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所属 |
医学部 附属病院 脳神経外科 |
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職名 |
講師 |
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外部リンク |
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Endovascular stent therapy for extracranial and intracranial carotid artery dissection: single-center experience. 査読あり 国際共著
Ohta H, Natarajan SK, Hauck EF, Khalessi AA, Siddiqui AH, Hopkins LN, Levy EI
Journal of neurosurgery 115 ( 1 ) 91 - 100 2011年7月
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Ohta H., Nakano S., Yokogami K., Iseda T., Yoneyama T., Wakisaka S.
Stroke 35 ( 4 ) 893 - 898 2004年4月
担当区分：筆頭著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Stroke
Background and Purpose-The purpose of this study was to evaluate the correlation between appearance of angiographic early venous filling during intra-arterial reperfusion therapy and posttherapeutic hemorrhagic complications. Methods-For the past 7 years, 104 patients prospectively underwent superselective local angiography via a microcatheter before and during intra-arterial reperfusion therapy for acute middle cerebral artery occlusion to evaluate the presence or absence of early venous filling. In principle, reperfusion therapy was discontinued just after appearance of early venous filling for fear of hemorrhage. There were 2 types of early venous filling: early filling of the thalamostriate vein from the lenticulostriate arteries and that of the cortical vein from the cortical arteries. Results-Among these 104 patients, 31 (29.8%) had early venous filling: 19 had early filling of the thalamostriate vein, and the other 12 had early filling of the cortical vein. Eight of the 19 patients (42.1%) and 2 of the 12 patients (16.7%) had massive hematoma with neurological worsening, whereas only 1 of the 73 patients (1.4%) without early venous filling had massive hematoma. There was a significant correlation between early venous filling and massive hematoma in both the deep (P<0.0001) and superficial (P=0.0019) middle cerebral artery territories. The sensitivity and specificity of the presence of early venous filling as an indicator of parenchymal hematoma were 71% and 83%, respectively. None of the 31 ischemic areas with early venous filling could escape cerebral infarction. Conclusions-Appearance of early venous filling may indicate irreversible brain damage and may be a predictive sign for parenchymal hematoma.
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Kurogi A., Onozuka D., Hagihara A., Nishimura K., Kada A., Hasegawa M., Higashi T., Kitazono T., Ohta T., Sakai N., Arai H., Miyamoto S., Sakamoto T., Iihara K., Takigami M., Kamiyama K., Houkin K., Nishi S., Kaneko S., Oka K., Nakagaki Y., Ooyama H., Takizawa K., Tokumitsu N., Suzuki S., Suzuki N., Kimura T., Izumi N., Nitta K., Ohtaki M., Isobe M., Nishiya M., Kaijima M., Mabuchi S., Ogasawara K., Kubo N., Shimizu Y., Saito K., Yamanome T., Yabuta A., Yoshino A., Harashina J., Shimoda M., Jimbo H., Murakami H., Masaoka H., Ohtaka H., Yoshida H., Suzuki I., Kohno M., Arai Y., Isoshima A., Hokari M., Kawai K., Maehara T., Arai H., Kawamata T., Noguchi M., Hoshino H., Hiyama H., Yoshida K., Fujitsuka M., Takeda Y., Karasudani H., Kobayashi S., Nakamura M., Ono J., Suda S., Hadeishi H., Wakui K., Tanno H., Sato N., Sakai H., Matsumoto T., Koketsu N., Nakahara I., Hasegawa T., Kuwayama N., Mizutani N., Suzaki N., Yasui K., Ikeda A., Takeuchi Y., Wakabayashi T., Tanaka H., Yoshimoto J., Koichiro O., Yokoe T., Murao K., Yamada T., Kato A., Wakayama A., Kataoka H., Iwatsuki K., Nakajima Y., Gi H., Uranishi R., Nakamura Y., Yamanaka K., Matsumoto H.
Scientific Reports 12 ( 1 ) 2022年12月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Scientific Reports
To determine whether increasing thrombectomy-capable hospitals with moderate comprehensive stroke center (CSC) capabilities is a valid alternative to centralization of those with high CSC capabilities. This retrospective, nationwide, observational study used data from the J-ASPECT database linked to national emergency medical service (EMS) records, captured during 2013–2016. We compared the influence of mechanical thrombectomy (MT) use, the CSC score, and the total EMS response time on the modified Rankin Scale score at discharge among patients with acute ischemic stroke transported by ambulance, in phases I (2013–2014, 1461 patients) and II (2015–2016, 3259 patients). We used ordinal logistic regression analyses to analyze outcomes. From phase I to II, MTs increased from 2.7 to 5.5%, and full-time endovascular physicians per hospital decreased. The CSC score and EMS response time remained unchanged. In phase I, higher CSC scores were associated with better outcomes (1-point increase, odds ratio [95% confidence interval]: 0.951 [0.915–0.989]) and longer EMS response time was associated with worse outcomes (1-min increase, 1.007 [1.001–1.013]). In phase II, neither influenced the outcomes. During the transitional shortage of thrombectomy-capable hospitals, increasing hospitals with moderate CSC scores may increase nationwide access to MT, improving outcomes.
