start-ver=1.4 cd-journal=joma no-vol=164 cd-vols= no-issue=2 article-no= start-page=517 end-page=523 dt-received= dt-revised= dt-accepted= dt-pub-year=2021 dt-pub=2021619 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Mobile endovascular therapy for acute treatment of ruptured vertebral artery dissecting aneurysm in multiple hospitals en-subtitle= kn-subtitle= en-abstract= kn-abstract=Background
The patients with ruptured vertebral artery dissecting aneurysm (rVADA) should be treated as early as possible because VADA carries extremely high risk of rebleeding in the acute phase. We have established a mobile endovascular strategy for the patients with rVADA between our flagship center and its affiliated local hospitals. We introduced and reviewed our mobile endovascular therapy in this study.
Methods
We retrospectively evaluated 98 consecutive patients who underwent endovascular surgery for rVADA from 2000 to 2018 at our institution or five affiliated hospitals. When each patient was initially transported to the local affiliated hospitals, neuroendovascular surgeons traveled directly to the affiliated hospital from the flagship center in order to treat the patient there. Clinical outcomes using modified Rankin Scale at 6 months after treatment, radiological results, and procedure-related complications were reviewed to justify our mobile endovascular strategy.
Results
All aneurysms were cured successfully by internal trapping. Favorable outcome was achieved in 61 patients (62.2%) even though 53 patients (54.1%) had presented with severe subarachnoid hemorrhage. Overall mortality rate, treatment-related mortality rate, and treatment related complication rate were 18.4% (18/98), 0%, and 16% (16/98), respectively. There were no differences in clinical and radiological outcomes between the patients treated in the flagship center and those who treated in the affiliated hospitals. Treatment in the affiliated hospital was not a predictive factor of unfavorable outcome in our multivariate analysis, and elderly age (>= 60) was negatively associated with favorable outcome.
Conclusions
Our results prove the efficacy and safety of mobile endovascular therapy for the treatment of rVADA in the ultra-acute stage. Mobile endovascular therapy may work well in the acute treatment of rVADAs in the certain circumstance. en-copyright= kn-copyright= en-aut-name=KidaniNaoya en-aut-sei=Kidani en-aut-mei=Naoya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=SugiuKenji en-aut-sei=Sugiu en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=TerasakaKaoru en-aut-sei=Terasaka en-aut-mei=Kaoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=NakashimaHiroyuki en-aut-sei=Nakashima en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TokunagaKoji en-aut-sei=Tokunaga en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KobayashiKazuki en-aut-sei=Kobayashi en-aut-mei=Kazuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KambaraHirokazu en-aut-sei=Kambara en-aut-mei=Hirokazu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HishikawaTomohito en-aut-sei=Hishikawa en-aut-mei=Tomohito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=HiramatsuMasafumi en-aut-sei=Hiramatsu en-aut-mei=Masafumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=DateIsao en-aut-sei=Date en-aut-mei=Isao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=2 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=3 en-affil=Department of Neurosurgery, Kure Kyosai Hospital kn-affil= affil-num=4 en-affil=Department of Neurosurgery, Okayama Kyokuto Hospital kn-affil= affil-num=5 en-affil=Department of Neurosurgery, Okayama City Municipal Hospital kn-affil= affil-num=6 en-affil=Department of Neurosurgery, Tsuyama Chuo Hospital kn-affil= affil-num=7 en-affil=Department of Neurosurgery, Japanese Red Cross Okayama Hospital kn-affil= affil-num=8 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=9 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= affil-num=10 en-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences kn-affil= END start-ver=1.4 cd-journal=joma no-vol=54 cd-vols= no-issue=4 article-no= start-page=153 end-page=164 dt-received= dt-revised= dt-accepted= dt-pub-year=2000 dt-pub=200008 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Combined use of cellulose acetate polymer and retrievable platinum coils for the thrombosis of cervical carotid aneurysms. en-subtitle= kn-subtitle= en-abstract= kn-abstract=

Cellulose acetate polymer (CAP) solution is a new liquid embolic material, and it has been used clinically for the thrombosis of cerebral aneurysms. The purpose of the study was to test a method of aneurysm treatment. In an experimental model, retrievable interlocking detachable coils (IDCs) were used to create an intraaneurysmal frame or prop and then CAP was injected into 20 experimentally induced canine cervical aneurysms. Intraaneurysmal thrombosis was induced 1 week after aneurysm creation. Complete thrombosis was attempted in 12 aneurysms, and partial thrombosis was attempted in 4. Four other aneurysms served as controls. Follow-up angiography was performed for up to 8 weeks, and with the exception of 4 aneurysms, which were kept for a 2-year long-term follow-up study, the aneurysms were then harvested for histological examination. Thrombosis was successfully achieved in all cases except for 2 enlarged aneurysms that were initially partially thrombosed. No thromboembolism to distal vessels was observed. No compaction or shift of the CAP-IDC complex occurred even after 2 years. Histologically, CAP and IDCs conformed to the massive thrombotic complex without any fragmentation. By creating a frame or prop with retrievable microcoils, we were able to inject the CAP implies a comparison safely and precisely than has been previously reported. Our findings suggest that this method will be useful for the treatment of cerebral aneurysms.

