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Development of a simple perfusion score for mechanical thrombectomy

Research Project

Project/Area Number 16K09731
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Neurology
Research InstitutionKyorin University

Principal Investigator

HIRANO Teruyuki  杏林大学, 医学部, 教授 (50346996)

Project Period (FY) 2016-04-01 – 2019-03-31
Project Status Completed (Fiscal Year 2018)
Budget Amount *help
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2017: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2016: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Keywords血栓回収療法 / 脳梗塞急性期 / MRI / FLAIR / 灌流画像 / 神経科学 / 神経機能画像学 / 脳血行再建療法
Outline of Final Research Achievements

Many RCT of acute mechanical thrombectomy employed CT-perfusion study to select good responders. However, perfusion imaging is not commonly available in Japanese routine practice. MRI fluid-attenuated inversion recovery (FLAIR) image is known to link with cerebral hypoperfusion at the area of FLAIR hyperintense vessel (FHV). In this study, therefore, a simple score to evaluate cerebral perfusion employing FHV was developed. Using 25 patients with emergent large vessel occlusion (ELVO), presence of FHV was evaluated on 175 cortical lesions of ASPECTS+W. 89 lesions (51%) with positive-FHV tend to have positive-DWI compared to those of negative-FHV (56% vs. 17%, p<0.0001). Moreover, positive-FHV lesions progressed to infarction despite early (<6 hour) TICI 2b/3 recanalization (55% vs. 29%, p=0.0234). This simple perfusion score using FHV, therefore, will increase the accuracy of perfusion and core estimates on top of DWI evaluation.

Academic Significance and Societal Importance of the Research Achievements

脳梗塞救急現場で一般に行われている画像評価の中から、灌流情報を見極めるためのポイントを明らかにした。治療前に余分な検査時間を割く必要がなく、結果として治療開始までの時間は短縮され患者転帰改善に寄与できると考える。また、どの施設でも実施可能な評価法であり、臨床現場での有用性は極めて高い。

Report

(4 results)
  • 2018 Annual Research Report   Final Research Report ( PDF )
  • 2017 Research-status Report
  • 2016 Research-status Report
  • Research Products

    (43 results)

All 2019 2018 2017 2016 Other

All Journal Article (15 results) (of which Int'l Joint Research: 4 results,  Peer Reviewed: 14 results,  Open Access: 5 results) Presentation (17 results) (of which Int'l Joint Research: 8 results,  Invited: 17 results) Book (7 results) Remarks (4 results)

  • [Journal Article] Thrombectomy for stroke at 6 to 24 hours without perfusion CT software for patient selection.2019

    • Author(s)
      Tsurukiri J, Ota T, Jimbo H, Okumura E, Shigeta K, Amano T, Ueda M, Matsumaru Y, Shiokawa Y, Hirano T
    • Journal Title

      J Stroke Cerebrovasc Dis.

      Volume: 28 Pages: 774-781

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Rivaroxaban administration after acute ischemic stroke: the RELAXED study2019

    • Author(s)
      Yasaka M, Minematsu K, Toyoda K, Mori E, Hirano T, Hamasaki T, Yamagami H, Nagao T, Yoshimura S, Uchiyama S, for the RELAXED study group
    • Journal Title

      PLOS ONE

      Volume: 14 Issue: 2 Pages: 774-781

    • DOI

      10.1371/journal.pone.0212354

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Subcutaneous Heparin Therapy for Patients with Cancer-Associated Stroke.2019

    • Author(s)
      Kawano H, Honda Y, Amano T, Okano H, Suzuki R, Torii M, Unno Y, Shiokawa Y, Hirano T.
    • Journal Title

      J Stroke Cerebrovasc Dis.

