Publications by authors named "Hiroto Yamaoka"
Article Synopsis
- * Analyzing video footage from 25 patients, researchers found that successful recanalization occurred in 72% of cases, with a significant difference in vessel deviation ratios between successful and unsuccessful attempts.
- * The results indicated that minimizing vessel deviation during the procedure improves recanalization success, and positioning the aspiration catheter tip closer to M2 can help achieve better outcomes.
Article Synopsis
- - The study aimed to establish a method for predicting vascular access difficulty during mechanical thrombectomy by using a specific measurement called the distance from the sternum to the ascending aorta (S-AAD) from chest CT scans.
- - Researchers analyzed data from 115 patients who underwent mechanical thrombectomy and found that a shorter S-AAD was significantly correlated with longer guiding times, indicating access difficulty.
- - The findings suggest that a S-AAD of less than 5 mm is a strong predictor of challenging access, which can help clinicians choose better devices and approaches before the intervention.
Article Synopsis
- This study investigates the effectiveness of first-line contact aspiration compared to other treatment strategies for basilar artery occlusion in endovascular thrombectomy.
- A total of 84 patients from 16 Japanese stroke centers were analyzed, with findings showing no significant differences in recanalization rates but indicating contact aspiration led to faster results.
- The results suggest that while contact aspiration gives better functional outcomes, the main advantage is a significantly shorter time from puncture to successful recanalization.
Objective: In aneurysm clipping, the use of an endoscope improves the visualization of the anatomic structures around the aneurysm, allowing for improved dissection and clipping techniques. Furthermore, it makes the surgery less invasive. The disadvantage of using the endoscope and microscope together is that the surgeon must move the line of sight significantly between viewing the operative field through the eyepiece of the microscope and viewing the endoscope monitor.
View Article and Find Full Text PDFBackground: Adequate epidural procedures and anatomical knowledge are essential for the technical success of skull base surgery. We evaluated the usefulness of our three-dimensional (3D) model of the anterior and middle cranial fossa as a learning tool in improving knowledge of anatomy and surgical approaches, including skull base drilling and dura matter peeling techniques.
Methods: Using a 3D printer, a bone model of the anterior and middle cranial fossa was created based on multi-detector row computed tomography data, incorporating artificial cranial nerves, blood vessels, and dura mater.
Article Synopsis
- The study aimed to determine how the location of brain infarcts, measured by the posterior circulation Alberta Stroke Program Early Computed Tomographic Score (pc-ASPECTS), affects patient outcomes after endovascular therapy for basilar artery occlusion.
- Among 100 participants, 51% achieved favorable outcomes, with younger age, lower pre-treatment stroke severity, and higher pc-ASPECTS scores linked to better recovery.
- The research concluded that higher pc-ASPECTS scores are predictive of better outcomes, while bilateral cerebellar infarction is associated with poorer recovery chances.
P2Y12 reaction units and ischemic and bleeding events after neuro-endovascular treatment.
J Stroke Cerebrovasc Dis
September 2022
Background And Purpose: To investigate the associations of perioperative P2Y12 reaction units (PRU) measured using VerifyNow with ischemic and bleeding events, and to determine the PRU threshold in the setting of elective neuro-endovascular treatment (EVT) for intracranial/extracranial vascular disease in patients taking aspirin and clopidogrel.
Methods: Of the patients undergoing elective neuro-EVT while taking aspirin and clopidogrel, those taking both antiplatelet agents for 7 days or more and whose PRU and aspirin reaction units (ARU) were measured were included. The primary and safety outcomes were defined as symptomatic ischemic and major bleeding events within 30 days after EVT.
Background: Postoperative cerebral embolic stroke is a serious complication of pulmonary lobectomy, occurring in 1.1% of patients undergoing lobectomy through video-assisted thoracoscopic surgery (VATS). The mechanism of this complication is thought to be embolic stroke caused by thrombus formed due to stagnation in the pulmonary vein stump after VATS lobectomy.
View Article and Find Full Text PDFObjective: There are few detailed reports on abducens nerve palsy due to a ruptured vertebral artery dissecting aneurysm (VADA). We investigated the clinical characteristics and long-term course of abducens nerve palsy in ruptured VADA patients treated by endovascular surgery.
Methods: Of the 51 cases of ruptured VADA treated by endovascular intervention from 2011 to 2019, 31 with a good/fair outcome, in which ocular motility disorder was able to be followed, were included and investigated.
In-stent stenosis (ISS) triggered by a metal-induced allergic reaction of Pipeline embolization device (PED) placement is extremely rare. The present report describes a patient who presented with delayed parent artery occlusion and refractory ISS after PED placement due to cobalt allergy. A patient in her 70s underwent PED placement for a right internal carotid artery (ICA) large aneurysm; 4 months later, the patient presented with left-sided hemiparesis, and MRI revealed right ICA occlusion even though antiplatelet therapy was optimal.
View Article and Find Full Text PDFObjective: The present study investigated changes in the management of acute stroke patients between before and during the coronavirus disease 2019 (COVID-19) pandemic in several countries using a questionnaire.
Methods: A questionnaire survey was conducted at 23 stroke centers in 20 countries to examine how stroke management systems have changed from 2019 (before the COVID-19 pandemic) to 2020 (during the COVID-19 pandemic).
Results: Questionnaire responses were obtained from 14 stroke centers (61%) in 14 countries.
Objective: To examine the effectiveness of a newly developed emergency room (ER) protocol to treat patients with stroke and control the spread of SARS-CoV-2 by evaluating the door-to-picture time.
Methods: We retrospectively enrolled 126 patients who were transported to our ER by ambulance with suspected stroke between April 15 and October 31, 2020 (study group). A risk judgment system named the COVID level was introduced to classify the risk of infection as follows: level 0, no infection; I, infection unlikely; II, possible; III, probable; and IV, definite.