TY - JOUR
T1 - Endovascular treatment for vasospasm after aneurysmal subarachnoid hemorrhage based on data of JR-NET3
AU - JR-NET investigators
AU - Imamura, Hirotoshi
AU - Sakai, Nobuyuki
AU - Satow, Tetsu
AU - Iihara, Koji
AU - Ezura, Masayuki
AU - Hyodo, Akio
AU - Miyachi, Shigeru
AU - Miyamoto, Susumu
AU - Nagai, Yoji
AU - Nishimura, Kunihiro
AU - Toyoda, Kazunori
AU - Fujinaka, Toshiyuki
AU - Higashi, Toshio
AU - Hirohata, Masaru
AU - Ishii, Akira
AU - Ito, Yasushi
AU - Kuwayama, Naoya
AU - Oishi, Hidenori
AU - Matsumaru, Yuji
AU - Matsumoto, Yasushi
AU - Nakahara, Ichiro
AU - Sakai, Chiaki
AU - Sugiu, Kenji
AU - Terada, Tomoaki
AU - Yoshimura, Shinichi
N1 - Funding Information:
H. Imamura received Speakers’ Bureau/Honoraria from Medtronic Co. N. Sakai received Speakers’ Bureau/ Honoraria from Otsuka Pharmaceutical Co, Stryker Co, Medtronic Co, Medico’s Hirata Co, and Biomedical Solutions Co, and research funding from Otsuka Pharmaceutical Co, Terumo Co, and Daiichi Sankyo Co. K. Iihara received Speakers’ Bureau/Honoraria from Otsuka Pharmaceutical Co, and research funding from Otsuka Pharmaceutical Co, Mitsubishi Tanabe Pharma Co, Kaneka Medix Co, Chugai Pharmaceutical Co, and Eizai Co. T. Sato has no conflicts of interest to declare. All authors who are members of the Japan Neurosurgical Society (JNS) have registered online self-reported conflicts of interest disclosure statement forms through the website for JNS members.
Funding Information:
This study was supported in part by a Grant-in-Aid (Junkanki-Kaihatsu H24-4-3) from the National Cerebral and Cardiovascular Center, Japan and by Hatazaki Foundation, Kobe, Japan. The JR-NET3 Study Group: Co-principal investi-gator—Nobuyuki Sakai, Kobe City Medical Center General Hospital, Kobe, Japan, Koji Iihara, Kyushu University, Fukuoka, Japan, Tetsu Satow, National Cerebral and Cardiovascular Center, Suita, Japan; Investigators—Masayuki Ezura, Sendai Medical Center, Sendai, Japan, Akio Hyodo, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan, Shigeru Miyachi, Aichi Medical University, Aichi, Japan, Susumu Miyamoto, Kyoto University, Kyoto, Japan, Yoji Nagai, Kobe University, Kobe, Japan, Kunihiro Nishimura, National Cerebral and Cardiovascular Center, Suita, Japan, Kazunori Toyoda, National Cerebral and Cardiovascular Center, Suita, Japan; Co-investigators—Toshiyuki Fujinaka, Osaka Medical Center, Osaka, Japan, Toshio Higashi, Fukuoka University, Fukuoka, Japan, Masaru Hirohata, Kurume University, Kurume, Japan, Japan, Akira Ishii, Kyoto University, Kyoto, Japan, Hirotoshi Imamura, Kobe City Medical Center General Hospital, Kobe, Japan, Yasushi Ito, Shin-rakuen Hospital, Niigata, Japan, Naoya Kuwayama, Toyama University, Toyama, Japan, Hidenori Oishi, Juntendo University, Tokyo, Japan, Yuji Matsu-maru, Tsukuba University, Tsukuba, Japan, Yasushi Matsumoto, Konan Hospital, Sendai, Japan, Ichiro Nakahara, Fujita Medical University, Aichi, Japan, Chiaki Sakai, Hyogo College of Medicine, Nishinomiya, Japan, Kenji Sugiu, Okayama University, Okayama, Japan, Tomoaki Terada, Showa University Fujigaoka Hospital, Kanagawa, Japan, Shinichi Yoshimura, Hyogo College of Medicine, Nishinomiya, Japan, and Certified Specialist of Japanese Society of Neuroendovascular Therapy. We thank Lesley McCollum, PhD, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.
