Publications by authors named "Michihisa Umetsu"
Safety Assessment of Cyanoacrylate Closure for Treatment of Varicose Veins in a Large-Scale National Survey in Japan.
J Vasc Surg Venous Lymphat Disord
December 2024
Objective: Cyanoacrylate closure (CAC) is a minimally invasive technique for treating axial venous reflux. However, the incidence of serious adverse events (AEs) related to CAC is concerning. With an increasing number of patients receiving CAC and insufficient safety data in Japan, this study aimed to investigate the safety profile of CAC, focusing on the types and incidence of AEs.
View Article and Find Full Text PDFArticle Synopsis
- * In a subgroup analysis of 601 patients, those with anemia showed significantly fewer recurrent venous thromboembolism (VTE) cases with 12-month edoxaban treatment compared to 3 months, while no such reduction was observed in patients without anemia.
- * Overall, 12-month edoxaban treatment was more effective in preventing thrombotic events for both anemia and no-anemia groups, with no significant difference in major bleeding risk between the two treatment durations.
Article Synopsis
- The ONCO DVT study found that a 12-month course of edoxaban is more effective than a 3-month course for preventing thrombotic events in cancer patients with isolated distal deep vein thrombosis (DVT).
- This analysis categorized 601 patients into three groups based on their modified Ottawa score (low, intermediate, high) to determine the effectiveness of extended anticoagulation.
- Results showed that extended treatment significantly reduced thrombotic events in the intermediate and high score groups but not in the low score group, indicating limited benefit for those with a low risk.
Article Synopsis
- - The KUROSIO study examined the use of direct oral anticoagulants (DOACs) as the primary treatment for Japanese patients with acute venous thromboembolism (VTE), involving 993 patients after exclusions.
- - The study found low rates of recurrent symptomatic VTE (3.2%) and major bleeding (2.2%) during the first year of treatment, suggesting DOACs are generally effective and safe.
- - Additionally, chemotherapy and anemia were identified as significant risk factors for experiencing recurrent VTE and major bleeding, respectively.
Article Synopsis
- The ONCO DVT study showed that a 12-month treatment with edoxaban is more effective than a 3-month treatment for preventing blood clots in patients with cancer-associated isolated distal deep vein thrombosis (DVT).
- In a subgroup analysis, both standard (60 mg/day) and reduced (30 mg/day) dosages of edoxaban had lower rates of recurrent blood clots in those treated for 12 months compared to 3 months, but the risk of major bleeding was higher for the standard dose over 12 months.
- Overall, while a longer duration of edoxaban treatment is beneficial for reducing thrombotic risk, there is a cautionary note about increased bleeding risks with the higher dosage over extended periods
Article Synopsis
- * The CAC-AE survey collected data from 1,030 authorized institutions, reporting 16 cases of proximal deep vein thrombosis, 3 cases of pulmonary embolism, and various other complications.
- * The findings highlighted a total of 299 cases of localized phlebitis or allergic reactions, with one postoperative death linked to pulmonary embolism, aiming to present real-world data on CAC-related AEs in Japan.
Article Synopsis
- The CLOT-COVID Study analyzed 2894 hospitalized patients with COVID-19, focusing on 1738 patients with mild cases who didn’t need oxygen at admission.
- Patients were split into two groups: those receiving prophylactic anticoagulation (326 patients) and those who were not (1412 patients).
- Results showed that those on anticoagulation had higher severity levels during hospitalization and a slightly higher incidence of thrombosis, suggesting that routine use may not be beneficial for all stable patients.
Background: The multicenter, open-label, randomized clinical trial ONCO DVT compared 3-month and 12-month edoxaban treatment regimens for isolated distal deep vein thrombosis (DVT) and suggested potential benefits of prolonged edoxaban treatment in terms of thrombotic risk. However, the risk-benefit balance of prolonged edoxaban treatment in patients with renal function remains unclear.
