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脳動脈瘤再発予防に向けた数値流体力学解析によるステント併用コイル塞栓術の開発

Research Project

Project/Area Number 21K09120
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 56010:Neurosurgery-related
Research InstitutionKanazawa University

Principal Investigator

見崎 孝一  金沢大学, 附属病院, 講師 (20507082)

Project Period (FY) 2021-04-01 – 2025-03-31
Project Status Granted (Fiscal Year 2023)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2023: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2022: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2021: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords脳動脈瘤 / 数値流体力学 / 再発 / 血管内手術 / ステント
Outline of Research at the Start

申請者が数値流体力学を用いて同定した血管内治療後の脳動脈瘤の再発因子は“動脈瘤に挿入したコイルに作用する高い圧力”であった。しかしその再発を防ぐ有効な治療方法が確立されていない。金属製の筒であるステントに再発予防効果があること報告されているが、効果は症例よって異なり、その使用適応が明らかではない。そこで本研究ではステントの種類や留置数によって再発因子であるコイルにかかる高い圧力がどのように減弱するかを明らかにして再発しない脳動脈瘤治療を提唱する。

Outline of Annual Research Achievements

本研究は数値流体力学的解析を脳動脈瘤に応用することで、血管内手術後の脳動脈瘤の再発の防ぐ治療を提唱することを目的としている。2023年も脳動脈瘤に対する血管内治療や脳動脈瘤流体解析について複数の論文発表を行った(Misaki 2023 Heliyon, Uno 2023 J Stroke Cerebrovasc Dis, Tsutsui 203 Surg Neurol Int, Nogami 2023 Surg Neurol Int, Liao 2023 Heliyon, Kitabayashi 2023 Neurol Clin Neurosci, Futami 2023 J Neuroradiol, Nambu 2023 Interv Neuroradiol)。脳動脈瘤の再発を防ぐ効果的なデバイスとして金属の筒であるステントが報告されている。ステントの中でも網目の細かいフローダイバーターステントを留置すると動脈瘤内の血流速度が低下して血栓化を促すことで動脈瘤の治癒並びに再発防止に有効と考えられている。研究代表者によるフローダイバーターを用いた脳動脈瘤治療の実績が40例を越え、多くは1年を経過せずに動脈瘤が消失して良好な結果を得ている。コイルを留置せずに動脈瘤を血栓化させるこのフローダイバーターは研究テーマである動脈瘤再発予防効果を強く有していると考えられる。しかしながら動脈瘤が治癒しない症例も存在するため治癒の関連因子について統計学的に解析を行ったが有意差を見出すためにはさらなる症例の蓄積が必要であることが判明した。現時点では金属被覆率の低下が動脈瘤残存に関連することが考えられ、症例数を増やしてステントの動脈瘤消失や再発の関連因子を解析して効果的に動脈瘤を治療できるステントの使用方法を治療前に計画できるシステムを構築する予定である。

Current Status of Research Progress
Current Status of Research Progress

3: Progress in research has been slightly delayed.

Reason

動脈瘤再発因子の有意差を出すためには治療症例がさらに増える必要があるため。

Strategy for Future Research Activity

治療症例が順調に増えているため2024年度で研究が終了できる見込みである。

Report

(3 results)
  • 2023 Research-status Report
  • 2022 Research-status Report
  • 2021 Research-status Report
  • Research Products

    (38 results)

All 2024 2023 2022 2021

All Journal Article (23 results) (of which Int'l Joint Research: 5 results,  Peer Reviewed: 22 results,  Open Access: 7 results) Presentation (15 results) (of which Int'l Joint Research: 1 results,  Invited: 2 results)

  • [Journal Article] Fluid dynamic analysis in predicting the recanalization of intracranial aneurysms after coil embolization ? A study of spatiotemporal characteristics2024

    • Author(s)
      Liao Jing、Misaki Kouichi、Uno Tekehiro、Nambu Iku、Kamide Tomoya、Chen Zhuoqing、Nakada Mitsutoshi、Sakamoto Jiro
    • Journal Title

      Heliyon

      Volume: 10 Issue: 1 Pages: e22801-e22801

    • DOI

      10.1016/j.heliyon.2023.e22801

    • Related Report
      2023 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] 特集 Theモニタリング-基本から応用まで Ⅳ 術式別 脳血管障害手術におけるモニタリング2023

    • Author(s)
      見崎 孝一、吉識 賢志、上出 智也
    • Journal Title

      Neurological Surgery 脳神経外科

      Volume: 51 Issue: 3 Pages: 500-506

    • DOI

      10.11477/mf.1436204774

    • ISSN
      0301-2603, 1882-1251
    • Year and Date
      2023-05-10
    • Related Report
      2023 Research-status Report
  • [Journal Article] Evaluation of a scoring system to assess proficiency in cerebral angiography for neuroendovascular surgery education2023

    • Author(s)
      Misaki Kouichi、Kamide Tomoya、Uno Takehiro、Tsutsui Taishi、Nambu Iku、Nakada Mitsutoshi
    • Journal Title

      Heliyon

      Volume: 9 Issue: 2 Pages: e13249-e13249

    • DOI

      10.1016/j.heliyon.2023.e13249

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] Factors related to high bifurcation level of common femoral artery2023

