Publications by authors named "Yuji Kushi"
Background: Tentorium resection and detachment from the oculomotor nerve are sometimes required for surgical clipping of unruptured posterior communicating artery (PCoA) aneurysms. Using T2-weighted 3D images, we aimed to identify the preoperative radiological features required to determine the necessity of these additional procedures.
Methods: We reviewed 30 patients with unruptured PCoA aneurysms who underwent surgical clipping and preoperative simulation using T2-weighted 3D images for measurement of the distance between the tentorium and aneurysm.
Background And Purpose: Intracranial aneurysm growth is a significant risk factor for rupture; however, a few aneurysms remain unruptured for long periods, even after growth. Here, we identified hemodynamic features associated with aneurysmal rupture after growth.
Materials And Methods: We analyzed nine middle cerebral artery aneurysms that grew during the follow-up period using computational fluid dynamics analysis.
Article Synopsis
- The study investigates the relationship between plaque ulceration in carotid artery stenosis and the occurrence of cerebrovascular ischemic events.
- It analyzed clinical data from 60 patients with plaque ulcers, categorizing them into proximal and distal groups based on the ulcer location.
- Results indicated that distal plaque ulcers were more frequently associated with ischemic events, with a significant difference in occurrences between the two groups (59% distal vs 18% proximal), emphasizing the need to understand plaque characteristics for better ischemic risk assessment.
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.
View Article and Find Full Text PDFFlow diverter (FD) devices are new-generation stents placed in the parent artery at the aneurysmal neck to obstruct intra-aneurysmal blood flow, thus favoring intra-aneurysmal thrombosis. In Japan, about eight years have passed since health insurance approval was granted for FD devices, and FD placement to treat aneurysms has become widespread. Treatment indications have also been expanded with the introduction of novel devices.
View Article and Find Full Text PDFPurpose: Postoperative cognitive dysfunction and recovery remain unclear in older patients undergoing interventional therapies for unruptured intracranial aneurysms (UIAs). This study aimed to compare changes in postoperative cognitive function between younger and older patients and to detect factors associated with non-recovery from postoperative cognitive dysfunction.
Methods: This study reviewed 59 consecutive patients with UIAs who underwent interventional therapies, including microsurgical clipping or endovascular treatment, from 2021 to 2022.
Objective: Surgical indications for low-grade carotid stenosis have not yet been established. This study aimed to clarify the characteristics of low-grade carotid stenosis refractory to medical treatment.
Methods: We retrospectively analyzed 48 patients with symptomatic low-grade carotid stenosis (<50%).
Purpose: The first randomized controlled study on unruptured brain arteriovenous malformations (bAVM), the ARUBA trial, demonstrate the superiority of medical management; however, it failed to completely rule out the efficacy of therapeutic interventions due to several limitations. This study aimed to examine the outcomes of multimodal interventional treatment for bAVM in terms of safety and efficacy.
Methods: We reviewed 226 consecutive patients with unruptured bAVM admitted to our institute between 2002 and 2022.
The spread of coronavirus disease 2019(COVID-19)is a concern as it may delay the detection of malignant tumors due to delayed medical checkups. We examined changes in the treatment of metastatic brain tumors before and after COVID- 19. A retrospective review of 211 patients with metastatic brain tumors who underwent initial gamma knife radiosurgery between July 2019 and December 2021 was conducted.
View Article and Find Full Text PDFBackground: No previous study has established the factors associated with intracranial aneurysm growth using imaging data obtained before the appearance of morphological changes. Therefore, we investigated the factors related to future aneurysm growth in posterior communicating artery (Pcom) aneurysms.
Methods: Using a longitudinal database of intracranial aneurysm cases, we reviewed the findings for consecutive patients with unruptured Pcom aneurysms admitted to our institute from 2012 to 2021.
Background: The single-device simplicity for mechanical thrombectomy (MT) is now challenged by the complementary efficacy of dual-device first-line with a stent retriever and an aspiration catheter.
Objective: To compare the outcomes after MT initiated with a single device vs dual devices in acute anterior circulation large vessel occlusion.
Methods: Patients who underwent MT for acute internal carotid artery (ICA) or M1 occlusion between 2015 and 2020 were retrospectively analyzed.
Background: Although tortuosity of the internal carotid artery (ICA) can pose a significant challenge when performing mechanical thrombectomy, few studies have examined the impact of ICA tortuosity on mechanical thrombectomy outcomes.
Methods: In a registry-based hospital cohort, consecutive patients with anterior circulation stroke in whom mechanical thrombectomy was attempted were divided into 2 groups: those with tortuosity in the extracranial or cavernous ICA (tortuous group) and those without (nontortuous group). The extracranial ICA tortuosity was defined as the presence of coiling or kinking.
In case of symptomatic varix associated with cerebral arteriovenous malformations (AVM), nidus is usually treated with transarterial embolization (TAE). However, TAE is not always possible due to inaccessible nidus. A man in his 40s presented with numbness and clumsiness in the right hand.
View Article and Find Full Text PDFObjective: To evaluate whether changes in the practice of mechanical thrombectomy could affect the clinical outcomes during the coronavirus disease (COVID-19) pandemic.
Methods: Patients who underwent mechanical thrombectomy from April 2019 to March 2021 for anterior circulation proximal large artery occlusion in our institute were divided into two groups of pre- and post-COVID-19, with April 2020 assumed to be the start of the COVID-19 era with the first declaration of a state of emergency. We compared patient characteristics, proportions of patient selection depending on rapid processing of perfusion and diffusion (RAPID) CT perfusion, outcomes including treatment variables such as time and reperfusion status, and patient independence at 3 months.
Background And Purpose: Arterial spin labeling (ASL) is a non-invasive modality of magnetic resonance imaging (MRI) used to evaluate cerebral perfusion without a contrast agent. The usefulness of ASL for diagnosis in the acute phase of late seizure after stroke was evaluated.
Methods: Twelve consecutive patients diagnosed with late seizure after stroke were enrolled in this study.