と臨床判断へのフィードバック

    菱川 朋人, 平松 匡文, 杉生 憲志, 伊達 勲

    脳神経外科ジャーナル   28 ( 3 )   120 - 126   2019年3月

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    記述言語:日本語   出版者・発行元: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)

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    その他リンク: 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

  • Treatment Outcome of Intracranial Tumor Embolization in Japan: Japanese Registry of NeuroEndovascular Therapy 3 (JR-NET3)

    Kenji Sugiu, Tomohito Hishikawa, Satoshi Murai, Yu Takahashi, Naoya Kidani, Shingo Nishihiro, Masafumi Hiramatsu, Isao Date, Tetsu Satow, Koji Iihara, Nobuyuki Sakai

    NEUROLOGIA MEDICO-CHIRURGICA   59 ( 2 )   41 - 47   2019年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元: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.

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  • Effectiveness of staged angioplasty for avoidance of cerebral hyperperfusion syndrome after carotid revascularization. 国際誌

    Mikito Hayakawa, Kenji Sugiu, Shinichi Yoshimura, Tomohito Hishikawa, Hiroshi Yamagami, Mayumi Fukuda-Doi, Nobuyuki Sakai, Koji Iihara, Kuniaki Ogasawara, Hidenori Oishi, Yasushi Ito, Yuji Matsumaru

    Journal of neurosurgery   1 - 11   2019年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVECerebral hyperperfusion syndrome (CHS) is a serious complication after carotid artery stenting (CAS). Staged angioplasty (SAP)-i.e., angioplasty followed by delayed CAS-has been reported as a potential CHS-avoiding procedure. The purpose of this study was to clarify the effectiveness of SAP in avoiding CHS after carotid revascularization for patients at high risk for this complication.METHODSThe authors retrospectively studied cases involving patients at high risk for CHS from 44 Japanese centers who were scheduled for SAP, regular CAS, angioplasty, or staged procedures other than SAP between October 2007 and March 2014. They investigated the rate of CHS in the population scheduled for SAP or regular CAS, and for safety analysis, the composite rate of transient ischemic attack (TIA) and ischemic stroke in the population eventually receiving SAP or regular CAS.RESULTSData from a total of 525 patients (532 lesions, mean age 72.5 ± 7.5 years, 74 women ) were analyzed. Scheduled procedures included SAP for 113 lesions and regular CAS for 419 lesions. The rate of CHS was lower in the SAP group than in the regular CAS group (4.4% vs 10.5%, p = 0.047). Multivariate analysis showed that SAP was negatively related to CHS (OR 0.315; 95% CI 0.120-0.828). In the population eventually receiving SAP (102 lesions) or regular CAS (428 lesions), the composite rate of TIA and ischemic stroke was comparable between the SAP group and the regular CAS group (9.8% vs 9.3%).CONCLUSIONSSAP may be an effective and safe carotid revascularization procedure to avoid CHS.

    DOI: 10.3171/2018.8.JNS18887

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  • 急性期脳梗塞に対する血管内治療─新たな時代における脳神経内科医の役割─ 招待

    杉生憲志

    臨床神経学   59 ( 4 )   173 - 176   2019年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Endovascular treatment for craniofacial arteriovenous fistula/malformation 査読 国際誌

    Sugiu K, Hishikawa T, Hiramatsu M, Nishihiro S, Kidani N, Takahashi Y, Murai S, Date I

    Journal of Neuroendovascular Therapy   13 ( 5 )   206 - 215   2019年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • Ex vivo release of pipeline embolization device polytetrafluoroethylene sleeves: a technical note 査読 国際誌

    Takahashi Y, Sugiu K, Haruma J, Murai S, Kidani N, Nishihiro S, Hiramatsu M, Hishikawa T, Date I

    Journal of Neuroendovascular Therapy   12 ( 9 )   463 - 468   2018年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

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  • 【Hybrid Neurosurgeonのための疾患別臨床脳血管解剖テキスト】(第1章)開頭手術と血管内治療の選択 dAVF 脊髄dAVF 脊髄dAVFの血管内治療

    平松 匡文, 杉生 憲志

    脳神経外科速報   ( 2018増刊 )   161,163,165,167,169,171 - 161,163,165,167,169,171   2018年9月

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    記述言語:日本語   出版者・発行元:(株)メディカ出版  

    <血管内治療のポイント(まとめ)>(1)脊髄梗塞を予防するため、術前の詳細な画像診断、術中provocation testが重要(2)Drainer側までNBCAを注入するための術前画像診断を行い、治療戦略を立てる(3)術後の遅発性静脈血栓化を予防するため、術後のヘパリン投与を行う(著者抄録)

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  • Efficacy and Safety of REVIVE SE Thrombectomy Device for Acute Ischemic Stroke: River JAPAN (Reperfuse Ischemic Vessels with Endovascular Recanalization Device in Japan). 査読

    Sakai N, Ota S, Matsumoto Y, Kondo R, Satow T, Kubo M, Tsumoto T, Enomoto Y, Kataoka T, Imamura H, Todo K, Hayakawa M, Yamagami H, Toyoda K, Ito Y, Sugiu K, Matsumaru Y, Yoshimura S, RIVER JAPAN Investigators

    Neurologia medico-chirurgica   58 ( 4 )   164 - 172   2018年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2176/nmc.oa.2017-0145

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  • NADH fluorescence imaging and the histological impact of cortical spreading depolarization during the acute phase of subarachnoid hemorrhage in rats 査読 国際誌

    Tomohisa Shimizu, Tomohito Hishikawa, Shingo Nishihiro, Yukei Shinji, Yuji Takasugi, Jun Haruma, Masafumi Hiramatsu, Hirokazu Kawase, Sachiko Sato, Ryoichi Mizoue, Yoshimasa Takeda, Kenji Sugiu, Hiroshi Morimatsu, Isao Date

    Journal of Neurosurgery   128 ( 1 )   137 - 143   2018年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:American Association of 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 (P50) was estimated to be 22.4 minutes (95% confdence 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?uorescence 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?uorescence. 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

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  • Coil Embolization through Collateral Pathway for Ruptured Vertebral Artery Dissecting Aneurysm with Bilateral Vertebral Artery Occlusion 査読 国際誌

    Satoshi Murai, Kenji Sugiu, Tomohito Hishikawa, Masafumi Hiramatsu, Shingo Nishihiro, Naoya Kidani, Yu Takahashi, Isao Date

    Journal of Stroke and Cerebrovascular Diseases   27 ( 9 )   e215-e218   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:W.B. Saunders  

    DOI: 10.1016/j.jstrokecerebrovasdis.2018.04.036

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  • 顔面痙攣を呈した椎骨動脈瘤に対して血管内治療を行った一例

    坪井 伸成, 杉生 憲志, 菱川 朋人, 平松 匡文, 西廣 真吾, 木谷 尚哉, 高橋 悠, 村井 智, 伊達 勲

    脳血管内治療   2 ( Suppl. )   S283 - S283   2017年11月

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    記述言語:日本語   出版者・発行元:(NPO)日本脳神経血管内治療学会  

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  • Dissociated recovery between dementia and parkinsonism by transvenous embolization of recurrent dural arteriovenous fistula

    Yumiko Nakano, Emi Nomura, Masafumi Hiramatsu, Mami Takemoto, Kota Sato, Nozomi Hishikawa, Toru Yamashita, Yasuyuki Ohta, Kenji Sugiu, Isao Date, Koji Abe

    NEUROLOGY AND CLINICAL NEUROSCIENCE   5 ( 5 )   159 - 161   2017年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元: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.

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  • Outcome of Coil Embolization for Symptomatic Unruptured Cerebral Aneurysms

    Nishihiro Shingo, Sugiu Kenji, Hishikawa Tomohito, Hiramatsu Masafumi, Kidani Naoya, Takahashi Yu, Date Isao

    脳神経血管内治療   2017年

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    記述言語:英語   出版者・発行元:特定非営利活動法人 日本脳神経血管内治療学会  

    <p><b>Purpose:</b> We examined the outcome of coil embolization for symptomatic unruptured cerebral aneurysms, and investigated factors contributing to symptom relief after surgery.</p><p><b>Methods:</b> We retrospectively reviewed 19 patients who underwent coil embolization between January 2008 and April 2016.</p><p><b>Results:</b> 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><b>Conclusion:</b> Early therapeutic intervention and a postoperative reduction in the aneurysmal size may be important to achieve the relief of symptoms of symptomatic unruptured cerebral aneurysms after surgery.</p>

    DOI: 10.5797/jnet.oa.2017-0045

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  • 右総頸動脈に収縮期に逆行性血流を呈した腕頭動脈閉塞の1例 査読

    武本 梨佳, 戸田 洋伸, 戸田 由香, 勢井 麻梨, 中村 知子, 渡辺 修久, 江尻 健太郎, 麻植 浩樹, 杉生 憲志, 岡田 健, 大塚 文男, 伊藤 浩

    超音波検査技術   41 ( Suppl. )   S230 - S230   2016年6月

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    記述言語:日本語   出版者・発行元:(一社)日本超音波検査学会  

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  • Stent-assisted coil embolization of a dissecting aneurysm of the posterior cerebral artery: A case report 査読

    Jun Haruma, Kenji Sugiu, Tadato Yukiue, Tatsuya Sasaki, Yasuhiko Hattori, Kazuki Kobayashi, Hideyuki Yoshida, Koji Muneda, Isao Date

    Neurological Surgery   43 ( 12 )   1099 - 1104   2015年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Igaku-Shoin Ltd  

    Dissecting aneurysms of the posterior cerebral artery (PCA) are rare, especially those at the P1 segment. Here, we describe the case of a 57-year-old woman with a subarachnoid hemorrhage (SAH). Computed tomography angiography (CTA) and digital subtraction angiography (DSA) revealed a small (3 mm) dissecting aneurysm with the typical peari-and-string sign at the right P1 segment. Fourteen days after onset, the patient developed aphasia. DSA revealed vasospasm of the right middle cerebral artery, and we performed endovascular treatment by the intra-arterial injection of 1-(5-isoquinolinesulfonyl) homopiperazine. After this treatment, the patient's symptoms recovered immediately. Vertebral angiography revealed enlargement of the dissecting aneurysm (up to 7 mm diameter). We started a loading dose of 300 mg aspirin and 400 mg Clopidogrel after observing growth of the aneurysm. Fifteen days after onset, we performed a stent-assisted coil embolization, and obtained nearly complete obliteration of the aneurysm with preserved patency of the parent artery. Six-month follow-up DSA demonstrated complete occlusion of the aneurysm with good patency of the stented PCA: the patient was at modified Rankin Scale 1. In the treatment of ruptured dissecting aneurysms, parent vessel occlusion (PVO) with aneurysm is common. However. PVO may cause both cerebral infarction of the distal area and perforator occlusion of the occluded vessel. Stent-assisted coil embolization can preserve parent vessel flow and obliterate the aneurysm. Stents offer a therapeutic alternative for PCA dissecting aneurysms, especially when PVO cannot be tolerated.

    DOI: 10.11477/mf.1436203187

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  • 未破裂脳動脈瘤コイル塞栓術後に多発性の大脳病変を呈した一例

    出口 健太郎, 出口 章子, 河原 由子, 佐藤 恒太, 武本 麻美, 菱川 望, 太田 康之, 山下 徹, 徳永 浩司, 杉生 憲志, 河井 信行, 阿部 康二

    JNET: Journal of Neuroendovascular Therapy   9 ( 6 )   S358 - S358   2015年11月

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    記述言語:日本語   出版者・発行元:(NPO)日本脳神経血管内治療学会  

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  • Ethmoidal dural arteriovenous fistula with unusual drainage route treated by transarterial embolization. 国際誌

    Akihiro Inoue, Masahiko Tagawa, Yoshiaki Kumon, Hideaki Watanabe, Daisuke Shoda, Kenji Sugiu, Takanori Ohnishi

    Journal of neurointerventional surgery   7 ( 4 )   e15   2015年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Ethmoidal dural arteriovenous fistulas (AVFs) are rare intracranial lesions associated with a high risk of intracranial hemorrhage. In particular, this entity with reflux drainage directly into the ophthalmic vein is extremely rare. We report a case of ethmoidal dural AVF with direct drainage of the superior ophthalmic vein (SOV) and inferior ophthalmic vein (IOV), successfully treated by endovascular surgery. A 58-year-old man presented with progressive diplopia. Angiography and contrast-enhanced CT showed an ethmoidal dural AVF supplied via the bilateral anterior ethmoidal arteries and venous drainage through the left SOV and IOV. A transarterial approach through the bilateral anterior ethmoidal arteries was used to place the microcatheter close to the fistula site. After intra-arterial embolization with 20% N-butyl cyanoacrylate, the dural AVF was completely occluded. In patients with good vascular access, endovascular transarterial embolization may be an effective and less invasive treatment strategy for ethmoidal dural AVF.

    DOI: 10.1136/neurintsurg-2013-011098.rep

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  • A patient develops transient unique cerebral and cerebellar lesions after unruptured aneurysm coiling. 査読 国際誌

    Deguchi K, Kawahara Y, Deguchi S, Morimoto N, Kurata T, Ikeda Y, Ichikawa T, Tokunaga K, Kawai N, Sugiu K, Abe K

    BMC neurology   15   49 - 49   2015年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1186/s12883-015-0303-7

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  • Cervical Spinal dural arteriovenous fistula with rapidly progressive brainstem dysfunction due to venous congestion: A case report 査読

    Tatsuya Sasaki, Hiroaki Manabe, Takao Yasuhara, Yasuyuki Miyoshi, Kenji Sugiu, Isao Date

    Neurological Surgery   43 ( 1 )   51 - 56   2015年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Igaku-Shoin Ltd  

    Spinal dural arteriovenous fistulas (S-dAVFs) are rare vascular malformations of the spine. We experienced a case that presented with rapidly progressive brainstem dysfunction due to venous congestion of cervical dAVFs. A 56-year-old man diagnosed with cervical dAVF four years prior presented with gait disturbance and abnormal thermal nociception on his right side. In addition to the high-intensity lesion from the lower pons to the medulla oblongata on T2-weighted magnetic resonance imaging, diffusion-weighted imaging demonstrated cerebral infarction of the left ventrolateral medulla oblongata. Left vertebral angiography revealed that a feeding artery supplied by the radicular artery at the C4 level formed a fistula with the dilated ascending anterior perimedullary vein. We made a diagnosis of venous congestion due to cervical dAVFs. Numbness on the left upper limb occurred five days after the first symptom. Subsequently, hemiparesis on the left upper limb and swallowing disturbance occurred two weeks after the first symptom. The patient underwent surgical ligation of the dilated abnormal vein, with gradual improvement of his symptoms. Myelopathy due to venous congestion of S-dAVFs usually progresses slowly for several years. However, this case report warns about the possibility that some cases of S-dAVF with rapidly exacerbated symptoms may require prompt therapy.

    DOI: 10.11477/mf.1436202944

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  • Ethmoidal dural arteriovenous fistula with unusual drainage route treated by transarterial embolization. 国際誌

    Akihiro Inoue, Masahiko Tagawa, Yoshiaki Kumon, Hideaki Watanabe, Daisuke Shoda, Kenji Sugiu, Takanori Ohnishi

    BMJ case reports   2014   2014年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Ethmoidal dural arteriovenous fistulas (AVFs) are rare intracranial lesions associated with a high risk of intracranial hemorrhage. In particular, this entity with reflux drainage directly into the ophthalmic vein is extremely rare. We report a case of ethmoidal dural AVF with direct drainage of the superior ophthalmic vein (SOV) and inferior ophthalmic vein (IOV), successfully treated by endovascular surgery. A 58-year-old man presented with progressive diplopia. Angiography and contrast-enhanced CT showed an ethmoidal dural AVF supplied via the bilateral anterior ethmoidal arteries and venous drainage through the left SOV and IOV. A transarterial approach through the bilateral anterior ethmoidal arteries was used to place the microcatheter close to the fistula site. After intra-arterial embolization with 20% N-butyl cyanoacrylate, the dural AVF was completely occluded. In patients with good vascular access, endovascular transarterial embolization may be an effective and less invasive treatment strategy for ethmoidal dural AVF.

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  • Spontaneous indirect revascularization through the failed radial artery bypass in a patient with a giant intracavernous internal carotid artery aneurysm 査読

    Koji Tokunaga, Tomohito Hishikawa, Kenji Sugiu, Isao Date

    Neurological Surgery   42 ( 1 )   59 - 64   2014年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Epidemiology of Dural Arteriovenous Fistula in Japan: Analysis of Japanese Registry of Neuroendovascular Therapy (JR-NET2) 査読

    Masafumi Hiramatsu, Kenji Sugiu, Tomohito Hishikawa, Jun Haruma, Koji Tokunaga, Isao Date, Naoya Kuwayama, Nobuyuki Sakai

    NEUROLOGIA MEDICO-CHIRURGICA   54 ( 1 )   63 - 71   2014年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元: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.

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  • Endovascular treatment of basilar artery aneurysms associated with fenestration 査読

    Hisakazu Itami, Kenji Sugiu, Masafumi Hiramatsu, Koji Tokunaga, Jun Haruma, Yu Okuma, Tomohito Hishikawa, Ayumi Nishida, Isao Date

    Neurological Surgery   41 ( 7 )   583 - 592   2013年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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

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  • Endovascular treatment for cervical carotid artery aneurysm: A case report 査読

    Yasuhiko Hattori, Kenji Sugiu, Tomohito Hishikawa, Koji Tokunaga, Kazuya Takahashi, Isao Date

    Neurological Surgery   41 ( 6 )   515 - 523   2013年6月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    We report here a case of cervical carotid artery aneurysm. This 37-year-old male suffered from acute neck swelling when he was taking lunch after physical work. Ultrasonography demonstrated a cervical pseudoaneurysm and a jet flow, which was blowing into the dome from the carotid artery. Angiogram revealed an aneurysm with a diameter of 3 cm at the bifurcation of the common carotid artery. Coil embolization using double-catheter technique was performed and complete occlusion of the aneurysm was obtained without any complications. The patient returned to his normal life. Cervical carotid artery aneurysms are rare and they induce pain by swelling in the neck, hoarseness, swallowing disturbance, hemorrhage, and cerebral ischemia due to embolism. In case of a cervical carotid artery aneurysm, safe and effective treatments are required and endovascular treatment should be considered. Although stent-assisted coil embolization or covered-stent placement were reported as an effective treatment for cervical aneurysms, coil embolization without using a stent was performed in this particular patient who is a young, blue-collar worker because the avoidance of long-term anti-platelet therapy was desirable Preoperative evaluation is important to select adequate treatment.

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  • A case of a paraspinal arteriovenous fistula presenting with retroperitoneal hemorrhage treated by staged transarterial and transvenous embolization 査読

    Atsuhiko Toyoshima, Koji Tokunaga, Hiroaki Manabe, Kenji Sugiu, Masafumi Hiramatsu, Hisakazu Itami, Tomohito Hishikawa, Isao Date

    Neurological Surgery   41 ( 5 )   429 - 435   2013年5月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    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 retropentoneum 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 transveriously into the varix, and detachable coils were delivered into the small compartment just downstream to the shunts, leading to complete obliteration. We conclude that transarterial flow reduction followed by occlusion of the venous side of the shunts is effective to achieve cure of a complex and high-flow paraspinal AVF.

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  • Fatal outcomes of pediatric patients with moyamoya disease associated with pulmonary arterial hypertension. Report of two cases 査読 国際誌

    Koji Tokunaga, Tomohito Hishikawa, Kenji Sugiu, Isao Date

    CLINICAL NEUROLOGY AND NEUROSURGERY   115 ( 3 )   335 - 338   2013年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE BV  

    DOI: 10.1016/j.clineuro.2012.05.002

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  • Required knowledge for neuroendovascular surgeon (6) embolization of cranial dural arteriovenous fistulae and high flow arteriovenous fistulae 査読

    Koji Tokunaga, Kenji Sugiu, Isao Date

    Neurological Surgery   41 ( 2 )   153 - 162   2013年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Surgical and endovascular treatment for superior cerebellar artery aneurysms: Report of two cases 査読

    Jun Haruma, Kenji Sugiu, Yosuke Shimazu, Hiroyuki Michiue, Koji Tokunaga, Isao Date

    Neurological Surgery   41 ( 1 )   45 - 51   2013年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Aneurysms located on the supenor cerebellar artery (SCA) are uncommon and their presentation, natural history, and clinical management are poorly understood. Reports related to the endovascular or surgical management of SCA aneurysms are rare Herein, we report two cases of SCA aneurysm The first is that of a 70-year-old woman who presented with subarachnoid hemorrhage (SAH). Surgical treatment (neck clipping) of the ruptured SCA aneurysm was performed, and the flow of the parent artery disappeared. The second is that of a 69-year-old woman with an unruptured SCA aneurysm who underwent endovascular surgery to occlude the parent artery. Neither patients exhibited any additional neurological deficits SCA aneurysms often have either relatively wide or undefinable necks, so it is difficult to preserve the parent artery. According to several surgical reports, occlusion of the SCA appears well tolerated for a vanety of reasons.

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  • Endovascular coiling of thrombosed basilar tip aneurysm using double stents in a Y-configuration 査読

    Yoshihiro Otani, Kenji Sugiu, Koji Tokunaga, Tomohito Hishikawa, Hisakazu Itami, Masafumi Hiramatsu, Yu Okuma, Isao Date

    Neurological Surgery   40 ( 11 )   1005 - 1012   2012年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    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 widenecked 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.

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  • Endovascular treatment for basilar tip aneurysms 査読

    Kenji Sugiu, Koji Tokunaga, Tomohito Hishikawa, Hisakazu Itami, Yu Okuma, Masafumi Hiramatsu, Jun Haruma, Isao Date

    Neurological Surgery   40 ( 9 )   765 - 774   2012年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    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 reembolization. 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.

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  • Periprocedural cilostazol treatment and restenosis after carotid artery stenting: the Retrospective Study of In-Stent Restenosis after Carotid Artery Stenting (ReSISteR-CAS). 国際誌

    Hiroshi Yamagami, Nobuyuki Sakai, Yuji Matsumaru, Chiaki Sakai, Yutaka Kai, Kenji Sugiu, Toshiyuki Fujinaka, Yasushi Matsumoto, Shigeru Miyachi, Shinichi Yoshimura, Toshio Hyogo, Naoya Kuwayama, Akio Hyodo

    Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association   21 ( 3 )   193 - 9   2012年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Restenosis after carotid artery stenting (CAS) is a critical issue. Cilostazol can reduce restenosis after interventions in coronary or femoropopliteal arteries. We investigated whether periprocedural cilostazol treatment was related to the incidence of in-stent restenosis (ISR) or target vessel revascularization (TVR) after CAS. The study group comprised 553 of 580 patients who underwent CAS between April 2003 and August 2006 and were followed for 30 months after the procedure. ISR was defined as stenosis of at least 50% detected on angiography or ultrasonography. TVR was defined as revascularization of the treated carotid artery. During CAS, 207 patients (37.4%) were treated with cilostazol. Over 30 months, ISR occurred in 23 patients (4.2%), TVR occurred in 16 patients (2.9%), and either ISR or TVR occurred in 25 patients (4.5%). The incidence of ISR or TVR was significantly lower in the cilostazol-treated group than in the untreated group (1.4% vs 6.4%; log-rank P = .006). In a multivariate analysis, cilostazol treatment (hazard ratio [HR], 0.28; 95% confidence interval [CI], 0.08-0.95; P = .041) and stent diameter (HR, 0.73/1-mm increase; 95% CI, 0.54-0.99; P = .044) were independent factors for the occurrence of ISR or TVR. The incidence of a composite of events, including thromboembolism, hemorrhage, death, and TVR, tended to be lower in the cilostazol-treated group than in the untreated group (15.0% vs 19.9%; log-rank P = .17). Periprocedural cilostazol treatment was associated with lower rates of ISR and retreatment after CAS. A prospective randomized controlled trial is needed to clarify the effect of cilostazol on ISR after CAS.

    DOI: 10.1016/j.jstrokecerebrovasdis.2010.06.007

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  • Usefulness of endovascular treatment for delayed massive epistaxis following endoscopic endonasal transsphenoidal surgery: A case report 査読

    Tetsuo Oka, Kenji Sugiu, Joji Ishida, Tomohito Hishikawa, Shigeki Ono, Koji Tokunaga, Isao Date

    Neurological Surgery   40 ( 1 )   55 - 60   2012年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    We report here a case of massive nasal bleeding from the sphenopalatine artery three weeks after endonasal transsphenoidal surgery. This 66-year-old male suffered from massive nasal bleeding with the status of hypovolemic shock. Under general anesthesia, an emergent angiography revealed an extravasation from the sphenopalatine artery. Trans-arterial embolization using coil and n-butyl-cyanoacrylate (NBCA) was performed following the diagnostic angiography. Complete occlusion of the injured artery was achieved. The patient showed good recovery from general anesthesia. Delayed nasal bleeding after endonasal transsphenoidal surgery is a rare but important complication. The sphenopalatine artery and its branch are located in the hidden inferior lateral corner of the sphenoid sinus and may be injured during enlargement of the sphenoid opening. When massive delayed nasal bleeding follows transsphenoidal surgery and damage of the internal carotid artery has been ruled out, endovascular treatment of the external carotid artery should be considered.

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  • Improvement of depression after treatment of dural arteriovenous fistula: a case report and a review. 国際誌

    Minoru Nakagawa, Kenji Sugiu, Koji Tokunaga, Chihoko Sakamoto, Kenjiro Fujiwara

    Case reports in psychiatry   2012   730151 - 730151   2012年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Patients with dural arteriovenous fistulas (DAVFs) in the transverse-sigmoid sinus suffer from several symptoms: bruit, headache, visual impairment, and so on. But depression is rare in patients with DAVF. The authors reported a rare case presenting the improvement of depression after the treatment of a dural arteriovenous fistula in the left transverse-sigmoid sinus. A 46-year-old male had suffered from depression and was treated with antidepressants at a local hospital for four years. The patient was temporarily laid off due to his depression. Afterwards, he had Gerstmann's syndrome and came to our hospital. A DAVF in the left transverse-sigmoid sinus was demonstrated on the angiogram. The DAVF was successfully treated with endovascular surgery, coil embolization of the isolated diseased sinus through the mastoid emissary vein which was a draining vein from the fistula. After this treatment, his depression as well as Gerstmann's syndrome was improved and the quantity of the antidepressants decreased. The patient returned to work without any antidepressant two years after the treatment. DAVFs might be one of the causes of depression. It may be necessary to evaluate cerebral vessels in patients suffering from depression by using MRA or 3D-CTA even if there are not any abnormal findings on plain CT scans.

    DOI: 10.1155/2012/730151

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  • Cavernous sinus dural arteriovenous fistulas treated with percutaneous transvenous embolization using liquid material: Two case reports 査読

    Masafumi Hiramatsu, Kenji Sugiu, Koji Tokunaga, Ayumi Nishida, Mitsuo Kuriyama, Tomohide Maeshiro, Kaoru Terasaka, Isao Date

    Neurological Surgery   39 ( 12 )   1189 - 1196   2011年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    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.

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  • Computational fluid dynamics of carotid arteries after carotid endarterectomy or carotid artery stenting based on postoperative patient-specific computed tomography angiography and ultrasound flow data. 査読 国際誌

    Hitoshi Hayase, Koji Tokunaga, Toshio Nakayama, Kenji Sugiu, Ayumi Nishida, Seiji Arimitsu, Tomohito Hishikawa, Shigeki Ono, Makoto Ohta, Isao Date

    Neurosurgery   68 ( 4 )   1096 - 101   2011年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: There are significant differences in the postoperative morphological and hemodynamic conditions of the carotid arteries between carotid artery stenting (CAS) and endarterectomy (CEA). OBJECTIVE: To compare the postoperative rheological conditions after CAS with those after CEA with patch angioplasty (patch CEA) through the use of computational fluid dynamics (CFD) based on patient-specific data. METHODS: The rheological conditions in the carotid arteries were simulated in 2 patients after CAS and in 2 patients after patch CEA by CFD calculations. Three-dimensional reconstruction of the carotid arteries was performed with the images obtained with computed tomography angiography. The streamlines and wall shear stress (WSS) were calculated by a supercomputer. Adequate boundary conditions were determined by comparing the simulation results with ultrasound flow data. RESULTS: CFD was successfully calculated for all patients. The differences between the flow velocities of ultrasound data and those of the simulation results were limited. In the streamline analysis, the maximum flow velocities in the internal carotid artery after patch CEA were around two-thirds of those after CAS. Rotational slow flow was observed in the internal carotid artery bulb after patch CEA. WSS analysis found regional low WSS near the outer wall of the bulb. High WSS was observed at the distal end of the arteriotomy after patch CEA and at the residual stenosis after CAS. CONCLUSION: CFD of postoperative carotid arteries disclosed the differences in streamlines and WSS between CAS and patch CEA. CFD may allow us to obtain adequate rheological conditions conducive to achieving the best clinical results.

    DOI: 10.1227/NEU.0b013e318208f1a0

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  • [Vasospasm of Adamkiewicz artery after subarachnoid hemorrhage].

    Yasuyuki Miyoshi, Akihiko Kondo, Takao Yasuhara, Ayumi Nishida, Koji Tokunaga, Kenji Sugiu, Isao Date

    Brain and nerve = Shinkei kenkyu no shinpo   63 ( 2 )   182 - 3   2011年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Percutaneous Balloon Angioplasty for Acute Occlusion of Intracranial Arteries 査読 国際誌

    Koji Tokunaga, Kenji Sugiu, Kimihiro Yoshino, Yoshinori Terai, Takashi Imaoka, Akira Handa, Nobuyuki Hirotsune, Noboru Kusaka, Isao Date

    NEUROSURGERY   67 ( 3 )   189 - 196   2010年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    BACKGROUND: The benefits of intravenous thrombolysis for acute ischemic stroke are still limited.
    OBJECTIVE: To evaluate the safety and efficacy of double-lumen balloon catheter-based reperfusion therapy with or without intra-arterial thrombolysis for acute occlusion of intracranial arteries.
    METHODS: Fifty-nine patients with acute occlusion of intracranial arteries were enrolled. A Gateway balloon catheter was used to disrupt clots or dilate atheromatous plaques in every patient. The technical details, technique-related complications, recanalization rates, and clinical outcomes were analyzed.
    RESULTS: The occlusion sites were internal carotid arteries in 17 patients, M1 segments in 32 patients, the M2 segment in 1 patient, a vertebral artery in 1 patient, and basilar arteries in 8 patients. Twenty-four patients (41%) were treated with thrombolysis first, and 20 patients (34%) were treated with percutaneous transluminal angioplasty (PTA) followed by thrombolysis. PTA alone was performed in 15 patients (25%). The mean dose of urokinase was 205 x 103 U. The extent of recanalization was complete (Thrombolysis in Myocardial Infarction [TIMI] score of 3) in 17 patients (29%), and partial (TIMI 1/2) in 28 patients (47%). Functional independence at discharge was preserved in 76%, 25%, and 7% of patients with TIMI 3, TIMI 1/2, and TIMI 0, respectively. A combination of PTA and thrombolysis resulted in a significantly higher recanalization rate than PTA only. Seven patients (12%) experienced hemorrhagic events after treatment. Severe parenchymal hemorrhage with neurologic deterioration was observed in 2 patients (4%), and vessel rupture was encountered in 1 atherosclerotic case.
    CONCLUSIONS: Mechanical angioplasty using a Gateway catheter combined with a low-dose thrombolytic agent is a safe and effective treatment for acute intracranial embolic and atherosclerotic occlusion with a low risk of hemorrhagic complications.

    DOI: 10.1227/01.NEU.0000380954.29925.CE

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  • A case of a ruptured vertebral artery dissecting aneurysm recanalized after internal trapping 査読

    Yoichiro Kikuchi, Kenji Sugiu, Koji Tokunaga, Ayumi Nishida, Takushi Nishimura, Isao Date

    NEUROLOGICAL SURGERY   35 ( 8 )   813 - 819   2007年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:IGAKU-SHOIN LTD  

    A 35-year-old male experienced a sudden onset of severe headache. A CT scan revealed subarachnoid hemorrhage. By cerebral angiography, he was diagnosed as having a ruptured right vertebral artery dissecting aneurysm (VADA). It was successfully treated by endovascular occlusion of the affected site, including the aneurysm and parent artery, by using detachable coils. A follow-up angiography obtained seven months after the first treatment revealed the recanalization of the right vertebral artery and dissected aneurysm in an antegrade fashion. A skull X-ray image was useful for detecting the change in appearance of the coils. The second embolization was successfully performed in the same manner Based on this rare case, the authors emphasize that a careful angiographic analysis and complete internal trapping of the dissecting site are important in the treatment of the ruptured VADA.

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  • Endovascular treatment of adult pial arteriovenous fistula 査読

    Naohisa Itami, Kenji Sugiu, Koji Tokunaga, Shigeki Ono, Keisuke Onoda, Isao Date

    NEUROLOGICAL SURGERY   35 ( 6 )   599 - 605   2007年6月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:IGAKU-SHOIN LTD  

    The authors report a case of adult pial arteriovenous fistula successfully treated by endovascular glue embolization. A 65-year-old man presented with left hemiparesis and was admitted to the local hospital. Computed tomography scan showed a cerebral hematoma. Cerebral angiography revealed pial single-channel arteriovenous fistula at the right angular artery. An emergent craniotomy was performed and hematoma was successfully evacuated on the next day. Since the post-operative angiography revealed a persisting arteriovenous fistula, the patient was referred to our institute for additional treatment. With the patient under local anesthesia, endovascular treatment was performed through the trans-femoral artery approach. A flow-guided microcatheter was successfully navigated just proximal to the fistula site. Histoacryl was then injected, and complete obliteration of the fistula was obtained. The subsequent course was uneventful and the patient returned to his daily life with only very mild left hemiparesis. Endovascular glue embolization plays an important role in the treatment of pial arteriovenous fistula.

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  • [Preoperative assessment of microvascular decompression for hemifacial spasm with fusion imaging of 3D MR cisternogram/angiogram]. 査読

    Onoda K, Satoh T, Miyosnhi Y, Tokunaga K, Sugiu K, Date I

    No shinkei geka. Neurological surgery   34 ( 8 )   785 - 791   2006年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Direct surgery for paraclinoid aneurysm arising from the anterolateral wall of the internal carotid artery 査読

    K Onoda, K Tokunaga, K Sugiu, S Ono, Date, I

    NEUROLOGICAL SURGERY   34 ( 3 )   267 - 272   2006年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:IGAKU-SHOIN LTD  

    The internal carotid aneurysm (ICA) arising from the paraclinoid region is associated with the origins of the superior hypophyseal artery and the ophthalmic artery. Recently, other aneurysms which can arise in this region without imvolvement of the arterial branches has been reported. Among those aneurysms, there are very rare type of aneurysms located on the anterolateral aspect of the internal carotid artery.
    In this report, we described our experience with direct surgery for five cases of the unruptuted paraclinoid aneurysm arising from the anterolateral aspect of the ICA.
    Firstly, the conmon carotid artery was exposed to carry out proximal flow control. We used the pterional approach. The anterior clinoid process was deleted after having confirmed aneurysm and the dural ring was incised. Extreme care had to be taken during this step. All patients underwent Successful neck clipping.
    In recent two cases we employed the neuroendoscope (EndoArmTM) to observe the unrecognized area of surgical microscope and untrasonic bone curette (SONOPETTM) to perform the safe removal of the anterior clinoid process. This procedure is very useful for carring out the neck clipping for aneurysms which are located oil the anterolateral aspect of the internal carotid artery.

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  • [Percutaneous vertebroplasty combined with radiofrequency ablation for a patient with a spinal metastatic tumor: case report].

    Koji Tokunaga, Kenji Sugiu, Yasuyuki Miyoshi, Hidefumi Mimura, Susumu Kanazawa, Isao Date

    No shinkei geka. Neurological surgery   33 ( 8 )   811 - 5   2005年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Recent technological development has allowed expanding applications of radiofrequency ablation (RFA) for malignant tumor therapy. We report a case with a spinal metastatic tumor treated with combination of percutaneous vertebroplasty (PVP) that provides pain relief and spinal stabilization and RFA. A 68-year-old male who had undergone resection of left ureteric carcinoma was referred to our hospital with lower back pain due to the fifth lumbar (L5) vertebral metastatic tumor. Conventional radiation therapy was discontinued because of pneumonia. One year later, the patient was admitted again with weakness of the right knee and foot and severe pain of the back and the right lower extremity. Radiographs demonstrated a compressive fracture of the L5 vertebra predominantly on the right side. CT and MRI showed a tumor of the L5 body invading the right pedicle, the intervertebral foramen, and the retroperitoneal space. RFA was performed in the ventral part of the L5 body, and then around the right L5/the first sacral intervertebral foramen. Temperature and time for ablation ranged from 74 degrees C to 95 degrees C and from 11 min. to 30 min., respectively. Next, PVP was performed by the right transpedicular approach. Bone cement was injected into the L5 body and the pedicle by an amount of 3.0 ml in total without technical complications. Postoperatively, visual analogue scale demonstrated decreased pain degree from 10 cm to 5.4 cm. Combined treatment with RFA and PVP is a feasible and promising procedure for spinal metastatic tumors. Further evaluation is necessary to confirm its long-term efficacy.

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  • [Assessment of the perianeurysmal environment of unruptured internal carotid-posterior communicating artery aneurysms with fusion imaging of three-dimensional magnetic resonance cisternography and angiography]. 査読

    Satoh T, Omi M, Ohsako C, Katsumata A, Yoshimoto Y, Tsuchimoto S, Onoda K, Tokunaga K, Sugiu K, Date I

    No shinkei geka. Neurological surgery   33 ( 6 )   569 - 577   2005年6月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Local intraarterial fibrinolysis in central retinal artery occlusion: Case report 査読

    M Tagawa, K Sugiu, K Tokunaga, W Sasahara, K Watanabe, N Tamesa, S Ono, K Onoda, Date, I

    NEUROLOGICAL SURGERY   33 ( 6 )   619 - 623   2005年6月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:IGAKU-SHOIN LTD  

    The authors report a case of local intraarterial fibrinolysis (LIF) in central retinal artery occlusion (CRAO). A 79-year-old man with stenosis of the left internal carotid artery (ICA) suffered sudden loss of vision in his left eye. LIF was carried out using a microcatheter in the origin of the ophthalmic artery on the side of the CRAO. Treatment was performed with 120,000 IU of urokinase. After LIF, marked improvement of vision was established. No complication occurred during LIF One month later, carotid artery stenting was performed for the left ICA stenosis. We consider LIF in CRAO is effective treatment.

