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Department of Neuro endovascular Therapy

September 2,2019 Update

Introduction

Our Department of Neuro-endovascular Therapy is a medical department that performs catheter treatment of cerebrovascular vessels. It is a treatment that is positioned between "craniotomy" and "oral treatment", and the staff of the Department of Neurosurgery and the Department of Neurology jointly provide treatment. This is a state-of-the-art catheter treatment center, with the latest equipment, which was established in April 2017.

"The skill of the operator" is important for catheter therapy, but it is also a treatment that is largely influenced by the "latest medical equipment," and the innovation of medical devices is rapidly advancing. In fact, many cerebrovascular diseases (such as cerebral aneurysms and epidural arteriovenous fistula) and cervical vascular diseases (such as carotid artery stenosis) have become able to be cured using catheters. Please contact us if you have a problem with a patient where you found brain vascular disease.

I myself, want to cure the disease with medicine if possible. If it is not possible to cure it with medicine, then I think that it is good if it can be managed by the medicine. We would like to discuss the treatment policy to the extent possible according to the hopes of such patients. However, it may ultimately necessary to operate depending on the kind and the degree of the sickness. In that case, we will support the patient with catheter treatment to avoid "cutting" as much as possible.

Patient care at our department

Cerebrovascular catheter treatment is performed jointly by the Department of Neurosurgery and the Department of Neurology. For this reason, we can provide consultations for treatment in both the Department of Neurosurgery and the Department of Neurology. A specialist outpatient clinic for catheter treatment is open in the Department of Neurosurgery on Thursday mornings (Doctor in charge: Shojima). In the Department of Neurology, we are opening a specialist outpatient clinic for cerebrovascular disorders on Thursday afternoons (Doctor in charge: Dembo). Please contact us at the outpatient Department of Neurosurgery and Department of Neurology for consultation about catheter treatment on days other than these days of the week.

Cerebral aneurysm
  • When a cerebral aneurysm ruptures, you get subarachnoid bleeding. Sometimes you may feel ill with a strong headache, or feel ill, lose consciousness and fall. Most patients with a subarachnoid hemorrhage will be brought to the hospital by ambulance. The patient's condition is determined comprehensively, and in addition to information such as the shape and position of the aneurysm, they will determine whether catheter treatment can be performed. Approximately 70% of patients with an aneurysm can be treated with a catheter.
  • An aneurysm that is diagnosed in a "brain dock"(medical checkup of the brain by examination with MRI、MRA、etc.) is called an unruptured cerebral aneurysm. It is said that if the size is more than 5 mm then it is better to consider preventive surgery in order to prevent future ruptures, but we will discuss how to deal with this with the patient, taking into account the patient's individual lifestyle and health condition.
  • Our hospital is equipped with a state-of-the-art vascular imaging device. We also conduct pre-operative simulations using high definition three-dimensional image diagnosis and "3D printer."
Dural arteriovenous fistula
This is a disease where an artery and a vein are directly connected by the strong film (dura mater) which covers the brain. This is not originally a disease of the brain, but it may adversely affect the brain because the veins of the brain and the veins of the dura mater are connected. In addition to the "knowledge", "skill" and "treatment experience," "three-dimensional image diagnosis" with one of the "latest vascular imaging device" is indispensable for treatment. Our responsible physicians have extensive experience in the treatment of dural arteriovenous fistula (about 150 cases).
Cerebral arteriovenous malformation
This is an innate cerebrovascular disease where arteries and veins are connected in the brain tissue. A part of the blood vessel might rupture and cause a cerebral hemorrhage. Although this disease cannot be cured with catheter treatment alone, we are very adept at treating by specifying the damaged part of the blood vessel by doing a three-dimensional image diagnosis using virtual reality and stopping the bleeding with a catheter.
Carotid artery stenosis
A disease where garbage (plaque) collects in the arteries of the neck around the back of the jaw and the inside of the blood vessel becomes narrow is called carotid artery stenosis. It is currently thought that treatment by medicine is the best, but when the blood vessel has become considerably narrowed or the narrowing progresses, the blood vessel can be expanded by a catheter treatment. It is important to improve lifestyle and treat hypertension and hypercholesterolemia after the catheter treatment, and we will continue to support them after surgery.
Cerebral infarction
When the blood vessels of the brain become clogged, the brain cells have a lack of oxygen, and the patient may not be able to move their limbs or they become inarticulate. This disease is called a cerebral infarction. If a narrow blood vessel becomes clogged, it is best to treat it with a drip or a medicine you can swallow, but when a large blood vessel is clogged, the blood vessel can be expanded using a balloon catheter and a stent, because it is not possible to treat it well with medicine alone. In addition, if a blood clot breaks free from the heart to the brain, such as from arrhythmia (atrial fibrillation), a stent-type thrombus removal device or a thrombus-suction catheter can be used to resume flow in the clogged blood vessels.

Main diseases

The following are the diseases and the treatments that can be handled in our department.