en-copyright= kn-copyright= en-aut-name=HirotsuneNobuyuki en-aut-sei=Hirotsune en-aut-mei=Nobuyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KinugasaKazushi en-aut-sei=Kinugasa en-aut-mei=Kazushi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MandaiShinya en-aut-sei=Mandai en-aut-mei=Shinya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=TokunagaKoji en-aut-sei=Tokunaga en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=HandaAkira en-aut-sei=Handa en-aut-mei=Akira kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KawadaSanami en-aut-sei=Kawada en-aut-mei=Sanami kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OhmotoTakashi en-aut-sei=Ohmoto en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil= kn-affil=Okayama University affil-num=2 en-affil= kn-affil=Okayama Rehabilitation Center for Traumatic Apallics affil-num=3 en-affil= kn-affil=Kagawa Prefectual Central Hospital affil-num=4 en-affil= kn-affil=Okayama University affil-num=5 en-affil= kn-affil=Okayama University affil-num=6 en-affil= kn-affil=Okayama University affil-num=7 en-affil= kn-affil=Okayama University en-keyword=experimentally induced aneurysm kn-keyword=experimentally induced aneurysm en-keyword= cellulose acetate polymer (CAP) kn-keyword= cellulose acetate polymer (CAP) en-keyword= interlocking detachable coil (IDC) kn-keyword= interlocking detachable coil (IDC) en-keyword=endovascular technique kn-keyword=endovascular technique END start-ver=1.4 cd-journal=joma no-vol=63 cd-vols= no-issue=1 article-no= start-page=1 end-page=7 dt-received= dt-revised= dt-accepted= dt-pub-year=2009 dt-pub=200902 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Protein Transduction Method for Cerebrovascular Disorders en-subtitle= kn-subtitle= en-abstract= kn-abstract=

Many studies have shown that a motif of 11 consecutive arginines (11R) is one of the most effective protein transduction domains (PTD) for introducing proteins into the cell membrane. By conjugating this "11R", all sorts of proteins can effectively and harmlessly be transferred into any kind of cell. We therefore examined the transduction efficiency of 11R in cerebral arteries and obtained results showing that 11R fused enhanced green fluorescent protein (11R-EGFP) immediately and effectively penetrated all layers of the rat basilar artery (BA), especially the tunica media. This method provides a revolutionary approach to cerebral arteries and ours is the first study to demonstrate the successful transductionof a PTD fused protein into the cerebral arteries. In this review, we present an outline of our studies and other key studies related to cerebral vasospasm and 11R, problems to be overcome, and predictions regarding future use of the 11R protein transduction method for cerebral vasospasm (CV).