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  • [Assessment of the signal intensity distribution pattern within the unruptured cerebral aneurysms using color-coded 3D MR angiography]. 査読

    Satoh T, Omi M, Ohsako C, Katsumata A, Yoshimoto Y, Tsuchimoto S, Kunishio K, Onoda K, Tokunaga K, Sugiu K, Date I

    No shinkei geka. Neurological surgery   33 ( 5 )   445 - 454   2005年5月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Combination therapy for cerebral vasospasm after SAH: Importance of spinal drainage and Intraarterial injection of fasudil hydrochloride 査読

    S Ono, K Onoda, K Tokunaga, K Sugiu, Date, I

    Proceedings of the 13th World Congress of Neurological Surgery, Vols 1 and 2   379 - 385   2005年

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    記述言語:英語   掲載種別:研究論文(国際会議プロシーディングス)   出版者・発行元:MEDIMOND S R L  

    Introduction: We hypothesize that the combination therapy of lumbar drainage (LD) with intraarterial injection of Fasudil hydrochloride for cerebral vasospasm (VS) can improve the prognosis of the patients of SAH compared with the therapy of cisternal drainage (CD) with the arterial injection of Fasudil hydrochloride (FH). Materials and Methods: Forty-four patients with aneurysmal SAH who were admitted to our University between January 2003 and April 2005. The treatment group consisted of 30 patients in whom a LD had been placed with intraarterial FH, if necessary, whereas the control group was composed of 14 patients who received the CD with same interventional treatment, if necessary. Age, gender, Hunt and Kosnik grade (H & K), Fisher group, a VS rate, and a rate of normal pressure hydrocephalus (NPH) were compared between these two groups. Primary endpoint was set using Glasgow outcome scale (GOS) after 3 months from onset. Results: There was no difference of age, gender, H & K, and Fisher group between these two groups. Intraarterial FH injection was performed in 20% and 50% of the LD and CD groups, respectively. The rate of angiographic VS in the CD group was significantly higher than that in the LD group (36.7% and 85.7% respectively). Symptomatic VS occurred frequently in the CD group compared with that in the LD group. There was statistically significance between these groups (64.3% vs 23.3%). NPH was noted in 13.3% of the LD group and 42.9% of the CD group. However, regarding GOS there was no statistical difference between these two groups. Conclusions: Although outcome of these groups have no statistical difference, these results indicate that LD was more effective for preventing VS after SAH compared with CD. The combination therapies for VS using LD and intraarterial FH injection can improve the prognosis of VS after SAH, and it should be considered as a new multimodality therapy for the treatment of the patients with SAH.

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  • Endovascular treatment for ruptured vertebral artery dissecting aneurysms 査読

    K Sugiu

    NEUROLOGICAL SURGERY   32 ( 12 )   1229 - 1238   2004年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:IGAKU-SHOIN LTD  

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  • Complications of embolization for cerebral arteriovenous malformations 査読

    K Sugiu, K Tokunaga, W Sasahara, K Watanabe, A Nishida, S Ono, S Nishio, Date, I, DA Rufenacht

    INTERVENTIONAL NEURORADIOLOGY   10   59 - 61   2004年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:EDIZIONI CENTAURO  

    Embolization is recognized as an important adjunct in the treatment of cerebral arteriovenous malformations (AVMs). We reviewed our results of embolizations for AVMs and discussed procedure-related complications. Eleven complications were recorded in 68 consecutive patients (16%). Of these, four were technical problems including a glued catheter, inability to withdraw the catheter, vessel perforation by the microcatheter, and coil migration. Other complications included three cases of ischemic symptoms due to retrograde thrombosis, two cases of asymptomatic cerebral infarction, one case of asymptomatic small haemorrhage due to venous occlusion, and one case of post-embolization haemorrhage of unknown etiology. Our morbidity rate was 7%, mortality rate was 0%, and asymptomatic complication rate was 9%, retorospectively. Further improvements to endovascular techniques and devices are required.

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  • [A case of convulsion during selective intra-arterial infusion of fasudil hydrochloride for treatment of vasospasm following subarachnoid hemorrhage].

    Wataru Sasahara, Shigeki Ono, Koji Tokunaga, Kenji Sugiu, Hiroyuki Nakashimia, Isao Date, Takashi Ohmoto

    No shinkei geka. Neurological surgery   32 ( 5 )   487 - 91   2004年5月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    The authors report a case of convulsion during intra-arterial selective infusion of fasudil hydrochloride (FSD) for treatment of vasospasm following subarachnoid hemorrhage (SAH). A 47-year-old man (Hunt and Kosnik grade I) presented with sudden onset of headache and was diagnosed with SAH on CT, and admitted to our hospital. Digital subtraction angiography (DSA) performed on admission revealed an anterior communicating artery aneurysm. Neck clipping of the aneurysm was performed on the same day and no neurological deficits were noted postoperatively. Motor aphasia appeared on day 11 after the operation, and emergency DSA revealed vasospasm of the left middle cerebral artery and its branches. Emergency percutaneous transluminal angioplasty was performed with successful dilation of the left M1 artery, and 25 milligrams of FSD was injected into the left M1 artery selectively. During this injection, right hemifacial convulsion appeared, and three minutes later disappeared. No treatment was needed for the seizure. Additional injection of 30 milligrams of FSD into the left internal carotid artery resulted in vasodilatation of the left M1 artery and its branches, improvement of their blood flow on angiography, and recovery from motor aphasia. The patient was discharged 1 month later with no neurological deficits. Intra-arterial selective infusion of FSD plays an important role in treatment for vasospasm following SAH, however, we must be aware of risks of complications such as convulsion.

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  • [Evaluation of the contours and perianeurysmal environment of unruptured cerebral aneurysms, using three-dimensional magnetic resonance cisternogram]. 査読

    Satoh T, Ekino C, Ohsako C, Katsumata A, Onoda K, Tsuchimoto S, Yunoki M, Tokunaga K, Sugiu K, Date I

    No shinkei geka. Neurological surgery   32 ( 3 )   215 - 221   2004年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • [Spontaneous thrombosis of a fusiform aneurysm arising from the distal posterior cerebral artery: case report].

    Akihiko Kondo, Takao Yasuhara, Kenji Sugiu, Takashi Ohmoto

    No shinkei geka. Neurological surgery   31 ( 2 )   189 - 93   2003年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 58-year-old woman complaining of a mild headache was admitted to our hospital. MRI 3 months before admission revealed a round lesion at the right quadrigeminal cistern. Cerebral angiograms demonstrated a fusiform aneurysm arising from the parietooccipital artery, which is the distal branch of the right posterior cerebral artery. Repeated MRI and cerebral angiograms performed on admission demonstrated complete thrombosis of an aneurysm and the parent artery without any clinical symptoms. This is the first case of complete spontaneous thrombosis of an aneurysm of the distal posterior cerebral artery. The mechanism of its development and spontaneous thrombosis in a fusiform aneurysm is discussed.

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  • [Percutaneous vertebroplasty--indications and procedural techniques].

    Koji Tokunaga, Kenji Sugiu, Hiroyuki Nakashima, Isao Date, Takashi Ohmoto, Jean-Baptiste Martin, Daniel A Rüfenacht

    No shinkei geka. Neurological surgery   31 ( 1 )   7 - 14   2003年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Training in neurovascular intervention 査読

    K Sugiu, K Tokunaga, Date, I, T Ohmoto

    NEUROLOGICAL SURGERY   30 ( 11 )   1231 - 1237   2002年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:IGAKU-SHOIN LTD  

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  • [A review of dural arteriovenous fistulas with hemorrhagic onset].

    Ayumi Nishida, Kenji Sugiu, Atsushi Katsumata, Noboru Kusaka, Hiroyuki Nakashima, Takashi Ohmoto

    No shinkei geka. Neurological surgery   30 ( 10 )   1059 - 64   2002年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    The majority of dural arteriovenous fistulas are considered to have a benign clinical course, but some behave more aggressively, causing progressive neurological symptoms and/or intracranial hemorrhage. Several classifications of angiographic findings have been reported to predict what findings might result in catastrophic presentation. Cortical venous drainage has been described as one of the major risk factors of hemorrhage. We reviewed the records of 50 patients with dural arteriovenous fistulas admitted to our institution from 1991 to 2001 and analyzed their venous drainage patterns with reference to Cognard's classification. Six patients had hemorrhagic episodes caused by dural arteriovenous fistula and all of them had retrograde drainage through cerebral veins. The frequency of hemorrhage in Type I and IIa was 0%, in Type IIb it was 33.3%, in Type IIa + b it was 9.1%, in Type III and Type IV it was 50%, and in Type V it was 100%. These results agreed with those of Cognard reported in 1994, and we reconfirmed the usefulness of Cognard's classification. In order to adapt a firm strategy and treat them promptly and aggressively, it is important to be able to recognize what type of dural arteriovenous fistulas are perilous.

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  • [Ruptured fenestrated aneurysm of vertebral artery union successfully treated by endovascular surgery with GDC].

    Mitsuhisa Nishiguchi, Kenji Sugiu, Takashi Ohmoto, Toshikazu Saijyo, Hiroyuki Fujisawa

    No shinkei geka. Neurological surgery   30 ( 8 )   875 - 9   2002年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    It is difficult to operate on ruptured basilar artery aneurysms in the acute phase because of the anatomical complexity, brain swelling, patients' medical condition, etc., but because there is some risk of rebleeding and/or vasospasm if surgery is delayed, early surgery is recommended. We encountered a rare case of ruptured fenestrated aneurysm of the vertebral artery (VA) union, treated it safely by endovascular surgery with Guglielmi detachable coils (GDCs) in the acute phase, and obtained a good outcome after intensive care. We therefore conclude that endovascular surgery with GDCs is a first-line therapy for fenestrated aneurysms of the VA union in the acute phase after subarachnoid hemorrhage. Fenestrated aneurysms of the VA union are very rare, and long-term follow-up is mandatory.

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  • Usefulness of dynamic digitized cerebral parenchymography for cerebral vascular disease 査読

    K Sugiu, A Nishida, A Katsumata, N Kusaka, H Nakashima, T Ohmoto

    NEUROLOGICAL SURGERY   30 ( 4 )   379 - 388   2002年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:IGAKU-SHOIN LTD  

    Aortic arch injections according to Theron's method have been performed in patients with cerebral ischemia. Digital subtraction angiograms with modified windowing (low and narrow) have been used for better visualization of cerebral parenchymal condition. This "cerebral parenchymography" allows much easier understanding of cerebral parenchymal vascularization on angiographic imaging. Although further study is necessary to estimate accurate cerebral blood flow, this technique can enable an easy and quick understanding of the overall cerebral hemodynamics.

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  • Successful embolization of a spinal perimedullary arteriovenous fistula with cellulose acetate polymer solution: Technical case report 査読

    K Sugiu, T Meguro, H Nakashiama, T Ohmoto

    NEUROSURGERY   49 ( 5 )   1257 - 1260   2001年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    OBJECTIVE AND IMPORTANCE: Spinal perimedullary arteriovenous fistulae are rarely reported in the literature and can be treated via both endovascular and direct surgical approaches. Coils, glues, and balloons have all been used to embolize these fistulae. Cellulose acetate polymer (CAP) solution is a liquid embolic material that was originally developed for thrombosis of cerebral aneurysms. This is the first report of CAP solution being used to treat a spinal perimedullary arteriovenous fistula, with changes in the viscosity of the solution.
    CLINICAL PRESENTATION: A 15-year-old boy experienced spinal subarachnoid hemorrhage without any neurological deficits. A radiological examination revealed a spinal perimedullary arteriovenous fistula (Type 2) at the L1 level.
    INTERVENTION: Transarterial embolization was performed with local anesthesia. The microcatheter was navigated through the anterior spinal artery to a site just proximal to the fistula. After provocative testing demonstrated negative results, CAP solution was injected and the fistula was completely closed, without complications. The patient experienced an uneventful postoperative course.
    CONCLUSION: We describe the usefulness of CAP solution in the treatment of a spinal perimedullary arteriovenous fistula. This procedure must be performed for a larger series of patients for assessment of its long-term results.

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▼全件表示

書籍等出版物

  • 脳血管内治療の進歩 ブラッシュアップセミナー2020ー分岐部脳動脈瘤のすべてー

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    診断と治療社  2021年 

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    総ページ数:187   担当ページ:37-39   記述言語:日本語

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  • 改訂2版 脳脊髄血管撮影 超実践マニュアル─セッティングと撮影のコツがよく分かる解説Web動画付き─

    杉生憲志 編集( 範囲: 改訂2版 脳脊髄血管撮影 超実践マニュアル─セッティングと撮影のコツがよく分かる解説Web動画付き─)

    メディカ出版  2021年  ( ISBN:9784840475532

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    総ページ数:239   担当ページ:1-239   記述言語:日本語

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  • 改訂2版 脳脊髄血管撮影 超実践マニュアル─セッティングと撮影のコツがよく分かる解説Web動画付き─

    杉生憲志 編集( 範囲: 脳脊髄血管撮影とは─脳脊髄血管撮影の基礎知識─)

    メディカ出版  2021年  ( ISBN:9784840475532

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    総ページ数:239   担当ページ:12-14   記述言語:日本語

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  • 脳血管内治療の進歩─ブラッシュアップセミナー2019─(セッティングのすべて/再開通療法─より広く、より早く、より確実に、D2Pを短くするためになすべきこと─)

    坂井信幸、江面正幸、松丸祐司、宮地 茂、吉村紳一 編集( 担当: 共著 ,  範囲: バルーン閉塞試験(BTO)のセッティング)

    クリエイティブセンター広研  2020年 

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    担当ページ:113-117   記述言語:日本語

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  • 今日の治療指針2019年版(Volume 61)

    福井次矢高木 誠、小村一成 総編集( 担当: 共著 ,  範囲: 脳神経血管内治療─神経・筋疾患─)

    医学書院  2019年 

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    総ページ数:2069   担当ページ:907-908   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: トランサミン (トラネキサム酸)─抗血栓・止血薬 止血(拮抗)薬─)

    メディカ出版  2019年 

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    担当ページ:140-141   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: ワーファリン(ワルファリン)─抗血栓・止血薬 抗凝固薬─)

    メディカ出版  2019年 

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    担当ページ:130-131   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: ヘパリン(ヘパリン)─抗血栓・止血薬 抗凝固薬─)

    メディカ出版  2019年 

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    担当ページ:128-129   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: アドナ (カルバゾクロム)─抗血栓・止血薬 止血(拮抗)薬─)

    メディカ出版  2019年 

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    担当ページ:138-139   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: グルトパ (アルテプラーゼ)─抗血栓・止血薬 血栓溶解薬─)

    メディカ出版  2019年 

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    担当ページ:136-137   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: エフィエント (プラスグレル)─抗血栓・止血薬 抗血小板薬─)

    メディカ出版  2019年 

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    担当ページ:122-123   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: プレタール (シロスタゾール)─抗血栓・止血薬 抗血小板薬─)

    メディカ出版  2019年 

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    担当ページ:120-121   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: カタクロット (オザグレル)─抗血栓・止血薬 抗血小板薬─)

    メディカ出版  2019年 

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    担当ページ:126-127   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: パナルジン (チクロピジン)─抗血栓・止血薬 抗血小板薬─)

    メディカ出版  2019年 

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    担当ページ:124-125   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: プラビックス (クロピドグレル)─抗血栓・止血薬 抗血小板薬─)

    メディカ出版  2019年 

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    担当ページ:118-119   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: ガスター (ファモチジン)─緊急時に用いる薬剤 抗アレルギー薬─)

    メディカ出版  2019年 

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    担当ページ:110-111   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: ポララミン ─緊急時に用いる薬剤 抗アレルギー薬─)

    メディカ出版  2019年 

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    担当ページ:108-109   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: ラジカット (エダラボン)─脳神経外科で用いる薬剤 脳保護薬─)

    メディカ出版  2019年 

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    担当ページ:188-189   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: エリル (ファスジル)─脳神経外科で用いる薬剤 抗脳血管れん縮薬─)

    メディカ出版  2019年 

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    担当ページ:108-109   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: 中止薬─中止薬、小児科Note─)

    メディカ出版  2019年 

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    担当ページ:192-193   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 共著 ,  範囲: 脳神経外科Note(脳外科特有の使用法)─脳神経外科で用いる薬剤─)

    メディカ出版  2019年 

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    担当ページ:190   記述言語:日本語

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  • 脳血管内治療の進歩─ブラッシュアップセミナー2018─くも膜下出血の全て─再開通療法の新時代─

    坂井信幸、江面正幸、松丸祐司、宮地 茂、吉村紳一 編集( 担当: 共著 ,  範囲: 多発動脈瘤にSAHが生じた場合の診断・治療戦略─破裂脳動脈瘤治療、成功のヒント(塞栓術)─)

    診断と治療社  2019年 

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    総ページ数:189   担当ページ:53-57   記述言語:日本語

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  • 脳神経外科 周術期管理のすべて 第5版

    松谷雅生、田村 晃、藤巻高光、森田明夫 編集( 担当: 共著 ,  範囲: 脳血管撮影─検査・治療─)

    メジカルビュー社  2019年 

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    総ページ数:885   担当ページ:778-787   記述言語:日本語

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  • 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─

    杉生憲志 編集( 担当: 編集 ,  範囲: 血管内治療の薬 ケアブック─メディカルスタッフのための血管内治療シリーズ メディカテ①─)

    メディカ出版  2019年 

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    担当ページ:1-199   記述言語:日本語

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  • 新NS NOW No.18 Neurosurgical Controversies─脳神経外科の最新ディベート─

    黒田 敏 担当編集 森田明夫、伊達 勲、菊田健一郎 編集( 担当: 共著 ,  範囲: 治療困難な脳底動脈瘤の治療─血管内治療─)

    メジカルビュー社  2019年 

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  • 第32回微小脳神経外科解剖研究会 講演集

    香川大学医学部脳神経外科 編集( 担当: 共著 ,  範囲: 脳動脈瘤と動眼神経)

    メッド  2018年 

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    総ページ数:70   担当ページ:13-15   記述言語:日本語

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  • Hybrid Neurosurgeonのための疾患別 臨床脳血管解剖テキスト─脳神経外科速報 2018年増刊号─

    大宅宗一 監修、遠藤英徳 編集( 担当: 共著 ,  範囲: 脊髄dAVFの血管内治療)

    メディカ出版  2018年 

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    総ページ数:272   担当ページ:161-168   記述言語:日本語

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  • 脳神経外科ビデオジャーナル─日本脳神経外科 卒後研修用ビデオ─

    ( 担当: 共著 ,  範囲: 脳動脈瘤コイル塞栓術の基本と注意点─Balloon Remodeling Techniqueの実際─)

    メディカルリサーチセンター  2018年 

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    記述言語:日本語

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  • 脳動脈瘤に対する血管内治療 知行合一

    大石英則 編( 担当: 共著 ,  範囲: 脳底動脈上小脳動脈分岐部動脈瘤─脳動脈瘤塞栓術の知行合一─)

    メジカルビュー  2018年  ( ISBN:9784758315791

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    総ページ数:319   担当ページ:230-243   記述言語:日本語

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  • 完全版 脳血管内治療学─病態・治療法の本質的理解と臨床・研究発展のために─

    滝 和郎 監修、宮地 茂、松丸祐司、田中美千裕 編集( 担当: 共著 ,  範囲: マイクロガイドワイヤー①操作性、支持性、安全性─治療材料学 治療に必要なデバイスの特性─)

    メディカ出版  2018年 

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    総ページ数:511   担当ページ:345-348   記述言語:日本語

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  • 脳血管内治療の進歩─ブラッシュアップセミナー2017─

    坂井信幸、江面正幸、松丸祐司、宮地 茂、吉村紳一 編( 担当: 共著 ,  範囲: pull-through法─ミニレクチャー「アクセス・私の工夫」─)

    診断と治療社  2018年 

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    総ページ数:221   担当ページ:12月15日   記述言語:日本語

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  • 新NS NOW No.10 脳動静脈奇形治療のこれまでとこれから─脳神経外科のエベレスト登山─

    メジカルビュー社  2017年  ( ISBN:9784758315708

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  • プライム脳神経外科1 脳動脈瘤

    三輪書店  2017年  ( ISBN:9784895905879

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  • 日本医師会雑誌 第146巻・特別号(1) 脳血管障害診療のエッセンス─障害教育シリーズ 92─

    日本医師会  2017年 

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  • 神経内科 検査・処置マニュアル(ポケット版)

    新興医学出版社  2016年  ( ISBN:9784880021942

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  • 前大脳動脈瘤・椎骨脳底動脈瘤(ACA・VBA Aneurysm)のすべて─シミュレーションで経験する手術・IVR/130本のWEB動画付き─(脳神経外科速報EX 部位別に学ぶ脳動脈瘤シリーズ)

    メディカ出版  2016年  ( ISBN:9784840457873

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  • 脳血管内治療の進歩2017 基礎から最新知見まで─脳血管内治療ブラッシュアップセミナー2016─

    診断と治療社  2016年  ( ISBN:9784787822680

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  • 内頚動脈瘤(ICA Aneurysm)のすべて 近位部(cavernous-paraclinoid)─シミュレーションで経験する手術・IVR 92本のWEB動画付き─(脳神経外科速報EX 部位別に学ぶ脳動脈瘤シリーズ)

    メディカ出版  2015年  ( ISBN:9784840453332

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  • 内頚動脈瘤(ICA Aneurysm)のすべて 近位部(cavernous-paraclinoid)─シミュレーションで経験する手術・IVR 92本のWEB動画付き─(脳神経外科速報EX 部位別に学ぶ脳動脈瘤シリーズ)

    メディカ出版  2015年  ( ISBN:9784840453332

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  • 厚生労働科学研究費補助金 医療技術実用化総合研究事業(臨床研究・治験推進研究事業) 医師主導治験の実施支援並びに我が国の治験推進に関する研究 平成26年度 総括研究報告書集

    公益社団法人日本医師会  2015年 

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  • 脳神経外科診療プラクティス5 無症候性脳血管障害を解く

    文光堂  2015年  ( ISBN:9784830624056

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  • 脳血管内治療レファレンス

    中外医学社  2015年  ( ISBN:9784498228467

     詳細を見る

  • 厚生労働科学研究費補助金 医療技術実用化総合研究 臨床研究・治験推進研究事業 平成25年度 総括・総合研究報告書集

    公益社団法人日本医師会  2014年 

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  • Geriatric Neurosurgery Vol.26

    日本老年脳神経外科学科事務局  2014年 

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  • Geriatric Neurosurgery Vol.26

    2014年 

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  • 中大脳動脈瘤(MCA Aneurysm)のすべて─シミュレーションで経験する手術・IVR 50本のWEB動画付き─(脳神経外科速報EX 部位別に学ぶ動脈瘤シリーズ)

    メディカ出版  2014年  ( ISBN:9784840448956

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  • 中大脳動脈瘤(MCA Aneurysm)のすべて─シミュレーションで経験する手術・IVR 50本のWEB動画付き─(脳神経外科速報EX 部位別に学ぶ動脈瘤シリーズ)

    メディカ出版  2014年  ( ISBN:9784840448956

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  • 脳血管攣縮 Vol.29

    にゅーろん社  2014年 

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  • Interventional Radiology─Rad Fan 9月臨時増刊号Vol.10 No.11─

    三松堂  2012年  ( ISBN:9784862910851

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  • Geriatric Neurosurgery Vol.24

    日本老年脳神経外科学会事務局  2012年 

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  • 神経疾患最新の治療2012-2014

    南江堂  2012年  ( ISBN:9784524264681

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  • 硬膜動静脈瘻塞栓術ハンドブック

    診断と治療社  2011年  ( ISBN:9784840432955

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  • 脳血管攣縮26(脳卒中の外科 第38巻増刊号)

    にゅーろん社  2011年 

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  • 脳神経血管内治療と看護のすべて─これからのニューロナース必携バイブル・治療がわかるDVD付き─

    メディカ出版  2011年  ( ISBN:9784260011051

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  • Geriatric Neurosurgery Vol.22

    日本老年脳神経外科学会事務局  2010年 

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  • 脳血管攣縮25

    にゅーろん社  2010年 

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  • 脳血管内治療診療指針2009─JNET 2009 Vol.3 Suppl 1─

    メディカルトリビューン  2010年 

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  • 脳血管内治療診療指針2009─JNET 2009 Vol.3 Suppl 1─

    メディカルトリビューン  2010年 

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  • 脳血管内治療診療指針2009─JNET 2009 Vol.3 Suppl 1─

    メディカルトリビューン  2010年 

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  • 脳血管攣縮24: 11Rを用いた新しいタンパク質導入法─脳血管障害治療への効果的な新しい薬物導入システムの確立─

    にゅーろん社  2009年 

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  • 脊椎椎体形成術のすべてVol.2

    椎体形成術研究会  2009年 

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  • Geriatric Neurosurgery Vol.21: 骨粗鬆症性脊椎椎体圧迫骨折に対する経皮的椎体形成術の治療成績

    日本老年脳神経外科学会事務局  2009年 

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  • 脳神経外科エキスパート 血管内治療: 液体塞栓物質

    中外医学社  2009年  ( ISBN:9784498128446

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  • 脳血管攣縮24: 簡易型脳内酸素飽和度監視装置INVOS®によるくも膜下出血後脳血管攣縮の検出

    にゅーろん社  2009年 

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  • 脳血管攣縮24: ウサギくも膜下出血モデルにおける抗HMGB1抗体の脳血管攣縮抑制効果

    にゅーろん社  2009年 

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  • 第22回日本脳神経血管内治療学会総会講演集

    にゅーろん社,東京  2007年 

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  • 脳神経血管内治療のすべて─最新症例から学ぶ─

    にゅーろん社,東京  2007年 

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  • 脳神経血管内治療のすべて─最新症例から学ぶ─

    にゅーろん社,東京  2007年 

     詳細を見る

  • 脳神経血管内治療のすべて─最新症例から学ぶ─

    にゅーろん社,東京  2007年 

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  • 脳神経血管内治療のすべて─最新症例から学ぶ─

    にゅーろん社,東京  2007年 

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  • 脳底動脈遠位部動脈瘤─直達手術と血管内治療─第13回脳血管内治療仙台セミナー講演集

    にゅーろん社(東京)  2006年 

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  • 13 World Congress of Neurological surgery

    Bologna,Italy  2005年 

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  • 脳動脈瘤の血管内治療─最新症例集─

    先端医療技術研究所,東京  2005年 

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  • Cerebral Vasospasm Advances in Research and Treatment

    Thieme Medical Publishers,Inc.,New York  2004年 

     詳細を見る

  • 今日の治療指針2004 私はこう治療している

    医学書院,東京  2004年 

     詳細を見る

  • Cerebral Vasospasm Advances in Research and Treatment

    Thieme Medical Publishers,Inc.,New York  2004年 

     詳細を見る

  • Cerebral Vasospasm Advances in Research and Treatment

    Thieme Medical Publishers,Inc.,New York  2004年 

     詳細を見る

  • Cerebral Vasospasm Advances in Research and Treatment

    Thieme Medical Publishers,Inc.,New York  2004年 

     詳細を見る

  • Cerebral Vasospasm Advances in Research and Treatment

    Thieme Medical Publishers,Inc.,New York  2004年 

     詳細を見る

  • 第24回日本脳神経外科コングレス総会発表ビデオVol.6

    メディカルリサーチセンター,東京  2004年 

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  • 先端医療シリーズ29・脳神経外科 脳神経外科の最新医療

    先端医療技術研究所,東京  2004年 

     詳細を見る

  • 厚生労働省特定疾患「ウィリス動脈輪閉塞症の病因・病態に関する研究班」平成13年度総括・分担研究報告書

    2002年 

     詳細を見る

  • 脳血管障害の最新治療

    先端医療技術研究所,東京  2002年 

     詳細を見る

  • 厚生労働省特定疾患 ウィリス動脈輪閉塞症の病因・病態に関する研究班 平成12年度総括・分担研究報告書

    2001年 

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  • 厚生労働省特定疾患ウィリス動脈輪閉塞症の病因・病態に関する研究班 平成12年度総括・分担研究報告書

    2001年 

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▼全件表示

MISC

  • Cerebral circulation improves with indirect bypass surgery combined with gene therapy

    Alex Shear, Shingo Nishihiro, Tomohito Hishikawa, Masafumi Hiramatsu, Kenji Sugiu, Takao Yasuhara, Isao Date

    BRAIN CIRCULATION   5 ( 3 )   119 - 123   2019年7月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元: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

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  • Endovascular treatment for unruptured aneurysm associated with persistent primitive trigeminal artery: a case report and literature review 国際誌

    Satoshi Murai, Kenji Sugiu, Tomohito Hishikawa, Masafumi Hiramatsu, Shingo Nishihiro, Naoya Kidani, Yu Takahashi, Isao Date

    ACTA NEUROCHIRURGICA   161 ( 2 )   407 - 411   2019年2月

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    記述言語:英語   出版者・発行元: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

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  • Angioarchitecture of arteriovenous fistulas at the craniocervical junction: A multicenter cohort study of 54 patients 国際誌

    Masafumi Hiramatsu, Kenji Sugiu, Tomoya Ishiguro, Hiro Kiyosue, Kenichi Sato, Keisuke Takai, Yasunari Niimi, Yuji Matsumaru

    Journal of Neurosurgery   128 ( 6 )   1839 - 1849   2018年6月

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    記述言語:英語   出版者・発行元:American Association of 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

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  • Angioarchitecture of arteriovenous fistulas at the craniocervical junction: A multicenter cohort study of 54 patients

    Masafumi Hiramatsu, Kenji Sugiu, Tomoya Ishiguro, Hiro Kiyosue, Kenichi Sato, Keisuke Takai, Yasunari Niimi, Yuji Matsumaru

    Journal of Neurosurgery   128 ( 6 )   1839 - 1849   2018年6月

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    記述言語:英語   出版者・発行元:American Association of 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

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  • Combined gene therapy with vascular endothelial growth factor plus apelin in a chronic cerebral hypoperfusion model in rats

    Masafumi Hiramatsu, Tomohito Hishikawa, Koji Tokunaga, Hiroyasu Kidoya, Shingo Nishihiro, Jun Haruma, Tomohisa Shimizu, Yuji Takasugi, Yukei Shinji, Kenji Sugiu, Nobuyuki Takakura, Isao Date

    JOURNAL OF NEUROSURGERY   127 ( 3 )   679 - 686   2017年9月

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    記述言語:英語   出版者・発行元: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 &lt; 0.05, respectively). Larger vessels appeared in the VEGF+apelin group than in the other groups (p &lt; 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

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  • Combined gene therapy with vascular endothelial growth factor plus apelin in a chronic cerebral hypoperfusion model in rats

    Masafumi Hiramatsu, Tomohito Hishikawa, Koji Tokunaga, Hiroyasu Kidoya, Shingo Nishihiro, Jun Haruma, Tomohisa Shimizu, Yuji Takasugi, Yukei Shinji, Kenji Sugiu, Nobuyuki Takakura, Isao Date

    JOURNAL OF NEUROSURGERY   127 ( 3 )   679 - 686   2017年9月

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    記述言語:英語   出版者・発行元: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 &lt; 0.05, respectively). Larger vessels appeared in the VEGF+apelin group than in the other groups (p &lt; 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

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  • Combined gene therapy with vascular endothelial growth factor plus apelin in a chronic cerebral hypoperfusion model in rats 国際誌

    Masafumi Hiramatsu, Tomohito Hishikawa, Koji Tokunaga, Hiroyasu Kidoya, Shingo Nishihiro, Jun Haruma, Tomohisa Shimizu, Yuji Takasugi, Yukei Shinji, Kenji Sugiu, Nobuyuki Takakura, Isao Date

    JOURNAL OF NEUROSURGERY   127 ( 3 )   679 - 686   2017年9月

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    記述言語:英語   出版者・発行元: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 &lt; 0.05, respectively). Larger vessels appeared in the VEGF+apelin group than in the other groups (p &lt; 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.

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  • Training guidelines for endovascular stroke intervention: an international multi-society consensus document (vol 58, pg 537, 2016)

    S. D. Lavine, K. Cockroft, B. Hoh, N. Bambakidis, A. A. Khalessi, H. Woo, H. Riina, A. Siddiqui, J. A. Hirsch, W. Chong, H. Rice, J. Wenderoth, P. Mitchell, A. Coulthard, T. J. Signh, C. Phatouros, M. Khangure, P. Klurfan, K. ter Brugge, D. Iancu, T. Gunnarsson, O. Jansen, M. Muto, I. Szikora, L. Pierot, P. Brouwer, J. Gralla, S. Renowden, T. Andersson, J. Fiehler, F. Turjman, P. White, A. C. Januel, L. Spelle, Z. Kulcsar, R. Chapot, A. Biondi, S. Dima, C. Taschner, M. Szajner, A. Krajina, N. Sakai, Y. Matsumaru, S. Yoshimura, M. Ezura, T. Fujinaka, K. Iihara, A. Ishii, T. Higashi, M. Hirohata, A. Hyodo, Y. Ito, M. Kawanishi, H. Kiyosue, E. Kobayashi, S. Kobayashi, N. Kuwayama, Y. Matsumoto, S. Miyachi, Y. Murayama, I. Nagata, I. Nakahara, S. Nemoto, Y. Niimi, H. Oishi, J. Satomi, T. Satow, K. Sugiu, M. Tanaka, T. Terada, H. Yamagami, O. Diaz, P. Lylyk, M. V. Jayaraman, A. Patsalides, C. D. Gandhi, S. K. Lee, T. Abruzzo, B. Albani, S. A. Ansari, A. S. Arthur, B. W. Baxter, K. R. Bulsara, M. Chen, J. E. Delgado Almandoz, J. F. Fraser, D. V. Heck, S. W. Hetts, M. S. Hussain, R. P. Klucznik, T. M. Leslie-Mawzi, W. J. Mack, R. A. McTaggart, P. M. Meyers, J. Mocco, C. J. Prestigiacomo, G. L. Pride, P. A. Rasmussen, R. M. Starke, P. J. Sunenshine, R. W. Tarr, D. F. Frei, M. Ribo, R. G. Nogueira, O. O. Zaidat, T. Jovin, I. Linfante, D. Yavagal, D. Liebeskind, R. Novakovic, S. Pongpech, G. Rodesch, M. Soderman, A. Taylor, T. Krings, D. Orbach, L. Picard, D. C. Suh, H. Q. Zhang

    NEURORADIOLOGY   59 ( 8 )   829 - 829   2017年8月

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    記述言語:英語   出版者・発行元:SPRINGER  

    DOI: 10.1007/s00234-017-1861-8

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  • Training guidelines for endovascular stroke intervention: an international multi-society consensus document (vol 58, pg 537, 2016)

    S. D. Lavine, K. Cockroft, B. Hoh, N. Bambakidis, A. A. Khalessi, H. Woo, H. Riina, A. Siddiqui, J. A. Hirsch, W. Chong, H. Rice, J. Wenderoth, P. Mitchell, A. Coulthard, T. J. Signh, C. Phatouros, M. Khangure, P. Klurfan, K. ter Brugge, D. Iancu, T. Gunnarsson, O. Jansen, M. Muto, I. Szikora, L. Pierot, P. Brouwer, J. Gralla, S. Renowden, T. Andersson, J. Fiehler, F. Turjman, P. White, A. C. Januel, L. Spelle, Z. Kulcsar, R. Chapot, A. Biondi, S. Dima, C. Taschner, M. Szajner, A. Krajina, N. Sakai, Y. Matsumaru, S. Yoshimura, M. Ezura, T. Fujinaka, K. Iihara, A. Ishii, T. Higashi, M. Hirohata, A. Hyodo, Y. Ito, M. Kawanishi, H. Kiyosue, E. Kobayashi, S. Kobayashi, N. Kuwayama, Y. Matsumoto, S. Miyachi, Y. Murayama, I. Nagata, I. Nakahara, S. Nemoto, Y. Niimi, H. Oishi, J. Satomi, T. Satow, K. Sugiu, M. Tanaka, T. Terada, H. Yamagami, O. Diaz, P. Lylyk, M. V. Jayaraman, A. Patsalides, C. D. Gandhi, S. K. Lee, T. Abruzzo, B. Albani, S. A. Ansari, A. S. Arthur, B. W. Baxter, K. R. Bulsara, M. Chen, J. E. Delgado Almandoz, J. F. Fraser, D. V. Heck, S. W. Hetts, M. S. Hussain, R. P. Klucznik, T. M. Leslie-Mawzi, W. J. Mack, R. A. McTaggart, P. M. Meyers, J. Mocco, C. J. Prestigiacomo, G. L. Pride, P. A. Rasmussen, R. M. Starke, P. J. Sunenshine, R. W. Tarr, D. F. Frei, M. Ribo, R. G. Nogueira, O. O. Zaidat, T. Jovin, I. Linfante, D. Yavagal, D. Liebeskind, R. Novakovic, S. Pongpech, G. Rodesch, M. Soderman, A. Taylor, T. Krings, D. Orbach, L. Picard, D. C. Suh, H. Q. Zhang

    NEURORADIOLOGY   59 ( 8 )   829 - 829   2017年8月

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    記述言語:英語   出版者・発行元:SPRINGER  

    DOI: 10.1007/s00234-017-1861-8

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  • De novo vertebral artery dissecting aneurysm after internal trapping of the contralateral vertebral artery 国際誌

    Naoya Kidani, Kenji Sugiu, Tomohito Hishikawa, Masafumi Hiramatsu, Jun Haruma, Shingo Nishihiro, Yu Takahashi, Isao Date

    ACTA NEUROCHIRURGICA   159 ( 7 )   1329 - 1333   2017年7月

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    記述言語:英語   出版者・発行元: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.

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  • Post coiling syndrome might predict recurrence after coil embolization of unruptured cerebral aneurysms.

    Okuma Y, Sugiu K, Hirotsune N, Hishikawa T, Muraoka K, Hiramatsu M, Nishino S, Date I

    Journal of Neuroendovascular Therapy   11 ( 5 )   235 - 239   2017年

  • LVIS & LVIS Jr stent.

    杉生憲志

    Rad Fan   15 ( 12 )   72 - 74   2017年

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  • dAVFの治療─横S状静脈洞部─.

    平松匡文, 菱川朋人, 杉生憲志

    Clinical Neuroscience   35 ( 10 )   1222 - 1225   2017年

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  • 急性期脳梗塞の血管内治療最前線.

    杉生憲志, 平松匡文, 菱川朋人, 伊達 勲

    日本内科学会雑誌   106 ( 8 )   1646 - 1651   2017年

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  • 硬膜動静脈瘻─動脈・静脈の疾患(臓器別):脳血管疾患─.

    菱川朋人, 杉生憲志, 伊達 勲

    日本臨床 増刊号 動脈・静脈の疾患 下   75 ( Suppl 5 )   715 - 718   2017年

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  • 3DDSA-MRI fusion画像を用いた脳血管障害に対する開頭手術術前シミュレーション.

