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8. Transvenous embolization for an intraosseous clival arteriovenous fistula via a proper access route guiding a three-dimensional fusion image: illustrative case

Author

Iida, Yu, primary, Suenaga, Jun, additional, Shimizu, Nobuyuki, additional, Shizawa, Kaoru, additional, Suzuki, Ryosuke, additional, Miyake, Shigeta, additional, Akimoto, Taisuke, additional, Hori, Satoshi, additional, Tateishi, Kensuke, additional, Nakai, Yasunobu, additional, and Yamamoto, Tetsuya, additional

Published
2023
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10. Cerebral Infarction Due to Occlusion of Main Trunk of Middle Cerebral Artery in Patient with Accessory Middle Cerebral Artery

Author

Tsuchiya, Atsushi, additional, Tsukiyama, Atsushi, additional, Matsumoto, Shutaro, additional, Uekusa, Toshimasa, additional, Abe, Hiroyuki, additional, Fukui, Issei, additional, Iida, Yu, additional, Mori, Kentaro, additional, Kawahara, Yosuke, additional, Tamase, Akira, additional, Abe, Katsuya, additional, Yamashita, Ryotaro, additional, Takeda, Mutsuki, additional, Nakano, Tatsu, additional, and Nomura, Motohiro, additional

Published
2022
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11. Preoperative tumor embolization prolongs time to recurrence of meningiomas: a retrospective propensity-matched analysis

Author

Akimoto, Taisuke, primary, Ohtake, Makoto, additional, Miyake, Shigeta, additional, Suzuki, Ryosuke, additional, Iida, Yu, additional, Shimohigoshi, Wataru, additional, Higashijima, Takefumi, additional, Nakamura, Taishi, additional, Shimizu, Nobuyuki, additional, Kawasaki, Takashi, additional, Sakata, Katumi, additional, and Yamamoto, Tetsuya, additional

Published
2022
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14. Preoperative tumor embolization prolongs time to recurrence of meningiomas: a retrospective propensity-matched analysis

Author

Akimoto, Taisuke, Ohtake, Makoto, Miyake, Shigeta, Suzuki, Ryosuke, Iida, Yu, Shimohigoshi, Wataru, Higashijima, Takefumi, Nakamura, Taishi, Shimizu, Nobuyuki, Kawasaki, Takashi, Sakata, Katumi, and Yamamoto, Tetsuya

Abstract

BackgroundMeningiomas are often embolized preoperatively to reduce intraoperative blood loss and facilitate tumor resection. However, the procedure is controversial and its effects have not yet been reported. We evaluated preoperative embolization for meningiomas and its effect on postoperative outcome and recurrence.MethodsWe retrospectively reviewed the medical records of 186 patients with WHO grade I meningiomas who underwent surgical treatment at our hospital between January 2010 and December 2020. We used propensity score matching to generate embolization and no-embolization groups (42 patients each) to examine embolization effects.ResultsPreoperative embolization was performed in 71 patients (38.2%). In the propensity-matched analysis, the embolization group showed favorable recurrence-free survival (RFS) (mean 49.4 vs 24.1 months; Wilcoxon p=0.049). The embolization group had significantly less intraoperative blood loss (178±203 mL vs 221±165 mL; p=0.009) and shorter operation time (5.6±2.0 hours vs 6.8±2.8 hours; p=0.036). There were no significant differences in Simpson grade IV resection (33.3% vs 28.6%; p=0.637) or overall perioperative complications (21.4% vs 11.9%; p=0.241). Tumor embolization prolonged RFS in a subanalysis of cases who experienced recurrence (n=39) among the overall cases before variable control (mean RFS 33.2 vs 16.0 months; log-rank p=0.003).ConclusionsAfter controlling for variables, preoperative embolization for meningioma did not improve the Simpson grade or patient outcomes. However, it might have effects outside of surgical outcomes by prolonging RFS without increasing complications.

Published
2023
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20. “The microcatheter contrast injection technique”: A novel technique to detect the proximal end of a thrombus in mechanical thrombectomy

Author

Iida, Yu, Mori, Kentaro, Kawahara, Yosuke, Fukui, Issei, Yamashita, Ryotaro, Takeda, Mutsuki, Nakano, Tatsu, Hori, Satoshi, Suenaga, Jun, Shimizu, Nobuyuki, Nomura, Motohiro, and Yamamoto, Tetsuya

Abstract

Background:An aspiration catheter needs to attach to a thrombus in order to achieve first-pass recanalization by mechanical thrombectomy (MT) for acute ischemic stroke (AIS), particularly that using a direct aspiration first pass technique. The meniscus sign, which is defined as meniscoid contrast opacification indicating the proximal edge of a thrombus, has been suggested to contribute to successful recanalization. In some cases, the meniscus sign is not detected following an injection of contrast medium through a guiding catheter. To precisely identify the location of a thrombus, we use “the microcatheter contrast injection (MCI) technique,” which accurately shows the proximal edge of a thrombus. We herein introduce this novel technique and discuss its efficacy in MT. Methods:In cases without the meniscus sign, a microcatheter was advanced to the distal end of contrast opacification, and contrast medium was injected through the microcatheter to detect the meniscus sign. An aspiration catheter was then advanced to the thrombus indicated by the meniscus sign and slowly withdrawn under aspiration. Results:29 patients underwent MT for AIS using the MCI technique. Even in cases without the meniscus sign on initial angiography, the MCI technique accurately revealed the proximal edge of the thrombus. Moreover, middle cerebral artery occlusion due to atherosclerotic stenosis and displacement of the aspiration catheter and thrombus axis were detected using this technique. Conclusions:The MCI technique may effectively reveal the exact site of a thrombus and increase the success rate of first-pass recanalization.

