12 results on '"Meshii K"'
Search Results
2. The association between perioperative embolization of hypogastric arteries and type II endoleaks after endovascular aortic aneurysm repair.
- Author
-
Meshii K, Sugimoto M, Niimi K, Kodama A, Banno H, and Komori K
- Subjects
- Adult, Aged, Aged, 80 and over, Aortography, Computed Tomography Angiography, Endoleak diagnosis, Endoleak epidemiology, Female, Gastric Artery, Humans, Male, Middle Aged, Retrospective Studies, Aortic Aneurysm, Abdominal surgery, Embolization, Therapeutic methods, Endoleak prevention & control, Endovascular Procedures adverse effects
- Abstract
Objective: Type II endoleaks (T2ELs) are the most common type of endoleak after endovascular aneurysm repair (EVAR). The iliolumbar artery arising from the hypogastric artery is often a major source of T2ELs, and transarterial embolization of the iliolumbar artery through the hypogastric artery is sometimes performed to interrupt sac expansion during follow-up. Considering the equivocal results of an association between hypogastric embolization and T2ELs in previous studies, this topic has re-emerged after the advent of iliac branch devices. This study reviewed our series to clarify whether hypogastric embolization is associated with T2ELs at 12 months after EVAR., Methods: Patients who underwent elective EVAR between June 2007 and May 2017 at our institution were retrospectively reviewed. Patients with postoperative computed tomography angiography (CTA) at 12 months were included. Patients in whom CTA revealed type I or type III endoleaks during follow-up, who required reinterventions before 12 months, and who had solitary iliac aneurysms were excluded. The primary outcome was the incidence of T2ELs at 12 months after EVAR. The associations of patients' characteristics, anatomic factors, hypogastric embolization, and type of endograft with the primary outcome were analyzed., Results: In total, 375 patients were enrolled. During the median follow-up of 59.5 months (interquartile range, 19-126 months), 40 patients died, and 50 reinterventions were performed. In 108 patients (28.8%), either hypogastric artery was embolized to extend distal landings to the external iliac artery. Bilateral and unilateral embolization was performed in nine and 99 patients, respectively. In total, 153 patients (40.8%) had T2ELs found by CTA at 12 months. In the univariate analysis, the status of hypogastric artery occlusion or embolization was not significantly different between patients with and without T2ELs. However, there were not enough patients to detect a 10% difference in T2ELs with >80% statistical power. In the multivariate analysis, significant associations with T2EL were observed for female sex (P = .049), patent inferior mesenteric artery (P = .006), and presence of five or more patent lumbar arteries (P < .001) but not for hypogastric embolization. In addition, compared with the Zenith (Cook Medical, Bloomington, Ind) endograft, the Excluder (W. L. Gore & Associates, Flagstaff, Ariz) endograft was significantly related to T2EL (P = .001)., Conclusions: No significant association between hypogastric embolization and T2EL was demonstrated in this retrospective study, which lacked adequate statistical power., (Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2021
- Full Text
- View/download PDF
3. Early and midterm outcomes of celiac artery coverage during thoracic endovascular aortic repair.
- Author
-
Banno H, Ikeda S, Kawai Y, Meshii K, Takahashi N, Sugimoto M, Kodama A, and Komori K
- Subjects
- Adult, Aged, Aged, 80 and over, Aorta, Thoracic diagnostic imaging, Aorta, Thoracic surgery, Aortic Aneurysm, Thoracic diagnosis, Celiac Artery diagnostic imaging, Collateral Circulation, Computed Tomography Angiography, Endoleak etiology, Endovascular Procedures instrumentation, Feasibility Studies, Female, Follow-Up Studies, Humans, Male, Mesenteric Artery, Superior diagnostic imaging, Middle Aged, Retrospective Studies, Stents, Treatment Outcome, Aortic Aneurysm, Thoracic surgery, Celiac Artery surgery, Endoleak epidemiology, Endovascular Procedures methods
- Abstract
Background: In thoracic endovascular aortic repair (TEVAR), covering the celiac artery (CA) is sometimes necessary to secure the distal seal. We report the outcomes of planned CA coverage in our experience with TEVAR., Methods: Cases requiring CA coverage during TEVAR from October 2008 to September 2018 were retrospectively reviewed. Patient demographics, indications for CA coverage, communication between the CA and the superior mesenteric artery (SMA), concomitant CA embolization, and perioperative and late results were collected in a prospective database and analyzed., Results: During the study decade, 357 patients underwent TEVAR at our institution. Of these patients, 15 (4.2%) required CA coverage. All 15 patients were male, and the mean age was 72.8 years (range, 