    平松匡文, 杉生憲志, 菱川朋人, 春間 純, 高杉祐二, 西廣真吾, 新治有径, 伊達 勲

    脳卒中の外科   45 ( 4 )   270 - 275   2017年

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    記述言語:日本語   出版者・発行元:(一社)日本脳卒中の外科学会  

    2013年9月〜2015年10月に脳血管障害に対する開頭手術術前に3DDSA-MRI fusion画像を作成した3例を対象に、画像作成法を紹介し、脳血管障害に対する手術の術前シミュレーションとして有用か検討した。fusion画像は10〜15分程度で、全例問題なく作成できた。全例、fusion画像の有用性が認められ、手術戦略や手術アプローチに影響を与えていた。血管位置の最大誤差は平均2.5±0.1mmであったが、実際の術野での脳表上の血管構造物の同定には全例支障がなかった。頭蓋内血管病変に対する3DDSA-MRI fusionを活用することで、脳血管障害に対する術前シミュレーションとして有効と思われた。

    DOI: 10.2335/scs.45.270

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  • 手術当日術全塞栓術が有用であった充実性小脳血管芽腫の2例.

    桑原 研, 市川智継, 春間 純, 菱川朋人, 平松匡文, 杉生憲志, 伊達 勲

    脳神経外科   45 ( 7 )   615 - 622   2017年

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  • 血管内治療シミュレーターを用いたシミュレーション教育.

    新治有径, 杉生憲志, 村井 智, 春間 純, 菱川朋人, 平松匡文, 高橋 悠, 木谷尚哉, 西廣真吾, 伊野英男, 伊達 勲

    脳神経外科速報   27 ( 7 )   751 - 754   2017年

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  • Preoperative embolization for solid cerebellar hemangioblastoma on the day of surgery

    Ken Kuwahara, Tomotsugu Ichikawa, Jun Haruma, Tomohito Hishikawa, Masafumi Hiramatsu, Kenji Sugiu, Isao Date

    Neurological Surgery, No shinkei geka. Neurological surgery   45 ( 7 )   615 - 622   2017年

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    記述言語:日本語  

    DOI: 10.11477/mf.1436203560

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  • Post coiling syndrome might predict recurrence after coil embolization of unruptured cerebral aneurysms.

    Okuma Y, Sugiu K, Hirotsune N, Hishikawa T, Muraoka K, Hiramatsu M, Nishino S, Date I

    Journal of Neuroendovascular Therapy   11 ( 5 )   235 - 239   2017年

  • 非もやもや病小児脳梗塞・脳虚血症例の治療におけるチーム医療の重要性.

    安原隆雄, 菱川朋人, 亀田雅博, 平松匡文, 杉生憲志, 野坂宣之, 塚原紘平, 八代将登, 林裕美子, 伊達 勲

    脳卒中の外科   45 ( 6 )   476 - 482   2017年

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    記述言語:日本語   出版者・発行元:(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。

    DOI: 10.2335/scs.45.476

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  • 子どもたちだけではなく大人達にも夢を、100年続くような…─リレーエッセイ 時間の風景─.

    杉生憲志

    Medical Tribune   50 ( 36 )   24 - 24   2017年

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  • 頭痛のみを契機に発見された椎骨動脈解離性動脈瘤─内科治療で乗り切る?ステント留置を勧める?─.

    天野達雄, 早川幹人, 村井 智, 杉生憲志

    脳神経外科速報   27 ( 12 )   1266 - 1272   2017年

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  • Anti-high mobility group box-1 (HMGB1) antibody attenuates delayed cerebral vasospasm and brain injury after subarachnoid hemorrhage in rats 国際誌

    Jun Haruma, Kiyoshi Teshigawara, Tomohito Hishikawa, Dengli Wang, Keyue Liu, Hidenori Wake, Shuji Mori, Hideo Kohka Takahashi, Kenji Sugiu, Isao Date, Masahiro Nishibori

    SCIENTIFIC REPORTS   6   doi: 10.1038/srep37755 - 37755   2016年11月

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    記述言語:英語   出版者・発行元:NATURE PUBLISHING GROUP  

    Although delayed cerebral vasospasm (DCV) following subarachnoid hemorrhage (SAH) is closely related to the progression of brain damage, little is known about the molecular mechanism underlying its development. High mobility group box-1 (HMGB1) plays an important role as an initial inflammatory mediator in SAH. In this study, an SAH rat model was employed to evaluate the effects of anti-HMGB1 monoclonal antibody (mAb) on DCV after SAH. A vasoconstriction of the basilar artery (BA) associated with a reduction of nuclear HMGB1 and its translocation in vascular smooth muscle cells were observed in SAH rats, and anti-HMGB1 mAb administration significantly suppressed these effects. Upregulations of inflammation-related molecules and vasoconstriction-mediating receptors in the BA of SAH rats were inhibited by anti-HMGB1 mAb treatment. Anti-HMGB1 mAb attenuated the enhanced vasocontractile response to thrombin of the isolated BA from SAH rats and prevented activation of cerebrocortical microglia. Moreover, locomotor activity and weight loss recovery were also enhanced by anti-HMGB1 mAb administration. The vasocontractile response of the BA under SAH may be induced by events that are downstream of responses to HMGB1-induced inflammation and inhibited by anti-HMGB1 mAb. Anti-HMGB1 mAb treatment may provide a novel therapeutic strategy for DCV and early brain injury after SAH.

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  • Anti-high mobility group box-1 (HMGB1) antibody attenuates delayed cerebral vasospasm and brain injury after subarachnoid hemorrhage in rats

    Jun Haruma, Kiyoshi Teshigawara, Tomohito Hishikawa, Dengli Wang, Keyue Liu, Hidenori Wake, Shuji Mori, Hideo Kohka Takahashi, Kenji Sugiu, Isao Date, Masahiro Nishibori

    SCIENTIFIC REPORTS   6   doi: 10.1038/srep37755   2016年11月

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    記述言語:英語   出版者・発行元:NATURE PUBLISHING GROUP  

    Although delayed cerebral vasospasm (DCV) following subarachnoid hemorrhage (SAH) is closely related to the progression of brain damage, little is known about the molecular mechanism underlying its development. High mobility group box-1 (HMGB1) plays an important role as an initial inflammatory mediator in SAH. In this study, an SAH rat model was employed to evaluate the effects of anti-HMGB1 monoclonal antibody (mAb) on DCV after SAH. A vasoconstriction of the basilar artery (BA) associated with a reduction of nuclear HMGB1 and its translocation in vascular smooth muscle cells were observed in SAH rats, and anti-HMGB1 mAb administration significantly suppressed these effects. Upregulations of inflammation-related molecules and vasoconstriction-mediating receptors in the BA of SAH rats were inhibited by anti-HMGB1 mAb treatment. Anti-HMGB1 mAb attenuated the enhanced vasocontractile response to thrombin of the isolated BA from SAH rats and prevented activation of cerebrocortical microglia. Moreover, locomotor activity and weight loss recovery were also enhanced by anti-HMGB1 mAb administration. The vasocontractile response of the BA under SAH may be induced by events that are downstream of responses to HMGB1-induced inflammation and inhibited by anti-HMGB1 mAb. Anti-HMGB1 mAb treatment may provide a novel therapeutic strategy for DCV and early brain injury after SAH.

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  • Moyamoya Disease: A Review of Clinical Research

    Tomohito Hishikawa, Kenji Sugiu, Isao Date

    ACTA MEDICA OKAYAMA   70 ( 4 )   229 - 236   2016年8月

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    記述言語:英語   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    About 5 decades have passed since the concept of moyamoya disease (MMD) was established in Japan. In that time, many clinical MMD studies have been performed from several different points of view, such as epidemiology, pathophysiology, surgical procedures, and prognosis. In addition, rapid developments in MMD genetic analysis have occurred. In light of all this activity, clinicians must continually update their knowledge of MMD in order to improve the prognosis of MMD patients. In this review article, we summarize the clinical MMD studies and introduce cutting-edge findings regarding MMD.

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  • Training guidelines for endovascular stroke intervention: an international multi-society consensus document

    S. D. Lavine, K. Cockroft, B. Hoh, N. Bambakidis, A. A. Khalessi, H. Woo, H. Riina, A. Siddiqui, J. A. Hirsch, W. Chong, H. Rice, J. Wenderoth, P. Mitchell, A. Coulthard, T. J. Signh, C. Phatorous, M. Khangure, P. Klurfan, K. ter Brugge, D. Iancu, T. Gunnarsson, O. Jansen, M. Muto, I. Szikora, L. Pierot, P. Brouwer, J. Gralla, S. Renowden, T. Andersson, J. Fiehler, F. Turjman, P. White, A. C. Januel, L. Spelle, Z. Kulcsar, R. Chapot, A. Biondi, S. Dima, C. Taschner, M. Szajner, A. Krajina, N. Sakai, Y. Matsumaru, S. Yoshimura, M. Ezura, T. Fujinaka, K. Iihara, A. Ishii, T. Higashi, M. Hirohata, A. Hyodo, Y. Ito, M. Kawanishi, H. Kiyosue, E. Kobayashi, S. Kobayashi, N. Kuwayama, Y. Matsumoto, S. Miyachi, Y. Murayama, I. Nagata, I. Nakahara, S. Nemoto, Y. Niimi, H. Oishi, J. Satomi, T. Satow, K. Sugiu, M. Tanaka, T. Terada, H. Yamagami, O. Diaz, P. Lylyk, M. V. Jayaraman, A. Patsalides, C. D. Gandhi, S. K. Lee, T. Abruzzo, B. Albani, S. A. Ansari, A. S. Arthur, B. W. Baxter, K. R. Bulsara, M. Chen, J. E. Delgado Almandoz, J. F. Fraser, D. V. Heck, S. W. Hetts, M. S. Hussain, R. P. Klucznik, T. M. Leslie-Mawzi, W. J. Mack, R. A. McTaggart, P. M. Meyers, J. Mocco, C. J. Prestigiacomo, G. L. Pride, P. A. Rasmussen, R. M. Starke, P. J. Sunenshine, R. W. Tarr, D. F. Frei, M. Ribo, R. G. Nogueira, O. O. Zaidat, T. Jovin, I. Linfante, D. Yavagal, D. Liebeskind, R. Novakovic, S. Pongpech, G. Rodesch, M. Soderman, A. Taylor, T. Krings, D. Orbach, L. Picard, D. C. Suh, H. Q. Zhang

    NEURORADIOLOGY   58 ( 6 )   537 - 541   2016年6月

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    記述言語:英語   出版者・発行元:SPRINGER  

    DOI: 10.1007/s00234-016-1667-0

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  • Training guidelines for endovascular stroke intervention: an international multi-society consensus document

    S. D. Lavine, K. Cockroft, B. Hoh, N. Bambakidis, A. A. Khalessi, H. Woo, H. Riina, A. Siddiqui, J. A. Hirsch, W. Chong, H. Rice, J. Wenderoth, P. Mitchell, A. Coulthard, T. J. Signh, C. Phatorous, M. Khangure, P. Klurfan, K. ter Brugge, D. Iancu, T. Gunnarsson, O. Jansen, M. Muto, I. Szikora, L. Pierot, P. Brouwer, J. Gralla, S. Renowden, T. Andersson, J. Fiehler, F. Turjman, P. White, A. C. Januel, L. Spelle, Z. Kulcsar, R. Chapot, A. Biondi, S. Dima, C. Taschner, M. Szajner, A. Krajina, N. Sakai, Y. Matsumaru, S. Yoshimura, M. Ezura, T. Fujinaka, K. Iihara, A. Ishii, T. Higashi, M. Hirohata, A. Hyodo, Y. Ito, M. Kawanishi, H. Kiyosue, E. Kobayashi, S. Kobayashi, N. Kuwayama, Y. Matsumoto, S. Miyachi, Y. Murayama, I. Nagata, I. Nakahara, S. Nemoto, Y. Niimi, H. Oishi, J. Satomi, T. Satow, K. Sugiu, M. Tanaka, T. Terada, H. Yamagami, O. Diaz, P. Lylyk, M. V. Jayaraman, A. Patsalides, C. D. Gandhi, S. K. Lee, T. Abruzzo, B. Albani, S. A. Ansari, A. S. Arthur, B. W. Baxter, K. R. Bulsara, M. Chen, J. E. Delgado Almandoz, J. F. Fraser, D. V. Heck, S. W. Hetts, M. S. Hussain, R. P. Klucznik, T. M. Leslie-Mawzi, W. J. Mack, R. A. McTaggart, P. M. Meyers, J. Mocco, C. J. Prestigiacomo, G. L. Pride, P. A. Rasmussen, R. M. Starke, P. J. Sunenshine, R. W. Tarr, D. F. Frei, M. Ribo, R. G. Nogueira, O. O. Zaidat, T. Jovin, I. Linfante, D. Yavagal, D. Liebeskind, R. Novakovic, S. Pongpech, G. Rodesch, M. Soderman, A. Taylor, T. Krings, D. Orbach, L. Picard, D. C. Suh, H. Q. Zhang

    NEURORADIOLOGY   58 ( 6 )   537 - 541   2016年6月

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    記述言語:英語   出版者・発行元:SPRINGER  

    DOI: 10.1007/s00234-016-1667-0

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  • Training Guidelines for Endovascular Ischemic Stroke Intervention: An International Multi-Society Consensus Document

    S. D. Lavine, K. Cockroft, B. Hoh, N. Bambakidis, A. A. Khalessi, H. Woo, H. Riina, A. Siddiqui, J. A. Hirsch, W. Chong, H. Rice, J. Wenderoth, P. Mitchell, A. Coulthard, T. J. Signh, C. Phatorous, M. Khangure, P. Klurfan, K. terBrugge, D. Iancu, T. Gunnarsson, O. Jansen, M. Muto, I. Szikora, L. Pierot, P. Brouwer, J. Gralla, S. Renowden, T. Andersson, J. Fiehler, F. Turjman, P. White, A. C. Januel, L. Spelle, Z. Kulcsar, R. Chapot, L. Spelle, A. Biondi, S. Dima, C. Taschner, M. Szajner, A. Krajina, N. Sakai, Y. Matsumaru, S. Yoshimura, M. Ezura, T. Fujinaka, K. Iihara, A. Ishii, T. Higashi, M. Hirohata, A. Hyodo, Y. Ito, M. Kawanishi, H. Kiyosue, E. Kobayashi, S. Kobayashi, N. Kuwayama, Y. Matsumoto, S. Miyachi, Y. Murayama, I. Nagata, I. Nakahara, S. Nemoto, Y. Niimi, H. Oishi, J. Satomi, T. Satow, K. Sugiu, M. Tanaka, T. Terada, H. Yamagami, O. Diaz, P. Lylyk, M. V. Jayaraman, A. Patsalides, C. D. Gandhi, S. K. Lee, T. Abruzzo, B. Albani, S. A. Ansari, A. S. Arthur, B. W. Baxter, K. R. Bulsara, M. Chen, J. E. Delgado Almandoz, J. F. Fraser, D. V. Heck, S. W. Hetts, M. S. Hussain, R. P. Klucznik, T. M. Leslie-Mawzi, W. J. Mack, R. A. McTaggart, P. M. Meyers, J. Mocco, C. J. Prestigiacomo, G. L. Pride, P. A. Rasmussen, R. M. Starke, P. J. Sunenshine, R. W. Tarr, D. F. Frei, M. Ribo, R. G. Nogueira, O. O. Zaidat, T. Jovin, I. Linfante, D. Yavagal, D. Liebeskind, R. Novakovic, S. Pongpech, G. Rodesch, M. Soderman, K. terBrugge, A. Taylor, T. Krings, D. Orbach, A. Biondi, L. Picard, D. C. Suh, M. Tanaka, H. Q. Zhang

    AMERICAN JOURNAL OF NEURORADIOLOGY   37 ( 4 )   E31 - E34   2016年4月

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    記述言語:英語   出版者・発行元:AMER SOC NEURORADIOLOGY  

    DOI: 10.3174/ajnr.A4766

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  • Training Guidelines for Endovascular Ischemic Stroke Intervention: An International Multi-Society Consensus Document

    S. D. Lavine, K. Cockroft, B. Hoh, N. Bambakidis, A. A. Khalessi, H. Woo, H. Riina, A. Siddiqui, J. A. Hirsch, W. Chong, H. Rice, J. Wenderoth, P. Mitchell, A. Coulthard, T. J. Signh, C. Phatorous, M. Khangure, P. Klurfan, K. terBrugge, D. Iancu, T. Gunnarsson, O. Jansen, M. Muto, I. Szikora, L. Pierot, P. Brouwer, J. Gralla, S. Renowden, T. Andersson, J. Fiehler, F. Turjman, P. White, A. C. Januel, L. Spelle, Z. Kulcsar, R. Chapot, L. Spelle, A. Biondi, S. Dima, C. Taschner, M. Szajner, A. Krajina, N. Sakai, Y. Matsumaru, S. Yoshimura, M. Ezura, T. Fujinaka, K. Iihara, A. Ishii, T. Higashi, M. Hirohata, A. Hyodo, Y. Ito, M. Kawanishi, H. Kiyosue, E. Kobayashi, S. Kobayashi, N. Kuwayama, Y. Matsumoto, S. Miyachi, Y. Murayama, I. Nagata, I. Nakahara, S. Nemoto, Y. Niimi, H. Oishi, J. Satomi, T. Satow, K. Sugiu, M. Tanaka, T. Terada, H. Yamagami, O. Diaz, P. Lylyk, M. V. Jayaraman, A. Patsalides, C. D. Gandhi, S. K. Lee, T. Abruzzo, B. Albani, S. A. Ansari, A. S. Arthur, B. W. Baxter, K. R. Bulsara, M. Chen, J. E. Delgado Almandoz, J. F. Fraser, D. V. Heck, S. W. Hetts, M. S. Hussain, R. P. Klucznik, T. M. Leslie-Mawzi, W. J. Mack, R. A. McTaggart, P. M. Meyers, J. Mocco, C. J. Prestigiacomo, G. L. Pride, P. A. Rasmussen, R. M. Starke, P. J. Sunenshine, R. W. Tarr, D. F. Frei, M. Ribo, R. G. Nogueira, O. O. Zaidat, T. Jovin, I. Linfante, D. Yavagal, D. Liebeskind, R. Novakovic, S. Pongpech, G. Rodesch, M. Soderman, K. terBrugge, A. Taylor, T. Krings, D. Orbach, A. Biondi, L. Picard, D. C. Suh, M. Tanaka, H. Q. Zhang

    AMERICAN JOURNAL OF NEURORADIOLOGY   37 ( 4 )   E31 - E34   2016年4月

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    記述言語:英語   出版者・発行元:AMER SOC NEURORADIOLOGY  

    DOI: 10.3174/ajnr.A4766

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  • Training Guidelines for Endovascular Ischemic Stroke Intervention: An International Multi-Society Consensus Document

    S. D. Lavine, K. Cockroft, B. Hoh, N. Bambakidis, A. A. Khalessi, H. Woo, H. Riina, A. Siddiqui, J. A. Hirsch, W. Chong, H. Rice, J. Wenderoth, P. Mitchell, A. Coulthard, T. J. Signh, C. Phatorous, M. Khangure, P. Klurfan, K. terBrugge, D. Iancu, T. Gunnarsson, O. Jansen, M. Muto, I. Szikora, L. Pierot, P. Brouwer, J. Gralla, S. Renowden, T. Andersson, J. Fiehler, F. Turjman, P. White, A. C. Januel, L. Spelle, Z. Kulcsar, R. Chapot, L. Spelle, A. Biondi, S. Dima, C. Taschner, M. Szajner, A. Krajina, N. Sakai, Y. Matsumaru, S. Yoshimura, M. Ezura, T. Fujinaka, K. Iihara, A. Ishii, T. Higashi, M. Hirohata, A. Hyodo, Y. Ito, M. Kawanishi, H. Kiyosue, E. Kobayashi, S. Kobayashi, N. Kuwayama, Y. Matsumoto, S. Miyachi, Y. Murayama, I. Nagata, I. Nakahara, S. Nemoto, Y. Niimi, H. Oishi, J. Satomi, T. Satow, K. Sugiu, M. Tanaka, T. Terada, H. Yamagami, O. Diaz, P. Lylyk, M. V. Jayaraman, A. Patsalides, C. D. Gandhi, S. K. Lee, T. Abruzzo, B. Albani, S. A. Ansari, A. S. Arthur, B. W. Baxter, K. R. Bulsara, M. Chen, J. E. Delgado Almandoz, J. F. Fraser, D. V. Heck, S. W. Hetts, M. S. Hussain, R. P. Klucznik, T. M. Leslie-Mawzi, W. J. Mack, R. A. McTaggart, P. M. Meyers, J. Mocco, C. J. Prestigiacomo, G. L. Pride, P. A. Rasmussen, R. M. Starke, P. J. Sunenshine, R. W. Tarr, D. F. Frei, M. Ribo, R. G. Nogueira, O. O. Zaidat, T. Jovin, I. Linfante, D. Yavagal, D. Liebeskind, R. Novakovic, S. Pongpech, G. Rodesch, M. Soderman, K. terBrugge, A. Taylor, T. Krings, D. Orbach, A. Biondi, L. Picard, D. C. Suh, M. Tanaka, H. Q. Zhang

    AMERICAN JOURNAL OF NEURORADIOLOGY   37 ( 4 )   E31 - E34   2016年4月

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    記述言語:英語   出版者・発行元:AMER SOC NEURORADIOLOGY  

    DOI: 10.3174/ajnr.A4766

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  • 岡山大学におけるHybrid ORでの手術

    菱川朋人, 杉生憲志, 安原隆雄, 伊達 勲

    脳卒中の外科   44 ( 2 )   125 - 131   2016年

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  • LVIS を用いてステント併用コイル塞栓術を行った破裂脳底動脈本幹部紡錘状動脈瘤の1例

    村井 智, 伊丹尚多, 馬越通有, 大塚真司, 日下 昇, 西浦 司, 荻原浩太郎, 杉生憲志

    脳神経外科速報   26 ( 12 )   1318 - 1324   2016年

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  • バルーン閉塞試験(BOT)の重要性とピットフォール(Editorial Comment)

    杉生憲志

    脳神経外科ジャーナル   25 ( 9 )   783 - 783   2016年

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  • 急速に発展する急性期脳梗塞への血管内治療

    春間 純, 杉生憲志

    medicina   53 ( 2 )   284 - 288   2016年

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  • Moyamoya disease: A review of clinical research

    Tomohito Hishikawa, Kenji Sugiu, Isao Date

    Acta Medica Okayama   70 ( 4 )   229 - 236   2016年

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:Okayama University  

    About 5 decades have passed since the concept of moyamoya disease (MMD) was established in Japan. In that time, many clinical MMD studies have been performed from several different points of view, such as epidemiology, pathophysiology, surgical procedures, and prognosis. In addition, rapid developments in MMD genetic analysis have occurred. In light of all this activity, clinicians must continually update their knowledge of MMD in order to improve the prognosis of MMD patients. In this review article, we summarize the clinical MMD studies and introduce cutting-edge findings regarding MMD.

    DOI: 10.18926/AMO/54497

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  • 急速に発展する急性期脳梗塞への血管内治療.

    春間 純, 杉生憲志

    medicina   53 ( 2 )   284 - 288   2016年

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  • 外傷性椎骨動静脈瘻に対してinternal trappingで治療した1例

    西廣真吾, 杉生憲志, 菱川朋人, 平松匡文, 春間 純, 新治有径, 高杉祐二, 伊達 勲

    脳神経外科   44 ( 2 )   135 - 141   2016年

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  • A case of traumatic vertebral arteriovenous fistula treated by internal trapping of the vertebral artery

    Shingo Nishihiro, Kenji Sugiu, Tomohito Hishikawa, Masafumi Hiramatsu, Jun Haruma, Yukei Shinji, Yuji Takasugi, Isao Date

    Neurological Surgery   44 ( 2 )   135 - 141   2016年

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    記述言語:日本語  

    DOI: 10.11477/mf.1436203245

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  • 脳卒中Q & A─自身のスキルも上げつつ、若手に血管内治療を教育する方法は?─

    杉生憲志

    脳神経外科速報   26 ( 8 )   860 - 860   2016年

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  • 第31回日本脳神経血管内治療学会学術総会(JSNET2015岡山)を終えて

    杉生憲志

    岡山医学会雑誌   128   151 - 153   2016年

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  • Transient middle cerebral artery occlusion model in the macaca fuscata using a novel intravascular technique

    Okuma Y, Liu K, Hishikawa T, Hirotsune N, Sugiu K, Nishino S, Nishibori M, Date I

    Journal of Neuroendovascular Therapy   10 ( 3 )   121 - 126   2016年

  • Transient middle cerebral artery occlusion model in the macaca fuscata using a novel intravascular technique

    Okuma Y, Liu K, Hishikawa T, Hirotsune N, Sugiu K, Nishino S, Nishibori M, Date I

    Journal of Neuroendovascular Therapy   10 ( 3 )   121 - 126   2016年

  • Dabigatran内服中の脳梗塞に対し血栓回収術を施行した1例(Editorial Comment)

    杉生憲志

    脳神経外科ジャーナル   25 ( 7 )   598 - 598   2016年

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  • 外科学の根幹は手術である─すべては「患者さんのために」─(スペシャルインタビュー)

    松本健五, 杉生憲志

    脳神経外科速報   26 ( 6 )   552 - 563   2016年

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  • 岡山大学におけるHybrid ORでの手術.

    菱川朋人, 杉生憲志, 安原隆雄, 伊達 勲

    脳卒中の外科   44 ( 2 )   125 - 131   2016年

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  • HPへのstaged CASは有効か? 日本からの発信 「過灌流症候群高リスク例に対する頸動脈ステント留置術に関する後ろ向き研究」結果報告

    菱川 朋人, 杉生 憲志, 三橋 利晴, 早川 幹人, 山上 宏, 坂井 信幸, 飯原 弘二, 小笠原 邦昭, 大石 英則, 伊藤 靖, 松丸 祐司, 吉村 紳一, STOP CHS研究班

    JNET: Journal of Neuroendovascular Therapy   9 ( 6 )   S200 - S200   2015年11月

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    記述言語:日本語   出版者・発行元:(NPO)日本脳神経血管内治療学会  

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  • Combined Transarterial and Transvenous Approach for Curative Obliteration of Klippel-Trenaunay-Weber Syndrome-Associated Spinal Perimedullary Arteriovenous Fistulas

    K. Tokunaga, T. Hishikawa, K. Sugiu, I. Date

    CLINICAL NEURORADIOLOGY   25 ( 3 )   291 - 294   2015年9月

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    記述言語:英語   出版者・発行元:SPRINGER HEIDELBERG  

    DOI: 10.1007/s00062-014-0319-1

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  • Combined Transarterial and Transvenous Approach for Curative Obliteration of Klippel-Trenaunay-Weber Syndrome-Associated Spinal Perimedullary Arteriovenous Fistulas

    K. Tokunaga, T. Hishikawa, K. Sugiu, I. Date

    CLINICAL NEURORADIOLOGY   25 ( 3 )   291 - 294   2015年9月

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    記述言語:英語   出版者・発行元:SPRINGER HEIDELBERG  

    DOI: 10.1007/s00062-014-0319-1

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  • 静脈うっ滞により急速に脳幹症状を呈した頚髄硬膜動静脈瘻の1例

    佐々木達也, 眞鍋博明, 安原隆雄, 三好康之, 杉生憲志, 伊達 勲

    脳神経外科   43 ( 1 )   51 - 56   2015年

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  • NeuroIVR 5年後のカテ

    杉生憲志

    Rad Fan   13 ( 12 )   74 - 75   2015年

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  • 私の手術論no. 77─脳血管内治療の「文武両道」─

    杉生憲志, 吉村紳一

    脳神経外科速報   25 ( 11 )   1128 - 1138   2015年

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  • 摘出術前の腫瘍栄養血管塞栓術が有用であった馬尾血管芽腫の1例

    馬越通有, 安原隆雄, 三好康之, 平松匡文, 豊嶋敦彦, 佐々田晋, 守本 純, 菱川朋人, 眞鍋博明, 徳永浩司, 杉生憲志, 伊達 勲

    脊髄外科   29 ( 1 )   53 - 58   2015年

  • もやもや病の病態解析

    菱川朋人, 平松匡文, 徳永浩司, 杉生憲志, 伊達 勲

    脳神経外科ジャーナル   24 ( 4 )   239 - 243   2015年

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    記述言語:中国語  

    DOI: 10.7887/jcns.24.239

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  • Neoadjuvant Chemotherapy with or without Concurrent Hormone Therapy in Estrogen Receptor-Positive Breast Cancer:NACED-Randomized Multicenter Phase II Trial

    Sugiu K, Iwamoto T, Kelly CM, Watanabe N, Motoki T, Itoh M, Ohtani S, Higaki K, Imada T, Yuasa T, Omori M, Sonobe H, Fujiwara T, Matsuoka J

    Acta Medica Okayama   69 ( 5 )   291 - 299   2015年

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  • Long-term outcomes in adult patients with ischemic-type moyamoya disease involving posterior circulation 国際誌

    Tomohito Hishikawa, Koji Tokunaga, Kenji Sugiu, Isao Date

    ACTA NEUROCHIRURGICA   156 ( 9 )   1745 - 1751   2014年9月

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    記述言語:英語   出版者・発行元:SPRINGER WIEN  

    The object of this study was to compare the long-term outcomes in adult patients with moyamoya disease (MMD) with posterior circulation involvement (PCi) treated through surgical revascularization with those in adult patients without PCi.
    The records of 32 consecutive adult patients with ischemic-type MMD who were treated with revascularization were reviewed. Twelve of these patients (38 %) had PCi at initial onset. Clinical characteristics of the patients with PCi were compared to those without PCi. Neurological outcomes were assessed using the modified Rankin Scale (mRS) in the preoperative and postoperative follow-up periods. A five-year Kaplan-Meier stroke risk was calculated.
    The frequency of presenting with infarction was significantly higher among patients with PCi than among those without PCi (p = 0.006). mRS scores in the preoperative period were significantly higher in patients with PCi than in patients without PCi (p = 0.0004). There were no significant differences in mRS scores between the preoperative and postoperative follow-up period in patients with PCi (p = 0.3), nor were there any between the preoperative and postoperative follow-up periods in patients without PCi (p = 0.2). The five-year Kaplan-Meier risk of surgical morbidity and ipsilateral stroke was 14.3 % in surgically treated hemispheres with PCi versus 14.9 % in surgically treated hemispheres without PCi (p = 0.96).
    PCi at initial onset was significantly correlated with poor outcome. Revascularization for the middle cerebral artery territory in patients with PCi was effective at preventing recurrent ischemic stroke.

    DOI: 10.1007/s00701-014-2136-3

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  • Long-term outcomes in adult patients with ischemic-type moyamoya disease involving posterior circulation

    Tomohito Hishikawa, Koji Tokunaga, Kenji Sugiu, Isao Date

    ACTA NEUROCHIRURGICA   156 ( 9 )   1745 - 1751   2014年9月

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    記述言語:英語   出版者・発行元:SPRINGER WIEN  

    The object of this study was to compare the long-term outcomes in adult patients with moyamoya disease (MMD) with posterior circulation involvement (PCi) treated through surgical revascularization with those in adult patients without PCi.
    The records of 32 consecutive adult patients with ischemic-type MMD who were treated with revascularization were reviewed. Twelve of these patients (38 %) had PCi at initial onset. Clinical characteristics of the patients with PCi were compared to those without PCi. Neurological outcomes were assessed using the modified Rankin Scale (mRS) in the preoperative and postoperative follow-up periods. A five-year Kaplan-Meier stroke risk was calculated.
    The frequency of presenting with infarction was significantly higher among patients with PCi than among those without PCi (p = 0.006). mRS scores in the preoperative period were significantly higher in patients with PCi than in patients without PCi (p = 0.0004). There were no significant differences in mRS scores between the preoperative and postoperative follow-up period in patients with PCi (p = 0.3), nor were there any between the preoperative and postoperative follow-up periods in patients without PCi (p = 0.2). The five-year Kaplan-Meier risk of surgical morbidity and ipsilateral stroke was 14.3 % in surgically treated hemispheres with PCi versus 14.9 % in surgically treated hemispheres without PCi (p = 0.96).
    PCi at initial onset was significantly correlated with poor outcome. Revascularization for the middle cerebral artery territory in patients with PCi was effective at preventing recurrent ischemic stroke.

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  • Nationwide survey of the nature and risk factors of complications in embolization of meningiomas and other intracranial tumors: Japanese Registry of NeuroEndovascular Therapy 2 (JR-NET2) 国際誌

    Tomohito Hishikawa, Kenji Sugiu, Masafumi Hiramatsu, Jun Haruma, Koji Tokunaga, Isao Date, Nobuyuki Sakai

    NEURORADIOLOGY   56 ( 2 )   139 - 144   2014年2月

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    記述言語:英語   出版者・発行元: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.

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  • Nationwide survey of the nature and risk factors of complications in embolization of meningiomas and other intracranial tumors: Japanese Registry of NeuroEndovascular Therapy 2 (JR-NET2)

    Tomohito Hishikawa, Kenji Sugiu, Masafumi Hiramatsu, Jun Haruma, Koji Tokunaga, Isao Date, Nobuyuki Sakai

    NEURORADIOLOGY   56 ( 2 )   139 - 144   2014年2月

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    記述言語:英語   出版者・発行元: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.

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  • Recent Trends in Neuroendovascular Therapy in Japan: Analysis of a Nationwide Survey-Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and 2

    Nobuyuki Sakai, Shinichi Yoshimura, Waro Taki, Akio Hyodo, Shigeru Miyachi, Yoji Nagai, Chiaki Sakai, Tetsu Satow, Tomoaki Terada, Masayuki Ezura, Toshio Hyogo, Shunji Matsubara, Kentaro Hayashi, Toshiyuki Fujinaka, Yasushi Ito, Shigeki Kobayashi, Masaki Komiyama, Naoya Kuwayama, Yuji Matsumaru, Yasushi Matsumoto, Yuichi Murayama, Ichiro Nakahara, Shigeru Nemoto, Koichi Satoh, Kenji Sugiu, Akira Ishii, Hirotoshi Imamura

    NEUROLOGIA MEDICO-CHIRURGICA   54 ( 1 )   1 - 8   2014年1月

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    記述言語:英語   出版者・発行元:JAPAN NEUROSURGICAL SOC  

    The present study retrospectively analyzed the database of the Japanese Registry of Neuroendovascular Therapy 1 and 2 (JR-NET1&2) to determine annual trends, including adverse events and clinical outcomes at 30 days after undergoing neuroendovascular therapy. JR-NET1&2 are surveys that targeted all patients in Japan who underwent neuroendovascular therapy delivered by physicians certified by the Japanese Society of Neuroendovascular Therapy (JSNET) between 2005 and 2009. Medical information about the patients was anonymized and retrospectively registered via a website. Data from 32,608 patients were analyzed. The number of treated patients constantly increased from 5,040 in 2005 to 7,406 in 2009 and the rate of octogenarians increased from 7.0% in 2005 to 10.4% in 2009. The proportion of procedures remained relatively constant, but ratios of angioplasty slightly increased from 32.8% in 2005 to 33.7% in 2009. Procedural complications were associated more frequently with acute stroke (9.6%), ruptured aneurysms (7.4%), intracranial artery disease (ICAD) (5.4%), and arteriovenous malformation (AVM, 5.2%). The number of patients requiring neuroendovascular treatment in Japan is increasing and the outcomes of such therapy are clinically acceptable. Details of each type of treatment will be investigated in sub-analyses of the database.

    DOI: 10.2176/nmc.oa.2013-0197

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  • Recent trends in neuroendovascular therapy in Japan: Analysis of a nationwide survey ─Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and 2─

    Sakai N, Yoshimura S, Taki W, Hyodo A, Miyachi S Nagai Y, Sakai C, Satow T, Terada T, Ezura M, Hyogo T, Matsubara S, Hayashi K, Fujinaka T, Ito Y, Kobayashi S, Komiyama M, Kuwayama N, Matsumaru Y, Matsumoto Y, Murayama Y, Nakahara I, Nemoto S, Satoh K, Sugiu K, Ishii A, Imamura H, JR-NET Investigators

    Neurologia medico-chirurgica   54 ( 1 )   1 - 8   2014年1月

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  • 岡山大学における症候性脳血管攣縮への対策と現状─過去10年間の治療成績の検討─

    菱川朋人, 清水智久, 徳永浩司, 杉生憲志, 小野成紀, 伊達 勲

    脳血管攣縮 Vol.29   41 ( Suppl )   23 - 26   2014年

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  • コイル塞栓術は、なぜ充填率20%で塞栓できるのか?

    杉生憲志

    BRAIN NURSING   30 ( 10 )   64 - 64   2014年

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  • 閉塞した頭骨動脈バイパスグラフトに間接的な側副血行の発達を認め治療完遂に至った海綿静脈洞部巨大内頚動脈瘤の1例

    徳永浩司, 菱川朋人, 杉生憲志, 伊達 勲

    脳神経外科   42 ( 1 )   59 - 64   2014年

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  • Combined transarterial and transvenous approach for curative obliteration of Klippel-Trenaunay-Weber syndrome-associated spinal perimedullary arteriovenous fistulas

    Tokunaga K, Hishikawa T, Sugiu K, Date I

    Clin Neuroradiol   Jul 10. [Epub ahead of print]-Jul 10. [Epub ahead of print]   2014年

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  • コイル塞栓術─治療編─

    杉生憲志

    BRAIN NURSING   30 ( 4 )   387 - 389   2014年

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  • Combined transarterial and transvenous approach for curative obliteration of Klippel-Trenaunay-Weber syndrome-associated spinal perimedullary arteriovenous fistulas

    Tokunaga K, Hishikawa T, Sugiu K, Date I

    Clin Neuroradiol   Jul 10. [Epub ahead of print]-Jul 10. [Epub ahead of print]   2014年

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  • 海綿静脈洞部大型・巨大内頚動脈瘤に対する頭蓋外内バイパス術とそのピットフォール

    徳永浩司, 菱川朋人, 杉生憲志, 伊達 勲

    脳卒中の外科   42   189 - 195   2014年

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  • Cerebral Vasospasm in Patients over 80 Years Treated by Coil Embolization for Ruptured Cerebral Aneurysms 国際誌

    Tomohito Hishikawa, Yuji Takasugi, Tomohisa Shimizu, Jun Haruma, Masafumi Hiramatsu, Koji Tokunaga, Kenji Sugiu, Isao Date

    BIOMED RESEARCH INTERNATIONAL   2014   253867 - 253867   2014年

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    記述言語:英語   出版者・発行元:HINDAWI PUBLISHING CORPORATION  

    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.

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  • Cerebral Vasospasm in Patients over 80 Years Treated by Coil Embolization for Ruptured Cerebral Aneurysms

    Tomohito Hishikawa, Yuji Takasugi, Tomohisa Shimizu, Jun Haruma, Masafumi Hiramatsu, Koji Tokunaga, Kenji Sugiu, Isao Date

    BIOMED RESEARCH INTERNATIONAL   2014   253867 - 253867   2014年

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    記述言語:英語   出版者・発行元:HINDAWI PUBLISHING CORPORATION  

    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.