Published
2024
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28. Pseudoaneurysm formation due to rupture of intracranial aneurysms: Case series and literature review

Author

Nomura, Motohiro, primary, Mori, Kentaro, additional, Tamase, Akira, additional, Kamide, Tomoya, additional, Seki, Syunsuke, additional, Iida, Yu, additional, Nakano, Tatsu, additional, Kawabata, Yuichi, additional, Kitabatake, Taro, additional, Nakajima, Teruyuki, additional, Yasutake, Kiyoyuki, additional, Egami, Kei, additional, Takahashi, Tatsunori, additional, Takahashi, Mitsuyuki, additional, and Yanagimoto, Kunio, additional

Published
2017
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31. Post-ischaemic hyperperfusion in traumatic middle cerebral artery dissection detected by arterial spin labelling of magnetic resonance imaging

Author

Nomura, Motohiro, primary, Tamase, Akira, additional, Kamide, Tomoya, additional, Mori, Kentaro, additional, Seki, Syunsuke, additional, Iida, Yu, additional, Suzuki, Kei-ichiro, additional, Aoki, Takae, additional, Hirano, Ken-ichi, additional, Takahashi, Mitsuyuki, additional, Kawabata, Yuichi, additional, Nakano, Tatsu, additional, and Taguchi, Hiroki, additional

Published
2016
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37. Thromboembolic complications during endovascular treatment of ruptured cerebral aneurysms

Author

Nomura, Motohiro, Mori, Kentaro, Tamase, Akira, Kamide, Tomoya, Seki, Syunsuke, Iida, Yu, Shirokane, Kazutaka, Baba, Eiichi, Tsuchiya, Atsushi, and Shima, Hiroshi

Abstract

Background In cases of subarachnoid hemorrhage due to aneurysm rupture, the administration of an anticoagulant or antiplatelet agent involves the risk of rebleeding from the aneurysm. There is a possibility of inducing thromboembolic events during the endovascular embolization of ruptured cerebral aneurysms.Patients and methods From April 2006 to March 2017, we treated a total of 70 patients with ruptured cerebral aneurysms with an endovascular technique. Among them, five patients (7.1%) showed intra-arterial thrombus formation. The aneurysms were located at the anterior communicating artery and basilar artery in two patients each, and on the internal carotid artery at the bifurcation of the anterior choroidal artery (AChoA) in one. In these patients, the clinical course, radiological findings, and management were retrospectively reviewed.Results Thrombus formation was observed in the posterior cerebral artery, anterior cerebral artery (A2), AChoA, and middle cerebral artery. The timing of thrombus formation was during coil delivery in four cases, and guiding catheter advancement in one. As for thrombus management, for all patients, administrations of heparin and antiplatelet agents were performed. For four patients, urokinase injection into the affected arteries was added after the completion of embolization. Cerebral infarction was postoperatively identified in two patients, but no hemorrhage was noted.Conclusion Administrations of heparin and antiplatelet drugs should be performed appropriately during procedures, and close observation of the arterial condition on angiography is necessary. Once thromboembolism occurs during the endovascular embolization of ruptured cerebral aneurysms, adequate heparinization, and antiplatelet therapy should first be performed.

Published
2018
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38. "The microcatheter contrast injection technique": A novel technique to detect the proximal end of a thrombus in mechanical thrombectomy.

Author

Iida Y, Mori K, Kawahara Y, Fukui I, Yamashita R, Takeda M, Nakano T, Hori S, Suenaga J, Shimizu N, Nomura M, and Yamamoto T

