著者

Kazutaka UCHIDA Nobuyuki SAKAI Hiroshi YAMAGAMI Kohei UEMURA Hirotoshi IMAMURA Masataka TAKEUCHI Manabu SHIRAKAWA Fumihiro SAKAKIBARA Koichi HARAGUCHI Naoto KIMURA Kentaro SUZUKI Junichi AYABE Daisuke YAMAMOTO Seigo SHINDO Atsushi KIMOTO Kenichi MORITA Yoshinori AKIYAMA Hidesato TAKEZAWA Shingo TOYOTA Kanta TANAKA Shigen KASAKURA Eisuke TSUKAGOSHI Toshihiro UEDA Shinichi YOSHIMURA Japan Trevo Registry Investigators

出版者

The Japan Neurosurgical Society

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

pp.2023-0069, (Released:2023-10-18)

参考文献数

18

被引用文献数

2

---

Endovascular therapy (EVT) for real-world patients after extended time frames is associated with concerns about its efficacy and safety. We conducted a prospective registry at 77 centers between November 2019 and October 2020. The registry criteria included patients treated with Trevo Retriever alone or in combined therapy with an aspiration catheter. The primary outcome was effective reperfusion (thrombolysis in cerebral infarction grade ≥ 2b), the secondary outcome was a modified Rankin scale 0-2 at 90 days, and the safety outcomes were worsening of neurologic symptoms within 24 h postoperatively, intracranial hemorrhage (ICH) within 24 h after EVT and mortality. We also exlpored the difference between patients whose last known well time (LKWT) to a puncture was less than 6 h (0-6 h) and those whose LKWT was 6 h or more but less than 24 h (6-24 h). Among the 1041 patients registered, 1025 patients were analyzed. The mean age was 76.9 years, and 53.6% of the participants were males. The 6-24 h group was 206/998 (20.6%), the median National Institute of Health Stroke Scale (NIHSS) score at admission was 18, and the median Alberta Stroke Program Early CT score was 8. Combined technique as the first pass was used on 817 (79.7%) patients. The primary outcome was 934 (91.1%). The secondary outcome was 433/1021 (42.4%). Symptomatic ICH, any ICH, and mortality were 10/1019 (1.0%), 311/1019 (30.5%), and 75 (7.3%). In the subanalysis, the 6-24 h group was lower in NIHSS (median;18 vs 16), and the secondary outcome was not significantly different in the <6 h group. Even after treatment time expansion, this result was comparable to other Trevo-based trials and nationwide registries.

著者

Kokyo SAKURADA Akio TERANISHI Eisuke TSUKAGOSHI Satoshi IIHOSHI Hiroki KURITA Shinya KOHYAMA

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.9, pp.37-41, 2022-12-31 (Released:2022-04-01)

参考文献数

9

被引用文献数

1

---

Stent-assisted coil embolization (SACE) is useful for treating wide-necked aneurysms. Most superior cerebellar artery (SCA) aneurysms have a wide neck, but there are few reports of SCA aneurysms treated with SACE.One reason is that the anatomical characteristic of SCA aneurysm is not suitable for standard SACE. It is often challenging to deliver a stent to SCA via the basilar artery in an anterograde manner. In contrast, it is not difficult to deliver a stent to SCA from the anterior circulation via the posterior communicating artery. This method, in which a catheter is navigated from the anterior to the posterior circulation, is called a transcirculation technique.We report two cases of SCA aneurysm successfully treated with SACE using transcirculation technique. This approach is helpful for wide-necked SCA aneurysms.