Elucidation of pathogenesis of secondary aorto-esophageal fistula and construction of early diagnosis system

• Project/Area Number: 16K19963
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Cardiovascular surgery
• Research Institution: Tohoku University
• Principal Investigator: Hayatsu Yukihiro 東北大学, 大学病院, 助教 (50747433)
• Research Collaborator: Katahira Shintaro
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000); Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2017: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000); Fiscal Year 2016: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
• Keywords: 二次性大動脈食道瘻 / LDF / TEVAR / 血流 / 大動脈食道瘻 / 血流セン / LDF法

Outline of Final Research Achievements

This study aimed to demonstrate the reduction of the esophageal mucosal blood flow after thoracic stent-graft insertion and the clinical utility of esophageal blood flow sensor probe in clarifying the mechanisms underlying secondary aorto-esophageal fistula. In addition, this study aimed to establish the indication criteria for the prevention or early surgical intervention of secondary aorto-esophageal fistula. The esophageal blood flow sensor probe was developed, and an evident decrease in the esophageal mucosal blood flow in the acute phase after thoracic stent-graft insertion was demonstrated, thereby proving some of the hypotheses. Further, upon confirmation of the durability and safety of the device, it can be utilized for clinical applications, and the purpose of this research can be achieved.

Academic Significance and Societal Importance of the Research Achievements

今後増加するであると考えられる、胸部ステントグラフト治療後に発生する致死的合併症の二次性大動脈食道瘻の病因の一部を実験的に証明し得た。本実験に使用した新規デバイスを臨床応用することで、二次性大動脈食道瘻の早期発見・予防法の確立へ向け前進することができた。

Research Products

• [Journal Article] Oesophageal mucosal blood flow changes after thoracic endovascular stent graft implantation using a novel sensor probe† (2018)
  • Author(s): Katahira Shintaro、Kawamoto Shunsuke、Masaki Naoki、Hayatsu Yukihiro、Matsunaga Tadao、Haga Yoichi、Saiki Yoshikatsu
  • Journal Title: Interactive CardioVascular and Thoracic Surgery Volume: 26 Issue: 3 Pages: 487-493
  • DOI: 10.1093/icvts/ivx351
  • Peer Reviewed / Open Access
• [Presentation] Monitoring esophageal mucosal blood flow changes after thoracic endovascular aortic repair using a novel sensor: An experimental study in a swine model (2017)
  • Author(s): 片平 晋太郎
  • Organizer: ドイツ胸部外科学会
  • Place of Presentation: congress center Leipzig（ドイツ・ライプチヒ）
  • Year and Date: 2017-02-11
  • Int'l Joint Research