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  • The proposal of subgroups for grade V on World Federation of Neurologic Surgeons Grading for subarachnoid hemorrhage

    M. Nakagawa, K. Sugiu, K. Tokunaga, C. Sakamoto, K. Fujiwara

    JOURNAL OF NEUROSURGICAL SCIENCES   57 ( 4 )   303 - 306   2013年12月

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    記述言語:英語   出版者・発行元:EDIZIONI MINERVA MEDICA  

    Aim. Some of cases suffering from subarachnoid hemorrhages (SAHs) in grade V on World Federation of Neurologic Surgeons (WFNS) grading can gain a good prognosis. The outcome of patients of SAN in grade V on WFNS grading in their institute was here investigated.
    Methods. Between April 2007 and July 2012, consecutive 37 patients had SAN diagnosed on CT scan and were classified in grade V on WFNS grading in Kosei General Hospital. There were seventeen male and twenty female patients. We were assigned to patients with spontaneous respiration and without oculomotor palsy (N group, N.=11), and patients with oculomotor palsy (O group, N.=26). Patients were evaluated by mRS.
    Results. The prognosis in N group was significantly better than in 0 group (P&lt;0.001).
    Conclusion. Surgical treatments should be considered for SAN patients without oculomotor palsy. It is necessary to make subgroups in grade V on WFNS grading in order to decide operative indication and evaluate the treatment results of SAN in grade V.

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  • The proposal of subgroups for grade V on World Federation of Neurologic Surgeons Grading for subarachnoid hemorrhage

    M. Nakagawa, K. Sugiu, K. Tokunaga, C. Sakamoto, K. Fujiwara

    JOURNAL OF NEUROSURGICAL SCIENCES   57 ( 4 )   303 - 306   2013年12月

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    記述言語:英語   出版者・発行元:EDIZIONI MINERVA MEDICA  

    Aim. Some of cases suffering from subarachnoid hemorrhages (SAHs) in grade V on World Federation of Neurologic Surgeons (WFNS) grading can gain a good prognosis. The outcome of patients of SAN in grade V on WFNS grading in their institute was here investigated.
    Methods. Between April 2007 and July 2012, consecutive 37 patients had SAN diagnosed on CT scan and were classified in grade V on WFNS grading in Kosei General Hospital. There were seventeen male and twenty female patients. We were assigned to patients with spontaneous respiration and without oculomotor palsy (N group, N.=11), and patients with oculomotor palsy (O group, N.=26). Patients were evaluated by mRS.
    Results. The prognosis in N group was significantly better than in 0 group (P&lt;0.001).
    Conclusion. Surgical treatments should be considered for SAN patients without oculomotor palsy. It is necessary to make subgroups in grade V on WFNS grading in order to decide operative indication and evaluate the treatment results of SAN in grade V.

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  • Mannitol enhances therapeutic effects of intra-arterial transplantation of mesenchymal stem cells into the brain after traumatic brain injury

    Yu Okuma, Feifei Wang, Atsuhiko Toyoshima, Masahiro Kameda, Tomohito Hishikawa, Koji Tokunaga, Kenji Sugiu, Keyue Liu, Jun Haruma, Masahiro Nishibori, Takao Yasuhara, Isao Date

    NEUROSCIENCE LETTERS   554   156 - 161   2013年10月

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    記述言語:英語   出版者・発行元:ELSEVIER IRELAND LTD  

    Traumatic brain injury (TBI) sustained in a traffic accident or a fall is a major cause of death that affects a broad range of ages. The aim of this study was to investigate the therapeutic effects of intra-arterial transplantation of mesenchymal stem cells (MSCs) combined with hypertonic glycerol (25%) or mannitol (25%) in a TBI model of rats. TBI models were produced with a fluid percussion device. At 24 h after TBI, MSCs (1 x 10(6) cells/100 mu l) with glycerol or mannitol were administered via the right internal carotid artery. Rats were evaluated behaviorally and immunohistochemically, and hyperpermeability of the blood-brain barrier (BBB) induced by hypertonic solutions was explored. Compared to PBS or glycerol, the administration of mannitol resulted in increased BBB disruption. The mannitol-treated rats showed significant improvement in motor function. Intra-arterial transplantation of MSCs caused no thromboembolic ischemia. Immunohistochemically, more MSCs were observed in the injured brain tissues of mannitol-treated rats than in glycerol or PBS-treated rats at 24 h after transplantation. Intra-arterial transplantation of MSCs combined with mannitol is an effective treatment in a TBI model of rats. This technique might be used for patients with diseases of the central nervous system including TBI. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

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  • Assessment of the difference in posterior circulation involvement between pediatric and adult patients with moyamoya disease Clinical article 国際誌

    Tomohito Hishikawa, Koji Tokunaga, Kenji Sugiu, Isao Date

    JOURNAL OF NEUROSURGERY   119 ( 4 )   961 - 965   2013年10月

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    記述言語:英語   出版者・発行元:AMER ASSOC NEUROLOGICAL SURGEONS  

    Object. There is no description of the change in the posterior cerebral artery (PCA) in the diagnostic criteria of moyamoya disease (MMD). However, PCAs are often involved in the clinical setting, and an understanding of the significance of PCA lesions is therefore of great importance when evaluating the disease progression and predicting prognosis. The aim of this study was to assess the difference in posterior circulation involvement in pediatric and adult patients with MMD.
    Methods. The records of 120 consecutive patients with MMD were reviewed. The clinical manifestations at diagnosis were evaluated on the basis of symptoms and CT and MRI findings. The degree of steno-occlusive internal carotid artery (ICA) lesions and the existence of steno-occlusive PCA lesions were evaluated by observing a total of 240 ICAs and PCAs on angiography. Angiographic correlation between anterior and posterior circulation was assessed in pediatric and adult patients with MMD.
    Results. Seventeen (26%) of 66 pediatric patients and 18 (33%) of 54 adult patients exhibited steno-occlusive PCA lesions. There was no significant difference in the prevalence of PCA lesions between pediatric and adult patients with MMD (p = 0.36). The prevalence of infarction in pediatric and adult patients with PCA involvement was significantly higher than that in pediatric and adult patients without PCA involvement (p = 0.0003 and p = 0.003, respectively). There was no significant difference in the distribution of infarction areas between pediatric and adult patients with PCA involvement (p = 0.62). On the basis of the staging system used, steno-occlusive lesions in ICAs ipsilateral to PCAs with lesions were in significantly advanced stages compared with lesions in ICAs ipsilateral to PCAs without lesions in both pediatric and adult cases (p &lt; 0.0001 and p = 0.0008, respectively). Pediatric patients had less advanced steno-occlusive lesions in ICAs ipsilateral to PCAs with lesions compared with adults (p &lt; 0.05).
    Conclusions. The clinical significance of posterior circulation involvement in MMD was similar between pediatric and adult patients. The only significant difference was that less advanced ICA lesions could complicate posterior circulation involvement in pediatric patients.

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  • Assessment of the difference in posterior circulation involvement between pediatric and adult patients with moyamoya disease

    Tomohito Hishikawa, Koji Tokunaga, Kenji Sugiu, Isao Date

    Journal of Neurosurgery   119 ( 4 )   961 - 965   2013年10月

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    記述言語:英語  

    Object. There is no description of the change in the posterior cerebral artery (PCA) in the diagnostic criteria of moyamoya disease (MMD). However, PCAs are often involved in the clinical setting, and an understanding of the significance of PCA lesions is therefore of great importance when evaluating the disease progression and predicting prognosis. The aim of this study was to assess the difference in posterior circulation involvement in pediatric and adult patients with MMD. Methods. The records of 120 consecutive patients with MMD were reviewed. The clinical manifestations at diagnosis were evaluated on the basis of symptoms and CT and MRI findings. The degree of steno-occlusive internal carotid artery (ICA) lesions and the existence of steno-occlusive PCA lesions were evaluated by observing a total of 240 ICAs and PCAs on angiography. Angiographic correlation between anterior and posterior circulation was assessed in pediatric and adult patients with MMD. Results. Seventeen (26%) of 66 pediatric patients and 18 (33%) of 54 adult patients exhibited steno-occlusive PCA lesions. There was no significant difference in the prevalence of PCA lesions between pediatric and adult patients with MMD (p = 0.36). The prevalence of infarction in pediatric and adult patients with PCA involvement was significantly higher than that in pediatric and adult patients without PCA involvement (p = 0.0003 and p = 0.003, respectively). There was no significant difference in the distribution of infarction areas between pediatric and adult patients with PCA involvement (p = 0.62). On the basis of the staging system used, steno-occlusive lesions in ICAs ipsilateral to PCAs with lesions were in significantly advanced stages compared with lesions in ICAs ipsilateral to PCAs without lesions in both pediatric and adult cases (p &lt
    0.0001 and p = 0.0008, respectively). Pediatric patients had less advanced steno-occlusive lesions in ICAs ipsilateral to PCAs with lesions compared with adults (p &lt
    0.05). Conclusions. The clinical significance of posterior circulation involvement in MMD was similar between pediatric and adult patients. The only significant difference was that less advanced ICA lesions could complicate posterior circulation involvement in pediatric patients. © AANS, 2013.

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  • Mannitol enhances therapeutic effects of intra-arterial transplantation of mesenchymal stem cells into the brain after traumatic brain injury 国際誌

    Yu Okuma, Feifei Wang, Atsuhiko Toyoshima, Masahiro Kameda, Tomohito Hishikawa, Koji Tokunaga, Kenji Sugiu, Keyue Liu, Jun Haruma, Masahiro Nishibori, Takao Yasuhara, Isao Date

    NEUROSCIENCE LETTERS   554   156 - 161   2013年10月

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    記述言語:英語   出版者・発行元:ELSEVIER IRELAND LTD  

    Traumatic brain injury (TBI) sustained in a traffic accident or a fall is a major cause of death that affects a broad range of ages. The aim of this study was to investigate the therapeutic effects of intra-arterial transplantation of mesenchymal stem cells (MSCs) combined with hypertonic glycerol (25%) or mannitol (25%) in a TBI model of rats. TBI models were produced with a fluid percussion device. At 24 h after TBI, MSCs (1 x 10(6) cells/100 mu l) with glycerol or mannitol were administered via the right internal carotid artery. Rats were evaluated behaviorally and immunohistochemically, and hyperpermeability of the blood-brain barrier (BBB) induced by hypertonic solutions was explored. Compared to PBS or glycerol, the administration of mannitol resulted in increased BBB disruption. The mannitol-treated rats showed significant improvement in motor function. Intra-arterial transplantation of MSCs caused no thromboembolic ischemia. Immunohistochemically, more MSCs were observed in the injured brain tissues of mannitol-treated rats than in glycerol or PBS-treated rats at 24 h after transplantation. Intra-arterial transplantation of MSCs combined with mannitol is an effective treatment in a TBI model of rats. This technique might be used for patients with diseases of the central nervous system including TBI. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

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  • Mannitol enhances therapeutic effects of intra-arterial transplantation of mesenchymal stem cells into the brain after traumatic brain injury

    Yu Okuma, Feifei Wang, Atsuhiko Toyoshima, Masahiro Kameda, Tomohito Hishikawa, Koji Tokunaga, Kenji Sugiu, Keyue Liu, Jun Haruma, Masahiro Nishibori, Takao Yasuhara, Isao Date

    NEUROSCIENCE LETTERS   554   156 - 161   2013年10月

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    記述言語:英語   出版者・発行元:ELSEVIER IRELAND LTD  

    Traumatic brain injury (TBI) sustained in a traffic accident or a fall is a major cause of death that affects a broad range of ages. The aim of this study was to investigate the therapeutic effects of intra-arterial transplantation of mesenchymal stem cells (MSCs) combined with hypertonic glycerol (25%) or mannitol (25%) in a TBI model of rats. TBI models were produced with a fluid percussion device. At 24 h after TBI, MSCs (1 x 10(6) cells/100 mu l) with glycerol or mannitol were administered via the right internal carotid artery. Rats were evaluated behaviorally and immunohistochemically, and hyperpermeability of the blood-brain barrier (BBB) induced by hypertonic solutions was explored. Compared to PBS or glycerol, the administration of mannitol resulted in increased BBB disruption. The mannitol-treated rats showed significant improvement in motor function. Intra-arterial transplantation of MSCs caused no thromboembolic ischemia. Immunohistochemically, more MSCs were observed in the injured brain tissues of mannitol-treated rats than in glycerol or PBS-treated rats at 24 h after transplantation. Intra-arterial transplantation of MSCs combined with mannitol is an effective treatment in a TBI model of rats. This technique might be used for patients with diseases of the central nervous system including TBI. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

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  • Mannitol enhances therapeutic effects of intra-arterial transplantation of mesenchymal stem cells into the brain after traumatic brain injury

    Yu Okuma, Feifei Wang, Atsuhiko Toyoshima, Masahiro Kameda, Tomohito Hishikawa, Koji Tokunaga, Kenji Sugiu, Keyue Liu, Jun Haruma, Masahiro Nishibori, Takao Yasuhara, Isao Date

    NEUROSCIENCE LETTERS   554   156 - 161   2013年10月

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    記述言語:英語   出版者・発行元:ELSEVIER IRELAND LTD  

    Traumatic brain injury (TBI) sustained in a traffic accident or a fall is a major cause of death that affects a broad range of ages. The aim of this study was to investigate the therapeutic effects of intra-arterial transplantation of mesenchymal stem cells (MSCs) combined with hypertonic glycerol (25%) or mannitol (25%) in a TBI model of rats. TBI models were produced with a fluid percussion device. At 24 h after TBI, MSCs (1 x 10(6) cells/100 mu l) with glycerol or mannitol were administered via the right internal carotid artery. Rats were evaluated behaviorally and immunohistochemically, and hyperpermeability of the blood-brain barrier (BBB) induced by hypertonic solutions was explored. Compared to PBS or glycerol, the administration of mannitol resulted in increased BBB disruption. The mannitol-treated rats showed significant improvement in motor function. Intra-arterial transplantation of MSCs caused no thromboembolic ischemia. Immunohistochemically, more MSCs were observed in the injured brain tissues of mannitol-treated rats than in glycerol or PBS-treated rats at 24 h after transplantation. Intra-arterial transplantation of MSCs combined with mannitol is an effective treatment in a TBI model of rats. This technique might be used for patients with diseases of the central nervous system including TBI. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

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  • Novel 3D-CT evaluation of carotid stent volume: greater chronological expansion of stents in patients with vulnerable plaques

    Hisakazu Itami, Koji Tokunaga, Yu Okuma, Tomohito Hishikawa, Kenji Sugiu, Kentaro Ida, Isao Date

    NEURORADIOLOGY   55 ( 9 )   1153 - 1160   2013年9月

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    記述言語:英語   出版者・発行元:SPRINGER  

    Although self-expanding carotid stents may dilate gradually, the degrees of residual stenosis have been quantified by the NASCET criteria, which is too simple to reflect the configuration of the stented artery. We measured the volumes of the stent lumens chronologically by 3D-CT in patients after carotid artery stenting (CAS), and analyzed the correlations between the volume change and medical factors.
    Fourteen patients with carotid artery stenosis were treated using self-expanding, open-cell stents. All patients underwent preoperative plaque MRI (magnetization-prepared rapid acquisition gradient-echo, MPRAGE) and chronological 3D-CT examinations of their stents immediately after their placement and 1 day, 1 week, and 1 month after the procedure. The volume of the stent lumen was measured using a 3D workstation. The correlations between stent volume and various factors including the presence of underlying diseases, plaque characteristics, and the results of the CAS procedure were analyzed.
    Stent volume gradually increased in each case and had increased by 1.04-1.55 (mean, 1.25)-fold at 1 postoperative month. The presence of underlying medical diseases, plaque length, the degree of residual stenosis immediately after CAS, and plaque calcification did not have an impact on the change in stent volume. On the other hand, the stent volume increase was significantly larger in the patients with vulnerable plaques that demonstrated high MPRAGE signal intensity (P &lt; 0.05).
    A 3D-CT examination is useful for precisely measuring stent volume. Self-expanding stents in carotid arteries containing vulnerable plaques expand significantly more than those without such plaques in a follow-up period.

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  • Novel 3D-CT evaluation of carotid stent volume: greater chronological expansion of stents in patients with vulnerable plaques 国際誌

    Hisakazu Itami, Koji Tokunaga, Yu Okuma, Tomohito Hishikawa, Kenji Sugiu, Kentaro Ida, Isao Date

    NEURORADIOLOGY   55 ( 9 )   1153 - 1160   2013年9月

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    記述言語:英語   出版者・発行元:SPRINGER  

    Although self-expanding carotid stents may dilate gradually, the degrees of residual stenosis have been quantified by the NASCET criteria, which is too simple to reflect the configuration of the stented artery. We measured the volumes of the stent lumens chronologically by 3D-CT in patients after carotid artery stenting (CAS), and analyzed the correlations between the volume change and medical factors.
    Fourteen patients with carotid artery stenosis were treated using self-expanding, open-cell stents. All patients underwent preoperative plaque MRI (magnetization-prepared rapid acquisition gradient-echo, MPRAGE) and chronological 3D-CT examinations of their stents immediately after their placement and 1 day, 1 week, and 1 month after the procedure. The volume of the stent lumen was measured using a 3D workstation. The correlations between stent volume and various factors including the presence of underlying diseases, plaque characteristics, and the results of the CAS procedure were analyzed.
    Stent volume gradually increased in each case and had increased by 1.04-1.55 (mean, 1.25)-fold at 1 postoperative month. The presence of underlying medical diseases, plaque length, the degree of residual stenosis immediately after CAS, and plaque calcification did not have an impact on the change in stent volume. On the other hand, the stent volume increase was significantly larger in the patients with vulnerable plaques that demonstrated high MPRAGE signal intensity (P &lt; 0.05).
    A 3D-CT examination is useful for precisely measuring stent volume. Self-expanding stents in carotid arteries containing vulnerable plaques expand significantly more than those without such plaques in a follow-up period.

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  • Clinical and radiographic features of moyamoya disease in patients with both cerebral ischaemia and haemorrhage 国際誌

    Tomohito Hishikawa, Koji Tokunaga, Kenji Sugiu, Isao Date

    BRITISH JOURNAL OF NEUROSURGERY   27 ( 2 )   198 - 201   2013年4月

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    記述言語:英語   出版者・発行元:INFORMA HEALTHCARE  

    Objectives. Patients with moyamoya disease (MMD) very rarely develop both cerebral ischaemia and haemorrhage. The aim of this study was to clarify the clinical and radiographic features of MMD in patients who presented with both ischaemia and haemorrhage, compared with MMD patients who presented with one or the other. Materials and methods. The records of 92 consecutive patients with MMD were reviewed. These patients were divided into three groups, according to the type of presentation: ischaemic presentation (Group I); haemorrhagic presentation (Group H); and haemorrhagic-ischaemic presentation (Group H-I). The patient characteristics, areas of infarction, and angiographic findings were evaluated. Results. Seventy-six (82%) of the 92 patients were categorised as Group I, 7 (8%) as Group H, and 9 (10%) as Group H-I. Median follow-up periods for Group H-I was 55 months (IQR, 36-116 months). There were eight females in Group H-I, in which the median age was 30 years. Of the nine cases in Group H-I, six presented with cerebral haemorrhage as the precedent event and three had complications during the acute phase. In Group H-I, the prevalence of posterior cerebral artery (PCA) lesions was high (42%) and infarctions were most frequently found in PCA-related areas. Conclusions. The presence of steno-occlusive PCA lesions may be of pathogenic importance in MMD patients who develop both cerebral ischaemia and haemorrhage. The prevalence of this type of stroke in MMD patients is higher than expected, and further investigation in clinical settings is thus warranted

    DOI: 10.3109/02688697.2012.717983

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  • Clinical and radiographic features of moyamoya disease in patients with both cerebral ischaemia and haemorrhage

    Tomohito Hishikawa, Koji Tokunaga, Kenji Sugiu, Isao Date

    BRITISH JOURNAL OF NEUROSURGERY   27 ( 2 )   198 - 201   2013年4月

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    記述言語:英語   出版者・発行元:INFORMA HEALTHCARE  

    Objectives. Patients with moyamoya disease (MMD) very rarely develop both cerebral ischaemia and haemorrhage. The aim of this study was to clarify the clinical and radiographic features of MMD in patients who presented with both ischaemia and haemorrhage, compared with MMD patients who presented with one or the other. Materials and methods. The records of 92 consecutive patients with MMD were reviewed. These patients were divided into three groups, according to the type of presentation: ischaemic presentation (Group I); haemorrhagic presentation (Group H); and haemorrhagic-ischaemic presentation (Group H-I). The patient characteristics, areas of infarction, and angiographic findings were evaluated. Results. Seventy-six (82%) of the 92 patients were categorised as Group I, 7 (8%) as Group H, and 9 (10%) as Group H-I. Median follow-up periods for Group H-I was 55 months (IQR, 36-116 months). There were eight females in Group H-I, in which the median age was 30 years. Of the nine cases in Group H-I, six presented with cerebral haemorrhage as the precedent event and three had complications during the acute phase. In Group H-I, the prevalence of posterior cerebral artery (PCA) lesions was high (42%) and infarctions were most frequently found in PCA-related areas. Conclusions. The presence of steno-occlusive PCA lesions may be of pathogenic importance in MMD patients who develop both cerebral ischaemia and haemorrhage. The prevalence of this type of stroke in MMD patients is higher than expected, and further investigation in clinical settings is thus warranted

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  • Transvenous Approach Of Cavernous Sinus Dural Arteriovenous Fistula

    Kyohei Kin, Kenji Sugiu, Kouji Tokunaga, Masafumi Hiramatsu, Jun Haruma, Yu Ohkuma, Tomohisa Shimizu, Tomohito Hishikawa, Isao Date

    STROKE   44 ( 2 )   2013年2月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Stereotactic Radiosurgery For Dural Arteriovenous Fistula Reflactory To Endovascular Treatment

    Tomohisa Shimizu, Kenji Sugiu, Koji Tokunaga, Tomohito Hishikawa, Masafumi Hiramatsu, Yu Okuma, Isao Date, Kengo Sato, Yoshimi Baba

    STROKE   44 ( 2 )   2013年2月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Safety and Efficacy of Endovasucular Treatment of Superior Hypophyeal Artery Aneurysms: A Review of 86 Cases

    Jun Haruma, Kenji Sugiu, Koji Tokunaga, Tomohito Hishikawa, Kyouhei Kin, Naoya Kidani, Tomohisa Shimizu, Yu Ohkuma, Masafumi Hiramatsu, Isao Date

    STROKE   44 ( 2 )   2013年2月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • Usefulness of Staged Angioplasty for Carotid Artery Stenting

    Naoya Kidani, Kenji Sugiu, Koji Tokunaga, Tomohito Hishikawa, Masafumi Hiramatsu, Atsuhiko Toyoshima, Yu Okuma, Tomohisa Shimizu, Jun Haruma, Isao Date

    STROKE   44 ( 2 )   2013年2月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

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  • 未破裂脳動脈瘤コイル塞栓術後に多発性の脳病変を呈した一例

    出口 健太郎, 香西 由子, 出口 章子, 森本 展年, 倉田 智子, 池田 佳生, 松浦 徹, 阿部 康二, 杉生 憲志, 徳永 浩司, 河井 信行

    臨床神経学   53 ( 1 )   66 - 66   2013年1月

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    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

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  • 他科からみた放射線科

    杉生憲志

    Rad Fan   11 ( 4 )   86 - 87   2013年

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  • 頭部に発生する硬膜動静脈瘻およびhigh flow動静脈瘻に対する塞栓術

    徳永浩司, 杉生憲志, 伊達 勲

    脳神経外科   41 ( 2 )   153 - 162   2013年

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  • 頭蓋内硬膜動静脈瘻の分類と治療

    杉生憲志, 平松匡文, 徳永浩司, 菱川朋人, 大熊 佑, 春間 純, 清水智久, 伊達 勲

    脳神経外科ジャーナル   22 ( 1 )   37 - 43   2013年

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    記述言語:英語  

    DOI: 10.7887/jcns.22.37

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  • 脳底動脈窓形成部動脈瘤に対する血管内治療の有用性

    伊丹尚多, 杉生憲志, 平松匡文, 徳永浩司, 春間 純, 大熊 佑, 菱川朋人, 西田あゆみ, 伊達 勲

    脳神経外科   41 ( 7 )   583 - 592   2013年

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  • 頚部頚動脈瘤に対し血管内治療を行った1例

    服部靖彦, 杉生憲志, 菱川朋人, 徳永浩司, 高橋和也, 伊達 勲

    脳神経外科   41 ( 6 )   515 - 523   2013年

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  • 後腹膜出血で発症し、経動脈的および経静脈的塞栓術により根治に至ったparaspinal arteriovenous fistulaの1例

    豊嶋敦彦, 徳永浩司, 眞鍋博明, 杉生憲志, 平松匡文, 伊丹尚多, 菱川朋人, 伊達 勲

    脳神経外科   41 ( 5 )   429 - 435   2013年

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  • 胸腰椎部硬膜動静脈瘻の術中所見と治療結果の検討

    三好康之, 安原隆雄, 眞鍋博明, 服部靖彦, 菱川朋人, 徳永浩司, 杉生憲志, 伊達 勲

    脊髄外科   27   45 - 51   2013年

  • 脳動脈瘤塞栓術における“sheep technique”の有用性

    豊嶋敦彦, 杉生憲志, 徳永浩司, 清水智久, 春間 純, 平松匡文, 伊丹尚多, 菱川朋人, 伊達 勲

    Journal of Neuroendovascular Therapy   7 ( 1 )   3 - 10   2013年

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  • 脳血管内治療におけるDSA装置の進歩

    杉生憲志, 平松匡文

    新医療   40 ( 10 )   93 - 96   2013年

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  • 術前診断および治療手順に熟慮を要した脊髄血管障害の1例

    眞鍋博明, 徳永浩司, 杉生憲志

    脳神経外科ジャーナル   22 ( 9 )   720 - 724   2013年

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  • 硬膜動静脈瘻

    平松匡文, 杉生憲志

    BRAIN   3 ( 5 )   394 - 401   2013年

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  • 頚動脈内膜剥離術あるいは頚動脈ステント留置術施行後の患者固有データに基づく頚動脈血流の流体力学的シミュレーション

    早瀬 仁志, 伊達 勲, 徳永 浩司, 中山 敏男, 杉生 憲志, 西田 あゆみ, 有光 帥二, 菱川 朋人, 小野 成紀, 太田 信

    岡山医学会雑誌   125 ( 1 )   5 - 7   2013年

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    記述言語:日本語   出版者・発行元:岡山医学会  

    DOI: 10.4044/joma.125.5

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    その他リンク: http://ousar.lib.okayama-u.ac.jp/49377

  • 5. 硬膜動静脈瘻の分類と治療の課題(PS1-1 血管奇形の基礎と臨床,プレナリーセッション,脳神経外科学の課題,第32回日本脳神経外科コングレス総会)

    杉生 憲志, 徳永 浩司, 菱川 朋人, 伊丹 尚多, 平松 匡文, 大熊 佑, 伊達 勲

    脳神経外科ジャーナル   21   54 - 54   2012年4月

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    記述言語:日本語   出版者・発行元:日本脳神経外科コングレス  

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  • 4年の期間を経て反対側に新生・出血発症した多発硬膜動静脈瘻の1例

    大同 茂, 小林和樹, 棟田耕二, 和仁孝夫, 徳永浩司, 杉生憲志

    津山中央病院医学雑誌   26   113 - 118   2012年

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  • 脳底動脈先端部動脈瘤に対するコイル塞栓術

    杉生憲志, 徳永浩司, 菱川朋人, 伊丹尚多, 大熊 佑, 平松匡文, 春間 純, 伊達 勲

    脳神経外科   40 ( 9 )   765 - 774   2012年

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  • Onyxによる術前塞栓術を併用した脳動静脈奇形の外科的摘出術

    徳永浩司, 杉生憲志, 菱川朋人, 黒住和彦, 大熊 佑, 伊丹尚多, 小野成紀, 伊達 勲

    脳卒中の外科   40   217 - 222   2012年

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  • Factors predicting retreatment and residual aneurysms at 1 year after endovascular coiling for ruptured cerebral aneurysms: Prospective registry of subarachnoid aneurysms treatment (PRESAT) in Japan

    Taki W, PRESAT grou, Sugiu K, Tokunaga K, Nishida A

    Neuroradiology   54   597 - 606   2012年

  • 内視鏡下経鼻的経蝶形骨洞手術後の遅発性鼻出血に対し塞栓術が有効であった1例

    岡 哲生, 杉生憲志, 石田穣治, 菱川朋人, 小野成紀, 徳永浩司, 伊達 勲

    脳神経外科   40 ( 1 )   55 - 60   2012年

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  • 脳底動脈先端部血栓化動脈瘤に対してYステント併用コイル塞栓術を施行した1例

    大谷理浩, 杉生憲志, 徳永浩司, 菱川朋人, 伊丹尚多, 平松匡文, 大熊 佑, 伊達 勲

    脳神経外科   40 ( 11 )   1005 - 1012   2012年

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  • 頚動脈ステント内血栓症に対し緊急ステント留置術を追加した1例

    高杉祐二, 杉生憲志, 平松匡文, 大熊 佑, 伊丹尚多, 菱川朋人, 徳永浩二, 伊達 勲

    Journal of Neuroendovascular Therapy   6 ( 3 )   181 - 188   2012年

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    記述言語:英語  

    DOI: 10.5797/jnet.6.181

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  • Transcatheter arterial embolisation for paediatric inflammatory pseudotumour of the maxillary sinus

    A. Murai, K. Sugiu, S. Kariya, K. Nishizaki

    JOURNAL OF LARYNGOLOGY AND OTOLOGY   125 ( 11 )   1189 - 1192   2011年11月

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    記述言語:英語   出版者・発行元:CAMBRIDGE UNIV PRESS  

    Background: Inflammatory pseudotumours are mostly seen in the lung, and occasionally in the head and neck region including the sinonasal area. Reported treatment modalities comprise corticosteroid treatment, surgical excision and radiotherapy. The latter option is required because wide surgical resection may be difficult for head and neck lesions, especially in children. However, clinicians should be aware of the risk of late-onset side effects of radiotherapy in children.
    Case report: We present a two-year-old girl with a massive inflammatory pseudotumour of the maxillary sinus. Transcatheter arterial embolisation was performed, and the lesion was successfully managed without additional therapy. There was no evidence of recurrence over the next five years.
    Conclusion: This is the first report presenting the utility of arterial embolisation for inflammatory pseudotumour.

    DOI: 10.1017/S0022215111001848

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  • Determinants of Poor Outcome After Aneurysmal Subarachnoid Hemorrhage when both Clipping and Coiling Are Available: Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) in Japan

    Waro Taki, Nobuyuki Sakai, Hidenori Suzuki, Akio Hyodo, Shigeru Nemoto, Toshio Hyogo, Tomoaki Terada, Kouichi Satoh, Naoya Kuwayama, Shigeru Miyachi, Masaki Komiyama, Masayuki Ezura, Yuichi Murayama, Hiroshi Sakaida, Masayuki Maeda, Hiroshi Nagai, Taketo Kataoka, Shoichiro Ishihara, Yorio Koguchi, Shigeki Kobayashi, Yukiko Enomoto, Kiyofumi Yamada, Shinichi Yoshimura, Yasushi Matsumoto, Masaru Hirohata, Nobuyuki Sakai, Hidemitsu Adachi, Yasushi Ueno, Takeharu Kunieda, Chiaki Sakai, Hiroshi Yamagami, Hirotoshi Imamura, Masaomi Koyanagi, Kenichi Todo, Shiro Yamamoto, Yoji Kuramoto, Makoto Sonobe, Noriyuki Kato, Teruyasu Hirayama, Tsuneo Kano, Isao Naito, Shunji Matsubara, Junichiro Satomi, Koichi Satoh, Hidekazu Hamada, Naoki Toma, Fumio Asakura, Hidenori Suzuki, Hiroshi Sakaida, Satoshi Matsushima, Tadashi Shibuya, Hidenori Oishi, Hiroshi Abe, Yoshifumi Konishi, Eishi Sato, Mitsugu Nakamura, Akira Kurata, Katsumi Houya, Takanori Uchida, Akio Hyodo, Ichiro Nakahara, Toshio Higashi, Nozomi Murai, Yasushi Iwamuro, Yoshihiko Watanabe, Hideaki Nakagaki, Masahiro Takezawa, Daiki Murata, Yoichi Murayama, Toshihiro Ishibashi, Takayuki Saguchi, Masaki Ebara, Hideki Arakawa, Koreaki Irie, Naoya Kuwayama, Kenji Sugiu, Koji Tokunaga, Ayumi Nishida, Katsunori Nanba, Shigeru Nemoto, Masanori Tsutsumi, Kiyoshi Kazekawa, Mikito Hayakawa, Yuji Matsumaru, Yoshihiro Matsubayashi, Tomomi Sakabayashi, Keiko Miyakoda, Wataru Oohashi, Masaki Sano, Emiko Uno, Makiko Toyooka, Kaori Kuronaka, Kazuro Sakamoto, Hiroshi Nagai, Masanori Fukushima, Toshio Hyogo

    WORLD NEUROSURGERY   76 ( 5 )   437 - 445   2011年11月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:ELSEVIER SCIENCE INC  

    OBJECTIVE: To examine current determinants of poor outcome after aneurysmal subarachnoid hemorrhage (SAH) when ruptured aneurysms are treated with either microsurgery (clipping) or endovascular treatment (coiling) depending on each patient's characteristics.
    METHODS: Between March 2006 and February 2007, 534 patients with SAH were enrolled in the Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) project. Patients were treated according to the preference of investigators who were experienced in performing both clipping and coiling. Factors influencing poor outcome (12-month modified Rankin Scale [mRS], 3-6) were determined using multivariate logistic regression analyses.
    RESULTS: In this cohort, 32.4% of patients were World Federation of Neurosurgical Societies (WFNS) grade IV-V, and 28.1% had a poor outcome. Clipping was preferably performed for small aneurysms with a wide neck and for middle cerebral artery (MCA) aneurysms, whereas coiling was preferred for larger, internal carotid artery (ICA) and posterior circulation aneurysms. In addition to increasing age, admission WFNS grade IV-V, preadmission aneurysmal rerupture, vasospasm-induced cerebral infarct, pneumonia, sepsis, shunt-dependent hydrocephalus and seizure, postclipping hemorrhagic complications (odds ratio 4.8, 95% confidence interval 1.5-15.3, P &lt; 0.01), and postcoiling ischemic complications (odds ratio 4.4, 95% confidence interval 1.3-15.2, P &lt; 0.05) significantly caused poor outcomes, although the complications did not affect mortality. Type of treatment modality and size and location of aneurysms did not influence outcome.
    CONCLUSIONS: Introducing an endovascular treatment option has made aneurysm characteristics less important to outcome, but procedural complications are problematic and should be reduced to improve outcome.

    DOI: 10.1016/j.wneu.2011.04.026

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  • Endovascular Coil Embolization of a Ruptured Distal Anterior Choroidal Artery Aneurysm Associated With Ipsilateral Middle Cerebral Artery Occlusion-Case Report

    Ayumi Nishida, Koji Tokunaga, Tomohito Hishikawa, Kenji Sugiu, Isao Date

    NEUROLOGIA MEDICO-CHIRURGICA   51 ( 10 )   716 - 719   2011年10月

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    記述言語:英語   出版者・発行元:JAPAN NEUROSURGICAL SOC  

    An 84-year-old woman with a history of hypertension and a brain infarction presented with a rare distal anterior choroidal artery (AChoA) aneurysm not associated with moyamoya disease manifesting as sudden onset of headache caused by intraventricular hemorrhage. Digital subtraction angiography revealed a peripheral aneurysm in the left AChoA located distal to the plexal point and steno-occlusive changes of the proximal left middle cerebral artery (MCA) and the left posterior cerebral artery (PCA). Collateral arterial channels to the left MCA and left PCA territories were observed along the left AChoA. No neuroimaging findings were compatible with moyamoya disease. Since the aneurysm did not shrink at 2 months after the onset, endovascular treatment was indicated. Under local anesthesia, a microcatheter was placed into the AChoA proximal to the aneurysm with the aid of a 0.008-inch microguidewire. After a provocation test, three detachable platinum coils were delivered into the aneurysm and the parent artery. Complete obliteration of the aneurysm was achieved without additional neurological sequelae. Successful treatment of a ruptured distal AChoA aneurysm associated with atherosclerotic changes of the intracranial arteries was achieved using a meticulous endovascular technique.

    DOI: 10.2176/nmc.51.716

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  • Effectiveness of intraoperative near-infrared indocyanine green videoangiography in a case with recurrent spinal perimedullary arteriovenous fistula 国際誌

    Yasuyuki Miyoshi, Takao Yasuhara, Ayumi Nishida, Koji Tokunaga, Kenji Sugiu, Isao Date

    CLINICAL NEUROLOGY AND NEUROSURGERY   113 ( 3 )   239 - 242   2011年4月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE BV  

    DOI: 10.1016/j.clineuro.2010.10.014

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  • Posterior reversible encephalopathy syndrome 国際誌

    Takao Yasuhara, Koji Tokunaga, Tomohito Hishikawa, Shigeki Ono, Yasuyuki Miyoshi, Kenji Sugiu, Isao Date

    JOURNAL OF CLINICAL NEUROSCIENCE   18 ( 3 )   406 - 409   2011年3月

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    記述言語:英語   出版者・発行元:ELSEVIER SCI LTD  

    Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuroradiological entity with typical symptoms and symmetric high-signal intensity lesions in the bilateral parieto-occipital lobes on T2-weighted or fluid-attenuated inversion recovery (FLAIR) MRI. We described three patients with PRES of varied etiologies. Patient 1 was a young man with severe hypertension who presented with headache and visual disturbance. Patient 2 had leukemia and was receiving umbilical cord blood cell transplantation with immunosuppressant, and developed PRES with convulsions. Patient 3 was a pregnant woman with renal failure, who repeatedly developed PRES with convulsions. FLAIR and apparent diffusion coefficient mapping were useful in detecting PRES lesions in our patients, although diffusion-weighted imaging and CT scans had limited use in the diagnosis. Adequate and prompt treatment with antihypertensive medication immediately ameliorated the symptoms, with improvement of abnormal MRI findings. In previous reports, delayed diagnosis might have affected the prognosis. Further work on the clinical manifestations of PRES and its therapy is required. (C) 2010 Elsevier Ltd. All rights reserved.

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  • 脳血管内治療の最前線.

    杉生憲志

    医工学治療   23 ( 3 )   181 - 186   2011年

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  • MicroPlexコイル─特にHydroCoilについて─.

    杉生憲志

    Rad Fan   9 ( 10 )   68 - 70   2011年

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  • ケアミックス型病院におけるくも膜下出血の診療経験 —地域医療におけるケアミックス型病院を再考する—.

