Pub Date : 2019-01-01DOI: 10.5797/JNET.TN.2017-0122
Mitsuhiro Iwasaki, M. Saito, Akihiro Nemoto, Takanori Suzuki, C. Hikita, Shinya Fukuta, Hiroaki Sato, M. Morimoto
Objective: We here report the methods for and efficacy of C-arm cone-beam CT (CBCT) with diluted contrast medium during the recanalization therapy in acute ischemic stroke patients with middle cerebral artery occlusion. Case Presentation: The subjects were 30 patients who underwent recanalization therapy for acute ischemic stroke with occlusion of the middle cerebral artery at our hospital between January 2015 and December 2016. Utilizing leptomeningeal anastomosis (LMA), 20-second CBCT with fourfold diluted contrast medium was performed, and 3D image processing was subsequently conducted. In 25 (83.3%) of the 30 patients, a blood vessel distal to the site of occlusion and the extent of thrombus were favorably visualized. Conclusion: This procedure may be useful as an auxiliary examination that provides more detailed information to safely perform recanalization therapy for acute occlusion of the middle cerebral artery through the visualization of a blood vessel distal to the site of the occlusion.
{"title":"Diluted Contrast-enhanced Cone-beam CT during Acute-phase Recanalization Therapy for Occlusion of the Middle Cerebral Artery","authors":"Mitsuhiro Iwasaki, M. Saito, Akihiro Nemoto, Takanori Suzuki, C. Hikita, Shinya Fukuta, Hiroaki Sato, M. Morimoto","doi":"10.5797/JNET.TN.2017-0122","DOIUrl":"https://doi.org/10.5797/JNET.TN.2017-0122","url":null,"abstract":"Objective: We here report the methods for and efficacy of C-arm cone-beam CT (CBCT) with diluted contrast medium during the recanalization therapy in acute ischemic stroke patients with middle cerebral artery occlusion. Case Presentation: The subjects were 30 patients who underwent recanalization therapy for acute ischemic stroke with occlusion of the middle cerebral artery at our hospital between January 2015 and December 2016. Utilizing leptomeningeal anastomosis (LMA), 20-second CBCT with fourfold diluted contrast medium was performed, and 3D image processing was subsequently conducted. In 25 (83.3%) of the 30 patients, a blood vessel distal to the site of occlusion and the extent of thrombus were favorably visualized. Conclusion: This procedure may be useful as an auxiliary examination that provides more detailed information to safely perform recanalization therapy for acute occlusion of the middle cerebral artery through the visualization of a blood vessel distal to the site of the occlusion.","PeriodicalId":34768,"journal":{"name":"JNET","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5797/JNET.TN.2017-0122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71061757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.5797/JNET.TN.2018-0038
Shoko Fujii, M. Yoshimura, Shin Hirota, Juri Kiyokawa, Shinji Yamamoto
Objective: We report a case of superior sagittal sinus thrombosis, where aspiration of the thrombus using a 6 Fr coaxial catheter (CC) resulted in prompt and complete recanalization. Case Presentation: A 69-year-old female was brought to our hospital by ambulance due to headache and left hemiparesis. MRI images revealed superior sagittal sinus thrombosis. Endovascular treatment was performed in addition to anticoagulant therapy to prevent clinical deterioration and to achieve an early improvement. Unfortunately, neither intrasinus chemical thrombolysis nor mechanical thrombectomy with a balloon led to recanalization. Therefore, we used a CC, 6 Fr Cerulean catheter DD6 (Medikit co. ltd., Tokyo, Japan), as an aspiration catheter, which resulted in prompt and complete recanalization. Consequently, her symptoms disappeared shortly thereafter. Conclusion: As the endovascular treatment of venous sinus thrombosis, thrombus aspiration through a 6 Fr CC may be an effective option.
