著者

Kittipong Srivatanakul

出版者

The Japanese Society for Neuroendovascular Therapy

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

pp.ra.2020-0051, (Released:2020-04-22)

参考文献数

24

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The arterial anatomy of the parasellar area is complex in that it deals with extracranial–intracranial anastomosis and supply to various cranial nerves in a small area. Pathologies such as hypervascular tumors and shunts are not uncommon and require good knowledge of anatomy in planning the treatment. In this article, the basic anatomy of the arterial supply in this region is discussed, covering the origins, territories, relation to the cranial nerves, and the connections among different systems.

著者

Kittipong Srivatanakul Satomi Asai Akihiro Hirayama Hideaki Shigematsu Makiko Niita Tomoko Kawakami Takatoshi Sorimachi Mitsunori Matsumae

出版者

The Japanese Society for Neuroendovascular Therapy

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

pp.sr.2020-0075, (Released:2020-04-21)

参考文献数

11

被引用文献数

6

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The crisis of the coronavirus disease (COVID-19) is causing damage to the social and medical community. However, extreme emergency neuro-interventions such as mechanical thrombectomy still require the healthcare workers to offer the appropriate treatment while preventing further spread of the infection. This article outlines the necessary steps in managing a possible COVID-19 patient starting from patient screening to personnel infection and environmental contamination measures.

著者

Akihiro Hirayama Kittipong Srivatanakul Hideaki Shigematsu Kazuma Yokota Takatoshi Sorimachi Mitsunori Matsumae

出版者

The Japanese Society for Neuroendovascular Therapy

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

pp.tn.2020-0192, (Released:2021-03-09)

参考文献数

8

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Objective: We report the utility of microcatheter reshaping by referring to fusion images with 3D-DSA and microcatheter 3D images made using non-subtraction and non-contrast (non-SC) rotational images.Case Presentations: Case 1: The patient was a 74-year-old man who had an internal carotid-anterior choroidal artery bifurcation aneurysm with a tortuous proximal parent artery. The initial attempt to introduce the microcatheter into the aneurysm was unsuccessful. During this unsuccessful microcatheter introduction, we created fusion images with 3D-DSA and microcatheter 3D images by acquiring positional information of the microcatheter using the non-SC method. By reshaping the microcatheter with reference to the fusion images, the direction of the distal end of the microcatheter was reshaped to be in accordance with the long axis of the aneurysm, a shape more suitable for coiling. Case 2: The patient was a 47-year-old man who had an anterior communicating (A-com) artery aneurysm with two daughter sacs. We successfully placed two microcatheters in the direction of each sac to make more stable framing by referring to 3D fusion images after the first microcatheter was positioned. In both cases, microcatheter reshaping was necessary because of the vessel and aneurysm anatomy. We have used this technique successfully in 15 patients, for both ruptured and unruptured aneurysms. The average number of microcatheter reshaping was 1.3 times.Conclusion: This method provides effective microcatheter reshaping for coil embolization of aneurysms, particularly those with differences between the axis of the parent artery and the vertical axis of aneurysm, or with a tortuous proximal artery.

著者

Akihiro Hirayama Satomi Asai Kittipong Srivatanakul Kazuma Yokota Hideaki Shigematsu Takatoshi Sorimachi Mitsunori Matsumae

出版者

The Japanese Society for Neuroendovascular Therapy

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

vol.15, no.8, pp.484-488, 2021 (Released:2021-08-20)

参考文献数

17

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Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SAR-CoV-2), which appeared at the end of 2019 and has spread rapidly worldwide. In Japan, the increasing number of people infected with SAR-CoV-2 is also a cause of concern for physicians managing stroke patients. From the perspective of viral transmission in the hospital, stroke physicians must determine whether patients who have been transported by emergency have confirmed or suspected COVID-19. For this reason, stroke physicians must also understand about the characteristics and accuracy of the test for COVID-19 diagnosis. This article describes the sensitivity of the clinical symptoms, imaging investigations such as chest radiography and chest CT, and accuracy of nucleic-acid amplification tests and antigen tests used in the diagnosis of COVID-19. However, it should be noted that the accuracy of specimen tests may change depending on the collection site, timing, and method, because positive results in these tested specimens depend on the viral loads. In performing medical treatment for stroke, high accuracy and rapid inspection for COVID-19 is desired, but this is not currently available. For acute stroke treatment, such as thrombectomy, we recommend that these emergency patients, who are suspected of COVID-19 by clinical symptoms and image investigations, should be treated with implementation of strict infection control against droplets, contact, and airborne transmission until the most sensitive polymerase chain reaction test result is confirmed as negative.