JNET最新文献_第3页

Endovascular Treatment for Craniofacial Arteriovenous Fistula/Malformation 颅面动静脉瘘/畸形的血管内治疗

JNET Pub Date : 2019-05-01 DOI: 10.5797/JNET.OA.2018-0089

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

{"title":"Endovascular Treatment for Craniofacial Arteriovenous Fistula/Malformation","authors":"K. Sugiu, T. Hishikawa, M. Hiramatsu, S. Nishihiro, N. Kidani, Yu Takahashi, S. Murai, I. Date","doi":"10.5797/JNET.OA.2018-0089","DOIUrl":"https://doi.org/10.5797/JNET.OA.2018-0089","url":null,"abstract":"Objective: To introduce our experience of endovascular treatment for craniofacial arteriovenous fistula/malformation (AVF/M). Methods: We retrospectively analyzed the medical records of 13 patients (7 females and 6 males) with craniofacial AVF/M who were treated between 2001 and 2017 in our institution. We classified into three categories including single AVF (sAVF), multiple AVF (mAVF), and arteriovenous malformation (AVM). Treatment plans included 1) curative embolization, 2) preoperative embolization, and 3) palliative embolization. These strategies were decided by the discussion with plastic surgeons in every individual case. Results: Complete cure by embolization alone was obtained in all six patients with sAVF, in two among three patients with mAVF, and in none among four patients with AVM. Curative embolization was aimed at in eight patients, and complete cure obtained in all eight patients. Preoperative embolization was aimed at in three patients, and three patients resulted in total resection by surgery after successful partial embolization. Palliative embolization was aimed at in two patients, and these patients were kept in a stable condition after partial embolization. No permanent complications related to embolization were counted. Conclusion: Endovascular treatment for craniofacial AVF/M is safe and effective treatment, especially in the case with sAVF.","PeriodicalId":34768,"journal":{"name":"JNET","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5797/JNET.OA.2018-0089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43353564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

A Case Report of Re-occlusion after Mechanical Thrombectomy to the Patient with Protein C Deficiency-associated Cerebral Infarction 机械性血栓切除术后再闭塞治疗蛋白C缺乏相关脑梗死1例报告

JNET Pub Date : 2019-04-26 DOI: 10.5797/JNET.CR.2018-0071

Soichiro Numa, Toshinori Takagi, S. Ono, Kyohei Fujita, Masatomo Miura, S. Yoshimura

{"title":"A Case Report of Re-occlusion after Mechanical Thrombectomy to the Patient with Protein C Deficiency-associated Cerebral Infarction","authors":"Soichiro Numa, Toshinori Takagi, S. Ono, Kyohei Fujita, Masatomo Miura, S. Yoshimura","doi":"10.5797/JNET.CR.2018-0071","DOIUrl":"https://doi.org/10.5797/JNET.CR.2018-0071","url":null,"abstract":"Objective: We encountered the case of re-occlusion occurred within a short time after thrombectomy to the patient with acute cerebral embolism complicated by protein C deficiency. We have reported this case as its clinical presentation is rare and important for considering a treatment strategy for young adult-onset cerebral embolism in the future. Case Presentation: A 34-year-old male developed dysarthria, aphasia, and right hemiparesis and was diagnosed with cerebral infarction caused by left M1 occlusion. Mechanical thrombectomy was performed and achieved recanalization, but the same region was re-occluded after 7 hours and thrombectomy was repeated. The patient was diagnosed with protein C deficiency based on the blood test findings. Re-occlusion was considered due to epithelial damage by a stent retriever and a hypercoagulable state induced by protein C deficiency. Conclusion: Since young adult-onset cerebral embolism may be complicated by underlying disease, such as coagulopathy like this patient, the possibility of re-obstruction induced by epithelial damage should be considered.","PeriodicalId":34768,"journal":{"name":"JNET","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5797/JNET.CR.2018-0071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43324137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Late Embolism Following Recanalization of Occluded Extracranial Internal Carotid Artery Dissection 闭塞的颅外颈内动脉夹层再通术后晚期栓塞

