Clinical Outcomes of Shifting from Transfemoral-First to Transradial-First Approach in Carotid Artery Stenting: A Retrospective Two-Timeframe Comparison at a Single Center.

Carotid artery stenting (CAS) has traditionally been performed using the transfemoral approach (TFA). Recently, the transradial approach (TRA) has gained attention for its lower invasiveness and reduced complication risk. This study compares outcomes between two access strategy timeframes, TFA-first and TRA-first, to evaluate how this shift influences outcomes in a real-world setting.

Association between Hospital-acquired Disability and Clinical Outcomes in Older Patients Who Underwent Cardiac Surgical.

Objective: This study aimed to clarify the association between hospital-acquired disability (HAD) and prognosis in older patients who underwent cardiac surgery.

Methods: This single-center, retrospective, observational study included 141 patients aged ≥65 years who underwent cardiac surgery at our hospital from November 2016 to August 2021. The primary endpoint of this study was the occurrence of major adverse cardiac and cerebrovascular events (MACCEs) within 2 years of hospital discharge.

Stent assisted coil embolization for a dissecting cerebral aneurysm of middle cerebral artery: A case report and the literature review.

Background: Dissecting aneurysms of the middle cerebral artery (MCA) are very rare. We herein report a case of an unruptured dissecting aneurysm of the MCA treated by stent-assisted coil embolization.

Case Description: A 65-year-old man with no history of trauma presented with a headache.

Durability of Bioprosthetic Valves in Patients on Dialysis.

Purpose: This study focused on clarifying the durability of bioprosthetic valves in current practice.

Methods: A total of 238 consecutive patients who underwent aortic valve replacement at a single institution from 2011 to 2020 were reviewed. We evaluated valve-related outcomes such as structural valve deterioration (SVD), especially in dialysis patients who received bioprosthetic valve.

Mural vegetation in left ventricular apex caused by Staphylococcus aureus.

A 77-year-old male on chronic haemodialysis was admitted for repeated episodes of stroke and a high fever. The patient's blood culture was positive for Staphylococcus aureus and echocardiogram results revealed moderate mitral valve regurgitation, small masses in the left atrial appendage and a 20-mm mobile, spherical structure attached to the apical cavity of the left ventricle. Surgery was conducted to successfully excise these masses and pathological investigation confirmed the diagnosis of infective endocarditis.

Endovascular Internal Trapping by Low-Concentration N-butyl-2-Cyanoacrylate for a Ruptured Giant Common Carotid Artery Pseudoaneurysm.

Treating carotid blowout syndrome following rupture of giant pseudoaneurysms is difficult because the destroyed parent artery precludes conventional treatment. We present a patient with a ruptured giant pseudoaneurysm that we occluded using a modified internal trapping technique with low-concentration N-butyl-2-cyanoacrylate (NBCA) and a minimum number of coils. An 80-year-old man with a history of chemoradiation therapy for oropharyngeal cancer presented with several episodes of active bleeding from the subsequent tracheostomy site.

Delayed Rebleeding from Pseudoaneurysm After Mechanical Thrombectomy Using Stent Retriever Due to Small Artery Avulsion Confirmed by Open Surgery.

Background: Pseudoaneurysm after mechanical thrombectomy (MT) is rare but is one of the potential complications associated with endovascular procedures. There is limited information regarding its mechanism of formation and the potential risk of delayed bleeding.

Case Description: An 84-year-old woman was admitted to our institution with right hemiplegia and global aphasia.

MicroRNA regulating stanniocalcin-1 is a metastasis and dissemination promoting factor in glioblastoma.

Background: MicroRNAs (miRs) regulate many biological processes, such as invasion, angiogenesis, and metastasis. Glioblastoma (GBM) patients with metastasis/metastatic dissemination have a very poor prognosis; therefore, inhibiting metastasis/metastatic dissemination has become an important therapeutic strategy for GBM treatment.

Methods: Using 76 GBM tissues, we examined the expression levels of 23 GBM-related miRs and compared the miRs' expression levels between GBMs with metastasis/metastatic dissemination and GBMs without metastasis/metastatic dissemination.

Stent Expansion and In-Stent Thrombus Sign in the Trevo Stent Retriever Predict Recanalization and Possible Etiology During Mechanical Thrombectomy: A Case Series of 50 Patients with Acute Middle Cerebral Artery Occlusion.