    中川 実, 藤原賢次郎, 坂本千穂子, 城戸由紀子, 徳永浩司, 杉生憲志

    脳卒中   33   313 - 318   2011年

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  • 経静脈的液体塞栓術にて治療した海綿静脈洞部硬膜動静脈瘻の2例

    平松匡文, 杉生憲志, 徳永浩司, 西田あゆみ, 栗山充夫, 前城朝英, 寺坂 薫, 伊達 勲

    脳神経外科   39 ( 12 )   1189 - 1196   2011年

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  • Supraclinoid瘤(IC-Achor, IC-PC)のコイル塞栓術.

    杉生憲志

    脳神経外科速報   21 ( 9 )   970 - 981   2011年

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  • 脊髄くも膜下出血後Adamkiewicz動脈に生じた血管攣縮.

    三好康之, 近藤聡彦, 安原隆雄, 西田あゆみ, 徳永浩司, 杉生憲志, 伊達 勲

    BRAIN and NERVE   63 ( 2 )   182 - 183   2011年

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  • Retrospective Survey of Endovascular Treatment for Ruptured Intracranial Aneurysm in Japan: Retrospective Endovascular Subarachnoid Aneurysm Treatment (RESAT) Study

    Nobuyuki Sakai, Waro Taki, Shinichi Yoshimura, Toshio Hyogo, Masayuki Ezura, Yasushi Matsumoto, Yasushi Ito, Hiroshi Abe, Makoto Sonobe, Shigeki Kobayashi, Shigeru Nemoto, Yuichi Murayama, Yuji Matsumaru, Hidenori Oishi, Naoya Kuwayama, Shigeru Miyachi, Tomoaki Terada, Masaki Komiyama, Toshiyuki Fujinaka, Kenji Sugiu, Koichi Sato, Ichiro Nakahara, Kiyoshi Kazekawa, Masaru Hirohata, Akio Hyodo, Chiaki Sakai

    NEUROLOGIA MEDICO-CHIRURGICA   50 ( 11 )   961 - 965   2010年11月

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    記述言語:英語   出版者・発行元:JAPAN NEUROSURGICAL SOC  

    Annual retrospective surveys of 20 to 31 medical centers performing endovascular treatment of cerebral aneurysms in Japan from 1997 to 2008 were performed to analyze technical and clinical outcomes of en dovascular treatment for ruptured cerebral aneurysm Patients treated with dome embolization using bare platinum coils within 14 days after onset were retrospectively selected, and clinical features, and technical and clinical outcomes at discharge were studied Retrospective Endovascular Subarachnoid Aneurysm Treatment (RESAT) 1 covers patients treated from 1997, when the Guglielmi detachable coil was introduced, to 2002, lust after International Subarachnoid Aneurysm Trial was reported RESAT 2 to RESAT 7 were conducted annually between 2003 and 2008 Among 5,624 patients with ruptured aneurysms treated within 14 days after onset, 4,782 patients were treated by dome embolization using platinum detachable coils The patients in this large retrospective survey included 35 8% aged over 70 years, 36 6% with posterior circulation aneurysms, and 29 3% with poor grades (Hunt and Kosnik grades IV and V) The proportion of patients aged over 70 years tended to increase each year from 33 4% in RESAT 1 to 39 8% in RESAT 7, and the proportion of those with posterior circulation aneurysms decreased from 44 2% in RESAT 1 to 23 8% in RESAT 7 (p &lt;0 001) Overall technical success was obtained in 4,666 patients (97 6%), and favorable clinical outcome (good recovery and moderate disability) at discharge was obtained in 88 0% of grade I-III cases and 73 6% of grade I-V cases Procedure-related morbidity was 2 9% and mortality was 0 8% Despite this survey involving high proportions of aged, posterior circulation, and poor-grade patients, the technical success rate and immediate clinical results were relatively favorable The patient prognosis and aneurysm changes must be investigated over a longer period, together with the effects of the introduction of new endovascular devices for cerebral aneurysms

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  • Optimal Dose of Plasmid Vascular Endothelial Growth Factor for Enhancement of Angiogenesis in the Rat Brain Ischemia Model

    Atsushi Katsumata, Kenji Sugiu, Koji Tokunaga, Noboru Kusaka, Kyoichi Watanabe, Ayumi Nishida, Katsunari Namba, Hirofumi Hamada, Hiroyuki Nakashima, Isao Date

    NEUROLOGIA MEDICO-CHIRURGICA   50 ( 6 )   449 - 455   2010年6月

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    記述言語:英語   出版者・発行元:JAPAN NEUROSURGICAL SOC  

    Vascular endothelial growth factor (VEGF) administration has recently been assessed as a therapeutic strategy for ischemic diseases including brain ischemia because of its angiogenic effect. However, VEGF also causes detrimental adverse effects by increasing vascular permeability. This study examined whether plasmid human VEGF (phVEGF) administration induced angiogenic effects in the rat brain ischemia model caused by permanent ligation of both common carotid arteries, and investigated the occurrence of adverse effects. Administration of various doses (0-200 mu g) of phVEGF in the temporal muscle was followed by encephalo-myo-synangiosis. Thirty days after treatment, the numbers and areas of capillaries per field in the extracted brains were analyzed with the National Institutes of Health Image software program. The maximal angiogenic effect occurred with a 100 mu g dose of phVEGF in the numbers and areas of capillaries in the VEGF-treated brains. Histological examination showed no apparent adverse effects in the brain parenchyma even at the highest administration dose (200 mu g) of phVEGF. The maximal angiogenic effect at the optimal dose of phVEGF can be considered under the threshold to cause serious adverse effects in the rat brain.

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  • Percutaneous balloon angioplasty for acute occlusion of intracranial arteries.

    Tokunaga K, Sugiu K, Yoshino K, Terai Y, Imaoka T, Handa A, Hirotsune N, Kusaka N, Date I

    Neurosurgery   67 ( ONS Suppl 1 )   ons189-ons197   2010年

  • 細胞移植療法.

    菊池陽一郎, 安原隆雄, 伊達 勲, 杉生憲志

    総合臨床   59 ( 12 )   2396 - 2399   2010年

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  • Rebleeding From a Vertebral Artery Dissecting Aneurysm After Endovascular Internal Trapping: Adverse Effect of Intrathecal Urokinase Injection or Incomplete Occlusion?-Case Report

    Kenji Sugiu, Koji Tokunaga, Shigeki Ono, Ayumi Nishida, Isao Date

    NEUROLOGIA MEDICO-CHIRURGICA   49 ( 12 )   597 - 600   2009年12月

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    記述言語:英語   出版者・発行元:JAPAN NEUROSURGICAL SOC  

    A 67-year-old woman suffered rebleeding from a ruptured vertebral artery dissecting aneurysm after endovascular internal trapping. The dissecting aneurysm was initially successfully occluded with the affected vertebral artery using detachable coils. However, rebleeding from the aneurysm occurred on the next day. The rebleeding may have resulted from the thrombolytic effect of urokinase, which was injected intrathecally 3 hours before rebleeding occurred, or the relatively loose coil packing of the aneurysm. This case indicates the potential risk of intrathecal use of thrombolytic agents and the importance of complete tight coil packing of the whole dissected site in the treatment of ruptured vertebral artery dissecting aneurysms.

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  • SIGNIFICANT DIFFERENCES IN THE POSTOPERATIVE MORPHOLOGICAL AND HEMODYNAMIC CONDITIONS OF CAROTID ARTERIES OF PATIENTS UNDERGOING STENTING OR ENDARTERECTOMY WITH PATCH ANGIOPLASTY 国際誌

    Koji Tokunaga, Kenji Sugiu, Hitoshi Hayase, Ayumi Nishida, Isao Date

    NEUROSURGERY   65 ( 5 )   884 - 888   2009年11月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    OBJECTIVE: Carotid endarterectomy with a patch graft (Patch CEA) has been our Standard treatment for patients with carotid artery stenosis, but carotid artery stenting (CAS) has emerged as an alternative. The purpose of this study was to compare the postoperative changes in the configurations and the flow velocities of carotid arteries after CAS or Patch CEA.
    METHODS: Thirty-one patients undergoing CAS or Patch CEA were included. The pre- and postoperative shapes of the carotid arteries were evaluated by angiography and ultrasonography. Doppler waveforms were recorded in the middle portion of the common carotid artery and in the internal carotid artery bulb to measure flow velocities, including peak systolic, mean, and end-diastolic velocities.
    RESULTS: Eighteen patients were treated by CAS, and Patch CEA was performed for 13 patients. Preoperatively, there were no differences in the degrees of stenosis or the flow velocities between the 2 groups. The averages of the diameters of the postoperative internal carotid artery bulbs were 4.5 mm in the CAS group and 7.0 mm in the Ratch CEA group (P &lt; 0.01). The averages of peak systolic, mean, and end-diastolic velocities measured in the internal carotid artery were 80, 42, and 25 cm/s, respectively, in the CAS group, and were significantly greater than those (53, 28, and 16 cm/s, respectively) in the Patch CEA group (P &lt; 0.01).
    CONCLUSION: Significant differences in postoperative morphological and hemodynamic conditions between CAS and Patch CEA were observed. The impact of these differences will be determined by further studies.

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  • SIGNIFICANT DIFFERENCES IN THE POSTOPERATIVE MORPHOLOGICAL AND HEMODYNAMIC CONDITIONS OF CAROTID ARTERIES OF PATIENTS UNDERGOING STENTING OR ENDARTERECTOMY WITH PATCH ANGIOPLASTY

    Koji Tokunaga, Kenji Sugiu, Hitoshi Hayase, Ayumi Nishida, Isao Date

    NEUROSURGERY   65 ( 5 )   884 - 888   2009年11月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    OBJECTIVE: Carotid endarterectomy with a patch graft (Patch CEA) has been our Standard treatment for patients with carotid artery stenosis, but carotid artery stenting (CAS) has emerged as an alternative. The purpose of this study was to compare the postoperative changes in the configurations and the flow velocities of carotid arteries after CAS or Patch CEA.
    METHODS: Thirty-one patients undergoing CAS or Patch CEA were included. The pre- and postoperative shapes of the carotid arteries were evaluated by angiography and ultrasonography. Doppler waveforms were recorded in the middle portion of the common carotid artery and in the internal carotid artery bulb to measure flow velocities, including peak systolic, mean, and end-diastolic velocities.
    RESULTS: Eighteen patients were treated by CAS, and Patch CEA was performed for 13 patients. Preoperatively, there were no differences in the degrees of stenosis or the flow velocities between the 2 groups. The averages of the diameters of the postoperative internal carotid artery bulbs were 4.5 mm in the CAS group and 7.0 mm in the Ratch CEA group (P &lt; 0.01). The averages of peak systolic, mean, and end-diastolic velocities measured in the internal carotid artery were 80, 42, and 25 cm/s, respectively, in the CAS group, and were significantly greater than those (53, 28, and 16 cm/s, respectively) in the Patch CEA group (P &lt; 0.01).
    CONCLUSION: Significant differences in postoperative morphological and hemodynamic conditions between CAS and Patch CEA were observed. The impact of these differences will be determined by further studies.

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  • Endovascular Treatment for Bow Hunter&apos;s Syndrome: Case Report

    K. Sugiu, T. Agari, K. Tokunaga, A. Nishida, I. Date

    MINIMALLY INVASIVE NEUROSURGERY   52 ( 4 )   193 - 195   2009年8月

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    記述言語:英語   出版者・発行元:GEORG THIEME VERLAG KG  

    Introduction: Bow hunter&apos;s syndrome is a unique clinical entity caused by mechanical occlusion of the vertebral artery on head rotation. Although it is usually treated by direct surgical intervention, we report successful treatment using endovascular stent placement for contralateral vertebral artery stenosis.
    Case Description: A 56-year-old man presented with repeated vertigo and loss of consciousness caused by turning his head to the left. Right vertebral angiogram showed no abnormalities with the head in the neutral position. However, with the head rotated 60 degrees to the left, the right vertebral artery was completely occluded at the C1-2 level. A three-dimensional angiogram with bone window clearly demonstrated vertebral artery compression at the C1-2 level by the bony structure. The left subclavian angiogram revealed severe stenosis at the origin of the left vertebral artery. Left vertebral artery angioplasty followed by stent placement was successfully performed under local anesthesia. The patient showed an uneventful postoperative course and his preoperative symptoms disappeared. At 6 months postoperatively, a left subclavian angiogram showed good patency of the stented left vertebral artery and the patient showed no recurrent symptoms.
    Conclusion: Vertebral artery stenting is a useful and less invasive option in the treatment of bow hunter&apos;s syndrome in the setting of contralateral vertebral artery stenosis.

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  • Usefulness of 3-Dimensional CT Angiograms Obtained by 64-Section Multidetector Row CT Scanner for Dural Arteriovenous Fistula 国際誌

    Minoru Nakagawa, Kenji Sugiu, Koji Tokunaga, Kohei Tsuda, Matsuhiro Imaoka, Atsushi Kawahara, Kenjiro Fujiwara

    JOURNAL OF NEUROIMAGING   19 ( 2 )   179 - 182   2009年4月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL PUBLISHING, INC  

    The authors reported a case of a dural arteriovenous fistula (DAVF) in the left transverse-sigmoid sinus, in which 3-dimensional computed tomography (CT) angiograms (3D-CTAs) by a 64-section multidetector row CT scanner were useful for its diagnosis and treatment. The DAVF in the left transverse-sigmoid sinus appeared on the digital subtraction angiogram. 3D-CTAs were obtained by a 64-section multidetector row CT scanner before an endovascular treatment. The feeders and draining veins of the DAVF were clearly demonstrated on the 3D-CTAs, which clarified the relationship between the normal dural sinuses and DAVF. The DAVF was successfully treated with endovascular surgery, a transvenous embolization through the mastoid emissary vein, which was easily detected by using the 3D-CTA, showing both the subcutaneous vein and calvalium. 3D-CTAs by a 64-section multidetector row CT scanner are useful for both diagnosis and treatment of DAVFs.
    J Neuroimaging 2009;19:179-182.

    DOI: 10.1111/j.1552-6569.2007.00228.x

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  • Usefulness of 3-Dimensional CT Angiograms Obtained by 64-Section Multidetector Row CT Scanner for Dural Arteriovenous Fistula

    Minoru Nakagawa, Kenji Sugiu, Koji Tokunaga, Kohei Tsuda, Matsuhiro Imaoka, Atsushi Kawahara, Kenjiro Fujiwara

    JOURNAL OF NEUROIMAGING   19 ( 2 )   179 - 182   2009年4月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL PUBLISHING, INC  

    The authors reported a case of a dural arteriovenous fistula (DAVF) in the left transverse-sigmoid sinus, in which 3-dimensional computed tomography (CT) angiograms (3D-CTAs) by a 64-section multidetector row CT scanner were useful for its diagnosis and treatment. The DAVF in the left transverse-sigmoid sinus appeared on the digital subtraction angiogram. 3D-CTAs were obtained by a 64-section multidetector row CT scanner before an endovascular treatment. The feeders and draining veins of the DAVF were clearly demonstrated on the 3D-CTAs, which clarified the relationship between the normal dural sinuses and DAVF. The DAVF was successfully treated with endovascular surgery, a transvenous embolization through the mastoid emissary vein, which was easily detected by using the 3D-CTA, showing both the subcutaneous vein and calvalium. 3D-CTAs by a 64-section multidetector row CT scanner are useful for both diagnosis and treatment of DAVFs.
    J Neuroimaging 2009;19:179-182.

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  • Dural Arteriovenous Fistula CT Appearance Case Report and Review

    Minoru Nakagawa, Kenji Sugiu, Koji Tokunaga, Kenjiro Fujiwara

    NEUROSURGERY QUARTERLY   19 ( 1 )   46 - 49   2009年3月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Images of dural arteriovenous fistula (DAVF) on computed tomography (CT) are usually normal when 110 hemorrhages have occurred from the DAVF. Therefore, it is difficult to diagnose DAVF by plain CT scans which are usually performed in an initial examination. We present a rare case with DAVF in the transverse-sigmoid sinus that Could be diagnosed by reversible speckled high-density spots on a plain CT scan. A 46-year-old man had suffered from depression and had taken some antidepressants for 4 years. He developed a Gerstmann&apos;s syndrome and came to our hospital. On a plain CT scan obtained on admission, multiple high-density spots were demonstrated scattered in the left temporal, parietal, and occipital lobes. Subsequently, a digital Subtraction angiography was performed. A DAVF in the left transverse-sigmoid sinus was apparent on the angiogram. The DAVF was successfully treated with endovascular Surgery. The speckled high density decreased on the postoperative plain CT scan. Multiple high-density abnormalities in the brain shown on a plain CT scan are a rare but important finding for diagnosis of DAVF. Further examinations such as magnetic resonance angiography or digital subtraction angiography should be performed in case with these changes to access the possibility of DAVF.

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  • Percutaneous Coil Embolization Using the Direct Puncture Technique for a Subclavian Artery Pseudoaneurysm After Inadvertent Puncture

    Hidefumi Mimura, Hideo Gobara, Takao Hiraki, Hiroyasu Fujiwara, Jun Sakurai, Kenji Sugiu, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   32 ( 2 )   371 - 373   2009年3月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:SPRINGER  

    DOI: 10.1007/s00270-008-9436-z

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  • Percutaneous Coil Embolization Using the Direct Puncture Technique for a Subclavian Artery Pseudoaneurysm After Inadvertent Puncture 国際誌

    Hidefumi Mimura, Hideo Gobara, Takao Hiraki, Hiroyasu Fujiwara, Jun Sakurai, Kenji Sugiu, Susumu Kanazawa

    CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY   32 ( 2 )   371 - 373   2009年3月

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    記述言語:英語   出版者・発行元:SPRINGER  

    DOI: 10.1007/s00270-008-9436-z

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  • Dural Arteriovenous Fistula CT Appearance Case Report and Review

    Minoru Nakagawa, Kenji Sugiu, Koji Tokunaga, Kenjiro Fujiwara

    NEUROSURGERY QUARTERLY   19 ( 1 )   46 - 49   2009年3月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Images of dural arteriovenous fistula (DAVF) on computed tomography (CT) are usually normal when 110 hemorrhages have occurred from the DAVF. Therefore, it is difficult to diagnose DAVF by plain CT scans which are usually performed in an initial examination. We present a rare case with DAVF in the transverse-sigmoid sinus that Could be diagnosed by reversible speckled high-density spots on a plain CT scan. A 46-year-old man had suffered from depression and had taken some antidepressants for 4 years. He developed a Gerstmann&apos;s syndrome and came to our hospital. On a plain CT scan obtained on admission, multiple high-density spots were demonstrated scattered in the left temporal, parietal, and occipital lobes. Subsequently, a digital Subtraction angiography was performed. A DAVF in the left transverse-sigmoid sinus was apparent on the angiogram. The DAVF was successfully treated with endovascular Surgery. The speckled high density decreased on the postoperative plain CT scan. Multiple high-density abnormalities in the brain shown on a plain CT scan are a rare but important finding for diagnosis of DAVF. Further examinations such as magnetic resonance angiography or digital subtraction angiography should be performed in case with these changes to access the possibility of DAVF.

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  • スパズムへの新しいアプローチ 基礎から臨床まで 11Rを用いた新しいタンパク質導入法 脳血管障害治療への効果的な新しい薬物導入システムの確立

    小野 成紀, 小川 智之, 市川 智継, 有光 帥二, 菱川 朋人, 徳永 浩司, 杉生 憲志, 富澤 一仁, 松井 秀樹, 伊達 勲

    脳血管攣縮   24   11 - 14   2009年3月

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    記述言語:日本語   出版者・発行元:スパズム・シンポジウム事務局  

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  • Protein Transduction Method for Cerebrovascular Disorders

    Tomoyuki Ogawa, Shigeki Ono, Tomotsugu Ichikawa, Seiji Arimitsu, Keisuke Onoda, Koji Tokunaga, Kenji Sugiu, Kazuhito Tomizawa, Hideki Matsui, Isao Date

    ACTA MEDICA OKAYAMA   63 ( 1 )   1 - 7   2009年2月

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    記述言語:英語   掲載種別:書評論文,書評,文献紹介等   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    Many studies have shown that a motif of 11 consecutive arginines (11R) is one of the most effective protein transduction domains (PTD) for introducing proteins into the cell membrane. By conjugating this "11R", all sorts of proteins can effectively and harmlessly be transferred into any kind of cell. We therefore examined the transduction efficiency of 11R in cerebral arteries and obtained results showing that 11R fused enhanced green fluorescent protein (11R-EGFP) immediately and effectively penetrated all layers of the rat basilar artery (BA), especially the tunica media. This method provides a revolutionary approach to cerebral arteries and ours is the first study to demonstrate the successful transduction of a PTD fused protein into the cerebral arteries. In this review, we present an outline of our studies and other key studies related to cerebral vasospasm and 11R, problems to be overcome, and predictions regarding future use of the 11R protein transduction method for cerebral vasospasm (CV).

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  • Protein Transduction Method for Cerebrovascular Disorders

    Tomoyuki Ogawa, Shigeki Ono, Tomotsugu Ichikawa, Seiji Arimitsu, Keisuke Onoda, Koji Tokunaga, Kenji Sugiu, Kazuhito Tomizawa, Hideki Matsui, Isao Date

    ACTA MEDICA OKAYAMA   63 ( 1 )   1 - 7   2009年2月

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    記述言語:英語   出版者・発行元:OKAYAMA UNIV MED SCHOOL  

    Many studies have shown that a motif of 11 consecutive arginines (11R) is one of the most effective protein transduction domains (PTD) for introducing proteins into the cell membrane. By conjugating this "11R", all sorts of proteins can effectively and harmlessly be transferred into any kind of cell. We therefore examined the transduction efficiency of 11R in cerebral arteries and obtained results showing that 11R fused enhanced green fluorescent protein (11R-EGFP) immediately and effectively penetrated all layers of the rat basilar artery (BA), especially the tunica media. This method provides a revolutionary approach to cerebral arteries and ours is the first study to demonstrate the successful transduction of a PTD fused protein into the cerebral arteries. In this review, we present an outline of our studies and other key studies related to cerebral vasospasm and 11R, problems to be overcome, and predictions regarding future use of the 11R protein transduction method for cerebral vasospasm (CV).

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  • 頚動脈狭窄症に対するAngioguard XPを用いた頚動脈ステント留置術の治療成績─PercuSurge GuardWireによる治療成績との比較─

    徳永浩司, 杉生憲志, 西田あゆみ, 平松匡文, 菱川朋人, 小野成紀, 伊達 勲

    Journal of Neuroendovascular Therapy   3 ( 2 )   79 - 85   2009年

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    記述言語:英語  

    DOI: 10.5797/jnet.3.79

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  • Rebleeding from a vertebral artery dissecting aneurysm after endovascular internal trapping: Adverse effect of intrathecal urokinase injection or incomplete occlusion? - Case report

    Kenji Sugiu, Koji Tokunaga, Shigeki Ono, Ayumi Nishida, Isao Date

    Neurologia Medico-Chirurgica   49 ( 12 )   597 - 600   2009年

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    記述言語:英語  

    A 67-year-old woman suffered rebleeding from a ruptured vertebral artery dissecting aneurysm after endovascular internal trapping. The dissecting aneurysm was initially successfully occluded with the affected vertebral artery using detachable coils. However, rebleeding from the aneurysm occurred on the next day. The rebleeding may have resulted from the thrombolytic effect of urokinase, which was injected intrathecally 3 hours before rebleeding occurred, or the relatively loose coil packing of the aneurysm. This case indicates the potential risk of intrathecal use of thrombolytic agents and the importance of complete tight coil packing of the whole dissected site in the treatment of ruptured vertebral artery dissecting aneurysms.

    DOI: 10.2176/nmc.49.597

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  • Endovascular treatment for Bow hunter's syndrome: Case report

    K. Sugiu, T. Agari, K. Tokunaga, A. Nishida, I. Date

    Minimally Invasive Neurosurgery   52 ( 4 )   193 - 195   2009年

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    記述言語:英語  

    Introduction: Bow hunter's syndrome is a unique clinical entity caused by mechanical occlusion of the vertebral artery on head rotation. Although it is usually treated by direct surgical intervention, we report successful treatment using endovascular stent placement for contralateral vertebral artery stenosis. Case Description: A 56-year-old man presented with repeated vertigo and loss of consciousness caused by turning his head to the left. Right vertebral angiogram showed no abnormalities with the head in the neutral position. However, with the head rotated 60 to the left, the right vertebral artery was completely occluded at the C1-2 level. A three-dimensional angiogram with bone window clearly demonstrated vertebral artery compression at the C1-2 level by the bony structure. The left subclavian angiogram revealed severe stenosis at the origin of the left vertebral artery. Left vertebral artery angioplasty followed by stent placement was successfully performed under local anesthesia. The patient showed an uneventful postoperative course and his preoperative symptoms disappeared. At 6 months postoperatively, a left subclavian angiogram showed good patency of the stented left vertebral artery and the patient showed no recurrent symptoms. Conclusion: Vertebral artery stenting is a useful and less invasive option in the treatment of bow hunter's syndrome in the setting of contralateral vertebral artery stenosis. © Georg Thieme Verlag KG Stuttgart.

    DOI: 10.1055/s-0029-1239501

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  • 血管内治療が行われる疾患と治療 ㈪脳動静脈奇形、頚動脈狭窄症など

    杉生憲志

    BRAIN NURSING   25 ( 10 )   34 - 40   2009年

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  • 血管内治療が行われる疾患と適応 ㈰脳動脈瘤

    杉生憲志

    BRAIN NURSING   25 ( 10 )   29 - 33   2009年

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  • 右中大脳動脈狭窄症に対して、PTAとシロスタゾール(プレタール)の併用にて改善を認めた1例

    渡邊恭一, 杉生憲志, 島津洋介, 井上 智, 桐山英樹, 松本健五

    Progress in Medicine   29 ( 11 )   2835 - 2838   2009年

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  • 後頭部皮下静脈穿刺による横・S状静脈胴部硬膜動静脈瘻の塞栓術

    平松匡文, 杉生憲志, 徳永浩司, 西田あゆみ, 早瀬仁志, 三好康之, 藤原賢次郎, 中川実, 伊達 勲

    JNET Journal of Neuroendovascular Therapy   3 ( 2 )   112 - 117   2009年

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    記述言語:英語  

    DOI: 10.5797/jnet.3.112

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  • Japanese Society of Neuro-Endovascular Treatment Specialist Qualification System. Six Years&apos; Experience and Introduction of an Animal Model Examination

    T. Hyogo, W. Taki, M. Negoro, A. Takahashi, M. Edura, A. Hyodo, S. Kobayashi, M. Komiyama, N. Kuwayama, Y. Matsumaru, S. Miyachi, K. Murao, Y. Murayama, I. Nakahara, S. Nemoto, N. Sakai, K. Satoh, M. Sonobe, K. Sugiu, T. Terada, S. Yoshimura, T. Abe, Y. Itoh, H. Kiyosue, H. Nagashima, M. Nakamura, S. Matsushima

    INTERVENTIONAL NEURORADIOLOGY   14 ( 3 )   235 - 240   2008年9月

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    記述言語:英語   出版者・発行元:EDIZIONI CENTAURO  

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  • 11Rを用いた脳血管に対する新しい蛋白質導入法

    小川 智之, 小野 成紀, 市川 智継, 有光 帥二, 小野田 惠介, 徳永 浩司, 杉生 憲志, 富澤 一仁, 松井 秀樹, 伊達 勲

    岡山医学会雑誌   120 ( 2 )   129 - 133   2008年8月

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    記述言語:日本語   出版者・発行元:岡山医学会  

    脳血管に対する外来蛋白質導入法としての「蛋白質セラピー法」の可能性を模索するため、11Rにマーカー蛋白質である緑色蛍光色素タンパク(EGFP)を融合させて(11R-EGFP)、脳血管に対する導入効率を検討した。ラット大槽内に11R-EGFP、EGFPまたは生理食塩水を注入し、注入2、6時間後に脳底動脈を取り出し凍結切片を作成し、蛍光顕微鏡で観察した。その結果、注入2、6時間後に11R-EGFPタンパク質は、脳底動脈壁へ著明に導入されていた。一方、11Rを付加していないEGFPは、くも膜下腔にその存在を認めたが、脳底動脈壁には導入を認めなかった。部位別に導入効果率を検討するため、Scionイメージで蛍光強度の測定を行ったところ、11R-EGFP群は、EGFPおよび生理食塩水注入群と比較して、特に中膜に高い蛍光強度を示した。蛋白質セラピーのこれらの特徴は、くも膜下出血後の脳血管攣縮や脳梗塞等の急性で一過性の脳血管障害の治療に適していると考えられた。

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  • Orbital exenteration after transarterial embolization in a patient with Wyburn-Mason syndrome: Pathological findings

    Toshihiko Matsuo, Hiroyuki Yanai, Kenji Sugiu, Susumu Tominaga, Yoshihiro Kimata

    JAPANESE JOURNAL OF OPHTHALMOLOGY   52 ( 4 )   308 - 313   2008年7月

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    記述言語:英語   出版者・発行元:SPRINGER TOKYO  

    Background: We present the pathological findings at orbital exenteration in a patient with Wyburn-Mason syndrome who underwent transarterial embolization.
    Case: A 31-year-old man with a 10-year history of gradual exacerbation of left exophthalmos and left cheek swelling was found to have facial and orbital arteriovenous malformations on the left side. There was no vascular malformation in the brain. The feeding arteries derived from the left internal maxillary artery, facial artery, and ophthalmic artery. He underwent several courses of transarterial embolization of the feeding arteries from the left internal maxillary artery and then from the facial artery, resulting in no reduction of the arteriovenous malformation. He finally elected to undergo ophthalmic artery embolization in the expectation of a reduction and with the understanding that he would lose sight in his left eye. Two years later, he requested lid-sparing orbital exenteration and reconstruction with cutaneous flap transfer and prosthesis for cosmetic reasons.
    Observations: Pathologically, orbital vascular channels of varying sizes were filled with embolizing glue and had degenerating vascular wall cells surrounded by inflammatory cell infiltration. The central retinal artery in the optic nerve was also filled with the embolizing glue, and the retina lost the ganglion cell layer and inner nuclear layer but maintained the outer nuclear layer and outer segments.
    Conclusions: Marked anastomoses and hence incomplete embolization among the feeding arteries of facial and orbital vascular malformations in Wyburn-Mason syndrome do not respond well to attempts at feeding vessel embolization, which result in unsuccessful closure of the malformation.

    DOI: 10.1007/s10384-008-0563-5

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  • Fenestration of the supraclinoid internal carotid artery with associated aneurysm

    Keisuke Onoda, Shigeki Ono, Koji Tokunaga, Kenji Sugiu, Isao Date

    NEUROLOGIA MEDICO-CHIRURGICA   48 ( 3 )   118 - 120   2008年3月

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    記述言語:英語   出版者・発行元:JAPAN NEUROSURGICAL SOC  

    A 42-year-old woman presented with a rare case of fenestration of the supraclinoid internal carotid artery (ICA) with associated aneurysm manifesting as headache. Computed tomography (CT) found no abnormalities. Three-dimensional CT angiography showed fenestration of the left ICA with an associated aneurysm. Direct surgery was performed for the aneurysm, and the patient's postoperative course was uneventful. The present case of ICA fenestration associated with aneurysm indicates that surgical treatment should be considered for even small unruptured aneurysms arising from this location, because of the high risk of rupture.

    DOI: 10.2176/nmc.48.118

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  • Effects of deferoxamine-activated hypoxia-inducible factor-1 on the brainstem after subarachnoid hemorrhage in rats 国際誌

    Tomohito Hishikawa, Shigeki Ono, Tomoyuki Ogawa, Koji Tokunaga, Kenji Sugiu, Isao Date

    NEUROSURGERY   62 ( 1 )   232 - 240   2008年1月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    OBJECTIVE: Hypoxia-inducible factor (HIF)-1 is a transcription factor that regulates the expression of various neuroprotective genes. The goal of this study was to clarify the relationship between HIF-1 expression and subarachnoid hemorrhage (SAH) and to characterize the effects of deferoxamine (DFO)-induced increases in HIF-1 protein levels on the brainstem and the basilar artery (BA) after experimental SAH.
    METHODS: Rat single- and double-hemorrhage models (injected on Days 0 and 2) of SAH were used. We assessed the time courses for HIF-1 protein levels in the brainstems and the BA diameters within 10 minutes and 6 hours on Days 1 and 2 in the single-SAH model, and also on Day 7 in the double-SAH model. After induction of double hemorrhage in rats, DFO was injected intraperitoneally. We then evaluated HIF-1 protein expression and brainstem activity, BA diameter, and brainstem blood flow.
    RESULTS: After the rats experienced SAH, HIF-1 protein expression was significantly greater at 10 minutes in the single-injection model and at 7 days in the double-injection model than at similar time points in the control group, and these increases correlated with degrees of cerebral vasospasm. DFO injection resulted in significant increases in HIF-1 protein expression and activity in the brainstems of rats with SAH, compared with the rats with SAH that were given placebos, and the rats without SAH in the double-hemorrhage model. Cerebral vasospasm and reduction of brainstem blood flow were significantly attenuated in the rats that were administered DFO.
    CONCLUSION: These results show that a DFO-induced increase in HIF-1 protein level and activity exerts significant attenuation of BA vasospasm and reduction of brainstem blood flow in the rat model of SAH. DFO may be a promising agent for treating clinical SAH.

    DOI: 10.1227/01.NEU.0000296989.61911.81

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  • Continuous evaluation of regional oxygen saturation in cerebral vasospasm after subarachnoid haemorrhage using INVOS (R), portable near infrared spectrography

    S. Ono, S. Arimitsu, T. Ogawa, H. Manabe, K. Onoda, K. Tokunaga, K. Sugiu, I. Date

    CEREBRAL VASOSPASM: NEW STRATEGIES IN RESEARCH AND TREATMENT   104   215 - 218   2008年

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    記述言語:英語   出版者・発行元:SPRINGER-VERLAG WIEN  

    Background. Although several tools are available for the detection of cerebral vasospasm after subarachnoid haemorrhage, it has remained difficult to identify vasospasm timely and accurately. INVOS (R) monitoring measures the oxygen saturation by using near infrared spectroscopy, and in this study we examined the usefulness of this system for the detection of vasospasm.
    Method. Five patients who had suffered SAH were enrolled in this study. In view of the thickness of the clots, the probes of INVOS (R) were attached to the scalp in the areas where vasospasm was likely to occur, from day 3 to the end of vasospasm, up to 14 days post SAH. Patients were monitored every day by INVOS 0) and by neurological exams. Angiography was performed if regional oxygen saturation had continuously decreased by 10% or more as compared to the contralateral side, or if patients showed additional neurological deficits. If vasospasm was detected, interventional treatment using intraarterial fasudil injection or percutaneous, transluminal angioplasty was performed. The same interventional therapy was repeated until neurological deficits improved.
    Findings. When the INVOS (R) value decreased to lower than 60, angiographic or symptomatic vasospasm tended to occur, and the response of regional oxygen saturation correlated accurately, both symptomatically and angiographically, with brain ischemia due to vasospasm. Recovery from ischemia on angiography or single photon emission CT also correlated with the return of regional oxygen saturation by INVOS (R).
    Conclusions. INVOS (R) monitoring is handy and noninvasive; it is able to evaluate real-time regional oxygen saturation in the region of VS and may be superior to the other existing monitoring systems.

    DOI: 10.1007/978-3-211-75718-5-41

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  • Endovascular treatment for ruptured cerebral aneurysms in elderly patients.

    Sugiu K, Tokunaga K, Nishida A, Hayase H, Ono S, Onoda K, Date I

    Journal of Stroke & Cerebrovascular Disease   17 ( (5)Supplement 1 )   S92   2008年

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  • 塞栓物質の選び方と使用方法 2. コイル.

    杉生憲志

    IVR   23 ( -2 )   195 - 198   2008年

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  • 頸動脈ステント留置術と抗血小板療法.

    平松匡文, 杉生憲志, 徳永浩司, 西田あゆみ, 早瀬仁志, 菱川朋人, 小野成紀, 三好康之, 伊達 勲

    新薬と臨床   57 ( -12 )   1987 - 1993   2008年

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  • 内頸動脈海綿静脈洞部巨大・大型動脈瘤に対する複合治療.

    伊達 勲, 徳永浩司, 杉生憲志

    脳卒中の外科   36   12 - 18   2008年

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  • Endothelial nitric oxide synthase-11R protein therapy for prevention of cerebral vasospasm in rats: a preliminary report

    T. Ogawa, S. Ono, T. Ichikawa, S. Arimitsu, K. Onoda, K. Tokunaga, K. Sugiu, K. Tomizawa, H. Matsui, I. Date

    CEREBRAL VASOSPASM: NEW STRATEGIES IN RESEARCH AND TREATMENT   104   165 - +   2008年

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    記述言語:英語   出版者・発行元:SPRINGER-VERLAG WIEN  

    Background. In one of our studies we found that enhanced green fluorescent protein (EGFP) fused with consecutive 11 arginines (11R), one of the protein transduction domains (PTDs) [1-6, 11], and effectively penetrated into all layers of the rat basilar artery (BA). We examined whether eNOS (140-kDa) fused 11R (11R-eNOS) was also transduced into the BAs and had a positive effect on the attenuation of cerebral vasospasm.
    Method. 11R-eNOS or saline was injected into the cisterna magna of male Sprague-Dawley rats. Two hours after the injection, the BAs were extracted from the rats and transduction efficacy of 11R-eNOS in the BA was evaluated by immunofluorescence staining. To examine the effect of 11R-eNOS on the cerebral arteries exposed to SAH, we measured the post SAH BA diameters six hours after the injection of 11R-eNOS.
    Findings. Immunofluorescent study confirmed the presence of 11ReNOS protein in the layers of the cerebral arteries in vivo. 11R-eNOS had a positive effect on attenuation of cerebral vasospasm.
    Conclusions. 11R-eNOS was effectively transduced into the walls of the BA. 11R-eNOS inhibited the vasoconstriction after SAH. These results suggest that 11R-eNOS protein therapy has a potential in treating cerebral vasospasm.