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Koyanagi M, Hatano T, Uchida K, Ogura T, Yamagami H, Shibata M, Enomoto Y, Fukawa N, Matsumoto Y, Sakai N, Takeuchi M, Nonaka T, Shimizu F, Ezura M, Ota T, Ohta H, Morimoto M, Morimoto T, Yoshimura S, ALVO investigators.
Cerebrovascular diseases (Basel, Switzerland) 52 ( 3 ) 1 - 11 2022年10月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Cerebrovascular Diseases
Introduction: We investigated whether apixaban is safe for the prevention of further adverse events in non-valvular atrial fibrillation (NVAF) patients with intra-/extracranial artery stenosis (Stenosis group) compared with acute large vessel occlusion without intra-/extracranial artery stenosis (No stenosis group). We also examined whether combination therapy using apixaban and antiplatelet is safe. Methods: ALVO (Apixaban on clinical outcome of patients with Large Vessel Occlusion [LVO] or stenosis) was a historical and prospective multicenter registry at 38 centers in Japan. Patients with NVAF and acute LVO or stenosis who received apixaban within 14 days after onset were included. We conducted the post hoc analysis using the ALVO dataset. We compared patients with stenosis versus those without stenosis in terms of the primary outcome, which was defined as a composite of all-cause death, major bleeding events, and ischemic events 365 days after onset. Results: Of the 662 patients, 54 (8.2%) patients were classified into the Stenosis group, and 104 patients of the total (16%) reached the primary outcome. The cumulative incidence of primary outcome was not significantly different between the No stenosis and the Stenosis groups (hazard ratio [HR] 1.2, 95% confidence interval [CI]: 0.64-2.4; p = 0.52). Even after adjustment for predictive clinical variates, no significant difference in the primary endpoint between the No stenosis and the Stenosis groups was shown (adjusted HR 1.2, 95% CI: 0.59-2.5; p = 0.60). Fifty patients (7.6%) used an antiplatelet with apixaban. Among the Stenosis group patients, the cumulative incidence of the primary outcome was significantly higher among patients treated with an antiplatelet and apixaban (HR 3.5, 95% CI: 1.0-12; p = 0.048). Conclusion: Apixaban monotherapy appears safe for the prevention of further adverse events in the Stenosis group patients similar to the No stenosis group patients. Concomitant use of an antiplatelet might not be favorable in patients with stenosis.
DOI： 10.1159/000526896
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Shimamura N., Naraoka M., Uchida K., Tokuda K., Sakai N., Imamura H., Yamagami H., Tanaka K., Ezura M., Nonaka T., Matsumoto Y., Shibata M., Ohta H., Morimoto M., Fukawa N., Hatano T., Enomoto Y., Takeuchi M., Ota T., Shimizu F., Kimura N., Kamiya Y., Morimoto T., Yoshimura S.
World Neurosurgery 162 e503 - e510 2022年6月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：World Neurosurgery
Objective: The initiation of anticoagulant administration after large vessel occlusion (LVO) or stenosis with nonvalvular arterial fibrillation (NAVF) is controversial. We evaluate the timing of anticoagulation and its relationship with clinical factors. Methods: We enrolled 595 anterior circulation LVO or stenosis with NAVF cases from 38 stroke centers. Laboratory data; activities of daily living; the Alberta Stroke Program Early CT Score (ASPECTS); the National Institutes of Health Stroke Scale (NIHSS) score; occluded artery; treatment methods; date of the initiation of apixaban administration and outcome were recorded. Multivariate analyses were performed after univariate analysis. Results: The median start of apixaban administration after the stroke was 2 days (interquartile range, 1–5; range, 0–14). Multivariate analysis of variance showed that non–internal carotid artery occlusion (F value 4.60), reperfusion therapy (31.1), high ASPECTS (6.27) before anticoagulant intake, and absence of intracranial hemorrhage (12.9) were significantly correlated with early apixaban administration. Multiple logistic regression analysis for independent living at 90 days after the stroke showed significant factors: aging (odds, 0.94; 95% confidence interval [CI], 0.91–0.97); male (odds, 0.46; 95% CI, 0.26–0.79); prestroke independence (odds, 20.7; 95% CI, 6.48–93.9); number of white blood cells (odds, 0.99; 95% CI, 0.97–1.00); non–internal carotid artery occlusion; NIHSS score at 72 hours after the stroke (odds 0.92; 95% CI, 0.89–0.96); ASPECTS before apixaban intake (odds, 1.15; 95% CI, 1.00–1.31) and initiation of apixaban (odds, 0.91; 95% CI, 0.83–0.99). Conclusions: Early administration of apixaban is induced by nonsevere infarction, reperfusion therapy or none of intracranial hemorrhage and it correlates with an independent long-term outcome.