Background: Interaction between the stent retriever and clot is a key factor for recanalization during mechanical thrombectomy. The aim of this study was to evaluate the association between radiographically apparent features during thrombectomy and angiographic outcomes using the Trevo stent retriever with a fully radiopaque strut.

Methods: We retrospectively reviewed 50 patients with acute middle cerebral artery occlusion who were treated with the Trevo.

Early surgery with aggressive surgical approach to improve 6-month outcomes in patients with active infective endocarditis: contribution of cerebral preoperative magnetic resonance imaging.

Objectives: We investigated the hypothesis that early surgery for infective endocarditis (IE) attenuates the rate of death or embolic events and does not increase the rate of relapse or postoperative valvular dysfunction (PVD) at 6 months.

Methods: 21 consecutive patients who underwent surgical treatment of IE were prospectively included. We assessed 6-month postoperative clinical outcomes by comparing early surgery (Group E, surgery within 72 h) and conventional treatment (Group C).

Dependence of volume dose indices on dose calculation algorithms for VMAT-SBRT plans for peripheral lung tumor.

The purpose of this study was to investigate the dependence of volume dose indices on dose calculation algorithms for volumetric modulated arc therapy (VMAT) for stereotactic body radiotherapy (SBRT) plans to treat peripheral lung tumors by comparing them with those of Monte Carlo (MC) calculations. VMAT-SBRT plans for peripheral lung tumors were created using the Eclipse treatment planning system (TPS) for 24 patients with nonsmall cell lung cancer. VMAT dose distributions for gross tumor volume (GTV), internal target volume (ITV), and planning target volume (PTV) were calculated using the analytical anisotropic algorithm (AAA), the Acuros XB (AXB) algorithm, and a MC algorithm.

Myo-inositol concentration in MR spectroscopy for differentiating high grade glioma from primary central nervous system lymphoma.

It is sometimes difficult to distinguish gliomas from other tumors on routine imaging. In this study, we assessed whether 3-T magnetic resonance spectroscopy (MRS) with LCModel software might be useful for discriminating glioma from other brain tumors, such as primary central nervous system lymphomas (PCNSLs) and metastatic tumors. A total of 104 cases of brain tumor (66 gliomas, 20 PCNSLs, 6 metastatic tumors, 12 other tumors) were preoperatively investigated with short echo time (35 ms) single-voxel 3-T MRS.

Diagnostic value of glutamate with 2-hydroxyglutarate in magnetic resonance spectroscopy for IDH1 mutant glioma.

Background: Mutations in the isocitrate dehydrogenase 1 (IDH1) gene that are frequently observed in low-grade glioma are strongly associated with the accumulation of 2-hydroxyglutarate (2HG), which is a valuable diagnostic and prognostic biomarker of IDH1 mutant glioma. However, conventional MR spectroscopy (MRS)-based noninvasive detection of 2HG is challenging. In this study, we aimed to determine the additional value of other metabolites in predicting IDH1 mutations with conventional MRS.

[Intraoperative Aortic Dissection].

A 69-year-old man underwent mitral valve replacement for suspected infective endocarditis and coronary artery bypass grafting with left internal thoracic artery and saphenous vein graft. During the period of coming off cardiopulmonary bypass, enlargement of the ascending aorta and bleeding from the suture line were observed. Intraoperative transesophageal echocardiography and direct epi-aortic echography revealed acute aortic dissection extending from the ascending aorta to the descending aorta.

Accuracy of positioning and irradiation targeting for multiple targets in intracranial image-guided radiation therapy: a phantom study.

This study investigated the accuracy of positioning and irradiation targeting for multiple off-isocenter targets in intracranial image-guided radiation therapy (IGRT). A phantom with nine circular targets was created to evaluate both accuracies. First, the central point of the isocenter target was positioned with a combination of an ExacTrac x-ray (ETX) and a 6D couch.

[Mitral valve replacement after previous coronary artery bypass grafting with functioning left internal thoracic artery graft: effectiveness of the method using a direct vision retrosternal approach; report of a case].

Performing a redo-sternotomy when a mammary artery graft is patent can be rather difficult. We previously reported a redo-sternotomy technique involving direct visualization with a retrosternal dissection (DR) method using a Kent's retractor. The DR method in detail is as follows: 1) A midline skin incision is extended to the abdomen about 5 cm.