    DOI: 10.1007/978-3-211-75718-5-32

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  • Direct protein transduction method to cerebral arteries by using 11R: new strategy for the treatment of cerebral vasospasm after subarachnoid haemorrhage

    T. Ogawa, S. Ono, T. Ichikawa, H. Michiue, S. Arimitsu, K. Onoda, K. Tokunaga, K. Sugiu, K. Tomizawa, H. Matsui, I. Date

    CEREBRAL VASOSPASM: NEW STRATEGIES IN RESEARCH AND TREATMENT   104   161 - +   2008年

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    記述言語:英語   出版者・発行元:SPRINGER-VERLAG WIEN  

    Background. Gene transfer with some vectors may be useful for treatmcnt of cerebral vasospasm after subarachnoid haemorrhage (SAH) [2, 3, 6, 10, 12, 13, 19]. However, this method has some safety problems [18]. Previous studies have shown that direct delivery of therapeutic proteins by using protein transduction domain (PTD) may reduce these problems [14, 15]. Here, we examined the transduction efficiency of eleven consecutive arginines (11R), which is one of the most effective PTD 18, 91, into the rat cerebral arteries by using 11R-enhanced-green fluorescent protein (11R-EGFP).
    Method. 11R-EGFP or EGFP was injected into the cisterna magna of the rats with SAH. SAH model was made by autologous blood injection. The proteins were injected just after the autologous blood injection in SAH rats. The expression of 11R-EGFP or EGFP was observed by fluorescence microscope.
    Findings. The signal of 11R-EGFP was much stronger than that of EGFP in all the layers of the rat basilar artery (BA). The 11R-EGFP was especially transduced into the tunica media of the basilar artery 2 It after the injection.
    Conclusions. Our results demonstrate that 11R-fused fluorescent protein effectively penetrates into the all layers of the rat BA, and especially into the tunica media.

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  • Effect of deferoxamine-activated hypoxia inducible factor-1 on the brainstem following subarachnoid haemorrhage

    S. Ono, T. Hishikawa, T. Ogawa, M. Nishiguchi, K. Onoda, K. Tokunaga, K. Sugiu, I. Date

    CEREBRAL VASOSPASM: NEW STRATEGIES IN RESEARCH AND TREATMENT   104   69 - 73   2008年

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    記述言語:英語   出版者・発行元:SPRINGER-VERLAG WIEN  

    Background. Hypoxia inducible factor-1 (HIF-1) is a transcription factor that regulates the expression of various neuroprotective genes. The goal of this study was to clarify the relationship between HIF-1 a expression and subarachnoid haemorrhage (SAH) and to determine the effects of the deferoxamine (DFO)-induced increase in HIF-1 alpha protein levels on the brainstem and the basilar artery (BA) following experimental SAH.
    Method. Rat single- (10min, 6h, Day 1, Day 2) and double-haemorrhage (Day 7) models of SAH were used. The time course of HIF-1 alpha protein levels of the brainstems and the diameter of the BA was assessed. After an induction of double-haemorrhage in rats, DFO was injected intraperitoneally and HIF-1 alpha protein expression, activity in the brainstems, the diameter of the BA and the brainstem blood flow were assessed.
    Findings. The expression of HIF-1 alpha protein was significantly greater at 10 min and 7 days after SAH. The increase of HIF-1 alpha protein correlated with the degree of cerebral vasospasm. An injection of DFO resulted in significant increases it) HIF-1 alpha protein expression and activity in the brainstem of rats with SAH.
    Conclusions. These results indicate that DFO-induced increase in HIF-1 alpha protein levels and activity exerts neuroprotective and antivasospastic effects. DFO may be a potential therapeutic tool for cerebral vasospasm after SAH.

    DOI: 10.1007/978-3-211-75718-5-13

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  • 頸部内頸動脈狭窄症におけるCEAとCAS術後の医用画像を用いた患者特異的モデルと仮想モデルの流体力学シミュレーション

    早瀬仁志, 中山敏男, 徳永浩司, 杉生憲志, 西田あゆみ, 有光帥二, 菱川朋人, 小野成紀, 太田信, 伊達勲

    日本脳神経外科学会総会抄録集(CD-ROM)   67th   2008年

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  • Triple-catheter technique in the transvenous coil embolization of an isolated sinus dural arteriovenous fistula 国際誌

    Kenji Sugiu, Koji Tokunaga, Ayumi Nishida, Wataru Sasahara, Kyoichi Watanabe, Shigeki Ono, Keisuke Onoda, Isao Date

    NEUROSURGERY   61 ( 3 )   81 - 85   2007年9月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    OBJECTIVE: Dural arteriovenous fistulae involving the transverse-sigmoid sinus, which is occluded at its proximal and distal ends (i.e., an isolated sinus), carry a high risk of intracranial hemorrhage or progressive neurological deficits. Although transvenous coil embolization is a useful and safe,treatment for such lesions, it is often difficult to reach into the isolated sinus through the occluded sinus using the percutaneous catheter approach.
    METHODS: We report the successful treatment of two patients with transverse-sigmoid dural arteriovenous fistulae with isolated sinus using the percutaneous transvenous triple-catheter technique. A 6-French guiding catheter was placed at the internal jugular vein followed by a second 4-French catheter positioned at the end of the occluded sinus. A third microcatheter was then navigated into the isolated sinus with support of the second catheter.
    RESULTS: Although initial attempts to reach into the isolated sinus without the second catheter failed, insertion of the second catheter resulted in successful navigation of the third microcatheter into the affected sinus in both cases. Complete cure was obtained in both cases by coil packing of the affected sinus.
    CONCLUSION: Although careful maneuvering is required, this triple-catheter technique is useful for treatment of dural arteriovenous fistulae with isolated sinus.

    DOI: 10.1227/01.NEU.0000279984.56050.70

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  • Antivasospastic and antiinflammatory effects of caspase inhibitor in experimental subarachnoid hemorrhage 国際誌

    Keiichi Iseda, Shigeki Ono, Keisuke Onoda, Motoyoshi Saroh, Hiroaki Manabe, Mitsuhisa Nishiguchi, Kenji Takahashi, Koji Tokunaga, Kenji Sugiu, Isao Date

    JOURNAL OF NEUROSURGERY   107 ( 1 )   128 - 135   2007年7月

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    記述言語:英語   出版者・発行元:AMER ASSOC NEUROLOGICAL SURGEONS  

    Object. Inflammation in the subarachnoid space and apoptosis of arterial endothelial cells have been implicated in the development of delayed cerebral vasospasm after subarachnoid hemorrhage (SAH). The authors investigated mechanisms of possible antivasospastic effects of N-benzyl-oxycarbonyl-Val-Ala-Asp-fluoromethylketone (Z-VAD-FMK), a caspase inhibitor that can inhibit both inflammatory and apoptotic systems., in animal models of SAH.
    Methods. Rabbits were assigned to three groups of eight animals each and were subjected to SAH by injection of blood into the cisterna magna. The experiments were performed in the following groups: SAH only, SAH + vehicle, and SAH + Z-VAD-FMK. The Z-VAD-FMK (1 mg) or vehicle (5% dimethyl sulfoxide) was intrathecally administered before SAH induction. Diameters of the basilar artery (BA) were measured on angiograms obtained before and 2 days after SAH. The BA diameter on Day 2 was expressed as a percentage of that before SAH. Interleukin (IL)-1 beta in the cerebrospinal fluid (CSF) was examined using Western blotting, and brains were immunohistochemically examined for caspase-1 and IL-1 beta. In a separate experiment, 20 rats were subjected to SAH and their brains were immunohistochemically assessed for caspase-1, IL-1 beta, and macrophages.
    Results. In rabbits, Z-VAD-FMK significantly attenuated cerebral vasospasm (the BA diameter on Day 2 in SAH-only, SAH + vehicle, and SAH + Z-VAD-FMK groups was 66.6 +/- 3.2%, 66.3 +/- 3.7%, and 82.6 +/- 4.9% of baseline, respectively), and suppressed IL-1 beta release into the CSF and also suppressed immunoreactivities of caspase- I and IL-1 beta in macrophages infiltrating into the subarachnoid space. Immunoreactivities for caspase- I and IL-1 beta were observed in immunohistochemically proven infiltrating macrophages in rats.
    Conclusions. These results indicate that caspase activation may be involved in the development of SAH-induced vasospasm through inflammatory reaction.

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  • Packing efficacy of hydrocoil embolic system: in vitro study using ruptured aneurysm model 国際誌

    Kyoichi Watanabe, Kenji Sugiu, Koji Tokunaga, Wataru Sasahara, Shigeki Ono, Isao Date

    NEUROSURGICAL REVIEW   30 ( 2 )   127 - 130   2007年4月

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    記述言語:英語   出版者・発行元:SPRINGER  

    After endovascular coil embolization of cerebral aneurysms, coil compaction and late aneurysm recanalization have been ever observed. The HydroCoil Embolic System (HES) was developed to improve the packing efficacy of endovascular treatment of cerebral aneurysms. In this study, we evaluate the packing efficacy of HES using a silicone model of ruptured cerebral aneurysm. This silicone model was connected to a pulsatile flow pump and embolized with the initial framing coils followed by hydro coils (n = 3) or bare platinum coils (n = 3). The coils used in the two groups were identical to each other in size and length. In the hydro coil group, continuous outflow from ruptured aneurysm ceased in two out of three cases. On the other hand, in the bare platinum coil group, outflow from the ruptured point slightly decreased but did not stop in all cases. The hydro coil could result in a higher initial occlusion rate of silicone model. In addition, expanded hydrogel possibly sealed the ruptured point directly. Changes in the size of aneurysms were not detected, from which the risk of over-expansion seemed extremely low. The hydro Coil is a safe and feasible device for improving the packing efficacy in endovascular coil embolization.

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  • Novel protein transduction method by using 11R - An effective new drug delivery system for the treatment of cerebrovascular diseases 国際誌

    Tomoyuki Ogawa, Shigeki Ono, Tomotsugu Ichikawa, Seiji Arimitsu, Keisuke Onoda, Koji Tokunaga, Kenji Sugiu, Kazuhito Tomizawa, Hideki Matsui, Isao Date

    STROKE   38 ( 4 )   1354 - 1361   2007年4月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Background and Purpose-A motif of 11 consecutive arginines (11R) is reported to be one of the most effective protein transduction domains for introducing proteins into the cell membrane. We therefore examined the transduction efficiency of 11R in cerebral arteries.
    Methods-Basilar arteries (BAs) obtained from rats were incubated with either 11R-enhanced green fluorescent protein (11R-EGFP) or EGFP without 11R. After incubation, expression of 11R-EGFP or EGFP in BA serial sections was observed by fluorescence microscope. In an additional in vivo experiment, 11R-EGFP or EGFP was injected into the cisterna magna with or without subarachnoid hemorrhage. The 11R-EGFP or EGFP was injected just after the autologous blood injection, and then the expression of 11R-EGFP or EGFP in BA sections was also observed by fluorescence microscope.
    Results-The 11R-EGFP signal was much stronger than that of EGFP in all layers of the rat BA, in both in vivo and ex vivo experiments. Moreover, the 11R-EGFP was transduced into the BA immediately ( 2 hours after the injection). Interestingly, 11R-fused fluorescent protein was transduced especially into the tunica media of the BA.
    Conclusions-The 11R-fused fluorescent protein effectively penetrates into all layers of the rat BA, especially into the tunica media. This is the first study to our knowledge to demonstrate the successful transduction of a protein transduction domain fused protein into the cerebral arteries.

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  • Combined use of TruFill DCS detachable coil system and Guglielmi detachable coil for embolization of meningioma fed by branches of the cavernous internal carotid artery - Technical case report

    Noboru Kusaka, Takashi Tamiya, Kenji Sugiu, Koji Tokunaga, Mitsuhisa Nishiguchi, Kazuhiro Takayama, Yasuhiko Maeda, Kotaro Ogihara, Minoru Nakagawa, Tsukasa Nishiura

    NEUROLOGIA MEDICO-CHIRURGICA   47 ( 1 )   29 - 31   2007年1月

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    記述言語:英語   出版者・発行元:JAPAN NEUROSURGICAL SOC  

    A 57-year-old female presented with a left petroclival meningioma fed by the meningohypophyseal trunk of the internal carotid artery (ICA). The enlarged tentorial marginal artery and inferior hypophyseal artery were successfully embolized with the TruFill DCS Detachable Coil System through a 0.019-inch inner diameter microcatheter. Superselective catheterization into the dorsal meningeal artery could not be achieved with the same microcatheter, because the catheter tip was too large to pass into the vessel. Subsequently the feeding artery was successfully embolized with a Guglielmi detachable coil (GDC) through a 0.016-inch inner diameter microcatheter. The patient underwent surgery without blood loss on the day after embolization. Our subjective impression was that the TruFill DCS was softer and had less resistance during insertion, whereas the GDC could be delivered through a smaller caliber system for smaller vessels. Appropriate use of the TruFill DCS and GDCs can allow efficient embolization of the feeding branches of the ICA.

    DOI: 10.2176/nmc.47.29

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  • 高齢者に対する脳神経血管内治療.

    杉生憲志, 徳永浩司, 西田あゆみ, 佐々原渉, 小野成紀, 小野田惠介, 伊達 勲

    Geriatric Neurosurgery   19   39 - 41   2007年

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  • Internal trapping後に再発した破裂椎骨動脈解離性動脈瘤の1例.

    菊池陽一郎, 杉生憲志, 徳永浩司, 西田あゆみ, 西村卓士, 伊達 勲

    脳神経外科   35 ( 8 )   813 - 819   2007年

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  • 塞栓術にて完治せしめた成人pial AVFの1例.

    伊丹尚多, 杉生憲志, 徳永浩司, 小野成紀, 小野田惠介, 伊達 勲

    脳神経外科   35 ( 6 )   599 - 605   2007年

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  • 新しい脳動脈瘤塞栓コイルの使用経験─MicrusphereとMicroplex─.

    杉生憲志, 徳永浩司, 西田あゆみ, 早瀬仁志, 小野成紀, 小野田惠介, 伊達 勲

    Journal of Neuroendovascular Therapy   1 ( 1 )   45 - 53   2007年

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    記述言語:英語  

    DOI: 10.5797/jnet.1.45

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  • 頸部内頸動脈狭窄症におけるCEAとCASの術前後の3D-CTA,3D-DSA画像を使った生体力学シミュレーション

    早瀬仁志, 徳永浩司, 中山敏男, 西田あゆみ, 杉生憲志, 小野成紀, 小野田惠介, 太田信, 伊達勲

    日本脳神経外科学会総会抄録集(CD-ROM)   66th   2007年

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  • Chronic brain ischemia and revascularization - Response

    Noboru Kusaka, Kenji Sugiu, Koji Tokunaga, Isao Date

    JOURNAL OF NEUROSURGERY   105 ( 2 )   340 - 341   2006年8月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:AMER ASSOC NEUROLOGICAL SURGEONS  

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  • Differential Diagnosis of the Infundibular Dilation and Aneurysm of Internal Carotid Artery─Assessment with Fusion Imaging of 3D MR Cistenography/Angiography─.

    Satoh T, Omi M, Ohsako C, Fujiwara K, Tsuno K, Sasahara W, Onoda K, Tokunaga K, Sugiu K, Date I

    AJNR Am J Neuroradiol   27 ( 2 )   306 - 312   2006年2月

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    記述言語:英語  

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  • Adult unilateral moyamoya disease with familial occurrence in two definite cases: a case report and review of the literature

    N Kusaka, T Tamiya, Y Adachi, S Katayama, S Namba, K Tokunaga, K Sugiu, Date, I, T Ohmoto

    NEUROSURGICAL REVIEW   29 ( 1 )   82 - 87   2006年1月

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    記述言語:英語   出版者・発行元:SPRINGER  

    We documented an interesting case of adult "unilateral (probable)" moyamoya disease displaying familial occurrence in two "definite" cases. A 55-year-old female presented with motor aphasia, involuntary movement of the right hand and right homonymous hemianopia due to cerebral infarction. Cerebral angiography revealed typical angiographic findings on the left side and normal findings on the right side; consequently, the patient was diagnosed with probable moyamoya disease. Previously, her mother and nephew had been diagnosed with definite moyamoya disease with bilateral involvement. The patient continued to exhibit unilateral involvement on angiography for more than 4 years. Clinical features such as absence of familial occurrence suggest that most cases of probable moyamoya disease are distinct from definite cases, especially in adults. To the best of our knowledge, this report appears to be the first involving an adult probable case characterized by familial occurrence. The literature pertaining to adult probable moyamoya disease was reviewed and the etiology of this disease was discussed.

    DOI: 10.1007/s10143-005-0406-5

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  • Adult unilateral moyamoya disease with familial occurrence in two definite cases─a case report and review of the literature─. 国際誌

    Kusaka N, Tamiya T, Adachi Y, Katayama S, Namba S, Tokunaga K, Sugiu K, Date I, Ohmoto T

    Neurosurgical Review   29 ( 1 )   82 - 87   2006年1月

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  • 片側顔面痙攣に対するmicrovascular decompressionの新しい術前画像評価─3D MR cisternogram/angiogram fusion imagingの応用─.

    小野田惠介, 佐藤 透, 三好康之, 徳永浩司, 杉生憲志, 伊達 勲

    脳神経外科   2006年

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  • 脳血管への11Rを用いた蛋白質導入─脳血管攣縮への新しい治療戦略の開発─.

    小川智之, 小野成紀, 市川智継, 有光帥二, 小野田惠介, 徳永浩司, 杉生憲志, 松下正之, 富澤一仁, 松井秀樹, 伊達 勲

    脳卒中の外科   2006年

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  • くも膜下出血後脳血管攣縮に対する当科の治療戦略の変遷─集学的治療は脳血管攣縮を解説できたか─.

    小野成紀, 有光帥二, 小川智之, 小野田惠介, 徳永浩司, 杉生憲志, 伊達 勲

    脳卒中の外科   2006年

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  • 前床突起下前外側壁に生じた内頸動脈瘤に対する直達手術.

    小野田惠介, 徳永浩司, 杉生憲志, 小野成紀, 伊達 勲

    脳神経外科   2006年

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  • EBMに基づく動脈硬化性疾患の外科的治療とその成績─脳血管障害─.

    杉生憲志, 徳永浩司, 伊達 勲

    循環器科   59(Suppl 3), 496-503   2006年

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  • Enhanced brain angiogenesis in chronic cerebral hypoperfusion after administration of plasmid human vascular endothelial growth factor in combination with indirect vasoreconstructive surgery 国際誌

    N Kusaka, K Sugiu, K Tokunaga, A Katsumata, A Nishida, K Namba, H Hamada, H Nakashima, Date, I

    JOURNAL OF NEUROSURGERY   103 ( 5 )   882 - 890   2005年11月

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    記述言語:英語   出版者・発行元:AMER ASSOC NEUROLOGICAL SURGEONS  

    Object. Vascular endothelial growth factor (VEGF) is a secreted mitogen associated with angiogenesis. The conceptual basis for therapeutic angiogenesis after plasmid human VEGF gene (phVEGF) transfer has been established in patients presenting with limb ischemia and myocardial infarction. The authors hypothesized that overexpression of VEGF using a gene transfer method combined with indirect vasoreconstruction might induce effective brain angiogenesis in chronic cerebral hypoperfusion, leading to prevention of ischemic attacks.
    Methods. A chronic cerebral hypoperfusion model induced by permanent ligation of both common carotid arteries in rats was used in this investigation. Seven days after induction of cerebral hypoperfusion, encephalomyosynangiosis (EMS) and phVEGF administration in the temporal muscle were performed. Fourteen days after treatment, the VEGF gene therapy group displayed numbers and areas of capillary vessels in temporal muscles that were 2.2 and 2.5 times greater, respectively, in comparison with the control group. In the brain, the number and area of capillary vessels in the group treated with the VEGF gene were 1.5 and 1.8 times greater, respectively, relative to the control group.
    Conclusions. In rat models of chronic cerebral hypoperfusion, administration of phVEGF combined with indirect vaso-reconstructive surgery significantly increased capillary density in the brain. The authors' results indicate that administration of phVEGF may be an effective therapy in patients with chronic cerebral hypoperfusion, such as those with moyamoya disease.

    DOI: 10.3171/jns.2005.103.5.0882

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  • Brain stem ischemia from intracranial dural arteriovenous fistula: Case report 国際誌

    M Satoh, M Kuriyama, T Fujiwara, K Tokunaga, K Sugiu

    SURGICAL NEUROLOGY   64 ( 4 )   341 - 345   2005年10月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    Background: Intracranial dural arteriovenous fistulas (AVFs) with spinal perimedullary venous drainage are rarely reported, but most of the patients initially have presented with myelopathy or subarachnoid hemorrhage. This is the first report of the intracranial dural AVF patient who presented with brain stem infarction.
    Case Description: A 38-year-old woman experienced nausea and vomiting with an acute onset, followed by vertigo. Magnetic resonance imaging showed ischemic lesion in the medulla oblongata, and she was then sent to our hospital. On admission, she had nystagmus, swallowing difficulties, Homer syndrome, and right hemiparesis and hemisensory disturbance. Cerebral angiography revealed dural AVF draining into spinal perimedullary veins at the left transverse-sigmoid sinus. The patient was treated by transvenous ernbolization under local anesthesia. A microcatheter proceeded to the left sigmoid sinus via the internal jugular vein, and embolization of the sinus was performed using coils without complications. The patient's swallowing difficulties improved over a few days after the embolization, and I month later, there remained only a right mild hemiparesis and hemisensory disturbance. Six months after the onset, there was no ischemic lesion in the brain stem on magnetic resonance imaging.
    Conclusions: In this case, we showed the possibility of brain stem infarction, caused by the intracranial dural AVE (c) 2005 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.surneu.2004.12.029

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  • Influence of perianeurysmal environment on the deformation and bleb formation of the unruptured cerebral aneurysm: Assessment with fusion imaging of 3D MR cisternography and 3D MR angiography 国際誌

    T Satoh, M Omi, C Ohsako, A Katsumata, Y Yoshimoto, S Tsuchimoto, K Onoda, K Tokunaga, K Sugiu, Date, I

    AMERICAN JOURNAL OF NEURORADIOLOGY   26 ( 8 )   2010 - 2018   2005年9月

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    記述言語:英語   出版者・発行元:AMER SOC NEURORADIOLOGY  

    BACKGROUND AND PURPOSE: Surface irregularity and bleb formation are anatomical factors that are associated with aneurysm rupture. The perianeurysmal environment has been proposed as one factor that may influence aneurysm morphology. We have developed a fusion imaging technique of 3D MR cisternography and angiography that allows clear visualization of an aneurysm and its environment. This technique may prove useful in further understanding of the natural history of intracranial aneurysms.
    METHODS: Fusion images of 3D MR cisternography and angiography were reconstructed by a perspective volume-rendering algorithm from the volume datasets of MR cisternography, obtained by a T2-weighted 3D fast spin-echo sequence, and coordinated MR angiography, by a 3D time-of-flight sequence. On the fusion images, the anatomic relationship of an aneurysm to the perianeurysmal structures was assessed, and the influence of perianeurysmal environment on the deformation and bleb formation of the aneurysm was investigated.
    RESULTS: Marked and minor deformation and bleb formation of the aneurysmal dome were found at the areas confronted or adjacent to a certain contact with perianeurysmal structures, including cranial nerves, brain parenchyma, cranial base bones, petroclinoidal dural folds, and dura mater.
    CONCLUSION. Fusion images of 3D MR cisternography and angiography can depict the contact of an aneurysm with its perianeurysmal environment; this may provide an additional parameter in consideration for the natural history of cerebral aneurysms.

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  • Visualization of aneurysmal contours and perianeurysmal environment with conventional and transparent 3D MR cisternography 国際誌

    T Satoh, M Omi, C Ohsako, A Katsumata, Y Yoshimoto, S Tsuchimoto, K Onoda, K Tokunaga, K Sugiu, Date, I

    AMERICAN JOURNAL OF NEURORADIOLOGY   26 ( 2 )   313 - 318   2005年2月

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    記述言語:英語   出版者・発行元:AMER SOC NEURORADIOLOGY  

    We have developed conventional and transparent 3D MR cisternography to investigate the spatial relationship between the contours of aneurysmal complex and the perianeurysmal structures including the cranial nerves, dural fold, cranial base bone, and brain parenchyma. Volume data obtained by a T2-weighted 3D fast spin-echo sequence were reconstructed by using a perspective volume-rendering algorithm with a transluminal imaging technique. 3D MR cisternograms provide useful anatomic information in the therapeutic and follow-up management of unruptured cerebral aneurysms.

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  • Emergent endovascular treatment of ruptured vertebral artery dissecting aneurysms

    K Sugiu, K Tokunaga, K Watanabe, W Sasahara, S Ono, T Tamiya, Date, I

    NEURORADIOLOGY   47 ( 2 )   158 - 164   2005年2月

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    記述言語:英語   出版者・発行元:SPRINGER  

    The goal of this study was to evaluate the results of endovascular and surgical treatments for ruptured vertebral artery dissecting aneurysms ( VADAs) to determine which treatment is preferable. We evaluated the cases of 25 consecutive patients with ruptured VADAs treated in our institution. From 1992 to 1997,. five patients were treated surgically. Since 1998, 20 patients with VADAs have been treated with endovascular therapy. The goal of the treatment was to exclude the aneurysm from the circulation. Among the five patients undergoing surgery, three aneurysms were treated with proximal clipping, one with trapping, and one with dome clipping. None of the patients were treated during the acute stage of rupture. Transient complications occurred in two patients. Of the 20 patients treated through the endovascular approach, 15 were treated within 24 h of rupture, but 12 had rebleeding before treatment. Eighteen aneurysms were occluded, along with the affected vertebral artery (VA), by using detachable coils (internal trapping), and one was occluded with the VA preserved. A stent-assisted occlusion of one aneurysm was done in a patient who had a contralateral hypoplastic VA. In both groups, the outcome of each patient depended greatly on the patient's condition before treatment and whether there was rebleeding. No posttreatment bleeding occurred. All procedures were effective, but endovascular treatment was less invasive and easier to use during the acute stage of subarachnoid hemorrhage. Although this report does not describe a controlled study, we found that endovascular treatment is preferable for treating ruptured VADAs in the acute stage.

    DOI: 10.1007/s00234-005-1341-4

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  • 脳血管障害への新しい治療戦略としての11Rによる脳血管壁への蛋白導入.

    小川智之, 小野成紀, 市川智継, 有光帥二, 道上宏之, 小野田惠介, 徳永浩司, 杉生憲志, 富澤一仁, 松井秀樹, 伊達 勲

    脳卒中の外科   2005年

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  • くも膜下出血後症候性脳血管攣縮を呈し、塩酸ファスジルの繰り返し動注を試みた7症例.

    有光帥二, 小野成紀, 小川智之, 眞鍋博明, 小野田惠介, 徳永浩司, 杉生憲志, 伊達 勲

    脳卒中の外科   2005年

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  • Endovascular treatment for elderly patients with ruptured aneurysm

    K Sugiu, K Tokunaga, K Watanabe, W Sasahara, M Tagawa, N Tamesa, S Ono, K Onoda, Date, I

    New Trends of Surgery for Stroke and Its Perioperative Management   94   7 - 9   2005年

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    記述言語:英語   出版者・発行元:SPRINGER-VERLAG WIEN  

    We report our results of endovascular treatment for elderly patients with ruptured aneurysm and discuss the indication for treatment. One hundred and thirty four consecutive patients with ruptured aneurysm treated in our institute during the last 4 years were retrospectively evaluated. Fifty eight patients were included in group A (over 70 years old), and 76 patients in group B (under 69 years old). In both groups, the outcome was strongly related to the preoperative Hunt & Kosnik grade. However, significant risk factors (i.e. pneumonia, rupture of extracranial aneurysm) which make prognosis poor were more common in group A. Group A showed poor outcome in grade III patients, although there were no outcome differences between the two groups in patients of other grades. Endovascular treatment for elderly patients with ruptured aneurysms seemed to be useful. Their outcome was strongly related to their preoperative condition. General risk factors should be evaluated before treatment, especially in elderly patients. Patients with low Hunt & Kosnik grade seem to be most suitable for endovascular treatment. On the other hand, outcome of patients with poor preoperative grade was worse despite the less invasive nature of endovascular treatment. An improvement of outcome in grade III patients is desirable.

    DOI: 10.1007/3-211-27911-3-2

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  • 網膜中心動脈閉塞症に対する局所線溶療法─症例報告─.

    田川雅彦, 杉生憲志, 徳永浩司, 佐々原渉, 渡邊恭一, 為佐信雄, 小野成紀, 小野田惠介, 伊達 勲

    脳神経外科   2005年

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  • ラジオ波凝固療法を併用した経皮的錐体形成術により治療を行った転移性脊椎錐体腫瘍の1例.

    徳永浩司, 杉生憲志, 三好康之, 三村秀文, 金澤 右, 伊達 勲

    脳神経外科   2005年

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  • 脳腫瘍.

    杉生憲志, 徳永浩司, 伊達 勲

    Clinical Neuroscience   23,10,1170-1172   2005年

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  • 脳血管内治療の国際エビデンス.

    杉生憲志, 徳永浩司, 伊達 勲

    分子脳血管病   4,2,127-134   2005年

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  • 脳血管攣縮対策としてのspinal drainageとcisternal drainageの治療成績の比較─当科の脳血管攣縮予防プロトコールのもとで─.

    小野成紀, 有光帥二, 小川智之, 眞鍋博明, 小野田惠介, 徳永浩司, 杉生憲志, 伊達 勲

    脳卒中の外科   2005年

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  • 破裂脳動脈瘤急性期の血管内治療─岡山大学脳神経外科におけるシステム整備と治療成績─.

    杉生憲志, 徳永浩司, 渡邊恭一, 佐々原渉, 小野成紀, 小野田惠介, 伊達 勲

    Neurosurgical Emergency   2005年

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  • 破裂解離性椎骨動脈瘤に対する血管内治療─その有用性と最近経験した合併症からの教訓─.

    杉生憲志, 徳永浩司, 渡邊恭一, 佐々原渉, 小野成紀, 小野田惠介, 伊達 勲

    脳卒中の外科   2005年

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  • 3D MR Cisternography/Angiography Fusion Imagingによる部分的血栓化椎骨動脈瘤の画像評価.

    佐藤 透, 尾美 賜, 大迫知香, 西田あゆみ, 守山英二, 小野田恵介, 徳永浩司, 杉生憲志, 伊達 勲

    脳神経外科速報   2005年

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  • Color-coded 3D MRAによる個々の未破裂脳動脈瘤における瘤内MR信号強度分布パターンの画像解析.

    佐藤 透, 尾美 賜, 大迫知香, 勝間田篤, 吉本祐介, 土本正治, 国塩勝三, 小野田恵介, 徳永浩司, 杉生憲志, 伊達 勲

    脳神経外科   2005年

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  • 未破裂内頸動脈 - 後交通動脈瘤の伸展・変形に及ぼす瘤周囲環境の画像評価─3D MR Cisternography-3D MR angiography fusion imagingによる検討─.

    佐藤 透, 尾美 賜, 大迫知香, 勝間田篤, 吉本祐介, 土本正治, 小野田惠介, 徳永浩司, 杉生憲志, 伊達 勲

    脳神経外科   2005年

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  • 3次元MR Cisternographyによる脳内にdome/blebが埋没した内頸動脈─後交通動脈瘤の術前画像評価─.

    佐藤 透, 尾美 賜, 大迫知香, 勝間田篤, 吉本祐介, 土本正治, 小野田惠介, 徳永浩司, 杉生憲志, 伊達 勲

    脳神経外科速報   2005年

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  • Persistent primitive trigeminal artery-cavernous sinus fistula with intracerebral hemorrhage: endovascular treatment using detachable coils in a transarterial double-catheter technique - Case report and review of the literature 国際誌

    K Tokunaga, K Sugiu, M Kameda, K Sakai, K Terasaka, T Higashi, Dare, I

    JOURNAL OF NEUROSURGERY   101 ( 4 )   697 - 699   2004年10月

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    記述言語:英語   出版者・発行元:AMER ASSOC NEUROLOGICAL SURGEONS  

    Intracerebral hemorrhage occurred in this 61-year-old woman with preexisting diplopia and proptosis. Results of angiography demonstrated a persistent primitive trigeminal artery (PPTA)-cavernous sinus fistula with cortical venous reflux. Two microcatheters were introduced transarterially through the PPTA into the two draining pathways in the cavernous sinus. Coils were delivered in both pathways simultaneously to prevent further venous overload on either path. The fistula was successfully occluded without complication while the PPTA was preserved. The authors describe this double-catheter technique for coil embolization of a fistula and review the literature concerning PPTA-cavernous sinus fistulas.

    DOI: 10.3171/jns.2004.101.4.0697

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  • Combined use of electrolytically and mechanically detachable platinum coils for endovascular treatment of cerebral aneurysms - Technical note

    K Sugiu, A Katsumata, N Kusaka, W Sasahara, K Tokunaga, JB Martin, DA Rufenacht, T Ohmoto

    NEUROLOGIA MEDICO-CHIRURGICA   44 ( 5 )   269 - 273   2004年5月

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    記述言語:英語   出版者・発行元:JAPAN NEUROSURGICAL SOC  

    The combined use of Guglielmi detachable coils (GDCs) and newly developed mechanically detachable platinum coils (Detach Coil System: DCS) was evaluated for the endovascular treatment of 10 patients with cerebral aneurysms. The number and total length of detachable coils placed into the aneurysms, the detaching time for each coil, and any technical problems were recorded and evaluated. Sixty GDCs and 60 DCSs were used. The detachment time for the DCS (mean 21 seconds) was faster than that for the GDC (mean 2 minutes 35 seconds). One DCS moved inside the aneurysm during the mechanical detachment maneuver, but was successfully placed. Neither detachment system influenced the behavior of the other system during coil implantation. The DCS includes a useful J-shape coil, whereas the GDC can be detached safely in fragile aneurysms. The DCS is also cheaper. The coil systems complemented one another and the combination optimized cost and operating time.

    DOI: 10.2176/nmc.44.269

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  • Rebleeding of a vertebral artery dissecting aneurysm during stent-assisted coil embolization: A pitfall of the "stent and coil" technique 国際誌

    K Sugiu, K Takahashi, K Muneta, T Ohmoto

    SURGICAL NEUROLOGY   61 ( 4 )   365 - 370   2004年4月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    BACKGROUND
    A stent-assisted coil embolization has been applied as a novel choice of treatment for vertebral artery dissecting aneurysms (VADAs).
    CLINICAL PRESENTATION
    A 45-year-old man suffered from subarachnoid hemorrhage three times within 2 hours. The left vertebral angiogram showed a VADA at the distal origin of the posterior inferior cerebellar artery. The right vertebral artery was hypoplastic, and collateral circulation to the posterior fossa was poor.
    INTERVENTION
    Stent-assisted coil embolization was performed under general anesthesia. The aneurysm was excluded from the circulation with good patency of the vertebral artery, although the fourth coil caused rebleeding from the aneurysmal dome during the procedure.
    CONCLUSION
    This is the first case report that demonstrates rebleeding from VADA during stent-assisted coil embolization in the acute stage of its rupture. We have to be aware of the risks and be ready to prevent fatal complications with this novel technique. (C) 2004 Elsevier Inc. All rights reserved.

    DOI: 10.1016/S0090-3019(03)00515-9

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  • Pseudoxanthoma elasticum with carotid rete mirabile 国際誌

    T Yasuhara, K Sugiu, M Kakishita, Date, I

    CLINICAL NEUROLOGY AND NEUROSURGERY   106 ( 2 )   114 - 117   2004年3月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE BV  

    We describe a case of Pseudoxanthoma elasticum (PXE) in a 14-year-old girl. This case is especially rare because of its association with carotid rete mirabile (CRM). Only three cases have been reported previously in the literature. Although the relation between P. elasticum and carotid rete mirabile is unclear, both disorders are believed to be major risk factors for cerebrovascular disease. (C) 2003 Elsevier B.V. All rights reserved.

    DOI: 10.1016/j.clineuro.2003.10.008

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  • Training in neurovascular intervention usefulness of in-vitro model and clinical practice

    K Sugiu, K Tokunaga, W Sasahara, K Watanabe, A Nishida, A Katsumata, N Kusaka, Date, I, T Ohmoto, DA Rufenacht

    INTERVENTIONAL NEURORADIOLOGY   10   107 - 112   2004年3月

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    記述言語:英語   出版者・発行元:EDIZIONI CENTAURO  

    We introduce our training tools and system of neurovascular intervention. An in vitro cerebral vascular model was used for the young residents to understand the basic interventional techniques and devices.
    The model included several vascular lesions such as cerebral aneurysm, dural arterio-venous fistula, or carotid artery stenosis. Endovascular procedures in the model were performed under fluoroscopic or direct visual control, and consecutive haemodynamic changes were visualized by using digital subtraction angiography and direct observation. Thus, traineess could have an easy understanding of clinical conditions. New medical devices, such as platinum coils, were successfully implanted in the model under stable conditions.
    After the initial training using vascular model, the residents had started clinical experiences under the control of senior surgeons. Although it is difficult to describe usefulness of our clinical training, we believe that we provide enough good quality and quantity of clinical cases to the residents. Because our endovascular team has recently had150-200 interventional procedures every year, one resident can have experienced more than 100 cases per year The qualification of a Board Certified Specialist of the Japanese Society of Intravascular Neurosurgery (JSIN) requires that, the applicant must have experienced more than 100 cases for four years. So our residents can have enough case materials to qualify the board examination.

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  • くも膜下出血患者髄液におけるMCP-1、MIP-1α濃度の経時的変化について.

    小野成紀, 小川智之, 菱川朋人, 西口充久, 徳永浩司, 杉生憲志, 伊達 勲

    脳卒中の外科   2004年

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  • ヒトくも膜下出血後攣縮血管での炎症反応の役割─iNOS, NF-kappaB, IKKの発現について─.

    小野成紀, 西尾晋作, 徳永浩司, 杉生憲志, 伊達 勲

    脳卒中の外科   2004年

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  • 脳血管攣縮に対する塩酸ファスジル動注療法中に痙攣を起こした1例.

    佐々原渉, 小野成紀, 徳永浩司, 杉生憲志, 中嶋裕之, 伊達 勲, 大本堯史

    脳神経外科   2004年

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  • 解離性椎骨動脈瘤に対する血管内動脈瘤コイル塞栓術.

    佐藤元美, 槌田昌平, 徳永浩司, 杉生憲志

    西宮市医師会医学雑誌   2004年

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  • 破裂急性期椎骨動脈解離性動脈瘤に対する血管内治療.

    杉生憲志, 徳永浩司, 伊達 勲

    脳神経外科   32,1229-1238   2004年

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  • 内頚動脈閉塞試験の合併症─119例の経験から─.

    勝間田篤, 杉生憲志, 佐々原渉, 渡辺恭一, 西田あゆみ, 日下 昇, 徳永浩司, 伊達 勲

    脳神経外科ジャーナル   13 ( 8 )   572 - 577   2004年

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    記述言語:日本語  

    DOI: 10.7887/jcns.13.572

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  • 3次元MR脳槽画像による未破裂脳動脈瘤外壁形態と瘤周囲環境の画像評価.

    佐藤 透, 浴野千菜美, 大迫知香, 勝間田篤, 小野田恵介, 土本正治, 柚木正敏, 徳永浩司, 杉生憲志, 伊達 勲

    脳神経外科   2004年

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  • ラット慢性低灌流モデルにおける血管内皮増殖因子(VEGF)およびAngiopoietin-1遺伝子の血管新生効果.