目的:我们报告一例上矢状窦血栓形成，其中使用6fr同轴导管(CC)吸入血栓导致及时和完全的再通。病例介绍:一名69岁女性因头痛、左偏瘫被救护车送至我院。MRI显示上矢状窦血栓形成。血管内治疗在抗凝治疗的基础上进行，以防止临床恶化并实现早期改善。不幸的是，无论是静脉内化学溶栓还是机械球囊取栓都不能导致再通。因此，我们使用CC, 6 Fr Cerulean导管DD6 (Medikit co. ltd, Tokyo, Japan)作为抽吸导管，导致及时和完全的再通。因此，她的症状不久就消失了。结论:作为静脉窦血栓形成的血管内治疗，通过6fr CC吸血栓可能是一种有效的选择。
{"title":"Thrombus in the Superior Sagittal Sinus Was Successfully Aspirated by Coaxial Catheter Technique: A Technical Case Report","authors":"Shoko Fujii, M. Yoshimura, Shin Hirota, Juri Kiyokawa, Shinji Yamamoto","doi":"10.5797/JNET.TN.2018-0038","DOIUrl":"https://doi.org/10.5797/JNET.TN.2018-0038","url":null,"abstract":"Objective: We report a case of superior sagittal sinus thrombosis, where aspiration of the thrombus using a 6 Fr coaxial catheter (CC) resulted in prompt and complete recanalization. Case Presentation: A 69-year-old female was brought to our hospital by ambulance due to headache and left hemiparesis. MRI images revealed superior sagittal sinus thrombosis. Endovascular treatment was performed in addition to anticoagulant therapy to prevent clinical deterioration and to achieve an early improvement. Unfortunately, neither intrasinus chemical thrombolysis nor mechanical thrombectomy with a balloon led to recanalization. Therefore, we used a CC, 6 Fr Cerulean catheter DD6 (Medikit co. ltd., Tokyo, Japan), as an aspiration catheter, which resulted in prompt and complete recanalization. Consequently, her symptoms disappeared shortly thereafter. Conclusion: As the endovascular treatment of venous sinus thrombosis, thrombus aspiration through a 6 Fr CC may be an effective option.","PeriodicalId":34768,"journal":{"name":"JNET","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5797/JNET.TN.2018-0038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71061893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.5797/JNET.CR.2018-0047
Yusuke Morinaga, K. Nii, A. Eto, Hayatsura Hanada, Takafumi Mitsutake, Fumihiro Hiraoka, Ritsurou Inoue, K. Sakamoto, M. Tsutsumi
{"title":"Overlapping Stent-assisted Coil Embolization for Ruptured Blood Blister-like Aneurysms of Basilar Trunk: Two Case Reports","authors":"Yusuke Morinaga, K. Nii, A. Eto, Hayatsura Hanada, Takafumi Mitsutake, Fumihiro Hiraoka, Ritsurou Inoue, K. Sakamoto, M. Tsutsumi","doi":"10.5797/JNET.CR.2018-0047","DOIUrl":"https://doi.org/10.5797/JNET.CR.2018-0047","url":null,"abstract":"","PeriodicalId":34768,"journal":{"name":"JNET","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5797/JNET.CR.2018-0047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71055229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.5797/JNET.CR.2019-0005
M. Kugai, T. Suyama, M. Kitano, H. Hasegawa, Y. Tominaga, S. Tominaga
Objective: The authors report a rare case of symptomatic cerebral arteriovenous malformation (AVM) manifesting as trigeminal neuralgia (TGN) that was successfully treated by a multimodal treatment. Case Presentation: A 68-year-old man presented with right TGN. The symptom progressed with lancinating pain. Brain MRI showed a right temporal lobe AVM with a maximum diameter of approximately 50 mm. A right ectatic tortuous vertebral artery (VA) compressed the root of the right trigeminal nerve. The TGN completely disappeared after the 4th embolization. After the 6th embolization, excision was performed. No recurrence of TGN was observed in the 6 months after its excision. Conclusion: The present case suggested that treatment of nidus may improve AVM-induced TGN. Embolization was considered to be an effective modality, especially in multimodal treatment for high-grade AVM.