Objectives: To compare the safety and efficacy of 3-month and 12-month edoxaban treatment regimens in patients with cancer-associated isolated distal DVT and different renal functions.
Background: Information regarding optimal revascularization and digestive tract repair in secondary aortoenteric fistula (sAEF) remains unclear. Thus, reporting treatment outcomes and presenting comprehensive patient details through a structured treatment approach are necessary to establish a treatment strategy for this rare, complex, and fatal condition.
Methods: We performed a single-center retrospective review of consecutive sAEF managed based on our in situ revascularization and intestinal repair strategy.
Article Synopsis
- The study investigates the ideal length of anticoagulation therapy for cancer patients with isolated distal deep vein thrombosis (DVT), comparing 12 months versus 3 months of edoxaban treatment, considering the balance between preventing thrombotic events and the risk of bleeding.
- A multicenter clinical trial included 601 patients, showing that longer treatment (12 months) significantly reduced the risk of recurrent venous thromboembolism (VTE) or VTE-related deaths compared to 3 months (1% vs. 7.2%).
- However, the incidence of major bleeding was slightly higher in the 12-month group (9.5%) versus the 3-month group (7.2%), indicating that while longer treatment is
Article Synopsis
- SiPM-based PET/CT successfully detected a type II endoleak in a 73-year-old man, five years after he underwent endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms.
- The imaging revealed abnormal FDG accumulation near the stent graft, matching findings from a previous CT angiography and indicating possible complications.
- This advanced imaging technique offers higher sensitivity than traditional PET/CT, highlighting the need for further evaluation and alternative imaging options for patients unable to use iodine contrast.
This study aimed to investigate the clinical features of arterial thrombosis and venous thromboembolism (VTE) in coronavirus disease 2019 (COVID-19). The CLOT-COVID Study was a retrospective, multicenter cohort study that enrolled 2,894 consecutively hospitalized patients with COVID-19 among 16 centers in Japan from April 2021 to September 2021. We compared the clinical features of arterial thrombosis and VTE.
View Article and Find Full Text PDFArticle Synopsis
- * Researchers analyzed DNA samples from 39 AAA patients during surgery, specifically looking for the H. cinaedi-specific gene using nested PCR techniques.
- * Results showed that 23.1% of the patients tested positive for H. cinaedi in their aneurysm walls, marking the first time this bacterium has been identified in non-infectious AAA cases.
The relationship between the thrombotic event and prognosis in patients with coronavirus disease 2019 (COVID-19) has not yet been fully investigated in Japan. Our study aimed to investigate the clinical outcomes and risk factors for thrombosis in hospitalized patients with COVID-19 in Japan. We compared the patient characteristics and clinical outcomes among patients with thrombosis (N=55) and those without thrombosis (N=2839) by using a large-scale data of CLOT-COVID study (thrombosis and antiCoaguLatiOn Therapy in patients with COVID-19 in Japan Study: UMIN000045800).
View Article and Find Full Text PDFPregnancy-associated deep vein thrombosis (DVT) is a rare disease, and data on anticoagulation therapy are lacking. The present study examined the treatment outcome with unfractionated heparin (UFH) subcutaneous injection in patients with pregnancy-associated DVT. This single-center, retrospective, observational study enrolled 15 patients with pregnancy-associated DVT treated from January 2014 to April 2021.
View Article and Find Full Text PDFArticle Synopsis
- The study focused on understanding the use of prophylactic anticoagulation for COVID-19 patients in Japan, highlighting its clinical management strategies.
- Conducted as a multicenter observational study, it involved 2,894 hospitalized patients, ultimately analyzing 2,889 patients based on their anticoagulation treatment.
- Results revealed that the severity of COVID-19 at admission strongly influenced the use of pharmacological thromboprophylaxis and therapeutic dosing, particularly in patients with comorbidities.
Background: Reports of mortality-associated risk factors in patients with the novel coronavirus disease 2019 (COVID-19) are limited.