      Volume: 28 Issue: 2 Pages: 399-404

    • DOI

      10.1016/j.jstrokecerebrovasdis.2018.10.012

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Onset to reperfusion time was not important in mechanical thrombectomy for elderly patietns: A retrospective multicenter study in Tama area, Tokyo2018

    • Author(s)
      Koizumi S, Ota T, Shigeta K, Amano T, Ueda M, Matsumaru Y, Shiokawa Y, Hirano T
    • Journal Title

      Cerebrovasc Dis

      Volume: 46 Issue: 1-2 Pages: 89-96

    • DOI

      10.1159/000492867

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Mechanical Thrombectomy Combined Aspiration Catheter with Stent Retriever without Guiding Catheter via the Transbrachial Approach for Basilar Artery Occlusion2018

    • Author(s)
      天野達雄, 松本淑恵, 本田有子, 中西郁, 笹森寛生, 佐藤栄志, 塩川芳昭, 平野照之
    • Journal Title

      No Kekkannai Chiryo

      Volume: 3 Issue: 2 Pages: 80-86

    • DOI

      10.20626/nkc.tn.2018-0001

    • NAID

      130007520207

    • ISSN
      2423-9119, 2424-1709
    • Related Report
      2018 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Cerebral amyloid angiopathy(CAA)に関連したCortical superficiall siderosis(cSS)/convexity subarachnoid hemorrhage(cSAH)によるTransient focal neurological eisodes(TFNE)を認めた83歳女性例2018

    • Author(s)
      中島昌典, 平野照之, 塩川芳昭, 栗田瑛里子, 岡野晴子, 千葉厚郎
    • Journal Title

      CI研究

      Volume: 40 Pages: 141-146

    • Related Report
      2018 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Stroke due to infective endocarditis diagnosed by the retrieved thrombus: a case report2018

    • Author(s)
      中西 郁, 河野浩之, 天野達雄, 大森嘉彦, 菅間 博, 平野照之
    • Journal Title

      Rinsho Shinkeigaku

      Volume: 58 Issue: 1 Pages: 35-40

    • DOI

      10.5692/clinicalneurol.cn-001099

    • NAID

      130006320334

    • ISSN
      0009-918X, 1882-0654
    • Related Report
      2017 Research-status Report
    • Peer Reviewed
  • [Journal Article] Does Reducing the Duration from Symptom Onset to Recanalization Improve the Results of Intracranial Mechanical Thrombectomy in the Elderly?2017

    • Author(s)
      Komatsubara K, Dembo T, Sato E, Sasamori H, Torii M, Shiokawa Y, Hirano T.
    • Journal Title

      Neurologia medico-chirurgica

      Volume: 57 Issue: 3 Pages: 107-114

    • DOI

      10.2176/nmc.st.2016-0111

    • NAID

      130005439808

    • ISSN
      0470-8105, 1349-8029
    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Suboptimal anticoagulant management in Japanese nonvalvular atrial fibrillation patients receiving warfarin for stroke prevention2017

    • Author(s)
      Hirano T, Kaneko H, Mishina S, Wang F, Morita S
    • Journal Title

      J Stroke Cerebrovasc Dis

      Volume: 26 Issue: 10 Pages: 2102-2110

    • DOI

      10.1016/j.jstrokecerebrovasdis.2017.04.030

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Patient satisfaction after switching from warfarin to apixaban in patients with nonvalvular atrial fibrillation: AGAIN study2017

    • Author(s)
      Koretsune Y, Ikeda T, Kozuma K, Hirano T, Yasaka M, Kida M, Chachin M, Imura M
    • Journal Title

      Patient Prefer Adherence

      Volume: 11 Pages: 1987

    • DOI

      10.2147/ppa.s152579

    • URL

      https://pure.teikyo.jp/en/publications/9d262528-96a7-4410-9a32-950f7e6fc2ea

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] New diagnostic criteria for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukocencephalopathy in Japan.2017

    • Author(s)
      Mizuta I, Hosomi-Watanabe A, Koizumi T, Mukai M, Hamano A, Tomii Y, Kondo M, Nakagawa M, Tomimoto H, Hirano T, Uchino M, Onodera O, Mizuno T
    • Journal Title

      J Neurol Sci

      Volume: 381 Pages: 62-67

    • DOI

      10.1016/j.jns.2017.08.009

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Design and Rationale of the RELAXED (Recurrent Embolism Lessened by rivaroxaban, an Anti-Xa agent, of Early Dosing for acute ischemic stroke and transient ischemic attack with atrial fibrillation) Study.2016

    • Author(s)
      Yasaka M, Minematsu K, Toyoda K, Yamagami H, Yoshimura S, Nagao T, Mori E, Hirano T, Hamasaki T, Yamaguchi T.
    • Journal Title

