Trends and Progress in Neuroendovascular Treatment in Japan: Japanese Registry of Neuroendovascular Therapy (JR-NET) 4. Main Report.

We reported the main results of the Japanese Registry of Neuroendovascular Therapy (JR-NET) 4, a nationwide surveillance of therapy (NET) in Japan from January 2015 to December 2019. JR-NET 4 registered consecutive patients who underwent NETs by Japan Society of Neuroendovascular Therapy (JSNET) -certified specialists. The primary endpoint was functional independence (mRS score of 0-2) at 30 days post-NET, with secondary endpoints focusing on technical success and major adverse events within 30 days.

Differences in mechanical thrombectomy for acute ischemic stroke on weekdays versus nights/ weekends in a Japanese primary stroke core center.

Objective: The term "weekend effect" refers to an increase in the mortality rate for hospitalizations occurring on weekends versus weekdays. In this study, we investigated whether such an effect exists in patients undergoing mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (currently the standard treatment for this condition) at a single center in Japan.

Methods: We surveyed 151 patients who underwent mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (75 and 76 patients were treated during daytime and nighttime, respectively) from January 2019 to June 2021.

Safety of Apixaban Monotherapy for Non-Valvular Atrial Fibrillation-Related Acute Stroke with Intra-/Extracranial Artery Stenosis.

Introduction: We investigated whether apixaban is safe for the prevention of further adverse events in non-valvular atrial fibrillation (NVAF) patients with intra-/extracranial artery stenosis (Stenosis group) compared with acute large vessel occlusion without intra-/extracranial artery stenosis (No stenosis group). We also examined whether combination therapy using apixaban and antiplatelet is safe.

Methods: ALVO (Apixaban on clinical outcome of patients with Large Vessel Occlusion [LVO] or stenosis) was a historical and prospective multicenter registry at 38 centers in Japan.

Reperfusion Therapy Brings Apixaban Administration Forward in Patients with Nonvalvular Arterial Fibrillation with Anterior Circulation Large Vessel Occlusion or Stenosis.

Objective: The initiation of anticoagulant administration after large vessel occlusion (LVO) or stenosis with nonvalvular arterial fibrillation (NAVF) is controversial. We evaluate the timing of anticoagulation and its relationship with clinical factors.

Methods: We enrolled 595 anterior circulation LVO or stenosis with NAVF cases from 38 stroke centers.

Endovascular Therapy for an Aneurysm of a Distal Posterior Inferior Cerebellar Artery via the Ipsilateral Persistent Primitive Proatlantal Artery: A Case Report.

Objective: We describe the rare case of a patient who was treated for a ruptured distal posterior inferior cerebellar artery (PICA) aneurysm via an ipsilateral persistent primitive proatlantal artery (PPPA).

Case Presentation: An 86-year-old female with a medical history of hypertension presented with headache and nausea. CT showed subarachnoid hemorrhage in the posterior cranial fossa, and CTA revealed an aneurysm at the left-side distal PICA.

Early rebleeding of a foramen magnum dural arteriovenous fistula: A case report and review of the literature.

Foramen magnum dural arteriovenous fistula (FM-DAVF) is a subset of craniocervical junction arteriovenous fistulas. We report a rare case of FM-DAVF with early rebleeding and review the literature. A 50-year-old man experienced 3 episodes of intracranial bleeding from a vessel malformation in the acute stage.

Effect of prior antiplatelet therapy on large vessel occlusion in patients with non-valvular atrial fibrillation newly initiated on apixaban.

Introduction: We evaluated the effect of prior antiplatelet therapy on large vessel occlusion (LVO) in patients with non-valvular atrial fibrillation (NVAF) newly initiated on apixaban.

Methods: Patients with acute LVO with acute stroke due to NVAF or stenosis with NVAF started on apixaban within 14 days of onset were enrolled. We compared incidence of major bleeding, cerebral hemorrhage, ischemic events, cerebral infarction, and all-cause mortality between patients with and without prior antiplatelet therapy for acute LVO.

Usefulness of three-dimensional fast imaging employing steady-state acquisition MRI of large vessel occlusion for detecting occluded middle cerebral artery and internal carotid artery before acute mechanical thrombectomy.

Objective: Acute mechanical thrombectomy (AMT) in patients with acute ischemic stroke from large vessel occlusion (LVO) is performed without directly identifying the occluded vessels. In this study, we evaluated whether 1.5 T magnetic resonance imaging (MRI) with 3D-fast imaging employing steady-state acquisition (FIESTA) could visualize the occluded intracranial middle cerebral artery (MCA) and internal carotid artery (ICA) before AMT.

