- 著者
- Genki Usui Yohei Takayama Hirotsugu Hashimoto Takehiro Katano Masahiro Yanagiya Masashi Kusakabe Tamaki Miura Jun Matsumoto Hajime Horiuchi Seiji Okubo
- 出版者
- The Japanese Society of Internal Medicine
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- pp.1962-18, (Released:2018-12-18)
- 参考文献数
- 19
- 被引用文献数
- 17
Postoperative cerebral embolism after left upper lobectomy caused by a thrombus in the pulmonary vein stump (PVS) is a serious complication. However, it is unclear if cerebral embolism can develop after other types of lobectomy. We present a case of a 68-year-old man with cerebral embolism after left lower lobectomy with a longer PVS than normal. There were no clinically suspected sources for the thrombus except for the PVS. This thrombus seemed to have formed in the PVS. The endovascularly removed thrombus contained scattered nuclear debris around neutrophils, suggesting a physiological response caused by tissue injury.
- 著者
- Satoshi Suda Yuki Sakamoto Seiji Okubo Junya Aoki Takashi Shimoyama Takuya Kanamaru Kentaro Suzuki Akihito Kutsuna Noriko Matsumoto Chikako Nito Yasuhiro Nishiyama Masahiro Mishina Kazumi Kimura
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.82, no.10, pp.2647-2654, 2018-09-25 (Released:2018-09-25)
- 参考文献数
- 22
- 被引用文献数
- 1 7
Background: This study investigated changes in anticoagulant use, treatment, and functional outcomes in acute ischemic stroke (AIS) patients with non-valvular atrial fibrillation (NVAF) over a 6-year period. Methods and Results: Patients with AIS and NVAF admitted to our department from April 2011 to March 2017 were analyzed retrospectively. Patients were divided into 3 groups based on the time of the initial visit (Periods 1–3, corresponding to April 2011–March 2013, April 2013–March 2015, and April 2015–March 2017, respectively). Associations between prescribed medication prior to event and stroke severity, reperfusion therapy, and outcomes were assessed. There was no significant change in the rate of insufficient warfarin and inappropriately lowered doses of direct oral anticoagulant (DOAC) treatment over time. The number of patients receiving prior DOAC treatment increased, but neurological severity on admission was milder than in the other 2 groups. The rate of reperfusion therapy increased from 19.9% (Period 1) to 42.7% (Period 3) for moderate-to-severe stroke patients. Multivariate logistic regression analysis revealed that reperfusion therapy was independently positively associated with good functional outcomes, but negatively associated with mortality (odds ratios [95% confidence intervals] 7.14 [3.34–15.29] and 0.13 [0.008–0.69], respectively). Conclusions: Inappropriate anticoagulant use for stroke patients with NVAF did not decrease over time. An increase in reperfusion therapy was a strong factor in improved functional outcomes and mortality.