      J Stroke Cerebrovasc Dis

      Volume: 25 Issue: 6 Pages: 1342-8

    • DOI

      10.1016/j.jstrokecerebrovasdis.2016.01.035

    • Related Report
      2016 Research-status Report
    • Peer Reviewed
  • [Journal Article] Identification of covert atrial fibrillation in cryptogenic ischemic stroke: current clinical practice in Japan.2016

    • Author(s)
      Toyoda K, Okumura K, Hashimoto Y, Ikeda T, Komatsu T, Hirano T, Fukuda H, Matsumoto K, Yasaka M.
    • Journal Title

      Journal of Stroke and Cerebrovascular Diseases

      Volume: 25 Issue: 8 Pages: 1829-1837

    • DOI

      10.1016/j.jstrokecerebrovasdis.2016.05.012

    • Related Report
      2016 Research-status Report
    • Peer Reviewed
  • [Journal Article] 脳主幹動脈急性期血行再建術における当施設での現状と課題 時間短縮への取り組み2016

    • Author(s)
      小松原 弘一郎, 傳法 倫久, 笹森 寛生, 鳥居 正剛, 佐藤 栄志, 平野 照之, 塩川 芳昭
    • Journal Title

      Neurosurgical Emergency

      Volume: 21 Pages: 1-7

    • NAID

      40020926967

    • Related Report
      2016 Research-status Report
    • Peer Reviewed
  • [Journal Article] 急性期脳梗塞における画像診断 安全かつ最短の再開通のため、何をどう使うか2016

    • Author(s)
      平野 照之
    • Journal Title

      The Mt. Fuji Workshop on CVD

      Volume: 34 Pages: 41-50

    • Related Report
      2016 Research-status Report
  • [Presentation] テネクテプラーゼに対する期待2019

    • Author(s)
      平野照之
    • Organizer
      STROKE 2019
    • Related Report
      2018 Annual Research Report
    • Invited
  • [Presentation] The role of CT imaging in acute ischemic stroke2018

    • Author(s)
      Hirano T
    • Organizer
      Asia Pacific Stroke Conference 2018
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] How to use advanced imaging to select patients for endovascular therapy?2018

    • Author(s)
      Hirano T
    • Organizer
      Asia Pacific Stroke Conference 2018
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] maging selection; how will we reach a consensus on imaging selection? Future imaging to help selection; new physiologic information2018

    • Author(s)
      Hill M, Olivot JM, Hirano T, Yoo A
    • Organizer
      14th International Symposium on Thrombolysis, Thrombectomy and Acute Stroke Therapy
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research / Invited
  • [Presentation] TRAITをCTで見極める2017

    • Author(s)
      平野照之
    • Organizer
      第 42回日本脳卒中学会 シンポジウム1
    • Related Report
      2017 Research-status Report
    • Invited
  • [Presentation] 脳血管再開通療法 今そこにある危機2017

    • Author(s)
      平野照之
    • Organizer
      第 4回日本心血管脳卒中学会スポンサードセミナー
    • Related Report
      2017 Research-status Report
    • Invited
  • [Presentation] 神経超音波によるTRAIT評価は可能か?2017

    • Author(s)
      平野照之
    • Organizer
      第36回日本脳神経超音波学会総会 シンポジウム1
    • Related Report
      2017 Research-status Report
    • Invited
  • [Presentation] Current status of Mechanical Thrombectomy and role of neurologists for acute ischemic stroke in Japan.2017

    • Author(s)
      Hirano T
    • Organizer
      XXIII World Congress of Neurology. Japanese Pharma Sponsored Symposium Industry Session 39
    • Related Report
      2017 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] Acute revascularization utilizing thrombectomy and/or thrombolysis in patients with emergent large vessel occlusion.2017

    • Author(s)
      Hirano T
    • Organizer
      The 76th Annual Meeting of the Japan Neurosurgical Society
    • Related Report
      2017 Research-status Report
    • Invited
  • [Presentation] Newer Thrombolytic Agents.2017

    • Author(s)
      Hirano T
    • Organizer
      8th Korea-Japan Joint Stroke Conference Symposium
    • Related Report
      2017 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] Current Status of Acute Stroke Imaging in Patients with Large Vessel Occlusion in Japan2017