JNET Pub Date : 2019-04-01 DOI: 10.5797/JNET.TN.2018-0136

R. Kimura, Kenji Fukutome, K. Fujimoto, Y. Okumura, I. Nakagawa, H. Nakase

{"title":"Late Embolism Following Recanalization of Occluded Extracranial Internal Carotid Artery Dissection","authors":"R. Kimura, Kenji Fukutome, K. Fujimoto, Y. Okumura, I. Nakagawa, H. Nakase","doi":"10.5797/JNET.TN.2018-0136","DOIUrl":"https://doi.org/10.5797/JNET.TN.2018-0136","url":null,"abstract":"Objective: The clinical course of extracranial internal carotid artery dissection (eICAD) treated with medical therapy alone is usually benign, but late embolism may cause intracranial large artery occlusion (iLAO). We report a new procedure to treat iLAO caused by eICAD. Case Presentation: A 47-year-old man patient presented with two episodes of transient right hemiparesis and mild neck pain. An emergent MRI detected a left internal carotid artery (ICA) occlusion but no new infarction. Because it was strongly suspected that eICAD was the cause, medical therapy was started, and the patient’s neurological condition was frequently checked to ensure prompt response if a late embolism developed. One day after onset, a follow-up MRI revealed recanalization of the ICA occlusion and eICAD without a new infarction. Unfortunately, a late embolism of the left middle cerebral artery occurred 2 days after onset. We started intravenous tissue plasminogen activator administration immediately after a CT scan. We performed a mechanical thrombectomy (MT), resulting in thrombolysis in cerebral infarction (TICI) score of 3. Subsequently, we performed carotid artery stenting (CAS) for eICAD. Ten days after the stroke, the patient’s National Institutes of Health Stroke Scale (NIHSS) score was 2. Conclusion: When treating iLAO due to eICAD by MT and CAS, further vascular injury and intracranial embolism must be prevented. We used proximal and distal protection in combination, employing an aspiration catheter to withdraw the stent retriever and deliver a distal embolic protection device before CAS. As a result, the patient’s condition improved.","PeriodicalId":34768,"journal":{"name":"JNET","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5797/JNET.TN.2018-0136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43736185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Enlargement of Asymptomatic VA Dissecting Aneurysm after Initial Treatment with Stent-assisted Coil Embolization with Contra Lateral Ruptured VA Dissecting Aneurysm Treated by Parent Artery Occlusion: A Case Report 支架辅助螺旋栓塞治疗对侧破裂VA夹层动脉瘤经母动脉闭塞治疗后无症状VA夹层动脉瘤扩大1例

JNET Pub Date : 2019-03-29 DOI: 10.5797/JNET.CR.2018-0126

Karim Gaber, M. Ezura, A. Narisawa, Yusuke Takahashi, Takashi Inoue, H. Uenohara

引用次数: 1

A Ruptured Large Thrombosed True Posterior Communicating Artery Aneurysm Treated with Endovascular Treatment Three Times 血管内治疗三次治疗破裂的大面积血栓性真后交通动脉瘤

JNET Pub Date : 2019-03-28 DOI: 10.5797/JNET.CR.2018-0139

S. Kawada, K. Sugiu

{"title":"A Ruptured Large Thrombosed True Posterior Communicating Artery Aneurysm Treated with Endovascular Treatment Three Times","authors":"S. Kawada, K. Sugiu","doi":"10.5797/JNET.CR.2018-0139","DOIUrl":"https://doi.org/10.5797/JNET.CR.2018-0139","url":null,"abstract":"Objective: We report a case of ruptured large thrombosed true posterior communicating artery (PCoA) aneurysm and consider its treatment. Case Presentation: A 71-year-old male patient had a left ruptured large thrombosed true PCoA aneurysm (maximum diameter 23 mm) with a small neck. Intra-aneurysmal coil embolization via the internal carotid artery was performed to preserve the premammillary artery (PMA). The adjunctive technique could not be used because the diameter of the PCoA was 1.5 mm. The result was a neck remnant and the aneurysm was recanalized. After 14 months, similar treatment was performed, and the aneurysm was recanalized again. The acute and twisted angle of the PCoA origin and the thinness of the PCoA were considered as factors for incomplete embolization. Because the distance between the origin of the PMA and aneurysmal neck was 5 mm, short-segment internal trapping of the aneurysm was performed 13 months after the second embolization. As a result, the PMA was no longer visualized on DSA; however, he had no neurologic deficit. The aneurysm remained obliterated after 7 months. Conclusion: Making a tight intra-aneurysmal coil embolization of a large thrombosed true PCoA aneurysm is difficult. If there is a certain distance between the PMA and the aneurysm neck, short-segment internal trapping might be useful to treat it.","PeriodicalId":34768,"journal":{"name":"JNET","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42883437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

A Parameter to Identify Thin-walled Regions in Aneurysms by CFD CFD识别动脉瘤薄壁区的一个参数

JNET Pub Date : 2019-03-19 DOI: 10.5797/JNET.OA.2018-0095

Kazutoshi Tanaka, H. Takao, Tomoaki Suzuki, S. Fujimura, Takashi Suzuki, Y. Uchiyama, H. Ono, K. Otani, Hiroaki Ishibashi, M. Yamamoto, Y. Murayama