Cerebral aneurysms
The best treatment for an unruptured cerebral aneurysm is the improvement of lifestyle, including lowering blood pressure and not smoking. First, we will discuss how to improve their lifestyle. However, if the size is large or the shape is distorted and there is a high risk of rupture, we may recommend surgical treatment. Most cerebral aneurysms can be treated with catheter surgery thanks to advances in medical equipment, so please contact us. The physician in charge of our department is the 1 of 40 flow diverter physicians in nation, and 1 of only two in Saitama Prefecture.
Carotid artery stenosis
The best treatment for carotid artery stenosis is the improvement of lifestyle, including lowering blood pressure and not smoking. In many cases, it will be sufficient to improve lifestyle and treat with medicine. However, if the blood vessel becomes narrower rapidly, even if the lifestyle is improved, and if it becomes considerably narrow, then surgical treatment will be necessary. Surgical methods include direct surgery with carotid endarterectomy and cervical stent implantation via catheter therapy. Although we determine in advance which treatment is suitable by performing MRI etc., most cases can be handled with catheter treatment, so please talk to us.
Cerebrovascular obstruction within 8 hours of onset
It is easy for a clot to form in the heart if there is an arrhythmia such as atrial fibrillation. When a blood clot that has flown from the heart obstructs a blood vessel, half of the body may suddenly stop working or they may not be able to form words. Previously, when the patient had reached such a state, only about 30% were able to recover, but it is now possible for 60% to 80% to recover and be able to walk by performing a catheter treatment and sucking and removing the blood clot. Please call an ambulance immediately if you notice sudden paralysis. If you call the paramedics, they can transport you to a facility like ours that allows us to perform catheter treatment, so feel free to trust the ambulance team.
Dural arteriovenous fistula
The strong membrane that wraps around the brain is called the dura mater, and the disease where the arteries and veins that nourish the dura mater are connected is called dural arteriovenous fistula. It is necessary to advance treatment by combining radiation therapy and direct surgery in order to do the treatment, and we have a three-dimensional understanding of the complex vascular construction and develop a patient-specific treatment plan as well as the technique for inducing a catheter into the narrow blood vessels. Please consult with us because this is a disease that requires both a state-of-the-art vascular imaging device and rich treatment experience.
Cerebral arteriovenous malformation
The disease where the arteries and veins are connected inside the brain is called cerebral arteriovenous malformation. Either craniotomy or radiation therapy treatment will be necessary in order to fully cure this disease. Catheter treatment is done to assist these treatments. For example, it is possible to cure a cerebral arteriovenous malformation by radiotherapy without craniotomy, especially if you find a place where it seems to be easy to rapture and if you treat that part with a catheter.

Target Symptoms

  • Patients who can receive catheter treatment at our Department of Neuro-endovascular Therapy are mostly, (1) People brought to the hospital by ambulance with symptoms such as sudden consciousness disorder or paralysis, or (2) People who visit us because cerebrovascular disease was found by accident without any symptoms during a medical checkup of the brain. For this reason, there may be no specific symptoms in patients who are subject to catheter treatment.
  • Many cerebrovascular diseases such as cerebral aneurysms, epidural arteriovenous fistulas, and carotid artery stenosis have come to be treated with catheters. Please come to consult about whether catheter treatment is necessary and whether it is possible if you find a disease in the blood vessels of the brain or the neck.

Treatment results

Admissions in 2017
Disease name Number of cases
Total number 72cases
Cerebral aneurysm coil embolization 32cases
Stent implantation for carotid stenosis/occlusion 7cases
Dural arteriovenous fistula embolization 5cases
Cerebral arteriovenous malformation embolization 6cases
Cerebral artery stenosis vasodilation 10cases
Acute cerebral infarction (catheter clot removal) 5cases
Intracranial tumor embolization 1cases
Embolization for traumatic vertebral artery injury 5cases