    渡邊恭一, 日下 昇, 勝間田篤, 佐々原渉, 徳永浩司, 杉生憲志, 西尾晋作, 小野成紀, 濱田洋文, 伊達 勲

    脳循環代謝   2004年

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  • DeferoxamineによるHypoxia inducible factor-1を介したラットくも膜下出血後脳血管攣縮時における脳保護効果の検討.

    菱川朋人, 小野成紀, 小川智之, 西口充久, 徳永浩司, 杉生憲志, 伊達 勲

    脳卒中の外科   2004年

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  • Spiral versus J-shaped coils for neurovascular embolisation - an in-vitro study

    K Sugiu, K Tokunaga, S Mandai, JB Martin, B Jean, DA Rufenacht

    NEURORADIOLOGY   45 ( 7 )   417 - 422   2003年7月

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    記述言語:英語   出版者・発行元:SPRINGER-VERLAG  

    Our purpose was to compare the characteristics of J-shaped detachable platinum coils with those of spiral coils in in-vitro vascular models. J-shaped coils consist of distal semicircular and proximal straight segments, the latter extending for most of the length of the coil. Spiral coils have a helical shape memory and are thus limited in expansion. In in-vitro silicone vascular models simulating intracranial aneurysms and dural arteriovenous fistulae, we compared J-shaped and spiral coils with regard to ease of delivery, anchoring and folding patterns, and stability in various types of vascular lumen. Delivery and retrieval were comparable. In large and irregular aneurysms and venous sinuses, J-shaped coils could form a more complex basket which conformed to the shape of the vascular cavity. The J-shaped coil was always in contact with the vessel wall. In wide-necked aneurysms, coil protrusion was more frequent with J-shaped coils, while spiral coils tended to stay compact and circular. Arteries were occluded in a shorter segment with spiral coils. J-shaped coils were safe and superior for large and irregular aneurysms or sinuses. Spiral coils were preferable for spherical aneurysms and segmental occlusion of arteries.

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  • Angioplasty and coiling of ruptured aneurysm with symptomatic vasospasm: Technical case report 国際誌

    K Sugiu, A Katsumata, Y Ono, T Tamiya, T Ohmoto

    SURGICAL NEUROLOGY   59 ( 5 )   413 - 417   2003年5月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    BACKGROUND Treating a ruptured cerebral aneurysm during symptomatic vasospasm is very difficult. We describe the successful endovascular treatment of such a case and discuss its efficacy.
    CASE PRESENTATION A 34-year-old man had a sudden onset of severe headache. One week later, he was referred to our institute with gradually progressing right hemiparesis and global aphasia. Cerebral angiography demonstrated severe vasospasm of the left internal carotid artery system and an anterior communicating artery aneurysm. With the patient under general anesthesia, 90% occlusion of the aneurysm was achieved with detachable coils after successful dilatation of the spastic vessels. The patient had an uneventful postoperative course and his neurologic symptoms were improved. Seven months after the endovascular treatment, the enlarged neck remnant of the aneurysm was successfully clipped without difficulty.
    CONCLUSION The simultaneous treatment of a ruptured aneurysm and vasospasm with percutaneous transluminal angioplasty and coils can produce a better outcome for the patient. (C) 2003 Elsevier Inc. All rights reserved.

    DOI: 10.1016/S0090-3019(03)00071-5

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  • De novo aneurysms [2] (multiple letters)

    Biodun Ogungbo, Takao Yasuhara, Takashi Tamiya, Kenji Sugiu, Satoshi Inoue, Takashi Ohmoto

    Journal of Neurosurgery   98 ( 4 )   933 - 934   2003年4月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)  

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  • Artificial cerebral aneurysm model for medical testing, training, and research

    K Sugiu, JB Martin, B Jean, P Gailloud, S Mandai, DA Rufenacht

    NEUROLOGIA MEDICO-CHIRURGICA   43 ( 2 )   69 - 72   2003年2月

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    記述言語:英語   出版者・発行元:JAPAN NEUROSURGICAL SOC  

    Artificial models of cerebral aneurysms for medical training and testing of medical devices were constructed from corrosion casts of the main cerebral arteries of a human specimen. Three aneurysms with a variety of shapes were simulated at typical locations. Rigid and soft models were made of silicone using the "lost wax" technique. The transparent silicone models were anatomically accurate and reproducible copies of human vascular casts. These models could be connected in a closed circuit that used an electric pump to simulate pulsatile flow. Endovascular procedures and surgical clip application were performed under fluoroscopic or direct visual control. Surgical clipping, endoluminal coil manipulation, and consecutive hemodynamic changes were visualized by digital subtraction angiography and direct observation. The model provides trainee surgeons with an understanding of clinical conditions. New medical devices, such as platinum coils, would be experimentally implanted in the model under stable conditions. These anatomically accurate and reproducible models of cerebral vasculature and aneurysms are valuable for medical testing, training, and research.

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  • 自然血栓化した後大脳動脈末梢部紡錘状動脈瘤の1例

    近藤聡彦, 安原隆雄, 杉生憲志, 大本堯史

    脳神経外科   2003年

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  • 新しい塞栓物質と今後の塞栓術の展開.

    杉生憲志, 渡邊恭一, 佐々原渉

    脳神経外科速報   13,1067-1073   2003年

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  • 骨粗鬆症性椎体圧迫骨折に対する経皮的椎体形成術(percutaneous vertebroplasty)の手術手技.

    徳永浩司, 杉生憲志, 三好康之, 小野恭裕, 伊達 勲

    脳神経外科速報   13,985-991   2003年

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  • 経皮的椎体形成術─適応と手技─.

    徳永浩司, 杉生憲志, 中嶋裕之, 伊達 勲, 大本堯史, Martin JB, Ruefenacht DA

    脳神経外科   31,7-14   2003年

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  • 虚血性脳卒中に対する血管内治療―急性期〜慢性期―

    杉生憲志

    最新医学   58,886-892   2003年

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  • くも膜下出血後脳血管攣縮に対する当科の治療戦略─ウロキナーゼ脳室内bolus injectionおよび血管内治療(PTAと塩酸ファスジル動注)の効果─.

    小野成紀, 伊達 勲, 徳永浩司, 杉生憲志, 大本堯史

    脳卒中の外科   2003年

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  • カタクロット(オザグレルナトリウム)と経皮的血管形成術(PTA)による治療が奏功した脳底動脈狭窄症の1例

    小坂章, 渡邊恭一, 為佐信雄, 杉生憲志, 大本堯史

    新薬と臨床   2003年

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  • De Novo Aneurysm

    Yasuhara T, Tamiya T, Sugiu K, Inoue S, Ohmoto T

    J. Neurosurg   2003年

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  • De novo formation and rupture of an aneurysm - Case report 国際誌

    T Yasuhara, T Tamiya, K Sugiu, S Inoue, T Ohmoto

    JOURNAL OF NEUROSURGERY   97 ( 3 )   697 - 700   2002年9月

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    記述言語:英語   出版者・発行元:AMER ASSOC NEUROLOGICAL SURGEONS  

    The authors describe a case of de novo fori-nation and rupture of an aneurysm located at the junction of the left internal carotid artery and the superior hypophyseal artery in a middle-aged woman 2 months after another aneurysm, located on the anterior communicating artery, had been clipped. This case is rare because of the short interval between the last angiographic study performed at the first operation and the diagnosis of the de novo aneurysm; in this case the interval was only 47 days, compared with other cases in the literature in which the intervals were 3 to 34 years. Aneurysms can enlarge considerably in 2 to 4 weeks and can rupture at or soon after their formation. This case provides insight into aneurysm formation and rupture.

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  • Performance of long J-shaped coils in large and giant intracranial aneurysms: an in vitro study

    K Tokunaga, N Tanaka, K Sugiu, O Levrier, JB Martin, DA Rufenacht

    NEURORADIOLOGY   44 ( 3 )   261 - 267   2002年3月

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    記述言語:英語   出版者・発行元:SPRINGER-VERLAG  

    We evaluated the performance of long straight coils (Detach-18(R) J-shaped coils) in large and giant in-vitro aneurysms. The coils consisted of a distal semicircular part 7 or 15 mm in diameter and a proximal 70 em straight part having three types of stiffness: soft, standard, and stiff. We first investigated the ease of passage through a microcatheter in a realistic cerebral vessel model. Second, vie made silicone models simulating lateral-type aneurysms of various spherical dome diameters (12, 15, 20 and 30 mm) and neck sizes (3-10 mm; dome-to-neck ratio approximately 3:1) and connected them to a pulsating circulatory pump. We evaluated the anchoring and folding patterns of the coils, stability of the microcatheter and coils in the aneurysm, and smoothness of delivery and retrieval of coils. Third, we compared the conformability of a coil in a large, irregular aneurysm with that of a spiral coil. The long J-shaped coils were easily advanced and retrieved through a microcatheter in a tortuous vessel model. In 12, mm spherical aneurysms, each coil made a complex framework, and knot formation or damage to the coil during withdrawal was often observed. In 15 mm aneurysms, the coils were all easily delivered and retrieved; standard-stiffness coils adapted best to this size. In 20 mm aneurysms, frameworks were less complex but still good with a standard or stiff coil, but those with soft coil were unstable and changed significantly within 3 min of detachment due to gravity and pulsatile flow. In 30 mm aneurysms, soft coils filled only the lower part during introduction, whereas a stiff coil still made a favourable framework. Conformability of a long J-shaped coil was superior to that of a spiral coil in a large, irregular aneurysm. Long J-shaped coils conform well to various configurations of large and giant aneurysms and can shorten procedures since a. larger implant volume can be delivered with a single coil. Their principle of action may promote more favourable occlusion of irregular and large aneurysms by improved conformability and stability.

    DOI: 10.1007/s00234-001-0712-8

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  • Rescue balloon procedure for an emergency situation during coil embolization for cerebral aneurysms 国際誌

    K Sugiu, JB Martin, B Jean, DA Rufenacht

    JOURNAL OF NEUROSURGERY   96 ( 2 )   373 - 376   2002年2月

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    記述言語:英語   出版者・発行元:AMER ASSOC NEUROLOGICAL SURGEONS  

    In this article the authors describe a rescue balloon procedure for coil implantation in three cases. In each patient, the coil seemed likely to unravel. The coils stretched when attempts were made to remove the partially implanted but trapped device. The inflation of a nondetachable microballoon in front of the aneurysm orifice allowed the surgeons to complete implantation of the coil and to avoid a more forceful and potentially harmful retrieval. This rescue balloon method may be useful for emergency situations, such as coil stretching, with or without migration.

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  • Guglielmi detachable coilを用いて治療した破裂fenestrated aneurysm of vertebral artery unionの1例.

    西口充久, 杉生憲志, 大本堯史, 西条寿一, 藤沢洋之

    脳神経外科   2002年

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  • 出血を来しやすい硬膜動静脈瘻について.

    西田あゆみ, 杉生憲志, 勝間田篤, 日下 昇, 中嶋裕之, 大本堯史

    脳神経外科   2002年

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  • 脳血管性疾患に対するcerebral parenchymographyの有用性.

    杉生憲志, 西田あゆみ, 勝間田篤, 日下 昇, 中嶋裕之, 大本堯史

    脳神経外科   2002年

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  • Is the rupture of cerebral berry aneurysms influenced by the perianeurysmal environment?

    DS Ruiz, K Tokunaga, AR Dehdashti, K Sugiu, J Delavelle, DA Rufenacht

    NEW TRENDS IN CEREBRAL ANEURYSM MANAGEMENT   82   31 - 34   2002年

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    記述言語:英語   出版者・発行元:SPRINGER-VERLAG WIEN  

    Purpose. To evaluate contact between cerebral berry aneurysms and the perianeurysmal environment and to study the influence this contact has on aneurysm rupture.
    Materials and Methods. In a series of 76 consecutive patients, pre- and post-contrast CT images of 87 aneurysms were evaluated. Aneurysm locations were identified and aneurysms were divided into two different groups depending on whether they had ruptured or not. Contact between aneurysms and the perianeurysmal environment was studied when present, and considered to be balanced or unbalanced according to symmetry of contact and type of contact interface, i.e. with bone, dura, etc.
    Results. Rupture occurred in 47 aneurysms at an average maximum dome size of 7.4 mm. There was contact with elements of the perianeurysmal environment in 38 (81%) of ruptured cases and no evidence of contact in 7 (15%). The nature of contact was unclear in 2 (4%) ruptured aneurysms. In the aneurysms with contact, the nature of contact was unbalanced in 34 (72%) and balanced in 4 (9%). Unbalanced aneurysms ruptured at significantly smaller sizes (average: 7.7 mm) than balanced aneurysms (average: 11.4 mm). Seven aneurysms of small size (3.3-6.9 mm, average: 4.8 mm) were found to have ruptured, despite the fact that they were too small to exhibit contact with the perianeurysmal environment. In 40 unruptured aneurysms (average size: 6.3 mm), contact with the perianeurysmal environment was found in 15 aneurysms, for which balanced contact was found in 11 (27.5%) and unbalanced contact in 4 (10%), and no contact in 25 (62.5%). The average size of the aneurysms without contact (3.7 mm) was significantly smaller than that with balanced contact (10.3 mm) or with unbalanced contact (11.3 mm).
    Conclusion. Aneurysms exhibit contact with their perianeurysmal environment as soon as they reach a size that exceeds their allowance given by the local subarachnoid space. The contact with the environment was found to be an additional determinant parameter in the evolution of cerebral berry aneurysms and their risk to rupture.

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  • 脳血管内治療のトレーニングについて.

    杉生憲志, 徳永浩司, 伊達 勲, 大本堯史

    脳神経外科   30,1231-1237   2002年

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  • 岡山県におけるウィリス動脈輪閉塞症の実態調査と長期予後調査

    大本堯史, 西田あゆみ, 勝間田篤, 日下 昇, 杉生憲志, 中嶋裕之

    厚生労働省特定疾患 ウィリス動脈輪閉塞症の病因・病態に関する研究班 平成13年度総括・分担研究報告書   2002年

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  • The importance of venous hypertension in the formation of dural arteriovenous fistulas: a case report of multiple fistulas remote from sinus thrombosis

    N Kusaka, K Sugiu, A Katsumata, H Nakashima, T Tamiya, T Ohmoto

    NEURORADIOLOGY   43 ( 11 )   980 - 984   2001年11月

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    記述言語:英語   出版者・発行元:SPRINGER-VERLAG  

    Various hypotheses have been reported concerning the pathogenesis of dural arteriovenous fistulas (DAVFs). However, it is still controversial whether sinus thrombosis or venous hypertension has a greater influence on the formation of DAVFs. We present a rare case of multiple DAVFs that developed after sinus thrombosis. Chronic venous hypertension secondary to sinus thrombosis in the left transverse-sigmoid sinus induced the multiple DAVFs, including one in the right cavernous sinus, which was remote from the occluded sinus. This case indicates the importance of venous hypertension in the formation of DAVFs.

    DOI: 10.1007/s002340100596

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  • In vitro evaluation of the effectiveness of distal protection in the prevention of cerebral thromboembolism during carotid stent placement

    JB Martin, KJ Murphy, P Gailloud, K Sugiu, MM Treggiari, M Muster, L Guimaraens, JG Theron, DA Rufenacht

    ACADEMIC RADIOLOGY   8 ( 7 )   623 - 628   2001年7月

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    記述言語:英語   出版者・発行元:ASSOC UNIV RADIOLOGISTS  

    Rationale and Objectives. The purpose of this in vitro study was to evaluate and quantify the benefit of the balloon protection device, to identify the most: effective sequence of irrigation or flushing, and to determine the most effective catheter position to remove the maximum number of emboli or debris beneath the flow-arrest balloon.
    Materials and Methods. Silicone models of the neurovasculature were attached to a systodiastolic pump. Stents were placed in carotid stenoses by using the distal flow protection technique. Embolic material was released within the stent. The effectiveness of different irrigation techniques was evaluated.
    Results. Aspiration under the balloon through the guiding catheter with a 60-mL syringe followed by one power injection at 40 mL injected at 2 mL/sec will result in removal of about 98% of potential emboli from the inferior vena cava.
    Conclusion. In vitro evaluation of the distal flow protection technique indicates that it should reduce stroke risk during carotid stent placement.

    DOI: 10.1016/S1076-6332(03)80687-6

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  • Role of the distal balloon protection technique in the prevention of cerebral embolic events during carotid stent placement

    JB Martin, JC Pache, M Treggiari-Venzi, KJ Murphy, P Gailloud, E Puget, G Pizzolato, K Sugiu, L Guimaraens, J Theron, DA Rufenacht

    STROKE   32 ( 2 )   479 - 484   2001年2月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Background and Purpose-We sought to quantitatively and qualitatively evaluate the release of atheromatous plaque debris induced by carotid stenting procedures.
    Methods-Eight patients with severe carotid atheromatous stenoses were treated by stent implantation under distal balloon protection, Blood samplings were obtained after stent deployment in the blood pooled below the inflated protection balloon. The samples were centrifuged and evaluated for plaque debris with the use of light microscopy. The debris release was quantitatively estimated by dividing the total volume of debris obtained by the mean debris size. Five patients without endovascular procedure were used as a control group.
    Results-The 2 main debris types found were nonrefringent cholesterol crystals (4 to 389 mum; 115 to 8697 in number) and lipoid masses (7 to 600 mum; 341 to 34 000 in number). There was a statistically significant difference compared with the samples obtained in the control group (P = 0,017).
    Conclusions-Blood samples collected during stent implantation procedures contain a large quantity of atheromatous plaque debris. This emphasizes the role of distal protection techniques in avoiding migration of this plaque material into the cerebral circulation.

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  • A report of the clinical use of the Detach-18 mechanical detachable platinum coil in 41 patients

    KJ Murphy, E Houdart, KT Szopinski, O Levrier, L Guimaraens, D Kuhne, L Solymosi, NJ Bartholdy, K Sugiu, DA Rufenacht

    AMERICAN JOURNAL OF NEURORADIOLOGY   22 ( 2 )   341 - 344   2001年2月

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    記述言語:英語   出版者・発行元:AMER SOC NEURORADIOLOGY  

    BACKGROUND AND PURPOSE: The purpose of this study was to determine the safety and reliability of the mechanical detachment system of a new platinum coil, Detach-18, when used as a vascular occlusive device for neurovascular disease.
    METHODS: Forty-one patients (nine male and 32 female patients; age range, 26-75 years; mean age, 54.4 years) underwent treatment at seven centers. Twenty-two patients had dural arteriovenous fistulae of the transverse sinus treated by a transvenous route. Fourteen patients underwent internal carotid artery occlusion in the treatment of aneurysms, meningioma, facial tumor, or carotid injury. One patient underwent occlusion of the basilar artery and one patient underwent occlusion of the vertebral artery for treatment of aneurysms. In two patients, coils were used as part of the treatment of their arteriovenous malformations. In all cases, the Detach-18 coils were delivered through a microcatheter with two distal markers, Two types of coils, a 0.015-inch-diameter "regular" coil and a 0.014-inch-diameter "soft" coil, were used,
    RESULTS: A total of 569 coils were used, 541 of which were detached. The number of coils in ranged from four to 53 (average number of coils, 14), The coils passed easily through the microcatheter. The detachment maneuver occurred within 10 to 25 s with 20 turns of the introducing wire. No premature coil detachment occurred. Complete occlusion of the vessel lumen was achieved in 35 cases. In three cases, 80% to 90% occlusion was achieved. In two cases, 70% to 80% occlusion was achieved, There were no device-related complications.
    CONCLUSION: The detachment system was safe, reliable, consistent, and fast. This is a useful system for coil embolization in neurovascular applications.

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  • Endovascular treatment of cerebral aneurysms: An in vitro study with detachable platinum coils and tricellulose acetate polymer

    M Piotin, S Mandai, K Sugiu, P Gailloud, DA Rufenacht

    AMERICAN JOURNAL OF ROENTGENOLOGY   176 ( 1 )   235 - 239   2001年1月

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    記述言語:英語   出版者・発行元:AMER ROENTGEN RAY SOC  

    OBJECTIVE. The purpose of our experimental study was to determine the effectiveness of filling the cavity of in vitro aneurysms with detachable platinum coils and the combination of detachable platinum coils and liquid embolic agent.
    MATERIALS AND METHODS. Silicone aneurysm models were connected to a circulatory system to simulate arterial flow. A microcatheter was used to introduce detachable coils into the aneurysm cavities. First, platinum coils were introduced until the point of minimal dense packing, indicated by aneurysmal circulatory exclusion. Packing was continued up to maximal dense packing, indicated by protrusion of the coil into the parent artery. Volumetric ratios (coil volume-aneurysm volume) were calculated for minimal and maximal dense packing. Then, after purposeful undercoiling of aneurysm models, a micropump system was used to fill the aneurysm by stepwise injection of tricellulose acetate polymer through the coil mesh until angiographic aneurysm exclusion was completed. The volumetric ratios of maximal packing with coils and tricellulose acetate polymer in relation to the aneurysm volume were calculated.
    RESULTS. Maximal dense packing ratios with coils (mean, 32.5%; standard deviation [SD], 3%) were slightly higher than those with the minimal dense packing (mean, 28.2%; SD, 3%) but were always less than 37%. The ratios of packing with the combined use of coils and tricellulose acetate polymer were greater than 100% (mean, 124.4%; SD, 15%).
    CONCLUSION. Knowledge of the volumetric ratio of maximal dense packing was useful for effective filling with coils and tricellulose acetate polymer. The combined use of coils and liquid polymer appeared more effective than the use of coils alone for the complete occlusion of the aneurysm lumen.

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  • 脳神経外科学─臨床医学の展望─

    大本堯史, 松本健五, 田宮 隆, 中嶋裕之, 伊達 勲, 富田 享, 山本良裕, 小野恭裕, 杉生憲志, 相原 寛

    日本医事新報   4007,14-24   2001年

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  • 新しいバルーン付きガイディングカテーテルの使用経験

    勝間田篤, 杉生憲志, 西田あゆみ, 日下 昇, 中嶋裕之, 大本堯史

    脳神経外科速報   2001年

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  • GDCを用いて腫瘍栄養血管である内頚動脈小分枝の塞栓術を行った錐体斜台部髄膜腫の1例

    勝間田篤, 日下 昇, 杉生憲志, 中嶋裕之, 伊達 勲, 大本堯史

    脳神経外科   2001年

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  • 新しいmechanical detachable coilの脳血管内手術における有用性

    杉生憲志, 勝間田篤, 日下 昇, 中嶋裕之, 大本堯史, Daniel A Rufenacht

    脳神経外科   2001年

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  • 脳動脈瘤の診断と治療─どんな動脈瘤が破れるのか─

    杉生憲志, Rufenacht DA

    NEURO・IMAGING CONFERENCE 筑後・佐賀症例集2000   ,4-4   2001年

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  • Curative treatment of cerebral arteriovenous malformations by embolisation using cellulose acetate polymer followed by surgical resection

    K Tokunaga, K Kinugasa, T Meguro, K Sugiu, H Nakashima, S Mandai, T Ohmoto

    JOURNAL OF CLINICAL NEUROSCIENCE   7   1 - 5   2000年9月

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    記述言語:英語   出版者・発行元:CHURCHILL LIVINGSTONE  

    To investigate the usefulness of embolising cerebral arteriovenous malformations (AVMs) with a cellulose acetate polymer solution before surgical resection.
    Methods: The cases of 12 patients with AVMs treated by embolisation before surgical resection were renewed. Two types of cellulose acetate polymer solutions were used to occlude 40 feeding vessels. All patients underwent surgical resection 1-51 days after embolisation.
    Results: Reduction of the nidus volume after embolisation ranged from 20% to nearly 100%. Transient neurological deficits occurred in three patients, persistent deficits occurred in one and there were no haemorrhagic complications. All but one arteriovenous malformation were completely resected, Embolisation helped to identify feeding vessels and ease dissection. Histopathological examination of resected specimens disclosed mild inflammatory reactions in the acute stage and no unfavourable granulomatous changes in the chronic stage.
    Conclusion: Embolisation with cellulose acetate polymer solutions followed by surgical resection is safe and efficacious for treating cerebral AVMs. (C) 2000 Harcourt Publishers Ltd.

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  • Dense packing of cerebral aneurysms: An in vitro study with detachable platinum coils

    M Piotin, S Mandai, KJ Murphy, K Sugiu, P Gailloud, JB Martin, DA Rufenacht

    AMERICAN JOURNAL OF NEURORADIOLOGY   21 ( 4 )   757 - 760   2000年4月

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    記述言語:英語   出版者・発行元:AMER SOC NEURORADIOLOGY  

    Aneurysm models were used to study the density of packing after coil embolization, Platinum coils were introduced until the point of minimally dense packing, indicated by aneurysmal circulatory exclusion, Packing was continued up to the point of maximal density, indicated by protrusion into the parent artery. Volumetric ratios (coil volume/aneurysmal volume) were calculated for minimally and maximally dense packing. Maximally dense packing ratios were a little higher than the minimally dense ratios, but less than 37%.

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  • Endovascular occlusion and percutaneous treatment of vasospasm

    Jean B, Sugiu K, Muster M, Rufenacht DA

    Rev Med Suisse Romande   2000年

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  • ウィリス動脈輪閉塞症(もやもや病)の岡山県実態調査長期追跡調査の中間報告

    大本堯史, 勝間田 篤, 日下 昇, 難波克成, 杉生憲志, 中嶋裕之

    厚生省特定疾患・ウィリス動脈輪閉塞症の病因・病態に関する研究班 平成11年度研究報告書   2000年

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  • Curative treatment of cerebral arteriovenous malformations by embolisation using cellulose acetate polymer followed by surgical resection

    Koji Tokunaga, Kazushi Kinugasa, Toshinari Meguro, Kenji Sugiu, Hiroyuki Nakashima, Shinya Mandai, Takashi Ohmoto

    Journal of Clinical Neuroscience   7 ( 1 )   1 - 5   2000年

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    記述言語:英語   出版者・発行元:Churchill Livingstone  

    Aim: To investigate the usefulness of embolising cerebral arteriovenous malformations (AVMs) with a cellulose acetate polymer solution before surgical resection. Methods: The cases of 12 patients with AVMs treated by embolisation before surgical resection were renewed. Two types of cellulose acetate polymer solutions were used to occlude 40 feeding vessels. All patients underwent surgical resection 1-51 days after embolisation. Results: Reduction of the nidus volume after embolisation ranged from 20% to nearly 100%. Transient neurological deficits occurred in three patients, persistent deficits occurred in one and there were no haemorrhagic complications. All but one arteriovenous malformation were completely resected. Embolisation helped to identify feeding vessels and ease dissection. Histopathological examination of resected specimens disclosed mild inflammatory reactions in the acute stage and no unfavourable granulomatous changes in the chronic stage. Conclusion: Embolisation with cellulose acetate polymer solutions followed by surgical resection is safe and efficacious for treating cerebral AVMs. (C) 2000 Harcourt Publishers Ltd.

    DOI: 10.1054/jocn.2000.0700

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  • Malignant cerebellar astrocytoma developing 15 years after radiation therapy for a medulloblastoma

    T. Furuta, K. Sugiu, T. Tamiya, K. Matsumoto, T. Ohmoto

    Clinical Neurology and Neurosurgery   100 ( 1 )   56 - 59   1998年3月

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    記述言語:英語  

    A case of malignant cerebellar astrocytoma occurring 15 years after the radiation therapy for a medulloblastoma is reported. The tumor developed at the same site of irradiation after a sufficient latent period and was completely different from medulloblastoma in its histology. This tumor fulfilled the criteria of radiation-induced neoplasm. Only seven similar cases have been reported up to the present. Whole neuraxis irradiation following a gross total resection is a standard treatment for medulloblastoma, but the possibility of the development of radiation-induced tumors must be borne in mind for a long time after the radiation therapy for medulloblastoma.

    DOI: 10.1016/S0303-8467(97)00122-4

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  • Malignant cerebellar astrocytoma developing 15 years after radiation therapy for a medulloblastoma.(共著)

    Clinical Neurology and Neurosurgery   100 ( 1 )   56 - 59   1998年3月

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  • Neurovascular embolization of cerebral and spinal arteriovenous malformations and fistulas with liquid cellulose acetate polymer

    K Sugiu, S Mandai, Kamata, I, K Kinugasa, T Ohmoto, KJ Murphy

    RADIOLOGY   205   1450 - 1450   1997年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:RADIOLOGICAL SOC NORTH AMER  

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  • Prophylactic thrombosis to prevent new bleeding and to delay aneurysm surgery

    Kazushi Kinugasa, Shinya Mandai, Ichiro Kamata, Koji Tokunaga, Kenji Sugiu, Akira Handa, Hiroyuki Nakashima, Takashi Ohmoto

    Neurosurgery   36 ( 4 )   661 - 667   1995年

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    記述言語:英語  

    SIX ANEURYSMS IN five patients with acute aneurysmal subarachnoid hemorrhages were treated with direct thrombosis using cellulose acetate polymer within 4 hours of rupture. The aneurysms involved the internal carotid and posterior communicating arteries (two patients), the anterior choroidal artery (one patient), the bifurcation of the basilar artery (one patient), and the middle cerebral artery (two patients). Four patients underwent aggressive volume expansion after direct thrombosis with cellulose acetate polymer. The aneurysms remained thrombosed until operations on the necks were performed 2 to 7 weeks after the subarachnoid hemorrhages. Three patients were given intrathecal tissue plasminogen activator. One patient, who remained at neurological Grade V, was not treated surgically and died from cardiac failure. Five aneurysms in the remaining four patients were successfully clipped. These preliminary data suggest that immediate aneurysmal thrombosis, then aggressive preoperative prophylactic volume expansion and/or administration of intrathecal tissue plasminogen activator, can help prevent new bleeding and reduce delayed cerebral ischemia in patients after aneurysmal subarachnoid hemorrhages. © by the Congress of Neurological Surgeons.

    DOI: 10.1227/00006123-199504000-00004

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  • Prophylactic thrombosis to prevent new bleeding and to delay aneurysm surgery.(共著)

    Neurosurgery   36 ( 4 )   661 - 667   1995年

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  • Early treatment of subarachnoid hemorrhage after preventing rerupture of an aneurysm.(共著)

    J Neurosurg   83 ( 1 )   34 - 41   1995年

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  • Direct thrombosis of experimental aneurysms with cellulose acetate polymer (CAP): Technical aspects, angiographic follow up, and histological study

    K. Sugiu, K. Kinugasa, S. Mandai, K. Tokunaga, T. Ohmoto

    Journal of Neurosurgery   83 ( 3 )   531 - 538   1995年

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    記述言語:英語   出版者・発行元:American Association of Neurological Surgeons  

    Experimental aneurysms were created using a microsurgical technique to produce anastomosed venous pouches in the bilateral common carotid arteries of 12 dogs. The 24 aneurysms were then thrombosed via an endovascular approach with injection of a cellulose acetate polymer (CAP) solution that the authors have developed for use as a liquid thrombotic material. Angiography performed 1 to 4 weeks after CAP injection revealed complete thrombosis of the aneurysm with patency of the parent artery in 16 aneurysms. Histological analysis disclosed that the aneurysmal orifice in these cases was completely covered with newly formed endothelial cells 2 weeks after CAP thrombosis. Three other aneurysms exhibited parent artery occlusion caused by protrusion of the CAP mass through the aneurysmal orifice into the parent artery
    this was thought to be caused by over-injection of the CAP solution. Histological analysis of the remaining five aneurysms, initially shown to have incomplete occlusion, revealed that they each possessed a residual neck that was partially covered with endothelial cells. No rupture of the aneurysms or migration of CAP into the distal arteries was observed. These results suggest that using an endovascular approach, direct thrombosis of cerebral aneurysms with CAP is safe and effective. This technique may prove to be an alternative treatment for such aneurysms. However, there is a potential risk of regrowth or rupture of aneurysms that retain a residual neck and long-term follow-up studies will be required to evaluate this issue.

    DOI: 10.3171/jns.1995.83.3.0531

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  • Cellulose acetate polymer thrombosis for the emergency treatment of aneurysms: Angiographic findings, clinical experience, and histopathological study

    Kazushi Kinugasa, Shinya Mandai, Shohei Tsuchida, Kenji Sugiu, Ichiro Kamata, Kouji Tokunaga, Takashi Ohmoto, Kohji Taguchi

    Neurosurgery   34 ( 4 )   694 - 701   1994年

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    記述言語:英語  

    CELLULOSE ACETATE POLYMER solution is a liquid thrombotic material that hardens into the shape of an aneurysm into which it is injected. Therapy using this solution is a rapid technique that helps prevent the rupture of aneurysms, especially those that extravasate contrast material during angiography in the acute stage of subarachnoid hemorrhage. Using this polymer solution and an endovascular technique, we treated two patients who had aneurysms of the basilar and anterior communicating arteries with extravasation of contrast material during angiography a few hours after the initial subarachnoid hemorrhage. In one patient with an aneurysm of the anterior communicating artery, the aneurysm's wall was perforated with the catheter during neurointerventional procedures. In both patients, postoperative angiograms demonstrated obliteration of the aneurysmal dome, including the site of extravasation or perforation. The parent artery and surrounding perforating branches were preserved. Although we do not advocate aggressive therapy for patients who bleed during angiography, we pursued this therapy in these two patients because of the opportunity to introduce cellulose acetate polymer in an attempt to preserve the patients' lives. Unfortunately, both patients died. Histopathological studies performed at the time of autopsy demonstrated that the luminal surface of cellulose acetate polymer was covered with thrombus by 6 days after cellulose acetate polymer thrombosis. By 10 days, the thrombus had a prominent fibrin network, a concentrated plasma component, and few fibrocytes adhering to its luminal surface. The clinical description and results of treatment and histopathological studies are presented here. Copyright © by the Congress of Neurological Surgeons.

    DOI: 10.1227/00006123-199404000-00019

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  • Selection and Combination of Techniques for Treating Spontaneous Carotid-cavernous Sinus Fistulas.(共著)

    Neurol Med Chir(Tokyo)   34 ( 9 )   597 - 606   1994年

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  • Selection and Combination of Techniques for Treating Spontaneous Carotid-cavernous Sinus Fistulas

    Kazushi Kinugasa, Kouji Tokunaga, Ichiro Kamata, Shinya Mandai, Kenji Sugiu, Akira Handa, Takashi Ohmoto

    Neurologia Medico-Chirurgica   34 ( 9 )   597 - 606   1994年

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    記述言語:英語  

    Twenty-eight patients with spontaneous carotid-cavernous sinus fistulas (CCFs) were treated using a variety of techniques. Three of four patients with direct CCFs underwent intravascular embolization with a detachable balloon. Embolization with polyvinyl alcohol particles through an external carotid endoarterial route was used in six patients with indirect CCFs, and with ethylene-vinyl alcohol copolymer solution in two. Patients undergoing these conventional treatments, including embolization of the meningeal branches of the external carotid artery, had less satisfactory outcomes. The transvenous approach using minicoils through the inferior petrosal sinus was successful in eight patients. One patient treated using the transvenous approach using copper wire through the ophthalmic vein had worsening of visual acuity and field. Unsuccessful transvenous embolization in four patients required direct surgical exposure and embolization with spring coils. Spontaneous cures occurred in four patients. Direct CCFs with high flow rates were best treated with the detachable balloon or coil technique through a internal carotid endoarterial route. Indirect CCFs were best treated with the minicoil through the inferior petrosal sinus. If these techniques fail, direct surgical exposure allows placement of coils into the cavernous sinus. Copyright © 1994, The Japan Neurosurgical Society. All rights reserved.

    DOI: 10.2176/nmc.34.597

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  • Cellulose Acetate Polymer Thrombosis for the Emergency Treatment of Aneurysms : Angiographic Findings, Clinical Experience, and Histopathological Study.(共著)

    Neurosurgery   34 ( 4 )   694 - 701   1994年

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  • Direct thrombosis of aneurysms with cellulose acetate polymer. Part II: Preliminary clinical experience

    K. Kinugasa, S. Mandai, Y. Terai, I. Kamata, K. Sugiu, T. Ohmoto, A. Nishimoto

    Journal of Neurosurgery   77 ( 4 )   501 - 507   1992年

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    記述言語:英語  

    The authors report the treatment of seven intracranial aneurysms in six patients with direct infusion of cellulose acetate polymer solution, a new liquid thrombotic material. These aneurysms were considered inoperable because of their size or location, or because of the patient's neurological condition. This material avoids the difficulties associated with balloon occlusion, and completely fills even irregularly shaped aneurysms. Cellulose acetate polymer solution hardens in about 5 minutes and remains solid once inside the aneurysm. Because this technique is less invasive than surgery, it can be used for high-risk patients in the acute stage of subarachnoid hemorrhage. Transient motor aphasia occurred in one patient. A small residual neck, which caused rebleeding 3 months after the treatment, remained in another patient. This article describes the new material, the procedure for direct thrombosis, and preliminary clinical results.

