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Your search keyword '"Munetomo Nagao"' showing total 2 results
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2 results on '"Munetomo Nagao"'

1. High-flow arteriovenous malformation in the finger with transvenous ethanolamine oleate sclerotherapy using an arterial tourniquet and microballoon occlusion: A case report

Author

Hiromitsu Tannai, MD, PhD, Sota Oguro, MD, PhD, Munetomo Nagao, MD, PhD, Hideki Ota, MD, PhD, and Kei Takase, MD, PhD

Subjects
Arteriovenous malformation, Sclerotherapy, Endovascular, Ethanolamine oleate, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

Endovascular therapy is an important method of treating high-flow arteriovenous malformations (AVMs). The nidus of AVMs can be treated by transarterial or percutaneous approaches with the use of ethanol as a strong embolic agent; however, treatment outcomes are not always satisfactory and complications including skin necrosis often occur, particularly following the treatment of superficial lesions. Herein, we describe successful transvenous sclerotherapy of high-flow AVMs in the finger of a 47-year-old female patient that were causing erythema and spontaneous pain using ethanolamine oleate (EO) as a safe sclerosant. Dynamic contrast-enhanced computed tomography and angiography revealed a high-flow type Ⅲb AVM according to Yakes classification. Using the transvenous approach, 5% EO with idoxanol was injected into the nidus of the AVM 3 times over 2 sessions. An arterial tourniquet was used to achieve stasis of blood flow at the nidus and microballoon occlusion of the outflow vein was used to ensure the sclerosant effectively reached the nidus. Near-total occlusion of the nidus was achieved leading to improved symptoms. Mild edema lasting 2 weeks occurred as a minor reaction after each session. Finger amputation may have been avoided by using this treatment. Transvenous EO sclerotherapy using an arterial tourniquet and balloon occlusion may have utility in treating AVMs in the extremities.

Published
2023
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2. Oblique lateral incision and subpectoral dissection in modified Nuss procedure minimize future breast deformity

Author

Seiichiro Kobayashi, Munetomo Nagao, Shin Kudoh, Tomoyuki Yasuoka, and Hiroaki Kimura

Subjects
Reoperation, medicine.medical_specialty, pectus excavatum, Adolescent, Mammaplasty, Dissection (medical), Nuss procedure, Oblique lateral, Imaging, Three-Dimensional, Pectus excavatum, medicine, Humans, Inframammary fold, Breast, Child, Mammary Glands, Human, Retrospective Studies, Adult female, Breast deformity, business.industry, breast deformity, Anatomy, medicine.disease, Surgery, Treatment Outcome, Child, Preschool, Funnel Chest, Female, business, Complication, Mammography
Abstract

Summary Background We experienced the occurrence of breast deformity in some young female patients who underwent a modified Nuss procedure before breast development. We studied the causes of and preventive measures for this complication. Methods We classified 13 prepubescent female patients who underwent our modified Nuss procedure into three groups according to the direction of the skin incision and the dissection layer for bar insertion. Four patients who underwent transverse lateral thoracic skin incision and bar insertion through a subpectoral dissection were assigned to the T/SP group, five who underwent oblique skin incision along the rib and bar insertion through a suprapectoral dissection were assigned to the O/IP group, and four who underwent oblique skin incision and subpectoral dissection were assigned to the O/SP group. Each patient in the T/SP group underwent the operation by a different surgeon, two of whom were the authors, including the first author; the first author performed all operations in the O/IP and O/SP groups. The first author evaluated the shape of the developed breasts using the frontal- and oblique-view photographs. We also investigated the location of the lateral border of the mammary gland in seven other adolescent and adult female patients using three-dimensional computed tomography images. Results Lateral depression of the breast occurred in four of eight breasts with a transverse incision, and flattening of the lowermost portion of the inframammary fold occurred in six of 10 breasts with suprapectoral dissection. None of the eight breasts with an oblique incision and subpectoral dissection exhibited deformities. The lateral border of the mammary gland was on the fifth rib in five patients and on the fifth intercostal space in two patients. Conclusion An oblique lateral thoracic skin incision along the sixth rib and subpectoral dissection may reduce the occurrence of breast deformity.

Published
2015
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