Publications by authors named "Tsuyoshi Ohta"

Background: Past studies have reported that vertebrobasilar dolichoectasia (VBD) patients may develop similar arteriopathies other than the vertebrobasilar system. However, the details of these VBD-related arteriopathies are still unclear.

Methods: We retrospectively enrolled patients diagnosed with VBD at two stroke centers in Japan between January 2012 and December 2023.

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: The usefulness of bevacizumab (BEV) as first-line chemotherapy for advanced ovarian clear cell carcinoma (CCC) was retrospectively evaluated at Tohoku Gynecologic Cancer Unit institutions. : A total of 81 patients (52 patients without BEV and 29 with BEV) with advanced ovarian CCC who received initial platinum-based chemotherapy were enrolled. We selected 26 patients each without and with BEV according to propensity score matching methods, and compared the platinum-resistant recurrence rate, response rate, progression-free survival (PFS), overall survival (OS), and adverse events between the two groups.

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  • The study investigated how the CHADS-VASc score and prior oral anticoagulant (OAC) use affect endovascular treatment (EVT) outcomes in acute ischemic stroke patients with atrial fibrillation (AF).
  • Out of 6984 patients analyzed, a significant portion had high CHADS-VASc scores, which correlated with increased risks of complications and decreased independence post-treatment; however, prior use of direct oral anticoagulants (DOACs) improved some outcomes for high-risk patients.
  • Findings suggest that using DOACs in high- and selected moderate-risk AF patients prior to EVT can enhance treatment success, indicating potential benefits for preventive DOAC therapies.
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  • Endovascular therapy (EVT) is effective for treating acute large vessel occlusion (LVO), but some patients do not achieve successful recanalization, prompting this study.
  • The research analyzed data from the RESCUE-Japan Registry 2, comparing outcomes of patients who had unsuccessful EVT to those who received no EVT, focusing on recovery and complications.
  • Results indicated that patients with unsuccessful EVT had poorer recovery scores, increased mortality rates, and more frequent symptomatic intracranial hemorrhages compared to the no EVT group.
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  • Endovascular treatment (EVT) shows promise for addressing extracranial vertebral artery (VA) stenosis, but optimal procedures and efficacy are still unclear.
  • A study analyzed data from 308 patients in Japan who underwent EVT, focusing on procedural success and outcomes at 30 days post-treatment.
  • Results indicated a high procedural success rate (98%) and functional independence (80%) without significant differences based on type of treatment used, highlighting EVT's potential but also the need for additional research.
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  • - An 87-year-old woman with a history of stroke and pulmonary embolism developed aphasia and right hemiplegia, leading to a hospital visit where a CT scan revealed a hematoma in her left thalamus.
  • - After administering low-dose Andexanet alfa shortly after the onset of her stroke, her condition worsened to flaccid hemiplegia and coma, and further imaging showed occlusion of her left internal carotid artery.
  • - Despite mechanical thrombectomy attempts, she suffered extensive cerebral infarction and died on day 7, underscoring that thrombotic events can occur even after Andexanet alfa treatment, necessitating careful monitoring of patients.
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Background And Objectives: Endovascular treatment (EVT) for medium vessel occlusion (MeVO) raises concern about hemorrhagic complications; however, its clinical impact has not been elucidated. Therefore, we investigated the association between intracranial hemorrhage (ICH) after EVT for MeVO and functional outcomes.

Methods: We conducted a post hoc analysis of the Japan Registry of NeuroEndovascular Therapy 4, a nationwide registry in Japan from 2015 to 2019 including 13 479 patients who underwent EVT for acute ischemic stroke.

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Despite advancements in neurosurgical techniques, subarachnoid hemorrhage(SAH) caused by the rupture of a partially thrombosed intracranial giant aneurysm remains a challenging clinical entity. This report describes the successful treatment of an 80-year-old male patient with SAH due to a ruptured, partially thrombosed intracranial giant aneurysm. The patient underwent a staged endovascular strategy using a flow diverter.

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  • Ovarian cancer (OC) is a critical health issue as it often goes undiagnosed until advanced stages, leading to poor outcomes due to extensive disease spread.
  • Researchers analyzed ovarian cancer tissues and control samples using advanced techniques to identify changes in 130 metabolites, finding significant alterations, especially in glycometabolism pathways.
  • The study also showed that metabolites like N,N-diacetylspermine were elevated in biofluids such as plasma and urine from OC patients, suggesting potential biomarkers for early detection and understanding of OC metabolic dysregulation.
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  • The study evaluated a new device called the Stabilizer, designed to enhance the safety and efficacy of neuroendovascular procedures that require exchanging medical instruments, which can be risky due to potential vessel injury.! -
  • Conducted across nine centers in Japan, the trial involved 31 patients with conditions like intracranial aneurysms and artery stenosis, with the Stabilizer achieving a 100% technical success rate and no device-related complications.! -
  • The findings of this first multicenter trial underscore the Stabilizer's potential as a reliable tool in managing complex neuroendovascular cases where traditional exchange methods might pose challenges.!
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Introduction: Acute stroke rehabilitation is crucial for achieving good functional recovery, even during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to clarify the impact of the COVID-19 pandemic on acute stroke rehabilitation and identify which components in the acute stroke rehabilitation provision system were susceptible to the pandemic.

Methods: A web-based questionnaire survey was conducted in all primary stroke centers (PSCs) in Japan between February 7 and April 21, 2022.