Abstract

Background: An aspiration catheter needs to attach to a thrombus in order to achieve first-pass recanalization by mechanical thrombectomy (MT) for acute ischemic stroke (AIS), particularly that using a direct aspiration first pass technique. The meniscus sign, which is defined as meniscoid contrast opacification indicating the proximal edge of a thrombus, has been suggested to contribute to successful recanalization. In some cases, the meniscus sign is not detected following an injection of contrast medium through a guiding catheter. To precisely identify the location of a thrombus, we use "the microcatheter contrast injection (MCI) technique," which accurately shows the proximal edge of a thrombus. We herein introduce this novel technique and discuss its efficacy in MT. Methods: In cases without the meniscus sign, a microcatheter was advanced to the distal end of contrast opacification, and contrast medium was injected through the microcatheter to detect the meniscus sign. An aspiration catheter was then advanced to the thrombus indicated by the meniscus sign and slowly withdrawn under aspiration. Results: 29 patients underwent MT for AIS using the MCI technique. Even in cases without the meniscus sign on initial angiography, the MCI technique accurately revealed the proximal edge of the thrombus. Moreover, middle cerebral artery occlusion due to atherosclerotic stenosis and displacement of the aspiration catheter and thrombus axis were detected using this technique. Conclusions: The MCI technique may effectively reveal the exact site of a thrombus and increase the success rate of first-pass recanalization., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2023
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39. Angioarchitecture of the hemorrhagic developmental venous anomaly with stenosis of the collecting vein and cavernous malformation: a case report.

Author

Iida Y, Mori K, Kawahara Y, Fukui I, Yamashita R, Takeda M, Nakano T, Taguchi H, and Nomura M

Subjects
Female, Humans, Aged, Constriction, Pathologic diagnostic imaging, Cerebral Hemorrhage etiology, Cerebral Hemorrhage complications, Central Nervous System Vascular Malformations complications, Central Nervous System Vascular Malformations diagnostic imaging, Cerebral Veins diagnostic imaging, Cerebral Veins abnormalities, Hemangioma, Cavernous, Central Nervous System complications, Hemangioma, Cavernous, Central Nervous System diagnostic imaging
Abstract

We herein report a case of developmental venous anomaly (DVA) with venous congestion caused by stenosis of the collecting vein that presented with intracerebral hemorrhage (ICH). A 74-year-old woman was referred to our hospital a few days after the onset of motor aphasia. Computed tomography (CT) and magnetic resonance imaging (MRI) showed ICH in the left frontal lobe. Angiography revealed DVA in the left frontal lobe in the late venous phase. Stenosis of the collecting vein of DVA at the entrance to the superior sagittal sinus was detected and accompanied by cavernous malformation (CM) beside DVA. Cone-beam CT revealed the absence of the left septal vein and hypoplastic transverse caudate veins. The patient was treated by blood pressure management and no additional neurological symptoms were detected. DVA develops to compensate for the absence of pial or deep venous systems, and generally benign and clinically asymptomatic. However, the outflow restriction of DVA causes chronic venous hypertension and the formation of CM. These abnormalities are considered to occur during post-natal life and may result in ICH. The risk of hemorrhage needs to be considered in cases of DVA with restricted venous outflow or CM.

Published
2023
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40. Superficial Temporal Artery-Middle Cerebral Artery Bypass Using a Thick STA after Endarterectomy: A Rescue Technique.

Author

Nomura M, Tamase A, Kamide T, Mori K, Seki S, Iida Y, Kawabata Y, Nakano T, Shima H, and Yanagimoto K

Subjects
Aged, Anastomosis, Surgical methods, Cerebrovascular Circulation physiology, Humans, Male, Middle Aged, Treatment Outcome, Cerebral Revascularization methods, Endarterectomy methods, Infarction, Middle Cerebral Artery surgery, Middle Cerebral Artery surgery, Temporal Arteries surgery
Abstract

Background and Objective  Superficial temporal artery (STA)-middle cerebral artery (MCA) bypass is a procedure to reconstruct cerebral blood flow in the MCA territory. In some cases, the STA wall is thickened and the size discrepancy between STA and MCA is apparent. In such a situation, STA-MCA bypass is challenging. We present two patients who underwent STA-MCA bypass using STA in which a thickened intima was removed. We discuss the usefulness of this rescue technique. Patients and Results  A patient with an atherosclerotic MCA occlusion and another with an occluded internal carotid artery are included. Endarterectomy of STA was performed before or during anastomosis, and the intima-resected STA was anastomosed to MCA. In both cases, the STA was thick and hard, and it was difficult to anastomose the STA as it was to the MCA. Patency of the bypass was confirmed by postoperative angiography. Conclusion  Endarterectomy of a thickened STA might be an effective rescue technique in cases with severely atherosclerotic STA in STA-MCA bypass., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Georg Thieme Verlag KG Stuttgart · New York.)

Published
2017
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41. Aneurysm at origin of duplicated middle cerebral artery associated with another aneurysm.

Author

Iida Y, Tamase A, Kamide T, Mori K, Seki S, and Nomura M

Abstract

Background: A duplicated middle cerebral artery (DMCA) is a rare vessel anomaly. Aneurysms at the origin of DMCA have been reported., Case Description: We report 2 cases of aneurysms at the origin of DMCA accompanied by aneurysms at different sites. Each case of ruptured and unruptured aneurysm at the DMCA origin was associated with an unruptured aneurysm at the ipsilateral internal carotid artery and a ruptured one at the ipsilateral MCA, respectively. The aneurysms were clipped successfully in both patients., Conclusion: In cases of DMCA aneurysm associated with an aneurysm at another site, either aneurysm has a high risk of rupture. In such a case, radical treatment is necessary.

Published
2015
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