A5028498154- Intracranial Aneurysms: Treatment and Complications
- Vascular Malformations Diagnosis and Treatment
- Acute Ischemic Stroke Management
- Venous Thromboembolism Diagnosis and Management
- Cerebrovascular and Carotid Artery Diseases
- Traumatic Brain Injury and Neurovascular Disturbances
- Neurosurgical Procedures and Complications
- Vascular Procedures and Complications
- Aortic Disease and Treatment Approaches
- Moyamoya disease diagnosis and treatment
- Trigeminal Neuralgia and Treatments
- Spinal Fractures and Fixation Techniques
- Infective Endocarditis Diagnosis and Management
- Intracerebral and Subarachnoid Hemorrhage Research
- Central Venous Catheters and Hemodialysis
- Cerebrospinal fluid and hydrocephalus
- Aortic aneurysm repair treatments
- Meningioma and schwannoma management
- Cervical and Thoracic Myelopathy
- Inflammatory Biomarkers in Disease Prognosis
- Cutaneous Melanoma Detection and Management
- Cardiac tumors and thrombi
- Brain Tumor Detection and Classification
- Stroke Rehabilitation and Recovery
- Vascular anomalies and interventions
Kurashiki Central Hospital
2017-2025
Kitano Hospital
2023
Stony Brook University
2022
Neurological Surgery
2022
Shinshu University
2022
OBJECTIVE Aneurysmal subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality rates. In particular, functional outcomes of SAH caused by large or giant (≥ 10 mm) ruptured intracranial aneurysms are worsened procedure-related complication However, studies describing the risk factors for poor specific to large/giant sparse. addition, recurrence rebleeding rates following treatment such remain a concern. This study aimed clarify short-term long-term durability due using...
Eagle syndrome is characterized by an elongated styloid process causing mechanical stress on the internal carotid artery (ICA). The authors present case of a patient who had cervical ICA dissection with nonelongated process. A 43-year-old man presented left hemiparesis and hemispatial neglect. underwent endovascular treatment for tandem occlusion M1 segment right middle cerebral ICA. After thrombectomy, stenting was performed. Notably, tip matched caudal end cavity, which located lateral...
OBJECTIVE Delayed cerebral ischemia (DCI) is an important complication after aneurysmal subarachnoid hemorrhage (aSAH). Although intrathecal milrinone injection via lumbar catheter to prevent DCI has been previously reported be safe and feasible, its effectiveness remains unknown. The goal of this study was evaluate whether treatment aSAH significantly reduced the incidence DCI. METHODS prospectively maintained database used identify patients treated between January 2010 December 2015....
Objectives Thrombi in cerebral large vessel occlusion associated with active cancer are often fibrin and platelet-rich white thrombi. However, evaluating the thrombus composition a short time before thrombectomy is ineffective. We sought to determine factors related thrombi acute ischemic stroke due patients. Methods Consecutive patients undergoing for between January 2018 May 2022 were retrospectively reviewed. The classified into red groups on basis of pathological findings retrieved...
An 80-year-old woman presented with impaired consciousness after malignant melanoma resection. Magnetic resonance angiography showed basilar artery occlusion, which was subjected to mechanical thrombectomy for recanalization. A pathological analysis of the retrieved embolus revealed that it derived from a metastasis melanoma. Contrast-enhanced chest computed tomography multiple pulmonary metastases, one in right upper lobe and invaded vein. To our knowledge, this is first case white...
BACKGROUND Infectious aneurysms very rarely occur in the cavernous carotid artery. Recently, treatment by flow diverter implantation with preservation of parent artery has been choice. OBSERVATIONS A 64-year-old woman presented stenosis at C5 segment left internal (ICA), followed ocular symptoms within 2 weeks, a de novo aneurysm and wall irregularity from C2 to segments ICA. Antimicrobial therapy was given for 6 Pipeline Flex Shield implanted. Angiography months after showed complete...
The differences in clinical outcomes between endovascular coiling (EC) and surgical clipping (SC) patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) are controversial. Therefore, this study aimed to evaluate whether EC is superior SC identify risk factors aSAH.We used data from the "Predict for Outcome Study of SubArachnoid Hemorrhage." World Federation Neurological Societies (WFNS) grade III-V aSAH was defined as aSAH, unfavorable (modified Rankin Scale scores 3-6) were...
Background: There is no established opinion regarding embolization of asymptomatic traumatic vertebral artery injuries that do not require cervical spine repair and fixation. Case Description: A 78-year-old man fell backward from a height about 1 m was rushed to his previous hospital. He had fracture the left transverse process 6 th vertebra. Six hours after trauma, he became unconscious; magnetic resonance angiography showed occlusion basilar arteries, transferred our The completely...
BACKGROUND Calcified cerebral embolism has been reported as a cause of acute infarction, but an aortogenic origin rarely identified the embolic source. The authors describe case calcified in patient with other sources. OBSERVATIONS In infarction and atrial fibrillation, white hard embolus was retrieved by mechanical thrombectomy. Pathological analysis revealed that it mostly calcified, some foam cells giant cells. macroscopic pathological findings allowed to finally diagnose embolism....
In cerebral large vessel occlusion, even when an aneurysm is close to the target vessel, if relatively small and angiography shows no thrombus within aneurysm, it difficult identify as embolic source.