[Usefulness of the axillary artery perfusion in open heart surgery in a patient with severe ascending aortic calcification].

Because of high-aging Japanese society, high-risk patients with multiple co-morbidities have been increasing in regular open-heart surgery. Especially, extensive aortic atherosclerosis with severe calcification that involves the ascending aorta can complicate the choice of sites of cannulations and aortic cross-clamping for cardiopulmonary bypass. To date, the standard peripheral arterial cannulation site in such cases has been the common femoral artery;however, this approach carries the risk of atheroembolism due to retrograde aortic perfusion, or it is undesirable in case of severe iliofemoral disease.

[Dose impact of a carbon fiber couch for stereotactic body radiation therapy of lung tumors].

The aim of this study was to measure the dose attenuation caused by a carbon fiber radiation therapy table (Imaging Couch Top; ICT, BrainLab) and to evaluate the dosimetric impact of ICT during stereotactic body radiation therapy (SBRT) in lung tumors. The dose attenuation of ICT was measured using an ionization chamber and modeled by means of a treatment planning system (TPS). SBRT was planned with and without ICT in a lung tumor phantom and ten cases of clinical lung tumors.

Angular dependence correction of MatriXX and its application to composite dose verification.

We measured the angular dependence of central and off-axis detectors in a 2D ionization chamber array, MatriXX, and applied correction factors (CFs) to improve the accuracy of composite dose verification of IMRT and VMAT. The MatriXX doses were measured with a 10° step for gantry angles (θ) of 0°-180°, and a 1° step for lateral angles of 90°-110° in a phantom, with a 30 × 10 cm2 field for 6 MV and 10 MV photons. The MatriXX doses were also calculated under the same conditions by the Monte Carlo (MC) algorithm.

A retrospective, longitudinal study to evaluate healing lower extremity wounds in patients with diabetes mellitus and ischemia using standard protocols of care and platelet-rich plasma gel in a Japanese wound care program.

Chronic wounds, especially in patients with diabetes mellitus (DM), are a major health challenge in Japan. The goal of wound care centers (WCCs) in Japan is to facilitate healing and prevent lower extremity amputations (LEAs) using standardized protocols of patient and wound care. The standard treatment algorithm includes a complete patient and wound assessment, history, physical exam, and a variety of diagnostic tests that determine the need for infection control intervention, revascularization, excision and debridement, growth factor/platelet rich plasma (PRP) gel therapy, skin graft/ flap, wound protection, and education.

Effects of combined treatment with porous bovine inorganic bone grafts and bilayer porcine collagen membrane on refractory one-wall intrabony defects.

The aim of this study was to investigate the effects of a combination of porous bovine inorganic bone graft (Bio-Oss) and bilayer porcine collagen membrane (Bio-Gide) on refractory one-wall intrabony defects in dogs. Bio-Oss and Bio-Gide were applied into the refractory one-wall intrabony defect. The contralateral sites were used as controls (without the application of Bio-Oss and Bio-Gide).

Direct-vision retrosternal dissection using the Kent retractor for sternal re-entry.

Repeat median sternotomy is still associated with high morbidity and mortality from catastrophic hemorrhage or myocardial injury. To overcome these problems, we devised a new technique of sternal re-entry using the Kent retractor set (Takasago Ika Kogyo, Tokyo, Japan), which increases the safety of retrosternal dissection and sternal redivision.

Simultaneous aortic and mitral valve replacement: predictors of adverse outcome.

Background And Aim Of The Study: Uncertainties remain regarding the influence of several preoperative and intraoperative factors on outcome after double (simultaneous aortic and mitral) valve replacement (DVR).

Methods: Between 1981 and 1999, 132 patients (58 males, 74 females; mean age 53.8 years) underwent DVR with either aortic and mitral bileaflet mechanical valves in 81 patients, aortic tilting disk valve and mitral bileaflet valve in 36, and aortic tilting disk and mitral biological valve in 15.

Ten year clinical experience with the CarboMedics heart valve implants.

We reviewed the histories of 144 patients who underwent heart valve replacement with the CarboMedics prosthesis from 1990 to 2000. There were 74 males and 70 females, with a mean age of 52 years, including 69 aortic valve replacements, 48 mitral valve replacements, and 27 double (aortic and mitral) valve replacements. The mean duration of follow-up was 6.