Clinical Result of Mechanical Thrombectomy Using Sofia Plus with Acute Ischemic Stroke Compared with the Stent Retriever.

Objective: The Sofia catheter is a new large-bore aspiration catheter that allows easy access and good reperfusion. In this study, we analyzed the efficacy and safety of the Sofia catheter in comparison with stent retrievers as a contact aspiration thrombectomy (CAT) tool for large vessel occlusion.

Methods: We enrolled patients with acute ischemic stroke who underwent endovascular thrombectomy from April 2017 and April 2020 in our hospital.

Safety of Early Administration of Apixaban on Clinical Outcomes in Patients with Acute Large Vessel Occlusion.

Early administration of direct oral anticoagulants in patients with acute large vessel occlusion (LVO) and nonvalvular atrial fibrillation (NVAF) is a concern, as endovascular therapy (EVT) became highly utilized. We conducted a historical and prospective multicenter registry at 38 centers in Japan from July 2016 to February 2018. Patients aged ≥ 20 years with NVAF and acute LVO or stenosis who received apixaban within 14 days from onset were included.

Mechanical Thrombectomy for Large Vessel Occlusion via the Transbrachial Approach: Case Series.

Mechanical thrombectomy has become a standard treatment for acute ischemic stroke with large vessel occlusion. In aged patients, it is difficult to guide the catheter via the transfemoral approach due to vessel tortuosity and aortic elongation. We report our preliminary clinical experience using the transbrachial approach.

Parent Artery Occlusion for Treatment of a Traumatic Pericallosal Artery Aneurysm: Case Report and Review of the Literature.

Background: Traumatic intracranial aneurysms are rare complications after head trauma. This report describes the case of a patient with a traumatic pericallosal aneurysm.

Case Description: A 73-year-old man developed headache and lower limb paresis, and emergency computed tomography scan revealed a hematoma in the corpus callosum.

Clinical Outcomes of Mechanical Thrombectomy for Acute Ischemic Stroke in Transfer Cases.

Objective: There are regional disparities in endovascular thrombectomy, and problems with emergency transport systems and hospital collaboration when transferring need to be addressed. In this study, the clinical outcomes of endovascular thrombectomy for transferred patients were analyzed.

Methods: Acute ischemic stroke patients who underwent endovascular thrombectomy between January 2016 and March 2019 were enrolled.

Clinical Results of Mechanical Thrombectomy in Nonagenarians with Acute Ischemic Stroke.

Objective: Multiple randomized trials have demonstrated the efficacy of mechanical thrombectomy (MT), but very elderly patients aged ≥90 years were excluded. It remains uncertain whether endovascular therapy is effective for nonagenarians. The objective of this study was to investigate the effectiveness and safety of MT in nonagenarians.

[Comparison of Time-intensity Curve with Gadobenatedimeglumine and Gadobutrol on Multiphase Contrast-enhanced Breast MRI].

The purpose of this study was to compare the time-intensity curve (TIC) on multiphase contrast-enhanced breast magnetic resonance imaging (MRI) between Gadobenatedimeglumine (Gd-DTPA) and Gadobutrol. We assessed the images of 53 cases obtained from MRI that had malignant findings by pathology from October 2015 to October 2016 in our institute. Gd-DTPA and Gadobutrol were administrated in 16 and 37 cases, respectively.

[A Case of Moyamoya Disease with Postoperative Cerebral Hyperperfusion Syndrome Followed by Cerebral Infarction due to Watershed Shift].

The concept of "watershed shift"(WS)has been proposed as a cause of the ischemic complications following a superficial temporal artery-middle cerebral artery(STA-MCA)bypass operation performed for the management of moyamoya disease. Previous reports have observed that only 1.2-5.

A simulation study for estimating scatter fraction in whole-body F-FDG PET/CT.

Whereas Monte Carlo (MC) simulation is widely utilized in estimation of the scatter component, a simulation model which can calculate the scatter fraction (SF) of each patient is needed for making an accurate image quality assessment for clinical PET images based on the noise equivalent count. In this study, an MC simulation model was constructed which can calculate the SF for various phantoms. We utilized the Geant4 toolkit based on MC simulation to make a model of a PET scanner with a scatter phantom, and SFs calculated with this model were compared with the SF (SF: 44%) measured with use of an actual PET scanner.

[Variation in the quality of CT images of the upper abdomen when CT automatic exposure control is employed].

The aim of this study was to analyze the reason for variation of image quality in the upper abdomen CT with the use of CT-AEC. The CT investigated was 3D modulation in the 16MDCT and LSCT phantom was used to simulate the patient. When there was a phase difference, an image noise increase of around 15% at the maximum was accepted.