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  • * The study analyzed 810 patients who underwent treatment for aSAH, finding that meningitis significantly increases the risk of DCI, potentially due to the inflammatory response causing cerebral vasospasm.
  • * Key findings included that female patients and those who had surgical clipping were also at higher risk for DCI, emphasizing the importance of early detection and treatment of meningitis to improve patient outcomes.
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Objectives: Patients with acute ischemic stroke (AIS) often have an accumulation of pre-existing comorbidities, but its clinical impact on outcomes after mechanical thrombectomy (MT) remains unknown. Therefore, we examined whether comorbidity burden before AIS onset could predict clinical outcomes after MT.

Methods: In this retrospective cohort, we enrolled consecutive patients with community-onset AIS who underwent MT between April 2016 and December 2021.

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Objective: Intraorbital dural arteriovenous fistula (IO-dAVF) is a rare condition, and treatment options vary from case to case. We report a case of transarterial embolization (TAE) for IO-dAVF.

Case Presentation: A 62-year-old male complained of gradually worsening pain, hyperemia, and visual impairment in the right eye.

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Background: Aneurysms located in the distal middle cerebral artery (DMCA) are relatively rare and lack an established treatment strategy. For DMCA aneurysms, we performed a one-stage combined procedure of endovascular parent artery occlusion (PAO) with coils and superficial temporal artery to middle cerebral artery (STA-MCA) bypass in a hybrid operating room (HOR). The aim of this study was to evaluate the safety and efficacy of this procedure.

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  • The study evaluates the safety and effectiveness of using open-cell stents in carotid artery stenting (CAS) for patients with internal carotid artery stenosis over 17 years.
  • In 734 analyzed procedures, the periprocedural stroke rate was 3.7% and the mortality rate was 0.4%, indicating generally favorable outcomes.
  • The presence of low-echoic plaques significantly increased the risk of perioperative strokes, highlighting the importance of plaque characteristics when considering CAS.
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Objectives: In Japan, acute stroke rehabilitation has been expanding more steadily than previously with the nationwide establishment of primary stroke centers. However, Japan previously had no established guidelines for the rehabilitation. Consequently, rehabilitation programs and the provision systems for acute stroke varied among the facilities.

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Background: In mechanical thrombectomy for tandem occlusions in vertebrobasilar stroke, distal emboli from the vertebral artery lesion should be prevented. However, no suitable embolic protection devices are currently available in the posterior circulation. Here, the authors describe the case of a vertebral artery lesion effectively treated with a closed-tip stent retriever as an embolic protection device in the posterior circulation.

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Background: Electrochemical impedance spectroscopy can determine characteristics such as cell density, size, and shape. The development of an electrical impedance-based medical device to estimate acute ischemic stroke (AIS) clot characteristics could improve stroke patient outcomes by informing clinical decision making.

Objectives: To assess how well electrical impedance combined with machine learning identified red blood cell (RBC)-rich composition of AIS clots , which is associated with a successfully modified first-pass effect.

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Objective: Although consensus has been reached regarding the use of mechanical thrombectomy for acute large anterior circulation occlusion, its effectiveness in patients with posterior circulation occlusion remains unclear. This study aimed to establish the determining factors for good clinical outcomes of mechanical thrombectomy for posterior circulation occlusion.

Methods: We extracted cases of acute large vessel occlusion (LVO) in the posterior circulation from a database comprising 536 patients who underwent mechanical thrombectomy at our hospital between April 2015 and March 2021.

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Objectives: The early initiation of acute stroke rehabilitation with a sufficient dose, including at weekends/holidays, is important to improve functional outcome. We investigated the status of acute stroke rehabilitation in Japan by using a nationwide survey.

Materials And Methods: Facility features, rehabilitation dose provided in the first week in each stroke subtype, and weekend/holiday rehabilitation were investigated by using the results of a web-based survey among primary stroke centers.

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Background: Intracranial atherosclerotic disease (ICAD) significantly contributes to ischemic stroke, especially among Asian populations. Large vessel occlusion (LVO) due to underlying ICAD accounts for 15-35% of acute ischemic stroke cases requiring endovascular therapy. However, the successful recanalization rate of ICAD-related LVO remains lower.

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  • - The study evaluated aneurysmal subarachnoid hemorrhage (aSAH) in Kobe City, analyzing data from 334 patients treated at 13 stroke centers between 2017 and 2019, finding an incidence rate of 11.12 per 100,000 person-years.
  • - Curative treatment was administered to 94% of patients, with a preference for endovascular methods (51%) over surgical options (43%), and shunt surgeries had poorer outcomes compared to other treatments.
  • - While 30-day mortality was 12%, this increased to 17% after one year; however, neurological function improved over time, with better outcomes for those who received fasudil infusion for vasospasm.
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  • The study investigates the relationship between the Areal Deprivation Index (ADI) and delays in hospital arrival for acute ischaemic stroke patients in Kochi, Japan.
  • Higher ADI, indicating more deprived communities, was linked to significant prehospital delays and worse hospital outcomes, including increased mortality and higher chances of needing nursing facility care.
  • In contrast, no significant association was found in capital areas, suggesting that socioeconomic factors may influence patient outcomes differently based on location.
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Ovarian clear cell carcinoma (OCCC) is a rare subtype of epithelial ovarian carcinoma that responds poorly to chemotherapy. Glutathione (GSH) is a primary antioxidant, which protects cells against reactive oxygen species (ROS). High levels of GSH are related to chemotherapeutic resistance.

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