Medical staff

Name Job Title Position Specialized Field Credentials
庄島 正明
(Shoujima Masaaki)
脳血管センタースタッフ001
Professor(Department of Neurosurgery) Director,Center of Neuro endovascular Therapy Cerebral aneurysms
Carotid artery stenosis
Dural arteriovenous fistula
The Japan Neurosurgical Society認定医
Japan Stroke Society認定脳卒中専門医
Japanese Society for Neuroendovascular Therapy指導医
Japanese Society of Biorheology director
野村 恭一
(Nomura Kyouichi)
脳血管センタースタッフ002
Professor(Department of Neurology) Deputy Hospital Director
Chief of Clinical Services, Department of Neurology
immunologic neurological diseases
peripheral neurological disorders
Blood purification therapy
Japanese Society for Neuroimmunology director
Japanese Society for Apheresis director
Japanese Peripheral Nerve Society director
Japanese Society of Neurology councilor
The Japan Stroke Society認定脳卒中専門医
松居 徹
(Matsui Tooru)
脳血管センタースタッフ003
Professor(Department of Neurosurgery) Deputy Hospital Director
Chief of Clinical Services, Department of Neurosurgery
cerebrovascular disorders
Skull base tumors
Spinal cord disease
The Japan Neurosurgical Society認定医
Japan Stroke Society認定脳卒中専門医
Japanese Society on Surgery for Cerebral Stroke技術指導医
傳法 倫久
(Denbou Tomohisa)
脳血管センタースタッフ004
Associate Professor(Department of Neurology) Manager of Outpatient Services,Department of Neurology cerebrovascular disorders
Neuroendovascular Therapy
脳卒中急性期画像
Japan Stroke Society councilor・専門医
Japanese Society of Neurology専門医・指導医
Japanese Society for Neuroendovascular Therapy専門医
Member of Cardiovascular Stroke Society of Japan
Member of the Japan Academy of Neurosonology
印東 雅大
(Indou Masahiro)
脳血管センタースタッフ005
Assistant Professor(Department of Neurosurgery) Manager of Outpatient Services,Department of Neurosurgery Cerebrovascular disorders(Aneurysms/Arteriovenous malformation/Carotid artery stenosis/Moyamoya disease in adults and children etc.)
Skull base tumors(Meningioma/Schwannoma/転移性脳腫瘍)
Cerebrovascular treatment
The Japan Neurosurgical Society認定医
Japanese Society on Surgery for Cerebral Stroke技術指導医
Japanese Society for Neuroendovascular Therapy専門医
Japan Stroke Society認定脳卒中専門医
田島 孝士
(Tajima Takashi)
脳血管センタースタッフ006
Instructor(Department of Neurology) Cerebrovascular treatment
cerebrovascular disorders
Clinical Neurology
Fellow of the Japanese Society of Internal Medicine (FJSIM)・指導医
Japanese Society of Neurology専門医
Member of Japan Stroke Society
Member of Japanese Society of Neurological Therapeutics
Member of Japanese Society for Neuroendovascular Therapy

Outpatient clinic

Department of Neuro endovascular Therapy
  月曜日
Monday
火曜日
Tuesday
水曜日
Wednesday
木曜日
Thursday
金曜日
Friday
土曜日
Saturday
午前
浄化ユニット
腎・高血圧内科
担当医
腎・高血圧内科
担当医
腎・高血圧内科
担当医
腎・高血圧内科
担当医
腎・高血圧内科
担当医
腎・高血圧内科
担当医
専門外来
腹膜透析
(交替制)
腹膜透析
(交替制)
腹膜透析・在宅血液透析
小川 智也
(Ogawa Tomonari)
(1.3.5週)
腹膜透析・在宅血液透析
小川 智也
(Ogawa Tomonari)
(2.4週)


在宅血液透析
(交替制)
在宅血液透析
(交替制)
腹膜透析・腎移植
松村 治
(Matsumura Osamu)
(2.4週)
岩下 山連
(Iwashita Takatsugu)
(2.4週)


腎移植登録
清水 泰輔
(Shimizu Taisuke)
(2週)
佐野 達郎
(Sano Tatsuro)
(4週)



透析アクセス
小川 智也
(Ogawa Tomonari)
(2.4週)
透析アクセス
清水 泰輔
(Shimizu Taisuke)

午後
浄化ユニット
腎・高血圧内科
担当医
腎・高血圧内科
担当医
腎・高血圧内科
担当医
腎・高血圧内科
担当医
腎・高血圧内科
担当医
腎・高血圧内科
担当医
専門外来
腎移植
岩下 山連
(Iwasita Takatsugu)
(2週・4週)


透析アクセス
小川 智也
(Ogawa Tomonari)
腹膜透析・在宅血液透析
河合 雄一郎
(Kawai Yuichiro)




透析アクセス
肥田 徹
(Hida Toru)


教育外来
腎不全療法
腎不全療法
腎不全療法

腎不全療法
腎不全療法

To the Medical Institutions

To the Regional Medical Institutions

Please contact us regarding emergency patients where a stroke is suspected and who are within eight hours of onset. We will respond quickly. Also,

  • Unruptured cerebral aneurysms
  • Carotid artery stenosis/carotid artery obstructions
  • Dural arteriovenous fistula
  • Cerebral arteriovenous malformation
  • Other, diseases of the blood vessels from the neck up

Please feel free to refer patients who are concerned about vascular lesions such as in the face, in addition to the skull and neck.

You can come to the clinic on Thursday mornings, but we respond on the phone as needed (Department of Neurosurgery: 043-228-3655). In addition to the usual examinations (three-dimensional CT, MRI, and cerebral vascular imaging), we can also create a three-dimensional image and a blood flow simulation on a workstation.

To medical students and residents

We are looking forward to training physicians who aspire to be experts in cerebrovascular treatment (catheter treatment).

Surgery will not be the first class "simply because of the large number of experiences." We aim for the development of catheter treatment physicians who can perform the procedure after firmly understanding why such an operation is done for each procedure.

In addition, cerebrovascular treatment is inseparable from the development of the latest medical equipment. We are carrying out medicine-engineering cooperative research projects with various universities. Please come and experience the latest research and development during the training.

埼玉医科大学バナー 埼玉医科大学看護学校バナー