44-80 years). The mean aneurysm size was 67.5 mm (range, 50-82 mm). The etiologies included 10 degenerative aneurysms (66.7%; 2 ruptures [13.3%], 4 dissecting aneurysms [26.7%], and 1 case of type IB endoleak [6.7%]) after TEVAR. Communicating collaterals between the CA and the SMA were confirmed by preoperative computed tomography angiography in eight patients (53.3%) and by intraoperative angiography in four patients (26.7%). Seven patients (46.7%) underwent concomitant embolization of the CA. CA coverage offered a mean extension of 20.3 mm (range, 12-22 mm) in the length of the distal seal. Postoperative computed tomography angiography revealed a type IB endoleak that resolved spontaneously in one patient (6.7%). Postoperative complications included splenic infarction/pancreatitis in one patient (6.7%) and spinal cord ischemia in two patients (13.3%). There were no cases of postoperative in-hospital mortality. During the follow-up period (mean, 3.6 years; range, 0.9-8.0 years), two patients developed a new type IB endoleak. One patient underwent distal extension of the stent graft with ilio-SMA bypass, and one patient was observed conservatively in accordance with the patient's decision. There were no cases of type II endoleak via the CA. Most aneurysms (86.7%) were stable or reduced in size at the most recent follow-up. There were no cases of targeted aneurysm-related death during the follow-up period., Conclusions: Our study demonstrates the safety and efficacy of CA coverage in facilitating adequate distal sealing in selected patients undergoing TEVAR. Because the distal sealing length is not completely sufficient in most cases requiring CA coverage, the long-term efficacy of CA coverage during TEVAR should be determined in a large prospective study., (Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
4. Surgical resection of two independent primary intimal sarcomas in the left atrium.
- Author
-
Ohnaka M, Kyogoku M, Nakajima H, Osada H, Meshii K, and Kanemitsu N
- Subjects
- Aged, Biomarkers, Tumor analysis, Fatal Outcome, Heart Failure etiology, Heart Neoplasms surgery, Humans, Immunohistochemistry, Male, Neoplasms, Multiple Primary surgery, Sarcoma surgery, Heart Atria pathology, Heart Neoplasms pathology, Neoplasms, Multiple Primary pathology, Sarcoma pathology, Tunica Intima pathology
- Abstract
Primary intimal sarcoma of the heart is an extremely rare tumor that is known to have a very poor prognosis. We present a case of a 65-year-old man who suffered from deteriorating congestive heart failure due to a severe mitral stenosis caused by a large mobile left atrial tumor. The patient underwent an emergency operation of the tumor in the left atrium. The tumor was attached to the inferior wall of the left atrium. After the resection of the tumor, a second tumor on the interatrial septum, which had not been detected in the preoperative investigation, was discovered and resected. The patient developed acute respiratory failure soon after the operation and succumbed to his illness. The appearance of the main tumor was cauliflower-like, which strongly suggested the possibility of malignancy. Immunohistochemistry revealed that the neoplastic cells were positive for vimentin, desmin, p16, and especially murine double minute 2 (MDM-2). The first tumor was CD34 positive and cdk4 negative, but the second tumor was more anaplastic and CD34 negative and cdk4 positive, which suggests a different origin of the two tumors. The two tumors were diagnosed as intimal sarcomas by MDM-2, which is currently considered a conclusive marker. This is an exceptionally rare case of two simultaneous and possibly independent primary intimal sarcomas in the left atrium., (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
5. Giant atrial septal aneurysm originating from the right coronary artery.
- Author
-
Osada H, Kanemitsu N, Meshii K, and Ohnaka M
- Subjects
- Aged, Cardiac Surgical Procedures methods, Coronary Aneurysm complications, Coronary Aneurysm surgery, Coronary Vessels surgery, Fistula diagnosis, Fistula surgery, Heart Aneurysm etiology, Heart Aneurysm surgery, Humans, Male, Tomography, X-Ray Computed, Atrial Septum, Coronary Aneurysm diagnosis, Coronary Vessels diagnostic imaging, Fistula etiology, Heart Aneurysm diagnosis
- Abstract
Giant coronary artery aneurysm is a rare clinical entity and its involvement in the interatrial space is extremely rare. We here report the rare surgical case of a 67-year old man with giant right coronary artery aneurysm located in the atrial septum with fistula formation to the right atrium, complicated with congestive heart failure, rapid atrial fibrillation and left atrial appendage thrombus. The patient eventually recovered fully without sequelae., (© The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
6. [Severe Perioperative Coronary Artery Spasm in Thoracic Aortic Surgery; Report of Two Cases].