{"title":"A Parameter to Identify Thin-walled Regions in Aneurysms by CFD","authors":"Kazutoshi Tanaka, H. Takao, Tomoaki Suzuki, S. Fujimura, Takashi Suzuki, Y. Uchiyama, H. Ono, K. Otani, Hiroaki Ishibashi, M. Yamamoto, Y. Murayama","doi":"10.5797/JNET.OA.2018-0095","DOIUrl":"https://doi.org/10.5797/JNET.OA.2018-0095","url":null,"abstract":"Objective: Thin-walled regions of cerebral aneurysms are areas of risk for rupture, particularly during surgical procedures. Prediction of thin-walled regions before surgery can lead to safer treatment, avoiding interactions with thinwalled regions. It is considered that blood flow influences aneurysm wall thickness reduction. The objective of this study was to establish a parameter to accurately identify thin-walled regions using computational fluid dynamics (CFD) analysis. Methods: The surgical field was photographed during craniotomy in 50 patients with unruptured middle cerebral artery aneurysms and red regions of the aneurysm wall were compared with the color of the parent vessel and defined as a thin-walled region. CFD analysis was performed and the distribution map of wall shear stress divergence (WSSD*) was compared to the surgical image of the cerebral aneurysms. Results: The WSSDmax region and thin-walled region were coinciding in 41 (82.0%) of the 50 patients. There was a significant difference (P = 0.00022) between the patients with and without coincidence between the WSSDmax and thinwalled regions, and the threshold, sensitivity, specificity, and area under the curve (AUC) on receiver operating characteristic (ROC) analysis of WSSDmax were 0.230, 0.900, 0.875, and 0.883, respectively. Conclusion: High-WSSD regions tended to be coinciding with thin-walled regions, suggesting that WSSDmax is useful to identify thin-walled regions of cerebral aneurysms.","PeriodicalId":34768,"journal":{"name":"JNET","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5797/JNET.OA.2018-0095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43009314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Simultaneous Approach to Tandem Occlusion in Acute Ischemic Stroke Patients: Percutaneous Transluminal Angioplasty (PTA) Using Push Wire of Stent Retriever 同时入路治疗急性缺血性卒中患者串联闭塞:使用支架回收器推丝经皮腔内血管成形术(PTA)

JNET Pub Date : 2019-03-01 DOI: 10.5797/JNET.CR.2018-0108

N. Yamamoto, Yuki Yamamoto, M. Korai, Kenji Shimada, Y. Kanematsu, Y. Izumi, J. Satomi, Y. Takagi, R. Kaji

{"title":"Simultaneous Approach to Tandem Occlusion in Acute Ischemic Stroke Patients: Percutaneous Transluminal Angioplasty (PTA) Using Push Wire of Stent Retriever","authors":"N. Yamamoto, Yuki Yamamoto, M. Korai, Kenji Shimada, Y. Kanematsu, Y. Izumi, J. Satomi, Y. Takagi, R. Kaji","doi":"10.5797/JNET.CR.2018-0108","DOIUrl":"https://doi.org/10.5797/JNET.CR.2018-0108","url":null,"abstract":"Objective: For patients with tandem occlusion (TO), it is controversial whether an antegrade approach or retrograde approach should be undertaken. Here, we report our strategy for treating patients with TO by simultaneous approach. First, a microcatheter was advanced to the distal occlusion site along with a microwire. Second, a stent retriever (SR) was deployed as an anchor at the distal lesion, and percutaneous transluminal angioplasty (PTA) was performed at the proximal lesion using push wire of SR. After that, the microwire was removed and PTA balloon as well as the guiding catheter (GC) was advanced along the wire of SR. Finally, the SR was withdrawn with clot. Case Presentations: Cases 1 and 2, who were confi rmed as TO, were treated by the method described above. We could re-perfuse successfully. These two cases had favorable outcomes, indicating a modifi ed Rankin scale 2 at the time of discharge. Conclusion: Our therapeutic strategy for TO might be useful for early reperfusion of a distal occlusion site and associated with favorable outcome.","PeriodicalId":34768,"journal":{"name":"JNET","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41720391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

A Patient with Spinal Epidural Arteriovenous Fistula Cured by Balloon-assisted Transarterial Embolization under Flow Control 球囊辅助经动脉栓塞术治疗脊髓硬膜外动静脉瘘1例

JNET Pub Date : 2019-02-21 DOI: 10.5797/JNET.CR.2018-0122

Atsushi Uyama, A. Fujita, Y. Takaishi, T. Kondo, Atsushi Arai, M. Okada, Daigo Fujiwara, E. Kohmura

引用次数: 1

A Case of Cavernous Sinus Dural Arteriovenous Fistula Presenting with Medulla Oblongata Dysfunction in Parallel to Thrombosis of a Varix on a Drainage Route after Transvenous Embolization 一例海绵窦硬脑膜动静脉瘘经静脉栓塞后并发延髓功能障碍伴静脉曲张血栓形成的病例

JNET Pub Date : 2019-02-20 DOI: 10.5797/JNET.CR.2018-0096

Shinya Sonobe, M. Ezura, Kazuhiko Sato, H. Uenohara, T. Tominaga

引用次数: 0

A Patient with Encephalopathy Following Coil Embolization of Cerebral Aneurysm and Extracranial Stent Placement 脑动脉瘤线圈栓塞及颅外支架置入术后脑病1例

JNET Pub Date : 2019-02-07 DOI: 10.5797/JNET.CR.2018-0083

Y. Sagara, H. Kiyosue, M. Okahara, M. Oga, A. Kaga, Yosuke Kamenofuchi

引用次数: 0