{"title":"A Case of High-grade Arteriovenous Malformation Manifesting as Trigeminal Neuralgia Successfully Treated by Embolization in Multimodal Treatment","authors":"M. Kugai, T. Suyama, M. Kitano, H. Hasegawa, Y. Tominaga, S. Tominaga","doi":"10.5797/JNET.CR.2019-0005","DOIUrl":"https://doi.org/10.5797/JNET.CR.2019-0005","url":null,"abstract":"Objective: The authors report a rare case of symptomatic cerebral arteriovenous malformation (AVM) manifesting as trigeminal neuralgia (TGN) that was successfully treated by a multimodal treatment. Case Presentation: A 68-year-old man presented with right TGN. The symptom progressed with lancinating pain. Brain MRI showed a right temporal lobe AVM with a maximum diameter of approximately 50 mm. A right ectatic tortuous vertebral artery (VA) compressed the root of the right trigeminal nerve. The TGN completely disappeared after the 4th embolization. After the 6th embolization, excision was performed. No recurrence of TGN was observed in the 6 months after its excision. Conclusion: The present case suggested that treatment of nidus may improve AVM-induced TGN. Embolization was considered to be an effective modality, especially in multimodal treatment for high-grade AVM.","PeriodicalId":34768,"journal":{"name":"JNET","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5797/JNET.CR.2019-0005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71056118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.5797/JNET.OA.2018-0046
T. Yoshihara, R. Kanazawa, H. Ohbuchi, T. Uchida, T. Higashida, Naoyuki Arai, Manabu Osakabe, Yuichi Takahashi
Objective: To evaluate cerebral blood fl ow immediately after reperfusion following thrombectomy for acute large vessel occlusion, and to examine whether cerebral blood fl ow after reperfusion is related to hemorrhagic transformation. Methods: The patients with acute large vessel occlusion in the anterior circulation who obtained reperfusion by thrombectomy were included. Cerebral blood fl ow was evaluated using single photon emission computed tomography (SPECT) within 6 hours after reperfusion. The patients were divided into two groups with or without hemorrhagic transformation, and basic characteristics, the ratio of cerebral blood fl ow (aff ected-side to unaff ected-side ratio) in the perfusion area of the middle cerebral artery (MCA asymmetry index), and functional prognosis were compared among two groups. Results: In all, 23 patients were included; 11 presented hemorrhagic transformation, and 12 did not. The hemorrhagic group exhibited signifi cantly higher MCA asymmetry index than the non-hemorrhagic group (median: 1.54 [1.30–1.83] vs. 1.12 [1.07–1.24], respectively, P = 0.02), and a lower rate tendency of modifi ed Rankin Scale (mRS): 0-2 after 3 months (1 patient [9%] vs. 6 patients [50%], respectively, P = 0.06). Conclusion: In patients with successful reperfusion by thrombectomy, hemorrhagic transformation is predisposed to occur when high MCA asymmetry index is presented. Care should be taken in periprocedural management of blood pressure and sedation for those with high MCA asymmetry index.
{"title":"Hyperperfusion Immediately after Reperfusion by Thrombectomy May Predict Hemorrhagic Transformation","authors":"T. Yoshihara, R. Kanazawa, H. Ohbuchi, T. Uchida, T. Higashida, Naoyuki Arai, Manabu Osakabe, Yuichi Takahashi","doi":"10.5797/JNET.OA.2018-0046","DOIUrl":"https://doi.org/10.5797/JNET.OA.2018-0046","url":null,"abstract":"Objective: To evaluate cerebral blood fl ow immediately after reperfusion following thrombectomy for acute large vessel occlusion, and to examine whether cerebral blood fl ow after reperfusion is related to hemorrhagic transformation. Methods: The patients with acute large vessel occlusion in the anterior circulation who obtained reperfusion by thrombectomy were included. Cerebral blood fl ow was evaluated using single photon emission computed tomography (SPECT) within 6 hours after reperfusion. The patients were divided into two groups with or without hemorrhagic transformation, and basic characteristics, the ratio of cerebral blood fl ow (aff ected-side to unaff ected-side ratio) in the perfusion area of the middle cerebral artery (MCA asymmetry index), and functional prognosis were compared among two groups. Results: In all, 23 patients were included; 11 presented hemorrhagic transformation, and 12 did not. The hemorrhagic group exhibited signifi cantly higher MCA asymmetry index than the non-hemorrhagic