BACKGROUND Congenital external carotid–jugular arteriovenous fistulas (AVFs) are often diagnosed based on a pulsatile neck mass. Patients rarely complain of headaches or pain. OBSERVATIONS A 45-year-old woman with no history trauma had been congenital cervical carotid AVF 10 years earlier. At that time, only mass in the right observed, and she managed conservatively. Over next years, enlarged, started experiencing unbearable pain when turned her head. Angiography images showed outflow veins,...
Background: There is no established treatment strategy for traumatic vertebral artery occlusion that does not require cervical spine repair surgery. Case Description: A 49-year-old man was brought to our hospital with traffic trauma. Fractures were observed in the left lateral mass and transverse process of Atlas occluded at level foramen transversum Atlas. No acute cerebral infarction observed. Because spinal cord compressed by fracture, surgery performed. Continuous intravenous heparin...
Background There is no consensus as to whether balloon angioplasty alone or stent placement effective for sinus occlusion associated with dural arteriovenous fistula (DAVF). Herein, we first report a case of transverse DAVF in which gradual dilatation was observed after embolization the affected shunt flow. Case presentation A 69-year-old man presented executive dysfunction. Magnetic resonance imaging revealed left sinus–sigmoid jugular vein and right sinus. Before endovascular treatment,...
Anticoagulation and endovascular therapy are commonly used treatment methods for blunt cerebrovascular injury (BCVI). However, in certain cases, the perforating objects damaging blood vessels need to be removed. In such stenting coil embolization have been reported useful. Furthermore, we believe that distal can arrest bleeding at perforation site when using treatments. support of this procedure, report a case successful BCVI through contralateral side proximal protection.A 61-year-old man...
Objective: Injury to the inferior epigastric artery (IEA) caused by femoral puncture may lead retroperitoneal hematoma. We report on two cases of IEA injury due venipuncture for neuroendovascular intervention that resulted in hemorrhagic shock and required transcatheter arterial embolization.
We report a case of intraprocedural aneurysm rupture during coil embolization caused by delivery wire. A 68-year-old woman underwent stent-assisted for an unruptured in the internal carotid artery (ICA). low profile visible intraluminal support device was deployed at neck. Coil performed with jailing technique. After deflection jailed microcatheter released, placed against resistance to insertion. The movement tip restricted stent. wire that advanced after detachment perforated aneurysm....
In rare cases, septic embolism is diagnosed on the basis of pathological findings retrieved thrombi. Infected aneurysms can rapidly form and rupture after embolism, leading to a poor prognosis. We report case subcortical hemorrhage due an infected aneurysm forming shortly in left anterior cerebral artery.In this case, diagnosis was made thrombus from simultaneously occluded middle artery, endovascular embolization performed.The were useful for making embolism. The possibility short-term...
Low-profile visualized intraluminal support deployment in an Enterprise has been reported; however, that Atlas yet to be detail. a closed-cell design, while open-cell design. We detail here case of large wide-necked aneurysm treated by coil embolization with low-profile Blue within Neuroform and bench-top experiment using silicon tube test support, Atlas, Enterprise, their combinations. A better expansion was achieved simultaneously pushing the wire system placed at neck, which resulted...
77歳女性で感染性心内膜炎の既往がある脳梗塞患者において，血栓回収療法後に頭部CTで閉塞部遠位側の末梢性動脈瘤周囲に高吸収域を認めた．脳梗塞発症時には，敗血症性塞栓が鑑別診断に挙がっており，感染性動脈瘤の破裂を疑いコイル塞栓術を行ったが，最終的に感染性心内膜炎に合併した既存の動脈瘤からの過去の敗血症性塞栓による，動脈瘤と癒着した周囲組織への造影剤漏出と判断した．血栓回収療法後に発生した，末梢性動脈瘤周囲の造影剤漏出には，閉塞部遠位側でのマイクロカテーテルからの造影剤の注入，脳虚血，脳血管内の造影剤停滞，動脈瘤壁の造影剤透過性が関与している可能性がある．造影剤使用により，末梢性動脈瘤周囲が頭部CTで高吸収域に描出される可能性があるため，臨床経過と過去の画像とdual energy CTの所見を基に，動脈瘤塞栓術の必要性について慎重に判断すべきであると考えられる．
43歳女性．仕事で当院を訪問中に心室細動により心肺停止となったが，直流除細動器により自己心拍は再開した．左室駆出率が30%へと低下していたが，冠動脈に有意狭窄を認めなかった．重度の左室低心機能と急性心不全に対して，右大腿動脈経由で胸部下行大動脈に大動脈内バルーンポンプ（IABP）が挿入されて，補助循環が開始された．頭部CTで破裂脳動脈瘤による重症SAHと診断し，たこつぼ型心筋症に伴う心機能低下と判断した．IABP駆動により循環動態は安定化しており，脳室ドレーンを挿入し，右上腕動脈アプローチでコイル塞栓術を行った．経時的に心機能の改善を認め，第3病日にIABPを抜去し，良好な転帰が得られた．重症SAHで循環動態安定化のためのIABP駆動中であっても，初回CTで致命的な脳損傷がなければ，早期の頭蓋内圧管理と再破裂予防の動脈瘤治療が良好な転帰につながるかもしれない．
Objective Pseudoaneurysms are a serious complication of neuroendovascular therapy with femoral artery puncture, for which ultrasound-guided compression repair (UGCR) is often the first choice radical therapy. We sought to retrospectively investigate factors failure UGCR pseudoaneurysm at puncture site. Methods Among patients undergoing our hospital between January 2018 and April 2021, those who received diagnosis underwent were enrolled. They classified into two groups according whether was...