en-copyright= kn-copyright= en-aut-name=OgawaTomoyuki en-aut-sei=Ogawa en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OnoShigeki en-aut-sei=Ono en-aut-mei=Shigeki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=IchikawaTomotsugu en-aut-sei=Ichikawa en-aut-mei=Tomotsugu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=ArimitsuSeiji en-aut-sei=Arimitsu en-aut-mei=Seiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=OnodaKeisuke en-aut-sei=Onoda en-aut-mei=Keisuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TokunagaKoji en-aut-sei=Tokunaga en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=SugiuKenji en-aut-sei=Sugiu en-aut-mei=Kenji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=TomizawaKazuhito en-aut-sei=Tomizawa en-aut-mei=Kazuhito kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=MatsuiHideki en-aut-sei=Matsui en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=DateIsao en-aut-sei=Date en-aut-mei=Isao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=8 en-affil= kn-affil=Department of Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=9 en-affil= kn-affil=Department of Physiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=10 en-affil= kn-affil=Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=cerebral vasospasm kn-keyword=cerebral vasospasm en-keyword=11 consecutive arginines (11R) kn-keyword=11 consecutive arginines (11R) en-keyword=enhanced green fluorescent protein (EGFP) kn-keyword=enhanced green fluorescent protein (EGFP) END start-ver=1.4 cd-journal=joma no-vol=120 cd-vols= no-issue=2 article-no= start-page=129 end-page=133 dt-received= dt-revised= dt-accepted= dt-pub-year=2008 dt-pub=20080801 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=Novel protein transduction method for cerebral arteries using 11R kn-title=11Rを用いた脳血管に対する新しい蛋白質導入法 en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name=OgawaTomoyuki en-aut-sei=Ogawa en-aut-mei=Tomoyuki kn-aut-name=小川智之 kn-aut-sei=小川 kn-aut-mei=智之 aut-affil-num=1 ORCID= en-aut-name=OnoShigeki en-aut-sei=Ono en-aut-mei=Shigeki kn-aut-name=小野成紀 kn-aut-sei=小野 kn-aut-mei=成紀 aut-affil-num=2 ORCID= en-aut-name=IchikawaTomotsugu en-aut-sei=Ichikawa en-aut-mei=Tomotsugu kn-aut-name=市川智継 kn-aut-sei=市川 kn-aut-mei=智継 aut-affil-num=3 ORCID= en-aut-name=ArimitsuSeiji en-aut-sei=Arimitsu en-aut-mei=Seiji kn-aut-name=有光帥二 kn-aut-sei=有光 kn-aut-mei=帥二 aut-affil-num=4 ORCID= en-aut-name=OnodaKeisuke en-aut-sei=Onoda en-aut-mei=Keisuke kn-aut-name=小野田惠介 kn-aut-sei=小野田 kn-aut-mei=惠介 aut-affil-num=5 ORCID= en-aut-name=TokunagaKoji en-aut-sei=Tokunaga en-aut-mei=Koji kn-aut-name=徳永浩司 kn-aut-sei=徳永 kn-aut-mei=浩司 aut-affil-num=6 ORCID= en-aut-name=SugiuKenji en-aut-sei=Sugiu en-aut-mei=Kenji kn-aut-name=杉生憲志 kn-aut-sei=杉生 kn-aut-mei=憲志 aut-affil-num=7 ORCID= en-aut-name=TomizawaKazuhito en-aut-sei=Tomizawa en-aut-mei=Kazuhito kn-aut-name=富澤一仁 kn-aut-sei=富澤 kn-aut-mei=一仁 aut-affil-num=8 ORCID= en-aut-name=MatsuiHideki en-aut-sei=Matsui en-aut-mei=Hideki kn-aut-name=松井秀樹 kn-aut-sei=松井 kn-aut-mei=秀樹 aut-affil-num=9 ORCID= en-aut-name=DateIsao en-aut-sei=Date en-aut-mei=Isao kn-aut-name=伊達勲 kn-aut-sei=伊達 kn-aut-mei=勲 aut-affil-num=10 ORCID= affil-num=1 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　脳神経外科 affil-num=2 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　脳神経外科 affil-num=3 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　脳神経外科 affil-num=4 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　脳神経外科 affil-num=5 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　脳神経外科 affil-num=6 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　脳神経外科 affil-num=7 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　脳神経外科 affil-num=8 en-affil= kn-affil=熊本大学大学院医学薬学研究部　分子生理学 affil-num=9 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　細胞生理学 affil-num=10 en-affil= kn-affil=岡山大学大学院医歯薬学総合研究科　脳神経外科 en-keyword=cerebral vasospasm kn-keyword=cerebral vasospasm en-keyword=11R kn-keyword=11R en-keyword=protein transduction method kn-keyword=protein transduction method END start-ver=1.4 cd-journal=joma no-vol= cd-vols= no-issue= article-no= start-page= end-page= dt-received= dt-revised= dt-accepted= dt-pub-year=1998 dt-pub=19981231 dt-online= en-article= kn-article= en-subject= kn-subject= en-title=酢酸セルロ-スポリマ-によるイヌの頚動脈分岐部動脈瘤に対する部分閉塞術 kn-title=Partial thrombosis of canine carotid Bifurcation Aneurysms with Cellulose Acetate Polymer en-subtitle= kn-subtitle= en-abstract= kn-abstract= en-copyright= kn-copyright= en-aut-name= en-aut-sei= en-aut-mei= kn-aut-name=徳永浩司 kn-aut-sei=徳永 kn-aut-mei=浩司 aut-affil-num=1 ORCID= affil-num=1 en-affil= kn-affil=岡山大学 END