group (median: 1.54 [1.30–1.83] vs. 1.12 [1.07–1.24], respectively, P = 0.02), and a lower rate tendency of modifi ed Rankin Scale (mRS): 0-2 after 3 months (1 patient [9%] vs. 6 patients [50%], respectively, P = 0.06). Conclusion: In patients with successful reperfusion by thrombectomy, hemorrhagic transformation is predisposed to occur when high MCA asymmetry index is presented. Care should be taken in periprocedural management of blood pressure and sedation for those with high MCA asymmetry index.","PeriodicalId":34768,"journal":{"name":"JNET","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5797/JNET.OA.2018-0046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71058244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-01-01DOI: 10.5797/JNET.OA.2018-0018
H. Matsumoto, Hirokazu Nishiyama, Yoshiaki Tetsuo, Hideki Takemoto
Objective: We devised a method to readily create an ultra-small shape at the microcatheter tip using a sheath dilator. In the present study, we introduce the creation method and report its usefulness. Methods: For mandrel formation, 7 Fr. or 4 Fr. sheath dilators were used. 1) A small, round loop was prepared by rolling a mandrel on a sheath dilator. 2) The mandrel with an ultra-small loop was inserted into the tip of a straight-type microcatheter. 3) The microcatheter tip was heated using a heat gun. 4) The mandrel was removed from the microcatheter tip. Using the catheter which has ultra-small shaped tip, coil embolization was performed. Results: The mandrel loop diameter was 3 mm when a 7 Fr. sheath dilator was used. It was 2 mm when a 4 Fr. sheath dilator was used. It was possible to create various ultra-small shapes, such as J, S, and pigtail shapes, at the catheter tip. Ultra-small shaped catheters were used to treat 25 cerebral aneurysms. In all patients, catheters could be readily guided into the aneurysms, and their stability after insertion was favorable. Conclusion: The ultra-small catheter shaping method with a sheath dilator facilitated the creation of various ultra-small shapes measuring 2–3 mm in diameter at the microcatheter tip.
{"title":"Ultra-small Catheter Shaping Method with a Sheath Dilator: Usefulness for Coil Embolization of Cerebral Aneurysms","authors":"H. Matsumoto, Hirokazu Nishiyama, Yoshiaki Tetsuo, Hideki Takemoto","doi":"10.5797/JNET.OA.2018-0018","DOIUrl":"https://doi.org/10.5797/JNET.OA.2018-0018","url":null,"abstract":"Objective: We devised a method to readily create an ultra-small shape at the microcatheter tip using a sheath dilator. In the present study, we introduce the creation method and report its usefulness. Methods: For mandrel formation, 7 Fr. or 4 Fr. sheath dilators were used. 1) A small, round loop was prepared by rolling a mandrel on a sheath dilator. 2) The mandrel with an ultra-small loop was inserted into the tip of a straight-type microcatheter. 3) The microcatheter tip was heated using a heat gun. 4) The mandrel was removed from the microcatheter tip. Using the catheter which has ultra-small shaped tip, coil embolization was performed. Results: The mandrel loop diameter was 3 mm when a 7 Fr. sheath dilator was used. It was 2 mm when a 4 Fr. sheath dilator was used. It was possible to create various ultra-small shapes, such as J, S, and pigtail shapes, at the catheter tip. Ultra-small shaped catheters were used to treat 25 cerebral aneurysms. In all patients, catheters could be readily guided into the aneurysms, and their stability after insertion was favorable. Conclusion: The ultra-small catheter shaping method with a sheath dilator facilitated the creation of various ultra-small shapes measuring 2–3 mm in diameter at the microcatheter tip.","PeriodicalId":34768,"journal":{"name":"JNET","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5797/JNET.OA.2018-0018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71058635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-09-12DOI: 10.5797/JNET.CR.2017-0132
Daisuke Izawa, O. Masuo, Takumi Kawaguchi, Rie Yako, N. Nakao
{"title":"De Novo Multiple Dural Arteriovenous Fistulae Successfully Treated with Transarterial Embolization Using Low-concentration N-butyl-2-cyanoacrylate: A Case Report","authors":"Daisuke Izawa, O. Masuo, Takumi Kawaguchi, Rie Yako, N. Nakao","doi":"10.5797/JNET.CR.2017-0132","DOIUrl":"https://doi.org/10.5797/JNET.CR.2017-0132","url":null,"abstract":"","PeriodicalId":34768,"journal":{"name":"JNET","volume":"12 1","pages":"560-566"},"PeriodicalIF":0.0,"publicationDate":"2018-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48557022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-08-09DOI: 10.5797/JNET.OA.2018-0055
