- 著者
- Shigeta MIYAKE Yasunobu NAKAI Taisuke AKIMOTO Shun ISHIKAWA Wakiko SARUTA Hiroki KURODA Satoru SHIMIZU Tetsuya YAMAMOTO
- 出版者
- The Japan Neurosurgical Society
- 雑誌
- Neurologia medico-chirurgica (ISSN:04708105)
- 巻号頁・発行日
- pp.2022-0397, (Released:2023-04-06)
- 参考文献数
- 8
Common carotid artery (CCA) occlusion (CCAO) is a rare cause of ischemic stroke and bypass surgery is the common treatment approach. However, safer alternatives should be developed to treat CCAO. A 68-year-old male was diagnosed with left-sided CCAO with decreased left visual acuity due to neck radiation therapy for laryngeal cancer. Recanalization therapy using a pull-through technique was initiated because cerebral blood flow progressively decreased during the follow-up period. First, after a short sheath was inserted into the CCA, the occluded CCA was retrogradely penetrated through the sheath. Second, a micro-guidewire was guided to the aorta from the femoral sheath where it was caught using a snare wire guided from the cervical sheath. Subsequently, the micro-guidewire was gently pulled out from the cervical sheath, penetrated the occluded lesion, and was secured to the femoral and cervical sheaths. Finally, the occluded lesion was dilated using a balloon, and the stent was placed. Five days postprocedure, the patient was discharged uneventfully and exhibited improved left visual acuity. In terms of reliable penetration of obstructive lesions and reduction of embolic and hemorrhagic complications, combined endovascular antegrade and direct retrograde carotid artery stenting is a versatile and minimally invasive treatment option for CCAO.
- 著者
- Sai YAO Daichi KITAHARA Hiroki KURODA Akira HIRABAYASHI
- 出版者
- The Institute of Electronics, Information and Communication Engineers
- 雑誌
- IEICE TRANSACTIONS on Fundamentals of Electronics, Communications and Computer Sciences (ISSN:09168508)
- 巻号頁・発行日
- vol.E106-A, no.2, pp.106-123, 2023-02-01
The mean, median, and mode are usually calculated from univariate observations as the most basic representative values of a random variable. To measure the spread of the distribution, the standard deviation, interquartile range, and modal interval are also calculated. When we analyze continuous relations between a pair of random variables from bivariate observations, regression analysis is often used. By minimizing appropriate costs evaluating regression errors, we estimate the conditional mean, median, and mode. The conditional standard deviation can be estimated if the bivariate observations are obtained from a Gaussian process. Moreover, the conditional interquartile range can be calculated for various distributions by the quantile regression that estimates any conditional quantile (percentile). Meanwhile, the study of the modal interval regression is relatively new, and spline regression models, known as flexible models having the optimality on the smoothness for bivariate data, are not yet used. In this paper, we propose a modal interval regression method based on spline quantile regression. The proposed method consists of two steps. In the first step, we divide the bivariate observations into bins for one random variable, then detect the modal interval for the other random variable as the lower and upper quantiles in each bin. In the second step, we estimate the conditional modal interval by constructing both lower and upper quantile curves as spline functions. By using the spline quantile regression, the proposed method is widely applicable to various distributions and formulated as a convex optimization problem on the coefficient vectors of the lower and upper spline functions. Extensive experiments, including settings of the bin width, the smoothing parameter and weights in the cost function, show the effectiveness of the proposed modal interval regression in terms of accuracy and visual shape for synthetic data generated from various distributions. Experiments for real-world meteorological data also demonstrate a good performance of the proposed method.