- Author
-
Osada H, Kanemitsu N, Kushiyama A, Kato M, Meshii K, Ohnaka M, and Nakajima H
- Subjects
- Aged, Cardiopulmonary Bypass, Humans, Male, Perioperative Period, Aortic Dissection surgery, Aortic Aneurysm, Thoracic surgery, Coronary Artery Disease, Spasm
- Abstract
We report 2 cases of severe perioperative coronary artery spasm in thoracic aortic surgery. Case 1 was a 72-year-old male with a distal arch aneurysm of 74 mm while case 2 was a 74-year-old male with acute type A aortic dissection. We performed thoracic aortic repair (total arch replacement and ascending aorta replacement) under moderately hypothermic circulatory arrest (25 °C) and selective cerebral perfusion in both cases. ST elevation, abnormal left ventricular wall motion, and hypotension were noted intraoperatively. Because we were not able to wean the patients from the cardiopulmonary bypass, intraaortic balloon pump was initiated in case 1 and a coronary artery bypass graft was added in case 2. In addition to using vasodilators such as diltiazem, case 1 recovered without further intervention, but case 2 developed cardiopulmonary arrest and needed resuscitation on postoperative day 5 because of recurrence of coronary spasm. Perioperative coronary artery spasm is rare especially in aortic surgery, and may become lethal. Early recognition and special hemodynamic support is required.
- Published
- 2016
7. Intimal Flap Vegetation Following Aortic Root Re-dissection.
- Author
-
Osada H, Nakajima H, Meshii K, and Ohnaka M
- Abstract
A 75-year-old man who had undergone ascending aorta replacement for acute Type A aortic dissection presented with a recurring high fever. Transesophageal echocardiography revealed that a vegetation had formed on the re-dissected intimal flap of the noncoronary sinus of Valsalva. This didactic case suggests that antibiotic prophylactic measures be considered for aortic dissection flaps as for irregular valves susceptible to infective endocarditis.
- Published
- 2016
- Full Text
- View/download PDF
8. Acute coronary artery bypass graft failure in a patient with polycythemia vera.
- Author
-
Osada H, Nakajima H, Meshii K, and Ohnaka M
- Subjects
- Aged, Coronary Angiography, Coronary Artery Disease complications, Coronary Artery Disease diagnosis, Coronary Thrombosis diagnosis, Coronary Thrombosis therapy, Graft Occlusion, Vascular diagnosis, Graft Occlusion, Vascular therapy, Humans, Male, Myocardial Infarction diagnosis, Myocardial Infarction therapy, Percutaneous Coronary Intervention, Polycythemia Vera diagnosis, Risk Factors, Thromboembolism diagnosis, Time Factors, Treatment Failure, Coronary Artery Bypass adverse effects, Coronary Artery Disease surgery, Coronary Thrombosis etiology, Graft Occlusion, Vascular etiology, Myocardial Infarction etiology, Polycythemia Vera complications, Thromboembolism etiology
- Abstract
Polycythemia vera in patients undergoing cardiac surgery is clinically rare. A 65-year-old man with polycythemia vera was admitted with effort-related chest discomfort. We planned coronary artery bypass grafting for left anterior descending artery and obtuse marginal branch stenosis, using bilateral internal thoracic arteries, with perioperative prophylactic management to avoid thromboembolism. His internal thoracic arterial grafts occluded during and after surgery due to thrombus, and ST-elevation myocardial infarction developed, which needed a percutaneous coronary intervention. This case suggests that optimal management methods should be studied further to contribute to better patient outcomes in this condition., (© The Author(s) 2014.)