Y. Hanaoka, J. Koyama, Alhusain Nagm, Toshiya Uchiyama, Takafumi Kiuchi, Keisuke Kamiya, Takaaki Kamijo, T. Ogiwara, T. Horiuchi, K. Hongo
Objective: To clarify the usefulness and safety of neuroendovascular treatment with a 6 Fr guiding sheath via the right radial artery for anterior circulation lesions. Methods: A total of 20 patients (carotid artery stenting: 11 patients, coil embolization of cerebral aneurysms: nine patients) who underwent neuroendovascular treatment via the right radial artery under general anesthesia, between September 2016 and June 2017, were included in this study. We retrospectively analyzed 1) the pertinent anatomy of the target-side common carotid artery and the aortic arch, 2) devices, 3) method to advance the guiding sheath into the common carotid artery, 4) hemostasis at the puncture site, and 5) outcome (success rate, perioperative complications, and complications at the site of puncture). Results: In all patients, a 6 Fr guiding sheath could be guided into the common carotid artery, and treatment was accomplished. Furthermore, there was no perioperative or puncture-site complication. Conclusion: Transradial neuroendovascular treatment is considered as a safe and successful choice for anterior circulation lesions.
{"title":"Transradial Neuroendovascular Treatment for Anterior Circulation Lesions: An Initial Experience with a 6 Fr Guiding Sheath","authors":"Y. Hanaoka, J. Koyama, Alhusain Nagm, Toshiya Uchiyama, Takafumi Kiuchi, Keisuke Kamiya, Takaaki Kamijo, T. Ogiwara, T. Horiuchi, K. Hongo","doi":"10.5797/JNET.OA.2018-0055","DOIUrl":"https://doi.org/10.5797/JNET.OA.2018-0055","url":null,"abstract":"Objective: To clarify the usefulness and safety of neuroendovascular treatment with a 6 Fr guiding sheath via the right radial artery for anterior circulation lesions. Methods: A total of 20 patients (carotid artery stenting: 11 patients, coil embolization of cerebral aneurysms: nine patients) who underwent neuroendovascular treatment via the right radial artery under general anesthesia, between September 2016 and June 2017, were included in this study. We retrospectively analyzed 1) the pertinent anatomy of the target-side common carotid artery and the aortic arch, 2) devices, 3) method to advance the guiding sheath into the common carotid artery, 4) hemostasis at the puncture site, and 5) outcome (success rate, perioperative complications, and complications at the site of puncture). Results: In all patients, a 6 Fr guiding sheath could be guided into the common carotid artery, and treatment was accomplished. Furthermore, there was no perioperative or puncture-site complication. Conclusion: Transradial neuroendovascular treatment is considered as a safe and successful choice for anterior circulation lesions.","PeriodicalId":34768,"journal":{"name":"JNET","volume":"12 1","pages":"532-541"},"PeriodicalIF":0.0,"publicationDate":"2018-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41717882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-27DOI: 10.5797/JNET.CR.2018-0039
Tomohiro Kawano, Kiyotaka Saito, Takako Hidaka, N. Kajihara, H. Chuman, H. Ohta, K. Yokogami, H. Takeshima
Objective: We report two patients with a rapid increase in the ocular pressure after carotid artery stenting (CAS) for cervical internal carotid artery stenosis with ocular ischemic syndrome. Case Presentations: Case 1 was a 67-year-old male. Case 2 was a 70-year-old male. In the two patients, a reduction in vision and transient hemiparesis had persisted for a few months, leading to a diagnosis of severe internal carotid artery stenosis. Furthermore, they were diagnosed with ocular ischemic syndrome and neovascular glaucoma. Panretinal photocoagulation was performed before CAS in the Department of Ophthalmology. In Case 1, ocular pain appeared 9 days after CAS. In Case 2, it appeared the day after CAS, and increased ocular pressure was noted. After conservative treatment, trabeculectomy was performed, but the visual prognosis was unfavorable. Conclusion: In patients with severe internal carotid artery stenosis and ocular ischemic syndrome, there may be a rapid increase in the ocular pressure after revascularization. Therefore, it is necessary to establish a cross-sectional treatment strategy in cooperation with ophthalmologists.