Methods: We evaluated the clinical features that were associated with mortality among patients who died during hospitalization (n = 158) and those who were alive at discharge (n = 2,736) from the large-scale, multicenter, retrospective, observational cohort CLOT-COVID study, which enrolled consecutively hospitalized COVID-19 patients from 16 centers in Japan from April to September 2021. Data from 2,894 hospitalized COVID-19 participants of the CLOT-COVID study were analyzed in this study.
Background: The coronavirus disease 2019 (COVID-19) causes extensive coagulopathy and a potential benefit of anticoagulation therapy has been documented for prevention of thromboembolic events. Bleeding events has also been reported as a notable complication; whereas, the incidence, risks, and clinical impact of bleeding remain unclear.
Method: The CLOT-COVID Study was a nationwide, retrospective, multicenter cohort study on consecutive hospitalized patients with COVID-19 in Japan between April 2021 and September 2021.
Article Synopsis
- Obesity's impact on COVID-19 severity and thrombosis risk was explored in the CLOT-COVID study, involving 2,690 hospitalized patients in Japan from April to September 2021.
- The study found that patients with obesity had more severe COVID-19 symptoms at admission and a higher risk for serious outcomes (like mechanical ventilation) but no significant difference in thrombosis rates compared to non-obese patients.
- Overall, while obesity did not significantly increase the risk of thrombosis, it was linked to worsened COVID-19 severity and worse hospitalization outcomes.
Aim: There is scarce data on the impact of age on clinical outcomes in patients with coronavirus disease 2019 (COVID-19).
Method: The CLOT-COVID Study was a retrospective, multicenter cohort study enrolling 2894 consecutive hospitalized patients with COVID-19 among 16 centers in Japan from April 2021 to September 2021. We divided the entire cohort into five groups according to age strata; -19, 20-39, 40-59, 60-79, and 80- years.
A 68-year-old man underwent open surgical repair for an abdominal aortic aneurysm. The intraoperative period had no adverse events until postoperative extubation. His SpO rapidly dropped, and severe acute lung edema developed.
View Article and Find Full Text PDFBackground: The worsening of coronavirus disease 2019 (COVID-19) severity is a critical issue in current clinical settings and may be associated with the development of thrombosis.
Methods and results: This study used patient data obtained in the CLOT-COVID study, a retrospective multicenter cohort study. The demographics of patients with moderate COVID-19 on admission with and without worsened severity during hospitalization were compared and predictors were identified.
Background: The potential benefit of therapeutic-dose anticoagulation for critically ill patients with coronavirus disease 2019 (COVID-19) is still controversial.
Methods and results: In the CLOT-COVID study, 225 patients with severe COVID-19 on admission requiring mechanical ventilation or extracorporeal membrane oxygenation were divided into patients with therapeutic-dose anticoagulation (N=110) and those with prophylactic-dose anticoagulation (N=115). There was no significant difference in the incidence of thrombosis between the groups (9.
To date, there are no large-scale data on the association between D-dimer levels at admission and the occurrence of venous thromboembolism (VTE) in Japanese patients with coronavirus disease 2019 (COVID-19). The CLOT-COVID study was a retrospective, multicenter cohort study enrolling consecutive hospitalized patients with COVID-19 across 16 centers in Japan from April 2021 to September 2021. Among 2,894 enrolled patients, 2,771 (96%) had D-dimer levels measured at admission.
View Article and Find Full Text PDFPurpose: This prospective study aimed to assess the prognosis of claudication after endovascular aneurysm repair (EVAR) involving hypogastric artery (HGA) embolization.
Methods: Patients who were scheduled to undergo EVAR involving bilateral or unilateral HGA embolization (BHE or UHE, respectively) between May 2017 and January 2019 were included in this study. Patients underwent the walk test preoperatively, one week postoperatively, and monthly thereafter for six months.