Publications by authors named "Kimihiro Komori 古森 公浩"
Objective: Infected native aneurysms (INAs) of the abdominal aorta and iliac arteries are uncommon, but potentially fatal. Endovascular aneurysm repair (EVAR) has recently been introduced as a durable treatment option, with outcomes comparable to those yielded by conventional open repair. However, owing to the rarity of the disease, the strengths and limitations of each treatment remain uncertain.
View Article and Find Full Text PDFWhether drug therapy slows the growth of abdominal aortic aneurysms (AAAs) in the Japanese population remains unknown. In a multicenter prospective open-label study, patients with AAA at the presurgical stage (mean [±SD] AAA diameter 3.27±0.
View Article and Find Full Text PDFBackground: To investigate the impact of peak aortic jet velocity (Vmax) on the prognosis of patients undergoing open surgery for chronic limb threatening ischemia (CLTI).
Methods: Between April 2015 and March 2022, 352 patients underwent infrainguinal open surgery for CLTI. Patients who met the following exclusion criteria were excluded: subsequent infrainguinal surgeries in the registered period, no record of Vmax, history of aortic valve intervention, and Vmax ≥3.
Objective: To examine limb salvage (LS) and wound healing in dialysis-dependent and -independent patients with chronic limb-threatening ischemia (CLTI) after infrainguinal bypass surgery or endovascular therapy (EVT).
Methods: We retrospectively analyzed the multi-center data of patients who underwent infrainguinal revascularization for CLTI with Wound, Ischemia, and foot Infection (WIfI) stage 2 to 4 between 2015 and 2020. The primary endpoint was LS.
Background: The present study aimed to determine the preferred initial revascularization procedure between bypass surgery and endovascular therapy (EVT) in patients with chronic limb-threatening ischemia (CLTI) categorized as indeterminate according to the Global Vascular Guidelines (GVG).
Methods: We retrospectively analyzed the multicenter data of patients who underwent infrainguinal revascularization for CLTI categorized as indeterminate according to the GVG between 2015 and 2020. The end point was the composite of relief from rest pain, wound healing, major amputation, reintervention, or death.
Objective: Surgical treatment is an established method for popliteal artery entrapment syndrome (PAES), which, however, mainly derives from single centre experiences where PAES cases are centralised and treated periodically. This study evaluated clinical outcomes of surgical treatment for PAES in a clinical setting where PAES cases were not centralised.
Methods: Multicentre, retrospective cohort study using a national clinical registry.
Article Synopsis
- The study focused on comparing outcomes of bypass surgery and endovascular therapy (EVT) for patients with chronic limb-threatening ischemia (CLTI) classified as bypass-preferred by global guidelines.
- A total of 301 patients were analyzed, revealing that bypass surgery had significantly higher 2-year limb salvage rates (92.2%) and 1-year wound healing rates (86.7%) compared to EVT (76.3% and 67.8%, respectively).
- Risk factors for major amputation and impaired wound healing included decreased serum albumin levels, increased wound grades, and the use of EVT, indicating that bypass surgery is generally more effective for patients in this clinical category.
Objective: This study aimed to evaluate the influence of change in ambulatory status on the prognosis of patients with chronic limb-threatening ischemia (CLTI) undergoing infrainguinal bypass surgery or endovascular therapy (EVT).
Methods: We retrospectively analyzed data from two vascular centers for patients who underwent revascularization for CLTI between 2015 and 2020. The primary endpoint was overall survival (OS), and the secondary endpoints were changes in ambulatory status and postoperative complications.
Background: To evaluate limb salvage outcomes and risk factors for major amputation in chronic limb-threatening ischemia (CLTI) patients classified as stage 4 per the wound, ischemia, and foot infection (WIfI) classification following infrainguinal revascularization.
Methods: We retrospectively analyzed multicenter data of patients who had undergone infrainguinal revascularization for CLTI between 2015 and 2020. The endpoint was secondary major amputation defined as an above- or below-knee amputation following infrainguinal revascularization.
Purpose: An accurate distal deployment is essential for successful thoracic endovascular aortic repair (TEVAR) of a paradiaphragmatic aortic aneurysm. This study aimed to investigate the anatomical and intraoperative factors that affect the accuracy of distal deployment during TEVAR.
Methods: We conducted a retrospective review of preoperative and postoperative computed tomography scans of 426 patients undergoing TEVAR at our institution between October 2008 and May 2021, of which the stent-graft was attempted to be deployed just above the celiac axis or the superior mesenteric artery in 56 patients.