{"title":"Two Patients with a Rapid Increase in the Ocular Pressure after Carotid Artery Stenting for Cervical Internal Carotid Artery Stenosis with Ocular Ischemic Syndrome","authors":"Tomohiro Kawano, Kiyotaka Saito, Takako Hidaka, N. Kajihara, H. Chuman, H. Ohta, K. Yokogami, H. Takeshima","doi":"10.5797/JNET.CR.2018-0039","DOIUrl":"https://doi.org/10.5797/JNET.CR.2018-0039","url":null,"abstract":"Objective: We report two patients with a rapid increase in the ocular pressure after carotid artery stenting (CAS) for cervical internal carotid artery stenosis with ocular ischemic syndrome. Case Presentations: Case 1 was a 67-year-old male. Case 2 was a 70-year-old male. In the two patients, a reduction in vision and transient hemiparesis had persisted for a few months, leading to a diagnosis of severe internal carotid artery stenosis. Furthermore, they were diagnosed with ocular ischemic syndrome and neovascular glaucoma. Panretinal photocoagulation was performed before CAS in the Department of Ophthalmology. In Case 1, ocular pain appeared 9 days after CAS. In Case 2, it appeared the day after CAS, and increased ocular pressure was noted. After conservative treatment, trabeculectomy was performed, but the visual prognosis was unfavorable. Conclusion: In patients with severe internal carotid artery stenosis and ocular ischemic syndrome, there may be a rapid increase in the ocular pressure after revascularization. Therefore, it is necessary to establish a cross-sectional treatment strategy in cooperation with ophthalmologists.","PeriodicalId":34768,"journal":{"name":"JNET","volume":"12 1","pages":"553-559"},"PeriodicalIF":0.0,"publicationDate":"2018-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5797/JNET.CR.2018-0039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43705927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-07-18DOI: 10.5797/JNET.TN.2018-0040
Y. Hanaoka, J. Koyama, Alhusain Nagm, Keisuke Kamiya, A. Chiba, Takaaki Kamijo, T. Ogiwara, T. Horiuchi, K. Hongo
Objective: Carotid artery stenting (CAS) for common carotid artery stenosis via the transfemoral approach might have a potential risk of iatrogenic distal embolism. In this study, we present a technique of transradial stenting with 6 Fr modified Simmonds guiding sheath for stenosis of the common carotid artery. Case Presentations: A 6 Fr modified Simmonds guiding sheath was introduced via the right radial artery and advanced to the common carotid artery without passing a guidewire or coaxial catheter through the stenotic lesions. Two cases with common carotid artery stenosis were treated successfully with this procedure. Conclusion: Transradial CAS with modified Simmonds guiding sheath provides a safe and durable alternative option for patients with common carotid artery stenosis having vulnerable plaques.
{"title":"Transradial Stenting with a 6 Fr Modified Simmonds Guiding Sheath for Stenosis of the Common Carotid Artery","authors":"Y. Hanaoka, J. Koyama, Alhusain Nagm, Keisuke Kamiya, A. Chiba, Takaaki Kamijo, T. Ogiwara, T. Horiuchi, K. Hongo","doi":"10.5797/JNET.TN.2018-0040","DOIUrl":"https://doi.org/10.5797/JNET.TN.2018-0040","url":null,"abstract":"Objective: Carotid artery stenting (CAS) for common carotid artery stenosis via the transfemoral approach might have a potential risk of iatrogenic distal embolism. In this study, we present a technique of transradial stenting with 6 Fr modified Simmonds guiding sheath for stenosis of the common carotid artery. Case Presentations: A 6 Fr modified Simmonds guiding sheath was introduced via the right radial artery and advanced to the common carotid artery without passing a guidewire or coaxial catheter through the stenotic lesions. Two cases with common carotid artery stenosis were treated successfully with this procedure. Conclusion: Transradial CAS with modified Simmonds guiding sheath provides a safe and durable alternative option for patients with common carotid artery stenosis having vulnerable plaques.","PeriodicalId":34768,"journal":{"name":"JNET","volume":"12 1","pages":"573-579"},"PeriodicalIF":0.0,"publicationDate":"2018-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49068331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：