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1.
Ann Vasc Dis ; 8(2): 79-86, 2015.
Article in English | MEDLINE | ID: mdl-26131026

ABSTRACT

OBJECTIVE: To compare the clinical and angiographic outcomes after implantation of drug-eluting stents (DESs) in patients with coronary artery disease (CAD) with or without prior cerebral infarction. MATERIALS AND METHODS: Ninety-eight consecutive patients (130 lesions) who underwent successful coronary DES implantation were prospectively classified into two groups: those with a clinical history of symptomatic cerebral infarction (cerebral infarction group, 49 patients, 69 lesions) and those without a clinical history of symptomatic cerebral infarction (noncerebral infarction group, 49 patients, 61 lesions). The primary endpoint was defined as death, nonfatal myocardial infarction, and cerebrovascular events. RESULTS: The Kaplan-Meier method was used to create a primary endpoint curves to determine the time-dependent cumulative primary endpoint-free rate, which were compared using the log-rank test. The incidence of primary endpoints was higher in the cerebral infarction group than in the noncerebral infarction group (p = 0.0075). The Cox proportional hazards regression model for primary endpoint identified prior cerebral infarction (p = 0.0331, hazard ratio = 2.827) and patients with peripheral artery disease (p = 0.0271, hazard ratio = 2.757) as explanatory factors. CONCLUSION: The results showed that clinical outcomes were poorer in patients with CAD who had prior cerebral infarctions than in those who did not have infarction.

2.
Neurol Med Chir (Tokyo) ; 42(5): 217-20, 2002 May.
Article in English | MEDLINE | ID: mdl-12064156

ABSTRACT

A 57-year-old woman presented with a dural arteriovenous fistula (AVF) involving the superior sagittal sinus (SSS) based upon serial radiological examinations. Her chief complaints were headache and vomiting. Cerebral angiography and magnetic resonance (MR) venography revealed the sinus thrombosis involving the SSS, the bilateral transverse sinuses (TSs), and the right sigmoid sinus. Her symptoms disappeared after anticoagulant therapy. Follow-up MR venography revealed almost complete recanalization of the occluded sinuses, followed by restenosis of the SSS and the left TS and occlusion of the right TS without symptoms. She developed transient right hemiparesis 13 months after the initial onset. Cerebral angiography revealed a dural AVF involving the SSS with cortical reflux into the left frontoparietal region. The dural AVF was occluded by transarterial and transvenous embolization. Her symptom disappeared during the follow-up period.


Subject(s)
Central Nervous System Vascular Malformations/etiology , Magnetic Resonance Angiography , Sinus Thrombosis, Intracranial/etiology , Anticoagulants/therapeutic use , Central Nervous System Vascular Malformations/diagnosis , Central Nervous System Vascular Malformations/therapy , Cerebral Angiography , Cranial Sinuses/diagnostic imaging , Cranial Sinuses/pathology , Embolization, Therapeutic , Female , Humans , Middle Aged , Phlebography , Sinus Thrombosis, Intracranial/diagnosis , Sinus Thrombosis, Intracranial/drug therapy
3.
No Shinkei Geka ; 30(3): 293-9, 2002 Mar.
Article in Japanese | MEDLINE | ID: mdl-11905022

ABSTRACT

The usefulness of multi-planar reconstruction (MPR) images of three-dimensional computed tomographic angiography (3D-CTA) for the diagnosis of internal carotid artery (ICA) aneurysms is described. Eleven unruptured ICA aneurysms including six cases of IC-cavernous aneurysm, two cases of IC-ophthalmic artery aneurysm, two cases of IC-posterior communicating artery aneurysm and one cases of IC-anterior choroidal artery aneurysm, were examined by magnetic resonance angiography (MRA), digital subtraction angiography (DSA), 3D-CTA and its MPR images. 3D-CTA and DSA were useful to identify the aneurysmal neck in small aneurysms, but it was difficult to identify the aneurysmal neck in small aneurysms by 3D-CTA-MPR images. DSA and MRA were not useful for identifying the aneurysmal neck in aneurysms more than 10 mm in diameter, as a precise viewing of the neck could not be found due to their large size. For large aneurysms, neither was 3D-CTA useful for identifying the aneurysmal neck when their large size and surrounding bony structures overlapped the aneurysmal neck. On the other hand, 3D-CTA-MPR was very useful for identifying the aneurysmal neck without overlapping by surrounding bony structures. 3D-CTA-MPR images clearly visualized the calcification of the wall. 3D-CTA-MPR images are obtained from 3D-CTA source images without any additional stress to the patients, and they are more useful for the diagnosis as well as demonstration of the aneurysmal neck particularly in more than large aneurysms.


Subject(s)
Carotid Artery, Internal , Image Processing, Computer-Assisted/methods , Intracranial Aneurysm/diagnostic imaging , Tomography, X-Ray Computed/methods , Adolescent , Adult , Aged , Carotid Artery, Internal/diagnostic imaging , Female , Humans , Imaging, Three-Dimensional , Male , Middle Aged
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