    • Author(s)
      Hirano T
    • Organizer
      4th International Symposium on Collaterals to the Brain, Collaterals 2017
    • Related Report
      2017 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] Oral anticoagulant therapy for prevention of cardioembolism.2016

    • Author(s)
      Hirano T
    • Organizer
      第57回日本神経学会学術大会
    • Place of Presentation
      神戸
    • Related Report
      2016 Research-status Report
    • Invited
  • [Presentation] 生涯教育「一過性脳虚血発作を見逃さない」画像診断の役割を見直す2016

    • Author(s)
      平野照之
    • Organizer
      第57回日本神経学会学術大会
    • Place of Presentation
      神戸
    • Related Report
      2016 Research-status Report
    • Invited
  • [Presentation] Acute stroke presentation - the difference between the East and the West.2016

    • Author(s)
      Hirano T
    • Organizer
      Asia Pacific Stroke Conference 2016 Pre-conference workshop
    • Place of Presentation
      Brisbane, Australia
    • Related Report
      2016 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] Future of acute stroke imaging: areas of controversy and research direction.2016

    • Author(s)
      Hirano T
    • Organizer
      Asia Pacific Stroke Conference 2016
    • Place of Presentation
      Brisbane, Australia
    • Related Report
      2016 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] 脳梗塞の急性期治療戦略2016:HERMESの与えたインパクト.2016

    • Author(s)
      平野照之
    • Organizer
      第52回日本医学放射線学会秋季臨床大会
    • Place of Presentation
      東京
    • Related Report
      2016 Research-status Report
    • Invited
  • [Presentation] 脳血行再建の3つの切り口:治療可能時間,救済可能領域,再灌流障害.2016

    • Author(s)
      平野照之
    • Organizer
      第59回日本脳循環代謝学会学術集会
    • Place of Presentation
      徳島
    • Related Report
      2016 Research-status Report
    • Invited
  • [Book] Annual Review 神経 20192019

    • Author(s)
      平野照之(分担執筆)
    • Total Pages
      327
    • Publisher
      中外医学社
    • ISBN
      9784498328303
    • Related Report
      2018 Annual Research Report
  • [Book] マスター脳卒中学2019

    • Author(s)
      平野照之(分担執筆)
    • Total Pages
      587
    • Publisher
      西村書店
    • ISBN
      9784890134939
    • Related Report
      2018 Annual Research Report
  • [Book] 脳梗塞診療読本 第3版2019

    • Author(s)
      平野照之(分担執筆)
    • Total Pages
      443
    • Publisher
      中外医学社
    • ISBN
      9784498328280
    • Related Report
      2018 Annual Research Report
  • [Book] 脳卒中エキスパート 抗血栓療法を究める2019

    • Author(s)
      平野照之(分担執筆)
    • Total Pages
      243
    • Publisher
      中外医学社
    • ISBN
      9784498328228
    • Related Report
      2018 Annual Research Report
  • [Book] 今日の治療指針20182018

    • Author(s)
      平野照之(分担執筆)
    • Total Pages
      2066
    • Publisher
      医学書院
    • ISBN
      9784260032339
    • Related Report
      2018 Annual Research Report
  • [Book] Annual Review 神経 20182018

    • Author(s)
      平野照之(分担執筆)
    • Total Pages
      333
    • Publisher
      中外医学社
    • Related Report
      2018 Annual Research Report
  • [Book] 脳梗塞診療読本第2版2016

    • Author(s)
      平野照之(分担)
    • Total Pages
      18
    • Publisher
      中外医学社
    • Related Report
      2016 Research-status Report
  • [Remarks] 杏林大学医学部脳卒中医学教室

    • URL

      http://kyorinstroke.umin.jp

    • Related Report
      2018 Annual Research Report
  • [Remarks] 杏林大学医学部脳卒中医学

    • URL

      http://kyorinstroke.umin.jp

    • Related Report
      2017 Research-status Report 2016 Research-status Report
  • [Remarks] 杏林大学病院脳卒中センター

    • URL

      http://www.kyorinscu.umin.jp

    • Related Report
      2017 Research-status Report
  • [Remarks] 杏林大学病院脳卒中センター

    • URL

      http://www.kyorinsu.umin.jp

    • Related Report
      2016 Research-status Report

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Published: 2016-04-21   Modified: 2020-03-30  

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