- Published
- 2016
- Full Text
- View/download PDF
9. Acute subdural hematoma after aortic surgery: a retrospective comparative study.
- Author
-
Osada H, Marui A, Tanaka S, Meshii K, Ohnaka M, and Nakajima H
- Subjects
- Adult, Aged, Aged, 80 and over, Aortic Dissection diagnosis, Aortic Dissection physiopathology, Aorta, Thoracic physiopathology, Aortic Aneurysm, Thoracic diagnosis, Aortic Aneurysm, Thoracic physiopathology, Cerebrovascular Circulation, Female, Hematoma, Subdural, Acute diagnosis, Hematoma, Subdural, Acute physiopathology, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Perfusion adverse effects, Platelet Transfusion adverse effects, Retrospective Studies, Risk Factors, Treatment Outcome, Vascular Surgical Procedures methods, Aortic Dissection surgery, Aorta, Thoracic surgery, Aortic Aneurysm, Thoracic surgery, Hematoma, Subdural, Acute etiology, Vascular Surgical Procedures adverse effects
- Abstract
Background: Acute subdural hematoma is uncommon following open-heart surgery, but may result in increased mortality and morbidity., Methods: A retrospective analysis was performed involving all patients who underwent thoracic aortic surgery from January 2009 to February 2013. There were 53 patients who had thoracic aortic repair with open distal anastomosis and required selective cerebral perfusion with or without retrograde cerebral perfusion. We evaluated the incidence of postoperative acute subdural hematoma. The patients were divided into two groups: a subdural hematoma group who had symptomatic subdural hematoma postoperatively, and a non-subdural hematoma group who had no subdural hematoma. The variables were compared between the 2 groups., Results: Eight (15.1%) patients had a transient symptomatic subdural hematoma; none required surgical evacuation of the hematoma. There were significant differences between the two groups in terms mean and maximum retrograde cerebral perfusion flow, and the volume of intraoperative platelet transfusion. Multivariate analysis revealed that a significant risk factor for acute subdural hematoma following thoracic aortic surgery was the amount of intraoperative platelet transfusion (odds ratio = 0.9, 95% confidence interval: 0.81-0.98, p = 0.015)., Conclusions: This retrospective study demonstrated that the subdural hematoma group received fewer units of platelets, thus it appears to be important to give platelets appropriately. Strict flow regulation or avoidance of retrograde cerebral perfusion is suggested., (© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)
- Published
- 2015
- Full Text
- View/download PDF
10. Transmitral, video-assisted left ventricular thrombectomy.
- Author
-
Osada H, Nakajima H, Meshii K, and Ohnaka M
- Subjects
- Adult, Echocardiography, Humans, Male, Myocardial Infarction surgery, Coronary Thrombosis surgery, Heart Ventricles surgery, Thoracic Surgery, Video-Assisted methods, Thrombectomy methods
- Published
- 2015
- Full Text
- View/download PDF
11. Right atrial volume reduction for severely impaired pulmonary function.
- Author
-
Osada H, Nakajima H, Meshii K, and Ohnaka M
- Subjects
- Aged, Female, Heart Atria surgery, Heart Failure etiology, Humans, Treatment Outcome, Cardiac Surgical Procedures, Cardiomegaly complications, Cardiomegaly surgery, Pulmonary Atelectasis etiology
- Abstract
We report a patient with giant right atrium and severe pulmonary dysfunction who underwent successful surgical volume reduction with significant improvement of pulmonary function studies., (© 2014 Wiley Periodicals, Inc.)
- Published
- 2014
- Full Text
- View/download PDF
12. [Surgical treatment in an adult with coronary artery aneurysm at proximal site of left anterior descending artery; report of a case].
- Author
-
Okada Y, Doi K, Meshii K, and Kono S
- Subjects
- Coronary Artery Bypass, Humans, Male, Middle Aged, Mucocutaneous Lymph Node Syndrome complications, Coronary Aneurysm surgery
- Abstract
A 52-year-old man was admitted to our hospital with complaint of chest pain and abnormal electrocardiogram (ECG) findings showing ST depression in V2-V6. Coronary computed tomography (CT) and coronary arteriography (CAG) showed coronary artery aneurysm at #5 [left main trunk (LMT)] 20 mm, #11 [circumflex artery (Cx)] 8.3 mm, RV branch 4 mm, and severe stenosis at #5 and #11. Therefore, his chest pain was due to thromboembolism from coronary artery aneurysm. In the present case, Kawasaki disease was not diagnosed in childhood. Coronary artery aneurysms were rare in the elderly and were usually found in association with Kawasaki disease. Morphological evaluation findings strongly suggested that the coronary artery aneurysm were related to Kawasaki disease. Resection of coronary artery aneurysm and coronary artery bypass grafting [left internal thoracic artery (LITA) to #8 and saphenous vein graft (SVG): aorta (Ao) to #14] were successfully performed. We report a case of coronary artery aneurysms presumed to be due to childhood Kawasaki disease in an elderly man.
- Published
- 2011
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.