研究者詳細 - 杉生　憲志

論文 - 杉生　憲志

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結節性硬化症に合併した海綿静脈洞部巨大内頸動脈瘤に対してflow diverter stentを留置した一例

川上真人, 平松匡文, 杉生憲志, 菱川朋人, 木谷尚哉, 高橋悠, 村井智, 西和彦, 山岡陽子, 伊達勲

脳血管内治療 4 ( Suppl. ) S350 - S350 2019年11月

多発脊髄硬膜動静脈瘻診断にfusion imagingが有用であった1例

胡谷侑貴, 平松匡文, 杉生憲志, 菱川朋人, 木谷尚哉, 高橋悠, 村井智, 西和彦, 山岡陽子, 伊達勲

脳血管内治療 4 ( Suppl. ) S368 - S368 2019年11月

上腕動脈アプローチによる頸動脈ステント留置術の治療成績

西和彦, 杉生憲志, 菱川朋人, 平松匡文, 木谷尚哉, 高橋悠, 村井智, 山岡陽子, 伊達勲

脳血管内治療 4 ( Suppl. ) S234 - S234 2019年11月

内頸動脈結紮術後に再増大した海綿静脈洞部内頸動脈瘤に対し、後交通動脈経由でinternal trappingを行った1例

菅原千明, 平松匡文, 杉生憲志, 菱川朋人, 木谷尚哉, 高橋悠, 村井智, 西和彦, 山岡陽子, 伊達勲

脳血管内治療 4 ( Suppl. ) S271 - S271 2019年11月

内頸動脈-眼動脈分岐部周辺の動脈瘤に対する眼動脈の側副血行評価

山岡陽子, 平松匡文, 杉生憲志, 菱川朋人, 木谷尚哉, 高橋悠, 村井智, 西和彦, 伊達勲

脳血管内治療 4 ( Suppl. ) S207 - S207 2019年11月

頭蓋底腫瘍に対する術前塞栓術の治療成績

菱川朋人, 村井智, 山岡陽子, 西和彦, 高橋悠, 木谷尚哉, 平松匡文, 杉生憲志, 伊達勲

脳血管内治療 4 ( Suppl. ) S227 - S227 2019年11月

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, 高橋悠, 木谷尚哉, 菱川朋人, 安原隆雄, 杉生憲志, 伊達勲

脳血管内治療 4 ( Suppl. ) S161 - S161 2019年11月

Flow diverter時代における75歳以上の内頸動脈海綿静脈洞部未破裂脳動脈瘤に対する治療成績

高橋悠, 杉生憲志, 菱川朋人, 平松匡文, 木谷尚哉, 村井智, 西和彦, 山岡陽子

脳血管内治療 4 ( Suppl. ) S94 - S94 2019年11月

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

当院における脳主幹動脈閉塞に対する急性期血栓回収療法の取り組み

藤原賢次郎, 服部靖彦, 吉本祐介, 高橋悠, 村井智, 木谷尚哉, 杉生憲志

広島医学 72 ( 9 ) 425 - 425 2019年9月

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

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

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：(株)メディカ出版

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

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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=J03120&link_issn=&doc_id=20190703140011&doc_link_id=issn%3D0917-1495%26volume%3D29%26issue%3D7%26spage%3D762&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0917-1495%26volume%3D29%26issue%3D7%26spage%3D762&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

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

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：(一社)日本脳卒中の外科学会

当院でIC-PC AN(未破裂内頸動脈後交通動脈分岐部瘤)に対し初回塞栓術を行った42例を対象に、後交通動脈(Pcom A)の発達程度に基づきfetal type(F群)17例、adult type(A群)9例、hypoplastic type(H群)16例に分け、検討した。その結果、再発率はF群18%、A群11%、H群19%で、再治療率はF群6%、A群0%、H群13%であった。再発に関わる因子を検討すると、単変量解析では7mm以上の最大径と高難度瘤で有意差を認めたが、Pcom Aの有無では有意差を認められなかった。今回の検討から、Pcom Aが描出される症例でPcom Aの温存を重視してコイル塞栓術を行っても再発や再治療には影響しないことが判明した。

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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

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

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

【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

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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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

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.

DOI： 10.2176/nmc.st.2018-0220

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脊髄血管奇形の新知見脊髄硬膜・硬膜外動静脈瘻と脳神経外科救急

安原隆雄, 平松匡文, 菱川朋人, 守本純, 杉生憲志, 伊達勲

Neurosurgical Emergency 23 ( 3 ) 247 - 247 2019年2月

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

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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