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脳卒中データバンク2015
宮田史朗、大田元（ 担当： 分担執筆）
中山書店 2015年2月
総ページ数：209 担当ページ：78-79 記述言語：日本語 著書種別：学術書
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パーフェクトマスター 脳血管内治療 必須知識のアップデート 改訂第2版
大田 元（ 担当： 分担執筆）
Medical View 2014年10月
総ページ数：514 担当ページ：190-193, 258-261, 338-343, 480-481 記述言語：日本語 著書種別：学術書
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パーフェクトマスター 脳血管内治療 必須知識のアップデート
大田 元（ 担当： 分担執筆）
Medical View 2010年12月
総ページ数：434 担当ページ：372-375, 424-427, 410-411 記述言語：日本語 著書種別：学術書
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頸動脈ステント留置術 Carotid Artery Stenting(CAS)のすべて
大田 元（ 担当： 分担執筆 , 範囲: CASの周術期管理）
Medical View 2008年6月
総ページ数：307 担当ページ：82-93, 162-165 記述言語：日本語 著書種別：学術書
MISC 【 表示 ／ 非表示 】
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Yoshimura S., Uchida K., Sakai N., Imamura H., Yamagami H., Tanaka K., Ezura M., Nonaka T., Matsumoto Y., Shibata M., Ohta H., Morimoto M., Fukawa N., Hatano T., Enomoto Y., Takeuchi M., Ota T., Shimizu F., Kimura N., Kamiya Y., Shimamura N., Morimoto T.
Translational Stroke Research 12 ( 4 ) 692 - 694 2021年8月
記述言語：英語 掲載種別：速報，短報，研究ノート等（学術雑誌） 出版者・発行元：Translational Stroke Research
There was an error in Fig. 2d. The correct Fig. 2d is shown below. (Figure presented.). We sincerely apologize for this correction.
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術前にarterial spin labelingを施行した下垂体腺腫の検討 査読あり
武石剛, 渡邉孝, 東美菜子, 大田元, 横上聖貴, 平井俊範, 竹島秀雄
日本間脳下垂体腫瘍学会プログラム・抄録集 30th 2020年
講演・口頭発表等 【 表示 ／ 非表示 】
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スタッフの疲弊回復を念頭においた脳血栓回収療法施行体制の構築
大田元
第35回日本脳神経血管内治療学会
開催年月日： 2019年11月21日 - 2019年11月23日
記述言語：日本語 会議種別：口頭発表（一般）
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Superselective transvenous coil embolization for dural AVF at hypoglossal canal 国際会議
Ohta H
15th Congress of world federation of interventional and therapeutic neuroradiology
開催年月日： 2019年10月20日 - 2019年10月23日
記述言語：日本語 会議種別：口頭発表（一般）
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3D画像と3D血管モデルを駆使した術前シミュレーション教育システムの運用について
大田元
日本脳神経外科学会第78回学術総会
開催年月日： 2019年10月9日 - 2019年10月12日
記述言語：日本語 会議種別：口頭発表（一般）
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Hight flow bypass併用母血管遮断術が有用的であった難治性鼻出血発症の内頸動脈仮性動脈瘤の一例．
大田元
第48回日本脳卒中の外科学会
開催年月日： 2019年3月21日 - 2019年3月23日
記述言語：日本語 会議種別：口頭発表（一般）
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宮崎県における脳卒中診療体制の整備への取り組み
大田元
第48回日本脳卒中の外科学会
開催年月日： 2019年3月21日 - 2019年3月23日
記述言語：日本語 会議種別：口頭発表（一般）
受賞 【 表示 ／ 非表示 】
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第28回日本脳神経血管内治療学会 優秀応募論文賞・銅賞
2012年11月 第28回日本脳神経血管内治療学会 Appearance of early venous filling during intra-arterial reperfusion therapy for acute middle cerebral artery occlusion. A predictive sign for hemorrhagic complications
大田 元
受賞区分：国内学会・会議・シンポジウム等の賞 受賞国：日本国
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フィコンパ錠 特定使用成績調査 ―部分発作（二次性全般化発作を含む）又は強直間代発作を有する小児てんかん患者に対するフィコンパ錠長期投与時の安全性及び有効性に関する調査―
2017年11月 - 2021年03月