Funding Information:
This study was supported in part by a Grant-in-Aid (Junkanki-Kaihatsu H24-4-3) from the National Cerebral and Cardiovascular Center, Japan and by Hatazaki Foundation, Kobe, Japan.
Publisher Copyright:
© 2018 by The Japan Neurosurgical Society.
PY - 2018
Y1 - 2018
N2 - Endovascular treatments for vasospasm after subarachnoid hemorrhage are typically performed for patients who are refractory to recommended medical therapies. We analyzed the current status of endovascular treatments based on the data of Japanese Registry of Neuroendovascular Therapy (JR-NET)3, and evaluated factors related to improvement of imaging findings and neurological condition, and to mechanical hemorrhage complications. We collected data of 1211 treatments performed from 2010 to 2014. Target vessels for treatments were anterior circulation (n = 1079), posterior circulation (n = 91), and both (n = 32); the distribution of vasospasm was the proximal vessel (n = 754) to the Circle of Willis, distal vessel (n = 329), and both (n = 119). Of the treatments, 948 cases (78.3%) were intra-arterial administration of vasodilators and 259 (21.4%) were percutaneous transluminal angioplasty (PTA); 879 cases were the first intervention. The treatment time from onset was within 3 h in 378 (31.2%) cases, between 3 and 6 h in 349 (28.8%) cases, and over 6 h in 245 (20.2%) cases. The statistically significant factors associated with improvement on imaging findings was the first treatment, and treatment within 3 h from onset compared with that after 6 h. Additionally, the first and early treatments after the symptoms were associated with significantly improved neurological condition. All complications of mechanical hemorrhage occurred along with PTA. The findings show that endovascular treatment for vasospasm was effective, especially for cases who suffered from symptomatic vasospasm with a short interval after onset.
AB - Endovascular treatments for vasospasm after subarachnoid hemorrhage are typically performed for patients who are refractory to recommended medical therapies. We analyzed the current status of endovascular treatments based on the data of Japanese Registry of Neuroendovascular Therapy (JR-NET)3, and evaluated factors related to improvement of imaging findings and neurological condition, and to mechanical hemorrhage complications. We collected data of 1211 treatments performed from 2010 to 2014. Target vessels for treatments were anterior circulation (n = 1079), posterior circulation (n = 91), and both (n = 32); the distribution of vasospasm was the proximal vessel (n = 754) to the Circle of Willis, distal vessel (n = 329), and both (n = 119). Of the treatments, 948 cases (78.3%) were intra-arterial administration of vasodilators and 259 (21.4%) were percutaneous transluminal angioplasty (PTA); 879 cases were the first intervention. The treatment time from onset was within 3 h in 378 (31.2%) cases, between 3 and 6 h in 349 (28.8%) cases, and over 6 h in 245 (20.2%) cases. The statistically significant factors associated with improvement on imaging findings was the first treatment, and treatment within 3 h from onset compared with that after 6 h. Additionally, the first and early treatments after the symptoms were associated with significantly improved neurological condition. All complications of mechanical hemorrhage occurred along with PTA. The findings show that endovascular treatment for vasospasm was effective, especially for cases who suffered from symptomatic vasospasm with a short interval after onset.
KW - Endovascular treatment
KW - Neurological improvement
KW - Vasospasm
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U2 - 10.2176/nmc.oa.2018-0212
DO - 10.2176/nmc.oa.2018-0212
M3 - Article
C2 - 30464151
AN - SCOPUS:85058762733
VL - 58
SP - 495
EP - 502
JO - Neurologia Medico-Chirurgica
JF - Neurologia Medico-Chirurgica
SN - 0470-8105
IS - 12
ER -