    DOI: 10.3171/jns.1992.77.4.0501

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  • Direct thrombosis of aneurysm with cellulose acetate polymer Part (]G0001[) : Preliminary clinical experience.(共著)

    J Neurosurg   77 ( 4 )   501 - 507   1992年

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▼全件表示

講演・口頭発表等

  • 中型動脈瘤にはflow diverterよりもstent-assisted coilingが薦められる

    春間 純、杉生憲志、菱川朋人、平松匡文、村井 智、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、木村 颯、枝木久典、伊達 勲

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    開催年月日: 2021年11月25日 - 2021年11月27日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:福岡  

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  • 光造形3Dプリンターによる脳動脈瘤モデル作成法の確立とその応用

    木村 颯、春間 純、杉生憲志、菱川朋人、平松匡文、村井 智、西 和彦、佐藤 悠、山岡陽子、胡谷侑貴、枝木久典、伊達 勲

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    開催年月日: 2021年11月25日 - 2021年11月27日

    記述言語:日本語   会議種別:口頭発表(一般)  

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  • Cone-beam CTを用いたlateral spinal arteryの正常解剖と頭蓋頚椎移行部動静脈瘻の血管解剖の解析(シンポジウム)

    平松匡文、杉生憲志、安原隆雄、菱川朋人、春間 純、村井 智、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、伊達 勲

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    開催年月日: 2021年11月25日 - 2021年11月27日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

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  • 岡大チームが選ぶ、Flow Diverter or Stent Assisted Coiling─治療成績から─(アフタヌーンセミナー) 招待

    杉生憲志

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    記述言語:日本語   会議種別:口頭発表(基調)  

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  • ステント支援脳動脈瘤治療における二剤抗血小板薬投与の効果と安全性に関する多施設ランダム化比較試験および登録研究(シンポジウム)

    山上 宏、坂井信幸、飯原弘二、大石英則、杉生憲志、松丸祐司、松本康史、吉村紳一

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    開催年月日: 2021年11月25日 - 2021年11月27日

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  • 当院での高精度テーラーメード脳動脈瘤モデルを利用した脳血管内治療トレーニング(シンポジウム)

    春間 純、杉生憲志、木村 颯、胡谷侑貴、佐藤 悠、枝木久典、山岡陽子、西 和彦、村井 智、平松匡文、菱川朋人、伊達 勲

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  • 国内研修施設を対象とした脳血管治療のシミュレーショントレーニングに関するアンケート調査の報告(シンポジウム)

    胡谷侑貴、杉生憲志、菱川朋人、平松匡文、春間 純、村井 智、西 和彦、山岡陽子、佐藤 悠、木村 颯、枝木久典、伊達 勲

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    開催年月日: 2021年11月25日 - 2021年11月27日

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  • 経時的CBCT fusion画像を用いたPipeline embolization device留置術後の脳動脈瘤閉塞率の検討

    胡谷侑貴、春間 純、杉生憲志、菱川朋人、平松匡文、村井 智、西 和彦、山岡陽子、佐藤 悠、木村 颯、枝木久典、伊達 勲

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    開催年月日: 2021年11月25日 - 2021年11月27日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:福岡  

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  • 動脈瘤破裂による内頚動脈海綿静脈洞瘻に対してpterygoid plexus経由で経静脈的塞栓術を行った1例

    松田勇輝、平松匡文、杉生憲志、木村 颯、山岡陽子、胡谷侑貴、佐藤 悠、西 和彦、村井 智、春間 純、菱川朋人、伊達 勲

    第37回NPO法人日本脳神経血管内治療学会学術集会(現地・Web併催)  2021年11月25日  福岡大学筑紫病院 脳神経外科

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    開催年月日: 2021年11月25日 - 2021年11月27日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:福岡  

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  • 当院におけるCASのprotection deviceによる治療成績の検討

    枝木久典、春間 純、杉生憲志、菱川朋人、平松匡文、村井 智、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、木村 颯、伊達 勲

    第37回NPO法人日本脳神経血管内治療学会学術集会(現地・Web併催)  2021年11月25日  福岡大学筑紫病院 脳神経外科

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    開催年月日: 2021年11月25日 - 2021年11月27日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:福岡  

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  • Hybrid Neurosurgeryに求められるチームワーク─当院における診療放射線技師としての経験─(シンポジウム)

    氏福亜矢子、平松匡文、菱川朋人、杉生憲志、春間 純、市川大樹、大西治彦、本田 貢、伊達 勲

    第37回NPO法人日本脳神経血管内治療学会学術集会(現地・Web併催)  2021年11月25日  福岡大学筑紫病院 脳神経外科

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    開催年月日: 2021年11月25日 - 2021年11月27日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:福岡  

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  • Osseous involvementを伴う脊髄硬膜外動静脈瘻(シンポジウム)

    平松匡文、杉生憲志、安原隆雄、伊達 勲

    第37回NPO法人日本脳神経血管内治療学会学術集会(現地・Web併催)  2021年11月25日  福岡大学筑紫病院 脳神経外科

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    開催年月日: 2021年11月25日 - 2021年11月27日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:福岡  

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  • 部分血栓化中大脳動脈瘤に対するコイル塞栓術の有用性

    菱川朋人、春間 純、平松匡文、杉生憲志、伊達 勲

    第37回NPO法人日本脳神経血管内治療学会学術集会(現地・Web併催)  2021年11月25日  福岡大学筑紫病院 脳神経外科

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    開催年月日: 2021年11月25日 - 2021年11月27日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:福岡  

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  • 脳脊髄動静脈シャント疾患の罹患率に対して地域性が与える影響

    村井 智、 高杉祐二、平松匡文、鈴木越治、石橋良太、宮崎裕子、春間 純、菱川朋人、安原隆雄、杉生憲志、伊達 勲

    第37回NPO法人日本脳神経血管内治療学会学術集会(現地・Web併催)  2021年11月25日  福岡大学筑紫病院 脳神経外科

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    開催年月日: 2021年11月25日 - 2021年11月27日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:福岡  

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  • 当院における頭蓋内腫瘍塞栓術の治療成績─JR-NET3との比較─

    西 和彦、杉生憲志、菱川朋人、平松匡文、春間 純、村井 智、山岡陽子、佐藤 悠、胡谷侑貴、枝木久典、木村 颯、伊達 勲

    第37回NPO法人日本脳神経血管内治療学会学術集会(現地・Web併催)  2021年11月25日  福岡大学筑紫病院 脳神経外科

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    開催年月日: 2021年11月25日 - 2021年11月27日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:福岡  

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  • 視神経菅部硬膜動静脈瘻の2例報告

    佐藤 悠、平松匡文、杉生憲志、中嶋裕之、菱川朋人、春間 純、村井 智、西 和彦、山岡陽子、胡谷侑貴、枝木久典、伊達 勲

    第37回NPO法人日本脳神経血管内治療学会学術集会(現地・Web併催)  2021年11月25日  福岡大学筑紫病院 脳神経外科

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    開催年月日: 2021年11月25日 - 2021年11月27日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:福岡  

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  • 高脂血症ラットにおけるくも膜下出血後脳血管攣縮

    西 和彦、菱川朋人、 橋 悠、劉 克約、枝木久典、木村 颯、胡谷侑貴、佐藤 悠、山岡陽子、村井 智、春間 純、平松匡文、杉生憲志、西堀正洋、伊達 勲

    第64回日本脳循環代謝学会学術集会(現地・Web併催)  2021年11月12日  岐阜薬科大学

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    開催年月日: 2021年11月12日 - 2021年11月13日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:岐阜  

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  • 高脂血症ラットにおけるくも膜下出血後脳血管攣縮

    西 和彦、菱川朋人、高橋 悠、劉 克約、枝木久典、木村 颯、胡谷侑貴、佐藤 悠、山岡陽子、村井 智、春間 純、平松匡文、杉生憲志、西堀正洋、伊達 勲

    (一社)日本脳神経外科学会第80回学術総会(現地・Web併催)  2021年10月29日  山梨大学医学部 脳神経外科

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    開催年月日: 2021年10月27日 - 2021年10月30日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:横浜  

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  • 経時的CBCT fusion画像を用いたPipeline embolization deviceの短縮、拡張の検討

    胡谷侑貴、春間 純、杉生憲志、菱川朋人、平松匡文、村井 智、西 和彦、山岡陽子、佐藤 悠、木村 颯、枝木久典、伊達 勲

    (一社)日本脳神経外科学会第80回学術総会(現地・Web併催)  2021年10月28日  山梨大学医学部 脳神経外科

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    開催年月日: 2021年10月27日 - 2021年10月30日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:横浜  

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  • 高難度中型動脈瘤にはflow diverterよりもstent-assisted coilingが薦められる

    杉生憲志、菱川朋人、平松匡文、春間 純、村井 智、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、木村 颯、枝木久典、伊達 勲

    (一社)日本脳神経外科学会第80回学術総会(現地・Web併催)  2021年10月27日  山梨大学医学部 脳神経外科

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    開催年月日: 2021年10月27日 - 2021年10月30日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:横浜  

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  • 瘤周囲脳の接触による脳動脈瘤のブレブ形成

    佐藤 透、八木高伸、澤田陽一、杉生憲志、菱川朋人、平松匡文、春間 純、佐藤 悠、伊達 勲

    (一社)日本脳神経外科学会第80回学術総会(現地・Web併催)  2021年10月27日  山梨大学医学部 脳神経外科

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    開催年月日: 2021年10月27日 - 2021年10月30日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • 当施設での椎骨動脈紡錘状動脈瘤に対するステント留置単独治療の成績

    小橋藍子、杉生憲志、菱川朋人、平松匡文、春間 純、村井 智、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、木村 颯、枝木久典、伊達 勲

    (一社)日本脳神経外科学会第80回学術総会(現地・Web併催)  2021年10月27日  山梨大学医学部 脳神経外科

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    開催年月日: 2021年10月27日 - 2021年10月30日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • 右上肢アプローチ脳血管撮影検査における左内頚動脈選択撮影可否に関わる因子の検討

    佐藤 悠、春間 純、杉生憲志、菱川朋人、平松匡文、村井 智、西 和彦、山岡陽子、胡谷侑貴、枝木久典、木村 颯、伊達 勲

    (一社)日本脳神経外科学会第80回学術総会(現地・Web併催)  2021年10月27日  山梨大学医学部 脳神経外科

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    開催年月日: 2021年10月27日 - 2021年10月30日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • Ziostation2を用いた光造形型3Dプリンタ用血管中空化モデル作成方法の試み

    木村 颯、春間 純、枝木久典、胡谷侑貴、山岡陽子、佐藤 悠、西 和彦、村井 智、平松匡文、菱川朋人、杉生憲志、伊達 勲

    (一社)日本脳神経外科学会第80回学術総会(現地・Web併催)  2021年10月27日  山梨大学医学部 脳神経外科

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    開催年月日: 2021年10月27日 - 2021年10月30日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • 3DDSA arterial & venous phase fusionを用いた中大脳動脈瘤術前シミュレーションの有用性

    枝木久典、平松匡文、杉生憲志、菱川朋人、春間 純、村井 智、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、木村 颯、伊達 勲

    (一社)日本脳神経外科学会第80回学術総会(現地・Web併催)  2021年10月27日  山梨大学医学部 脳神経外科

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    開催年月日: 2021年10月27日 - 2021年10月30日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • 軟骨性骨に発生したosseous arteriovenous fistulaの特徴と治療

    平松匡文、杉生憲志、春間 純、菱川朋人、村井 智、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、木村 颯、枝木久典、伊達 勲

    (一社)日本脳神経外科学会第80回学術総会(現地・Web併催)  2021年10月27日  山梨大学医学部 脳神経外科

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    開催年月日: 2021年10月27日 - 2021年10月30日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:横浜  

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  • 小児もやもや病におけるribbon主義の有用性

    菱川朋人、平松匡文、Jun Haruma、杉生憲志、伊達 勲

    (一社)日本脳神経外科学会第80回学術総会(現地・Web併催)  2021年10月27日  山梨大学医学部 脳神経外科

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    開催年月日: 2021年10月27日 - 2021年10月30日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:横浜  

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  • Form3 3Dプリンタを用いた新しい脳動脈瘤モデル作成と脳血管内治療術前シミュレーションの試み

    春間 純、杉生憲志、木村 颯、枝木久典、胡谷侑貴、佐藤 悠、西 和彦、山岡陽子、村井 智、平松匡文、菱川朋人、伊達 勲

    (一社)日本脳神経外科学会第80回学術総会(現地・Web併催)  2021年10月27日  山梨大学医学部 脳神経外科

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    開催年月日: 2021年10月27日 - 2021年10月30日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • マルチモダリティを用いた術前シミュレーションが有用であった開頭クリッピング術の1例

    佐藤 悠、春間 純、木村 颯、杉生憲志、菱川朋人、平松匡文、村井 智、西 和彦、山岡陽子、胡谷侑貴、枝木久典、伊達 勲

    第23回中国四国脳卒中研究会  2021年9月25日  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2021年9月25日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:岡山  

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  • 動脈瘤─GeLVISの実力─ 招待

    杉生憲志

    第30回NPO法人日本脳神経血管内治療学会中国四国地方会  2021年9月25日  島根大学医学部 脳神経外科

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    開催年月日: 2021年9月25日

    記述言語:日本語   会議種別:口頭発表(基調)  

    開催地:岡山  

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  • 内頚動脈海綿静脈洞瘻に対してpterygoid plexus経由で経静脈的塞栓術を行った1例

    木村 颯、平松匡文、杉生憲志、菱川朋人、春間 純、村井 智、西 和彦、佐藤 悠、山岡陽子、胡谷侑貴、伊達 勲、枝木久典

    第30回NPO法人日本脳神経血管内治療学会中国四国地方会  2021年9月25日  島根大学医学部 脳神経外科

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    開催年月日: 2021年9月25日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:岡山  

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  • 進行性脳梗塞をきたした乳児もやもや病の1例

    小橋藍子、菱川朋人、杉生憲志、平松匡文、春間 純、村井 智、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、木村 颯、枝木久典、伊達 勲

    第23回中国四国脳卒中研究会  2021年9月25日  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2021年9月25日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:岡山  

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  • 症候性carotid webに対し頚動脈ステント留置術を施行した1例

    枝木久典、春間 純、杉生憲志、菱川朋人、平松匡文、村井 智、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、木村 颯、佐々木諒、山下 徹、伊達 勲

    第23回中国四国脳卒中研究会  2021年9月25日  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2021年9月25日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:岡山  

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  • 経時的cone-beam CT fusion画像を用いたFREDの短縮、形態変化の検討

    胡谷侑貴、春間 純、杉生憲志、菱川朋人、平松匡文、村井 智、西 和彦、山岡陽子、佐藤 悠、木村 颯、伊達 勲

    第30回NPO法人日本脳神経血管内治療学会中国四国地方会  2021年9月25日  島根大学医学部 脳神経外科

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    開催年月日: 2021年9月25日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:岡山  

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  • Vitreaの脳灌流画像解析が有用であった急性期脳梗塞の1例

    西 和彦、杉生憲志、菱川朋人、平松匡文、春間 純、村井 智、山岡陽子、佐藤 悠、胡谷侑貴、枝木久典、伊達 勲

    第30回NPO法人日本脳神経血管内治療学会中国四国地方会  2021年9月25日  島根大学医学部 脳神経外科

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    開催年月日: 2021年9月25日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:岡山  

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  • DAVFの緊急治療ーONYXの使えないアウェイ病院での戦略ー(ミニレクチャー) 招待

    杉生憲志

    脳血管内治療ブラッシュアップセミナー2021(現地・Web開催)  2021年6月  脳血管内治療技術と機器研究会

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    開催年月日: 2021年6月24日 - 2021年6月26日

    記述言語:日本語   会議種別:口頭発表(基調)  

    開催地:神戸  

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  • 小児もやもや病におけるribbon手技の有用性

    菱川朋人、平松匡文、春間 純、杉生憲志、伊達 勲

    第49回日本小児神経外科学会(現地・Web開催)  2021年6月  福島県立医科大学 脳神経外科

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    開催年月日: 2021年6月4日 - 2021年6月5日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:福島  

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  • 頭蓋頚椎移行部動静脈瘻の血管解剖ーJSNET特別企画からの知見ー(シンポジウム) 招待

    平松匡文、杉生憲志、石黒友也、清末一路、佐藤健一、高井啓介、新見康成、松丸祐司

    第36回日本脊髄外科学会(現地・Web開催)  2021年6月  社会医療法人信愛会 交野病院

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    開催年月日: 2021年6月3日 - 2021年6月4日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(指名)  

    開催地:京都  

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  • 脊椎脊髄疾患に対する血管撮影手技と血管解剖の読影(血管内セミナー) 招待

    平松匡文、杉生憲志

    第36回日本脊髄外科学会(現地・Web開催)  2021年6月  社会医療法人信愛会 交野病院

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    開催年月日: 2021年6月3日 - 2021年6月4日

    記述言語:日本語   会議種別:口頭発表(基調)  

    開催地:京都  

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  • 血管内治療における微小脳血管解剖の最前線(第35回日本微小脳神経外科解剖研究会合同セッション) 招待

    杉生憲志、平松匡文、菱川朋人、春間 純、高橋 悠、村井 智、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、伊達 勲

    第41回日本脳神経外科コングレス総会(現地・Web併催)  2021年5月  鹿児島大学大学院医歯学総合研究科 脳神経外科学

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    開催年月日: 2021年5月13日 - 2021年5月16日

    記述言語:日本語   会議種別:口頭発表(基調)  

    開催地:横浜  

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  • 光造形型3Dプリンタを用いた新しい脳動脈瘤モデル作成と術前シミュレーションの試み(シンポジウム)

    春間 純、杉生憲志、胡谷侑貴、佐藤 悠、西 和彦、山岡陽子、村井 智、高橋 悠、平松匡文、菱川朋人、伊達 勲

    第30回脳神経外科手術と機器学会(Web開催)  2021年4月  札幌医科大学 脳神経外科

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    開催年月日: 2021年4月23日 - 2021年4月24日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:札幌  

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  • 当院における80歳以上高齢者における身破裂脳動脈瘤治療の検討(シンポジウム)

    春間 純、杉生憲志、胡谷侑貴、佐藤 悠、西 和彦、山岡陽子、村井 智、高橋 悠、平松匡文、菱川朋人、伊達 勲

    第34回日本老年脳神経外科学会(Web開催)  2021年4月  秋田大学大学院医学系研究科 機能展開医学系 脳神経外科学

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    開催年月日: 2021年4月17日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:秋田  

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  • 光造形型3Dプリンタで作成した脳動脈瘤モデルでの術前シミュレーションが有用であった新規脳動脈瘤支援ステントデバイスPulseRiderを用いた1例

    春間 純、杉生憲志、胡谷侑貴、枝木久典、佐藤 悠、西 和彦、山岡陽子、村井 智、平松匡文、菱川朋人、安原隆雄、伊達 勲

    第91回(一社)日本脳神経外科学会中国四国支部学術集会(現地・Web併催)  2021年4月  島根大学医学部 脳神経外科

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    開催年月日: 2021年4月3日 - 2021年4月4日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:松江  

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  • 高脂血症ラットにおけるくも膜下出血後脳血管攣縮の検討(シンポジウム)

    西 和彦、菱川朋人、高橋 悠、劉 克約、胡谷侑貴、佐藤 悠、山岡陽子、村井 智、春間 純、平松匡文、杉生憲志、西堀正洋、伊達 勲

    第37回スパズム・シンポジウム:STROKE 2021(現地・Web併催)  2021年3月  東邦大学医療センター 大橋病院

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    開催年月日: 2021年3月11日 - 2021年3月13日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:福岡  

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  • 硬膜動静脈瘻 画像診断の新展開(シンポジウム)

    杉生憲志、平松匡文、菱川朋人、春間 純、高橋 悠、村井 智、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、伊達 勲

    第50回日本脳卒中の外科学会学術集会:STROKE 2021(現地・Web併催)  2021年3月  富山大学 脳神経外科

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    開催年月日: 2021年3月11日 - 2021年3月13日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:福岡  

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  • 当院におけるVertebroBasilar Dolichoectasiaの自然歴と血管内治療の治療成績

    胡谷侑貴、杉生憲志、菱川朋人、平松匡文、春間 純、高橋 悠、村井 智、西 和彦、山岡陽子、佐藤 悠、伊達 勲

    第46回日本脳卒中学会学術集会:STROKE 2021(現地・Web併催)  2021年3月  九州大学大学院医学研究院病態機能内科学

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    開催年月日: 2021年3月11日 - 2021年3月13日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:福岡  

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  • 遠位部前大脳動脈瘤に対する血管内治療の治療成績

    村井 智、胡谷侑貴、佐藤 悠、山岡陽子、西 和彦、高橋 悠、春間 純、平松匡文、菱川朋人、杉生憲志、伊達 勲

    第50回日本脳卒中の外科学会学術集会:STROKE 2021(現地・Web併催)  2021年3月  富山大学 脳神経外科

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    開催年月日: 2021年3月11日 - 2021年3月13日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:福岡  

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  • 光造形型3DプリンタForm3を用いた新しい脳動脈瘤モデル作成の試み

    春間 純、胡谷侑貴、佐藤 悠、西 和彦、山岡陽子、村井 智、高橋 悠、平松匡文、菱川朋人、杉生憲志、伊達 勲

    第50回日本脳卒中の外科学会学術集会:STROKE 2021(現地・Web併催)  2021年3月  富山大学 脳神経外科

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    開催年月日: 2021年3月11日 - 2021年3月13日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:福岡  

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  • コイル塞栓術後再発脳動脈瘤に対するコイル塞栓術の治療成績ー時期による比較検討ー

    佐藤 悠、平松匡文、杉生憲志、菱川朋人、春間 純、高橋 悠、村井 智、西 和彦、山岡陽子、胡谷侑貴、伊達 勲

    第46回日本脳卒中学会学術集会:STROKE 2021(現地・Web併催)  2021年3月  九州大学大学院医学研究院病態機能内科学

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    開催年月日: 2021年3月11日 - 2021年3月13日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:福岡  

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  • 未破裂椎骨動脈解離性動脈瘤における、造影cone-beam CTを用いた解離所見の描出とその所見に基づく治療戦略

    平松匡文、杉生憲志、菱川朋人、春間 純、高橋 悠、村井 智、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、伊達 勲

    第46回日本脳卒中学会学術集会:STROKE 2021(現地・Web併催)  2021年3月  九州大学大学院医学研究院病態機能内科学

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    開催年月日: 2021年3月11日 - 2021年3月13日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:福岡  

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  • 未破裂脳動脈瘤の診断と治療(教育講演) 招待

    菱川朋人、春間 純、平松匡文、杉生憲志、伊達 勲

    第46回日本脳卒中学会学術集会:STROKE 2021(現地・Web併催)  2021年3月  九州大学大学院医学研究院病態機能内科学

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    開催年月日: 2021年3月11日 - 2021年3月13日

    記述言語:日本語   会議種別:口頭発表(基調)  

    開催地:福岡  

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  • Cone-beam CT fusion画像を用いたflow diverter留置後の経時的変化の検討

    胡谷侑貴、春間 純、杉生憲志、菱川朋人、平松匡文、高橋 悠、村井 智、西 和彦、山岡陽子、佐藤 悠、伊達 勲

    第36回NPO法人日本脳神経血管内治療学会学術総会(現地・Web併催)  2020年11月  京都大学医学部附属病院 脳神経外科

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    開催年月日: 2020年11月19日 - 2020年11月21日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:京都  

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  • CASの軌跡と進化─CASPERに期待すること─(ランチョンセミナー) 招待

    杉生憲志

    第36回NPO法人日本脳神経血管内治療学会学術総会(現地・Web併催)  2020年11月  京都大学医学部附属病院 脳神経外

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    開催年月日: 2020年11月19日 - 2020年11月21日

    記述言語:日本語   会議種別:口頭発表(基調)  

    開催地:京都  

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  • 硬膜動静脈瘻の経静脈的塞栓術に対する内頚静脈直接穿刺の有用性

    木村 颯、春間 純、菱川朋人、胡谷侑貴、佐藤 悠、西 和彦、村井 智、高橋 悠、平松匡文、杉生憲志、伊達 勲

    第36回NPO法人日本脳神経血管内治療学会学術総会(現地・Web併催)  2020年11月  京都大学医学部附属病院 脳神経外科

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    開催年月日: 2020年11月19日 - 2020年11月21日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:京都  

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  • CASPER国内臨床試験成績(プレナリーシンポジウム)

    今村博敏、坂井信幸、松本康史、山上 宏、寺田友昭、藤中俊之、吉村紳一、杉生憲志、石井 暁、松丸祐司、泉 孝嗣

    第36回NPO法人日本脳神経血管内治療学会学術総会(現地・Web併催)  2020年11月  京都大学医学部附属病院 脳神経外

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    開催年月日: 2020年11月19日 - 2020年11月21日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:京都  

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  • 未破裂前大脳動脈 - 副中大脳動脈分岐部動脈瘤に対しコイル塞栓術を施行した1例 招待

    西 和彦、杉生憲志、菱川朋人、平松匡文、春間 純、高橋 悠、村井 智、山岡陽子、佐藤 悠、胡谷侑貴、伊達 勲

    第36回NPO法人日本脳神経血管内治療学会学術総会(現地・Web併催)  2020年11月  京都大学医学部附属病院 脳神経外科

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    開催年月日: 2020年11月19日 - 2020年11月21日

    記述言語:日本語   会議種別:口頭発表(基調)  

    開催地:京都  

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  • Terminal type動脈瘤に対するsingle neck-bridging techniqueの適当と限界

    村井 智、杉生憲志、菱川朋人、平松匡文、春間 純、高橋 悠、西 和彦、山岡陽子、佐藤 悠、胡谷侑貴、伊達 勲

    第36回NPO法人日本脳神経血管内治療学会学術総会(現地・Web併催)  2020年11月  京都大学医学部附属病院 脳神経外科

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    開催年月日: 2020年11月19日 - 2020年11月21日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:京都  

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  • 頚部内頚動脈のfenestrationと頚部内頚動脈解離を併発した1例

    枝木久典、春間 純、西 和彦、山岡陽子、高橋 悠、平松匡文、菱川朋人、杉生憲志、伊達 勲

    第36回NPO法人日本脳神経血管内治療学会学術総会(現地・Web併催)  2020年11月  京都大学医学部附属病院 脳神経外科

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    開催年月日: 2020年11月19日 - 2020年11月21日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:京都  

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  • 右上腕動脈アプローチでの左内頚動脈選択可否の検討

    佐藤 悠、春間 純、杉生憲志、菱川朋人、平松匡文、高橋 悠、村井 智、西 和彦、山岡陽子、胡谷侑貴、伊達 勲

    第36回NPO法人日本脳神経血管内治療学会学術総会(現地・Web併催)  2020年11月  京都大学医学部附属病院 脳神経外科

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    開催年月日: 2020年11月19日 - 2020年11月21日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:京都  

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  • 当院でのFlow diverterを用いた血管内治療成績の検討

    春間 純、杉生憲志、胡谷侑貴、佐藤 悠、西 和彦、山岡陽子、村井 智、高橋 悠、平松匡文、菱川朋人、伊達 勲

    第36回NPO法人日本脳神経血管内治療学会学術総会(現地・Web併催)  2020年11月  京都大学医学部附属病院 脳神経外科

     詳細を見る

    開催年月日: 2020年11月19日 - 2020年11月21日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:京都  

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  • 軟骨性骨に発生したosseous arteriovenous fistulaの特徴と治療

    平松匡文、杉生憲志、春間 純、菱川朋人、高橋 悠、村井 智、西 和彦、山岡陽子、伊達 勲

    第36回NPO法人日本脳神経血管内治療学会学術総会(現地・Web併催)  2020年11月  京都大学医学部附属病院 脳神経外科

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    開催年月日: 2020年11月19日 - 2020年11月21日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:京都  

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  • 複雑な中大脳動脈瘤に対する血管内治療の有用性

    菱川朋人、春間 純、平松匡文、杉生憲志、伊達 勲

    第36回NPO法人日本脳神経血管内治療学会学術総会(現地・Web併催)  2020年11月  京都大学医学部附属病院 脳神経外科

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    開催年月日: 2020年11月19日 - 2020年11月21日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:京都  

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  • 破裂解離性動脈瘤の母血管温存治療の中長期成績─安全性と根治は両立するか?─(シンポジウム)

    杉生憲志、菱川朋人、平松匡文、春間 純、高橋 悠、村井 智、山岡陽子、西 和彦、胡谷侑貴、佐藤 悠、伊達 勲

    第36回NPO法人日本脳神経血管内治療学会学術総会(現地・Web併催)  2020年11月  京都大学医学部附属病院 脳神経外科

     詳細を見る

    開催年月日: 2020年11月19日 - 2020年11月21日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:京都  

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  • ラット中大脳動脈閉塞モデルにおけるcrossed cerebellar diaschisis

    西 和彦、木谷尚哉、杉生憲志、菱川朋人、安原隆雄、平松匡文、西廣真吾、高橋 悠、村井 智、山岡陽子、佐藤 悠、胡谷侑貴、伊達 勲

    第63回日本脳循環代謝学会学術集会(現地・Web併催)  2020年11月  東海大学医学部 神経内科

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    開催年月日: 2020年11月13日 - 2020年11月14日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • くも膜下出血後の早期脳障害においてspreading depolarizationと細胞外グルタミン酸濃度が与える影響

    佐藤 悠、村井 智、菱川朋人、平松匡文、春間 純、高橋 悠、西 和彦、山岡陽子、胡谷侑貴、杉生憲志、武田吉正、伊達 勲

    第63回日本脳循環代謝学会学術集会(現地・Web併催)  2020年11月  東海大学医学部 神経内科

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    開催年月日: 2020年11月13日 - 2020年11月14日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • 3D fusion画像を用いたAVM術前シミュレーションの有用性

    西 和彦、平松匡文、菱川朋人、杉生憲志、春間 純、高橋 悠、村井 智、山岡陽子、佐藤 悠、胡谷侑貴、伊達 勲

    (一社)日本脳神経外科学会第79回学術総会(現地・Web併催)  2020年10月  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2020年10月15日 - 2020年10月17日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:岡山  

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  • 未破裂椎骨動脈解離性動脈瘤に対するsolo stenting治療

    杉生憲志、菱川朋人、平松匡文、春間 純、高橋 悠、村井 智、西 和彦、山岡陽子、胡谷侑貴、佐藤 悠、伊達 勲

    (一社)日本脳神経外科学会第79回学術総会(現地・Web併催)  2020年10月  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2020年10月15日 - 2020年10月17日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:岡山  

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  • 血管内治療のセッティング(ビデオシンポジウム) 招待

    杉生憲志、菱川朋人、平松匡文、春間 純、高橋 悠、村井 智、西 和彦、山岡陽子、胡谷侑貴、佐藤 悠、伊達 勲

    (一社)日本脳神経外科学会第79回学術総会(現地・Web併催)  2020年10月  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2020年10月15日 - 2020年10月17日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(指名)  

    開催地:岡山  

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  • フランスでの脳血管内治療臨床留学経験

    春間 純、杉生憲志、胡谷侑貴、佐藤 悠、山岡陽子、西 和彦、村井 智、高橋 悠、平松匡文、菱川朋人、Michel Piotin、伊達 勲

    (一社)日本脳神経外科学会第79回学術総会(現地・Web併催)  2020年10月  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2020年10月15日 - 2020年10月17日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:岡山  

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  • 蝶形骨縁および嗅窩部髄膜腫の動脈解剖

    平松匡文、杉生憲志、菱川朋人、春間 純、高橋 悠、村井 智、西 和彦、山岡陽子、島津洋介、藤井謙太郎、亀田雅博、黒住和彦、伊達 勲

    (一社)日本脳神経外科学会第79回学術総会(現地・Web併催)  2020年10月  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2020年10月15日 - 2020年10月17日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:岡山  

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  • 傍前床突起部動脈瘤における3D-MR CISS、3D TOFによるfusion画像の有用性

    胡谷侑貴、平松匡文、杉生憲志、菱川朋人、春間 純、高橋 悠、村井 智、西 和彦、山岡陽子、佐藤 悠、伊達 勲

    (一社)日本脳神経外科学会第79回学術総会(現地・Web併催)  2020年10月  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2020年10月15日 - 2020年10月17日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:岡山  

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  • Artery of Davidoff and Schechterに対する塞栓術─2例報告─

    佐藤 悠、春間 純、杉生憲志、菱川朋人、平松匡文、高橋 悠、村井 智、西 和彦、山岡陽子、胡谷侑貴、伊達 勲

    (一社)日本脳神経外科学会第79回学術総会(現地・Web併催)  2020年10月  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2020年10月15日 - 2020年10月17日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:岡山  

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  • 慢性透析患者での腕頭静脈狭窄症により引き起こされた硬膜動静脈瘻が疑われた2例

    皮居巧嗣、春間 純、菱川朋人、胡谷侑貴、佐藤 悠、山岡陽子、西 和彦、村井 智、高橋 悠、平松匡文、杉生憲志、Michel Piotin、伊達 勲

    (一社)日本脳神経外科学会第79回学術総会(現地・Web併催)  2020年10月  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2020年10月15日 - 2020年10月17日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:岡山  

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  • 未破裂脳動脈瘤開頭術後慢性硬膜下血腫発生と脳萎縮の関連性の検証

    山岡陽子、土方保和、安原隆雄、杉生憲志、菱川朋人、平松匡文、春間 純、高橋 悠、村井 智、西 和彦、佐藤 悠、胡谷侑貴、伊達 勲

    (一社)日本脳神経外科学会第79回学術総会(現地・Web併催)  2020年10月  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2020年10月15日 - 2020年10月17日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:岡山  

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  • くも膜下出血後の早期脳障害においてspreading depolarizationと細胞外グルタミン酸濃度が与える影響

    村井 智、菱川朋人、平松匡文、春間 純、高橋 悠、西 和彦、山岡陽子、胡谷侑貴、佐藤 悠、杉生憲志、武田吉正、伊達 勲

    (一社)日本脳神経外科学会第79回学術総会(現地・Web併催)  2020年10月  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2020年10月15日 - 2020年10月17日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:岡山  

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  • ラット中大脳動脈閉塞モデルにおけるcrossed cerebellar diaschisis 小脳血流と遺伝子発現解析

    木谷尚哉、杉生憲志、菱川朋人、安原隆雄、平松匡文、西廣真吾、高橋 悠、村井 智、伊達 勲

    (一社)日本脳神経外科学会第79回学術総会(現地・Web併催)  2020年10月  岡山大学大学院医歯薬学総合研究科 脳神経外科

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    開催年月日: 2020年10月15日 - 2020年10月17日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:岡山  

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  • 海外留学経験を日本で活かす─海外組の矜持─(シンポジウム)

    杉生憲志、春間 純、菱川朋人、平松匡文、高橋 悠、村井 智、西 和彦、山岡陽子、伊達 勲

    第45回日本脳卒中学会学術集会・第49回日本脳卒中の外科学会学術集会:STROKE 2020(Web開催)  2020年8月  杏林大学 脳神経外科、奈良県立医科大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:横浜  

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  • 直静脈洞近傍にシャントが存在するテント部硬膜動静脈瘻の血管解剖的特徴と経動脈的塞栓術 招待

    山岡陽子、平松匡文、杉生憲志、菱川朋人、春間 純、高橋 悠、村井 智、 西 和彦、伊達 勲

    第49回日本脳卒中の外科学会学術集会:STROKE 2020(Web開催)  2020年8月  奈良県立医科大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • 脊髄動静脈シャントの血管構築と臨床症状─JSNET稀少疾患シンポジウム4年間のまとめ─(シンポジウム)

    松丸祐司、田上秀一、石黒友也、遠藤俊毅、佐藤健一、清末一路、高井敬介、新見康成、平松匡文、杉生憲司

    第49回日本脳卒中の外科学会学術集会:STROKE 2020(Web開催)  2020年8月  奈良県立医科大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:横浜  

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  • 大脳鎌硬膜動静脈瘻の2症例

    川上真人、平松匡文、杉生憲志、菱川朋人、高橋 悠、村井 智、西 和彦、山岡陽子、伊達 勲

    第49回日本脳卒中の外科学会学術集会:STROKE 2020(Web開催)  2020年8月  奈良県立医科大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • 岡山県における脊椎脊髄動静脈シャント疾患の悉皆調査

    平松匡文、石橋良太、高井洋樹、村井 智、鈴木越治、宮崎裕子、高橋 悠、木谷尚哉、菱川朋人、安原隆雄、杉生憲志、伊達 勲

    第49回日本脳卒中の外科学会学術集会:STROKE 2020(Web開催)  2020年8月  奈良県立医科大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:横浜  

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  • Fusion画像を用いた頭蓋内・脊髄動静脈瘻の直達術前シミュレーション

    平松匡文、菱川朋人、安原隆雄、高橋 悠、村井 智、西 和彦、山岡陽子、杉生憲志、伊達 勲

    第49回日本脳卒中の外科学会学術集会:STROKE 2020(Web開催)  2020年8月  奈良県立医科大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:横浜  

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  • 短期間の経過で可動性プラークの再発を認めた放射線治療関連頚動脈狭窄症の1例

    冨田陽介、東 久登、高橋 潔、小川智之、服部靖彦、杉生憲志、伊達 勲

    第49回日本脳卒中の外科学会学術集会:STROKE 2020(Web開催)  2020年8月  奈良県立医科大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • 岡山県における脳脊髄動静脈シャント疾患の悉皆調査(シンポジウム)

    村井 智、平松匡文、石橋良太、高井洋樹、鈴木越治、山岡陽子、西 和彦、高橋 悠、菱川朋人、安原隆雄、杉生憲志、伊達 勲

    第49回日本脳卒中の外科学会学術集会:STROKE 2020(Web開催)  2020年8月  奈良県立医科大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:横浜  

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  • 血管内治療の到達点(基調講演) 招待

    坂井信幸、松丸祐司、石井 暁、飯原弘二、伊藤 靖、大石英則、桑山直也、杉生憲志、寺田友昭、東登志夫、廣畑 優、藤中俊之、松本康史、吉村紳一、今村博敏、坂井千秋

    第45回日本脳卒中学会学術集会・第49回日本脳卒中の外科学会学術集会:STROKE 2020(Web開催)  2020年8月  杏林大学 脳神経外科、奈良県立医科大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:口頭発表(基調)  

    開催地:横浜  

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  • Terminal typeの広頚動脈瘤に対してT-stent techniqueを用いたコイル塞栓術を行った3症例

    胡谷侑貴、杉生憲志、菱川朋人、平松匡文、高橋 悠、村井 智、西 和彦、山岡陽子、伊達 勲

    第45回日本脳卒中学会学術集会:STROKE 2020(Web開催)  2020年8月  杏林大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • 未破裂椎骨動脈解離性動脈瘤に対するsolo stenting治療の可能性と限界(シンポジウム)

    杉生憲志、菱川朋人、平松匡文、春間 純、高橋 悠、村井 智、西 和彦、山岡陽子、伊達 勲

    第49回日本脳卒中の外科学会学術集会:STROKE 2020(Web開催)  2020年8月  奈良県立医科大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:横浜  

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  • 脳動脈瘤の治療選択(教育講演) 招待

    菱川朋人、春間 純、平松匡文、杉生憲志、伊達 勲

    第45回日本脳卒中学会学術集会:STROKE 2020(Web開催)  2020年8月  杏林大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:口頭発表(基調)  

    開催地:横浜  

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  • 治療困難な大型血栓化動脈瘤に対する血管内治療戦略

    高橋 悠、杉生憲志、菱川朋人、平松匡文、村井 智、西 和彦、山岡陽子、伊達 勲

    第45回日本脳卒中学会学術集会:STROKE 2020(Web開催)  2020年8月  杏林大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:口頭発表(一般)  

    開催地:横浜  

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  • 慢性透析患者での左腕頭静脈狭窄が脳出血の原因であった1例

    春間 純、杉生憲志、菱川朋人、平松匡文、伊達 勲

    第45回日本脳卒中学会学術集会:STROKE 2020(Web開催)  2020年8月  杏林大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:ポスター発表  

    開催地:横浜  

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  • 脳動脈瘤の治療選択(教育講演) 招待

    菱川朋人、春間 純、平松匡文、杉生憲志、伊達 勲

    第45回日本脳卒中学会学術集会:STROKE 2020(Web開催)  2020年8月  杏林大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:口頭発表(基調)  

    開催地:横浜  

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  • くも膜下出血後の早期脳障害における皮質脱分極と細胞外グルタミン酸濃度の関係(シンポジウム)

    村井 智、菱川朋人、平松匡文、杉生憲志、武田吉正、森松博史、伊達 勲

    第36回スパズム・シンポジウム:STROKE 2020(Web開催)  2020年8月  三重大学 脳神経外科

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    開催年月日: 2020年8月23日

    記述言語:日本語   会議種別:シンポジウム・ワークショップ パネル(公募)  

    開催地:横浜  

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