The relationship between collateral status and ischemic tissue fate

• Project/Area Number: 17K09810
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Neurology
• Research Institution: Kyorin University
• Principal Investigator: HIROYUKI KAWANO 杏林大学, 医学部, 講師 (30602578)
• Co-Investigator(Kenkyū-buntansha): 平野 照之 杏林大学, 医学部, 教授 (50346996)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000); Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2017: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
• Keywords: 急性期脳梗塞 / 虚血ペナンブラ / 灌流画像 / 脳梗塞 / 時間 / CT灌流画像 / 側副血行

Outline of Final Research Achievements

In acute ischemic stroke, there is irreversible infarction (ischemic core) and reversible tissue (ischemic penumbra). Ischemic penumbra will be decrease as time goes by. However, in our MRI study, using 10 patients with acute anterior ischemic stroke, we showed that there is ischemic penumbra 6 hours after stroke onset as well as within 6 hours of onset. Our results suggest that ischemic penumbra does not disappear after 6 hours of onset.

Academic Significance and Societal Importance of the Research Achievements

急性期脳梗塞では一刻も早く治療を行うことが患者の転帰改善には重要である。一方、時間がある程度経過していても救済可能な脳組織が存在する場合があることが明らかになった。研究期間中に発表された発症6時間以降の症例にも血管再開通療法が有効な場合があることと一致する結果であり、血管再開通療法の恩恵にあずかることができる患者の増加に繋がる点で、臨床上の意義は大きい。

Research Products

• [Int'l Joint Research] メルボルン大学/ニューカッスル大学/ジョンハンター病院(オーストラリア)
• [Int'l Joint Research] 豪州ニューカッスル大学/豪州メルボルン大学/豪州ジョンハンター病院(オーストラリア)
• [Journal Article] A case of definite diagnosis of branch atheromatous disease confirmed by digital subtraction angiography-3 tesla magnetic resonance fusion imaging (2019)
  • Author(s): 齋藤 幹人, 河野 浩之, 天野 達雄, 岩本 敏彦, 平野 照之
  • Journal Title: Rinsho Shinkeigaku Volume: 59 Issue: 8 Pages: 525-529
  • DOI: 10.5692/clinicalneurol.cn-001297
  • NAID: 130007696268
  • ISSN: 0009-918X, 1882-0654
  • 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
  • Peer Reviewed
• [Journal Article] Predictable Value of Functional Independence Measure Differs between Anterior and Posterior Circulation Ischemic Strokes. (2018)
  • Author(s): Kawano H, Johno T, Torii M, Kamiyama H, Amano T, Honda Y, Okano H, Unno Y, Yamada S, Okajima Y, Shiokawa Y, Hirano T.
  • Journal Title: Eur Neurol. Volume: 80 Issue: 5-6 Pages: 313-320
  • DOI: 10.1159/000499132
  • Peer Reviewed
• [Journal Article] Stroke due to infective endocarditis diagnosed by the retrieved thrombus: a case report (2018)
  • 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
  • Peer Reviewed
• [Journal Article] Perfusion computed tomography in patients with stroke thrombolysis (2017)
  • Author(s): Kawano Hiroyuki、Bivard Andrew、Lin Longting、Ma Henry、Cheng Xin、Aviv Richard、O’Brien Billy、Butcher Kenneth、Lou Min、Zhang Jingfen、Jannes Jim、Dong Qiang、Levi Christopher R.、Parsons Mark W.
  • Journal Title: Brain Volume: 19 Pages: aww338-aww338
  • DOI: 10.1093/brain/aww338
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Hospital arrival times and post-imaging delays in stroke thrombolysis implementation. (2017)
  • Author(s): Kawano H, Bivard A, Parsons MW, Paul CL, Krause M, D’Este CA, Bladin CF, Lindley RI, Attia JR, Henskens F, Longworth M, Middleton S, Ryan A, Kerr E, Sanson-Fisher RW, Levi CR
  • Journal Title: J Neurol Disord Stroke Volume: -
  • Peer Reviewed / Int'l Joint Research
• [Presentation] Saving time for initial management of stroke by reorganization of in-hospital stroke code protocol. (2020)
  • Author(s): Kawano H, Ebisawa S, Ayano M, Nakanishi K, Yamashita H, Honda Y, Amano T, Unno Y, Komatsu Y, Ogawa Y, Shiokawa Y, Hirano T
  • Organizer: International Stroke Conference 2020
  • Int'l Joint Research
• [Presentation] Adoption of perfusion imaging (2019)
  • Author(s): Hiroyuki Kawano
  • Organizer: The 9th Japan Korea Joint Stroke Conference
  • Int'l Joint Research / Invited
• [Presentation] CT Perfusionを用いた急性期脳梗塞診断におけるベイズ推定法による虚血コア体積計測精度の初期検討 (2019)
  • Author(s): 藤田祐次郎, 安達卓哉, 河野浩之, 壷井美香, 町田治彦, 中西章仁, 横山 健一
  • Organizer: 第47回日本放射線技術学会秋期学術大会
• [Presentation] 脳卒中画像診断の現状と今後の展開. 脳組織に基づく急性期脳梗塞の治療戦略. (2018)
  • Author(s): 河野浩之
  • Organizer: STROKE2019
• [Presentation] Subcutaneous heparin injection for cancer-associated stroke. (2018)
  • Author(s): Kawano H, Hosaka M, Amano T, Okano H, Suzuki R, Honda Y, Torii M, Unno Y, Shiokawa Y, Hirano T
  • Organizer: 11th World Stroke Congress
  • Int'l Joint Research
• [Presentation] 3D-CTA is useful to identify underlying cause of embolic stroke of undetermined source. (2018)
  • Author(s): Saito M, Kawano H, Hirano T
  • Organizer: 11th World Stroke Congress
  • Int'l Joint Research
• [Presentation] 脳卒中センターにおける急性期脳梗塞の診断から治療．最新のモダリティと解析の活用 (2018)
  • Author(s): 河野浩之
  • Organizer: STROKE 2018
• [Presentation] 発症後6時間を超えた脳梗塞に虚血ペナンブラは存在する (2018)
  • Author(s): 山下ひとみ，河野浩之，齋藤幹人，城野喬史，丸岡響，中西郁，本田有子， 天野達雄，鈴木理恵子，鳥居正剛，岡野晴子，海野佳子，塩川芳昭，平野照之
  • Organizer: STROKE 2018
• [Presentation] Functional Independence Scores of Acute Stroke Patients is Associated With Discharge Directly to Home (2018)
  • Author(s): Hiroyuki Kawano, Takashi Johno, Masataka Torii, Hiroshi Kamiyama, Tatsuo Amano, Yuko Honda, Rieko Suzuki, Haruko Okano, Yoshiko Unno, Shin Yamada, Yasutomo Okajima, Yoshiaki Shiokawa and Teruyuki Hirano
  • Organizer: International Stroke Conference 2018
  • Int'l Joint Research
• [Funded Workshop] 11th World Stroke Congress (2018)
• [Funded Workshop] International Stroke Conference 2018 (2018)