Article Synopsis
- The study focuses on surgical revascularization for chronic limb-threatening ischemia (CLTI), aiming to identify factors that predict the need for graft revision and assess the impact of the Global Anatomic Staging System (GLASS) on these revisions.!* -
- Researchers analyzed data from 80 CLTI patients who had infrapopliteal bypass surgeries between 2011 and 2018 and found that those with higher GLASS stages and specific disease grades had significantly higher rates of graft revision.!* -
- The study concluded that a higher Inframalleolar (IM) disease grade (specifically grade P2) and the use of spliced vein grafts are strong predictors of the need for graft revision,
Background: Although endovascular aneurysmal repair (EVAR) is a preferred treatment for abdominal aortic aneurysm (AAA) owing to its low invasiveness, its impact on the local hemodynamics has not been fully assessed.
Purpose: To elucidate how EVAR affects the local hemodynamics in terms of energy loss (EL).
Study Type: Prospective single-arm study.
Article Synopsis
- The development of imaging techniques has improved the evaluation of lower extremity artery disease (LEAD) with accurate measurements and visual assessments.
- There is a need for standardization in these evaluation methods to reduce inconsistencies and risks associated with their use.
- The Japan Endovascular Treatment Conference (JET) has created a consensus document that outlines standardized approaches for intravascular ultrasound (IVUS), optical frequency domain imaging (OFDI), and angioscopy in endovascular therapy (EVT).
Objective: The aim of this study was to create prediction models for two year overall survival (OS) and amputation free survival (AFS) after revascularisation in patients with chronic limb threatening ischaemia (CLTI).
Methods: This was a retrospective analysis of prospectively collected multicentre registry data (JAPAN Critical Limb Ischaemia Database; JCLIMB). Data from 3 505 unique patients with CLTI who had undergone revascularisation from 2013 to 2017 were extracted from the JCLIMB for the analysis.
Background: The epicardial adipose tissue volume (EATV) is associated with cardiovascular diseases such as coronary artery disease. However, no information is available regarding the relationship between the EATV and abdominal aortic aneurysm (AAA) expansion. In the present study, we evaluated the association between the EATV and AAA growth and sought to identify the predictors of AAA expansion.
View Article and Find Full Text PDFBackground: Zinc (Zn) has been reported to play an important role in wound healing (WH). Nevertheless, the effect of Zn in chronic limb-threatening ischemia (CLTI) patients is unclear. This study investigated the effect of Zn on the clinical outcomes of CLTI patients undergoing bypass surgery.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to identify predictors of spontaneous sac shrinkage (SpS) in patients with persistent type 2 endoleaks (T2ELs) after endovascular aortic aneurysm repair (EVAR), as European guidelines suggest a wait-and-see approach for certain cases.
- A total of 141 patients with persistent T2ELs were included, showing cumulative SpS rates of 14.2% at 1 year and 25.6% at 5 years, with findings indicating that having six or more patent lumbar arteries negatively impacted the likelihood of SpS.
- Ultimately, the research suggests that patients with fewer patent lumbar arteries have a better chance of experiencing significant sac shrinkage over 5 years, highlighting
Background: We reviewed the results of endovascular aneurysm repair in patients from the Japanese Committee for Stentgraft Management registry to determine the significance of persistent type II endoleak (p-T2EL) and the risk of late adverse events, including aneurysm sac enlargement.
Methods: The prospectively captured medical records of 17 099 patients <75 years of age who underwent endovascular aneurysm repair for abdominal aortic aneurysm from 2006 to 2015 were reviewed. Patients were divided into 2 groups (with or without p-T2EL) and compared to examine the correlation between p-T2EL and the occurrence of aneurysm sac enlargement after endovascular aneurysm repair.
Objective: Inframalleolar (IM) bypass has been reported to demonstrate acceptable patency and limb salvage in patients with chronic limb-threatening ischemia. However, wound healing after IM bypass and comparisons between pedal artery (PA) bypass and pedal branch artery (PBA) bypass are lacking.
Methods: We reviewed prospectively collected data from 208 consecutive patients after IM bypass performed over a period of 6 years.
Objective: Zinc is an important essential trace metal involved in many physiologic functions, and its deficiency can affect the development of multiple organs, including the vasculature. However, clarity is lacking regarding the effects of zinc deficiency in the regulation of angiogenesis. We investigated the effects of zinc deficiency on the revascularization process through animal experiments and examined the relationship between the circulating zinc levels and tissue blood perfusion in patients with chronic limb-threatening ischemia (CLTI).
View Article and Find Full Text PDFBackground: The purpose of this study was to evaluate the effect of preoperative motor and cognitive activities of daily living (ADL) on long-term outcomes of patients with chronic limb-threatening ischemia (CLTI) after distal bypass.
Methods: A retrospective review was performed for patients who underwent distal bypass for CLTI from 2013 to 2019 at multiple centers in Japan. Comparisons were made among patients with high and low motor and cognitive ADL based on the functional independence measure (FIM).