Publications by authors named "Wataro Tsuruta"

Objectives: This study aimed to examine nationwide trends in acute stroke endovascular thrombectomy (EVT) following five pivotal trials in 2015 that established it as the 'standard of care'.

Methods: The Japanese Registry of NeuroEndovascular Therapy 4 was a nationwide retrospective study registering consecutive patients who underwent neurointervention by specialists certified by the Japanese Society for Neuroendovascular Therapy at 166 centers from January 2015 to December 2019. We extracted patients who underwent EVT, and analyzed the annual trends in baseline characteristics, revascularization procedures and outcomes.

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Congenital absence of the internal carotid artery is a rare anatomical variant. The primarily reported origins of the ophthalmic artery associated with this variant are the posterior communicating, middle cerebral, and external carotid arteries. We report the case of a patient without an internal carotid artery whose ophthalmic artery originated from the contralateral internal carotid artery.

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This study aimed to evaluate the radiation doses (peak skin dose (PSD) and bilateral lens dose) for each interventional neuroradiology procedure. A direct measurement system consisting of small radiophotoluminescence glass dosimeter chips and a dosimetry cap made of thin stretchable polyester was used for radiation dosimetry. The mean PSDs for each procedure were 1565 ± 590 mGy (simple technique coil embolization (STCE) cases), 1851 ± 825 mGy (balloon-assisted coil embolization (BACE) cases), 2583 ± 967 mGy (stent-assisted coil embolization (SACE) cases), 1690 ± 597 mGy (simple flow-diverter stenting (FDS) cases), and 2214 ± 726 mGy (FDS + coiling cases).

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Background And Importance: Flow diverters (FDs) provide curative endovascular treatment for wide-necked sidewall aneurysms. The efficacy of FDs for bifurcation or branching sidewall aneurysms is probably limited. We used anatomical flow diversion (AFD) for intractable large cerebral aneurysms.

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Article Synopsis
  • - Heart failure can reduce blood flow to the brain, potentially affecting recovery after mechanical thrombectomy (MT) in stroke patients, and this study examined the relationship between brain natriuretic peptide (BNP) levels and recovery outcomes.
  • - Data from 169 stroke patients showed that those with favorable outcomes (score of 0-2 on the modified Rankin scale at 3 months) had lower median BNP levels compared to those with unfavorable outcomes, suggesting that higher BNP levels are linked to poorer recovery.
  • - The analysis indicated that patients with BNP levels above 186 pg/mL had a significantly lower rate of favorable outcomes, even when considering other factors like atrial fibrillation, reinforcing the idea that high BNP concentration correlates with
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Background: Transvenous embolization (TVE), such as selective shunt occlusion, is the first line treatment for cavernous sinus dural arteriovenous fistula (CSDAVF). Despite the favorable outcomes of TVE, some cases necessitating retreatment due to recurrence or incomplete occlusion persist. Given the physical, psychological, and financial burden of multiple treatments, understanding the predictive factors for recurrence, spontaneous occlusion, or retreatment is important.

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Thorough understanding of the vascular anatomy, including embryological development of vessels is important to safely perform endovascular procedures. The posterior cerebral and anterior choroidal arteries are embryologically complementary, which suggests a potential network. Numerous perforators originate from the posterior communicating and posterior cerebral arteries.

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Objective: Intraoperative rebleeding during endovascular treatment for ruptured intracranial aneurysms is associated with poor prognosis. Lumbar drainage is performed preoperatively to control intracranial pressure; however, it is associated with a risk of brain herniation or rebleeding because intracranial pressure may change rapidly. Therefore, this study aimed to examine the efficacy and safety of preoperative lumbar drainage.

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There has been an increase in the use of interventional neuroradiology procedures because of their non-invasiveness compared to surgeries and the improved image quality of fluoroscopy, digital subtraction angiography, and rotational angiography. Although cone-beam computed tomography (CBCT) images are inferior to multi-detector CT images in terms of low-contrast detectability and lower radiation doses, CBCT scans are frequently performed because of their accessibility. This study aimed to evaluate the image quality and radiation dose of two different high-resolution CBCTs (HR CBCT): conventional (C-HR CBCT) and wide-field HR CBCT (W-HR CBCT).

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Article Synopsis
  • The study investigates the effect of subarachnoid haemorrhage (SAH) on clinical outcomes in patients who underwent mechanical thrombectomy for acute large-vessel occlusion.
  • Conducted as the SKIP trial in Japan, it included 197 patients, analyzing the relationship between SAH detected on CT within 36 hours post-procedure and outcomes at 90 days.
  • Results showed that while there was a trend towards lower favorable outcomes in patients with SAH, particularly isolated SAH, it was not statistically significant, suggesting SAH may not adversely affect long-term recovery post-thrombectomy.
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Background: To investigate whether ultra-early recombinant tissue-plasminogen activator (rt-PA) administration can improve patient outcomes on mechanical thrombectomy (MT) in patients with large vessel occlusion (LVO).

Methods: Participants comprised rt-PA-eligible 204 patients with internal carotid artery or middle cerebral artery occlusion in the SKIP trial, who were randomly assigned to receive mechanical thrombectomy alone or combined intravenous thrombolysis (rt-PA: alteplase at 0.6 mg/kg) plus mechanical thrombectomy.

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Purpose: Some aneurysms remain patent after treatment with flow diverters (FD) due to residual blood flow in the aneurysm. Several studies have proposed that branches and residual flow are associated with delayed aneurysm occlusion. We propose that aneurysm isolation (i.

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Objective: Proximal internal carotid artery (ICA) ligation with high-flow bypass is an important vascular reconstructive technique for giant ICA aneurysms or skull base tumors involving the ICA to control intraoperative bleeding. Retrograde or collateral blood flow occasionally remains postoperatively and requires complete internal trapping. Although transgraft internal trapping is one of the options, there are few reports on transgraft treatment.

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The influence of aneurysm size on the outcomes of endovascular management (EM) for aneurysmal subarachnoid hemorrhages (aSAH) is poorly understood. To evaluate the outcomes of EM for ruptured large cerebral aneurysms, we retrospectively analyzed the medical records of patients with aSAH that were treated with coiling between 2013 and 2020 and compared the differences in outcomes depending on aneurysm size. A total of 469 patients with aSAH were included; 73 patients had aneurysms measuring ≥10 mm in diameter (group L), and 396 had aneurysms measuring <10 mm in diameter (group S).

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Purpose: Arteriovenous fistulas (AVFs) adjacent to the clivus, such as cavernous sinus dural AVFs (CSDAVFs) and condylar AVFs, sometimes have an intraosseous shunted pouch and recruit blood supply from transosseous feeders. Precise analysis of transosseous feeders regarding the clival lesion has not yet been performed. Therefore, this study aimed to clarify the characteristics and identity of transosseous feeders in clival lesions.

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Background: The pathogenesis and endovascular treatment strategy for spontaneously thrombosed unruptured cerebral aneurysms have not yet been comprehensively described.

Observations: The authors reported on a 78-year-old woman who had large bilateral unruptured cavernous carotid artery aneurysms that induced chronic disseminated intravascular coagulation and acquired factor XIII deficiency. The right aneurysm was symptomatic and partially thrombosed.

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Background: Mechanical thrombectomy (MT) is effective in acute ischemic stroke patients ≥80 years old with large vessel occlusion (LVO). However, data for patients ≥90 years old remain very limited, and factors influencing functional outcomes are unclear. This study aimed to investigate factors influencing functional outcomes in patients ≥90 years old treated with MT for acute LVO.

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Purpose: Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are recommended based on certain risk factors. The volume of an institution's treatment experience may be associated with good clinical outcomes. There is a dilemma between the treatment strategy based on risk factors and the experience volume.

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Background: Parent artery occlusion (PAO) is an effective treatment for hemorrhagic diseases associated with the internal carotid artery. There are several reports of long-term cerebral infarction or the formation of de novo cerebral aneurysms following PAO.

Materials And Methods: We retrospectively reviewed these complications in 38 patients who underwent PAO for therapeutic treatment.

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Flow diverter stent has been a promising device for intracranial aneurysm treatment. For treating aneurysms located in the anterior circulation, critical branches may be covered by flow diverter stent. The occlusion incidence of these branches has been reported, and even if branch vessel occlusions occur, associated neurological deficits are extremely rare.

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Article Synopsis
  • The study focuses on measuring radiation doses in interventional neuroradiology (INR) procedures to assess the impact of procedure complexity on patient radiation exposure.
  • Data was collected from 332 patients with different conditions (unruptured aneurysms, dural arteriovenous fistulas, and arteriovenous malformations), finding higher skin and lens doses in more complex cases like DAVF and AVM compared to URAN.
  • Results highlighted significant correlations between radiation doses and reference air kerma, suggesting the need for better radiation protection measures in complex cases.
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This study aimed to determine the placement distance, number, and position of the bismuth shield for developing a lens protective device for cone-beam computed tomography (CBCT). To determine the dose reduction rate, the lens doses were measured using an anthropomorphic head phantom and a real-time dosimeter. The image quality assessment was determined by analyzing the change in the pixel value, caused by the bismuth shield, and the artifact index was calculated from the pixel value and image noise within various regions of interest in the head phantom.

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Background: Aneurysm treatment using the Pipeline Embolization Device has been established but appropriate maintenance of dual antiplatelet therapy (APT) is essential. This multicenter retrospective study assessed whether APT was properly adjusted for clopidogrel resistance and identified risk factors associated with periprocedural complications.

Methods: Consecutive cases of use of the Pipeline Embolization Device for internal carotid artery aneurysms (>10 mm) between November 2015 and April 2020 were analyzed.

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Purpose: To investigate the effect of alteplase, either combined with stent-retriever thrombectomy or a direct aspiration first pass technique (ADAPT), in patients with large-vessel occlusion stroke.

Methods: This was a retrospective post hoc analysis of data from The Direct Mechanical Thrombectomy in Acute LVO Stroke (SKIP) study. Patients were divided into two groups according to the first-line thrombectomy technique: stent-retriever and ADAPT.

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Several basic experimental studies have demonstrated that statins have beneficial effects for intracranial aneurysm (IA). Clinical studies on unruptured IAs, however, remain limited to four retrospective studies that have reached different conclusions. This study was the first open-label, multicenter, randomized controlled trial to assess the preventive effects of atorvastatin.

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