    • Author(s)
      Takehiro Uno, Kouichi Misaki, Riho Nakajima, Iku Nambu, Akifumi Yoshikawa, Tomoya Kamide, Mitsutoshi Nakada
    • Journal Title

      Journal of Stroke and Cerebrovascular Diseases

      Volume: 32 Issue: 3 Pages: 106976-106976

    • DOI

      10.1016/j.jstrokecerebrovasdis.2022.106976

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] Targeted transvenous embolization of a dural arteriovenous fistula at the jugular tubercle venous complex2023

    • Author(s)
      Tsutsui Taishi、Misaki Kouichi、Yoshikawa Akifumi、Nogami Kenshu、Nambu Iku、Kamide Tomoya、Muramatsu Naoki、Nakada Mitsutoshi
    • Journal Title

      Surgical Neurology International

      Volume: 14 Pages: 44-44

    • DOI

      10.25259/sni_1087_2022

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] The first coil embolization ratio is the key factor for retreatment for unruptured cerebral aneurysms2023

    • Author(s)
      Nogami Kenshu、Misaki Kouichi、Tsutsui Taishi、Nambu Iku、Kamide Tomoya、Nakada Mitsutoshi
    • Journal Title

      Surgical Neurology International

      Volume: 14 Pages: 53-53

    • DOI

      10.25259/sni_1100_2022

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] Prediction of post-embolization recurrence in internal carotid-posterior communicating aneurysms with Vel-PointNet2023

    • Author(s)
      LIAO Jing、SAKAMOTO Jiro、MISAKI Kouichi、SIRITANAWAN Prarinya、KOTANI Kazunori
    • Journal Title

      Journal of Biomechanical Science and Engineering

      Volume: 18 Issue: 2 Pages: 22-00471-22-00471

    • DOI

      10.1299/jbse.22-00471

    • ISSN
      1880-9863
    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] Minimum wall shear stress points and their underlying intra-aneurysmal flow structures of unruptured cerebral aneurysms on 4D flow MRI2023

    • Author(s)
      Kazuya Futami, Kouichi Misaki, Takehiro Uno, Iku Nambu, Taishi Tsutsui, Tomoya Kamide, Mitsutoshi Nakada
    • Journal Title

      Journal of Neuroradiology

      Volume: 50 Issue: 3 Pages: 302-308

    • DOI

      10.1016/j.neurad.2022.09.001

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] Carotid artery stenting after balloon aortic valvuloplasty in cervical internal carotid artery stenosis associated with severe aortic stenosis: A case report2023

    • Author(s)
      Kitabayashi T.、Misaki Kouichi、Kamide T.、Nakada M.
    • Journal Title

      Neurology and Clinical Neuroscience

      Volume: 11 Issue: 6 Pages: 319-321

    • DOI

      10.1111/ncn3.12763

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] Partially thrombosed distal posterior cerebral artery aneurysm treated with surgical trapping through occipital transtentorial approach assisted by endovascular coil embolization2023

    • Author(s)
      Nambu Kosuke、Kamide Tomoya、Tsutsui Taishi、Kitabayashi Tomohiro、Yoshikawa Akifumi、Misaki Kouichi、Nakada Mitsutoshi
    • Journal Title

      Surgical Neurology International

      Volume: 14 Pages: 20-20

    • DOI

      10.25259/sni_1109_2022

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] Periprocedural antiplatelet medication assessed by VerifyNow for neuroendovascular treatment: Comparison of prasugrel with clopidogrel2023

    • Author(s)
      Nambu Kosuke、Misaki Kouichi、Uno Takehiro、Tsutsui Taishi、Kamide Tomoya、Nakada Mitsutoshi
    • Journal Title

      Interventional Neuroradiology

      Volume: 11 Pages: 019-019

    • DOI

      10.1177/15910199231219019

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] Improvement of intrapartum reversible cerebral vasoconstriction syndrome over 12 weeks after onset: A Case Report2022

    • Author(s)
      Misaki K, Sano H, Tsutsui T, Nambu I, Kamide T, Nakada M
    • Journal Title

      Journal of Medical Case Reports and Case Series

      Volume: 3 Pages: 15-15

    • DOI

      10.38207/jmcrcs/2022/decc031503111

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Morphological factors affecting vortex core instability on 4D flow MRI of unruptured cerebral aneurysms2022

    • Author(s)
      Futami Kazuya、Misaki Kouichi、Uno Takehiro、Nambu Iku、Kamide Tomoya、Nakada Mitsutoshi
    • Journal Title

      Neurological Research

      Volume: 44 Issue: 5 Pages: 455-462

    • DOI

      10.1080/01616412.2021.2004365

    • Related Report
      2022 Research-status Report 2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Recurrence pattern predicts aneurysm rupture after coil embolization2022

    • Author(s)
      Nambu I, Misaki K, Uno T, Yoshikawa A, Uchiyama N, Mohri M, Nakada M
    • Journal Title

      PLoS One

      Volume: 17 Issue: 9 Pages: e0261996-e0261996

    • DOI

      10.1371/journal.pone.0261996

    • Related Report
      2022 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Late complications of visual impairment and hydrocephalus after flow diverter-assisted coil embolisation for intracranial large aneurysm: a case report and literature review2022

    • Author(s)
      Ichinose Toshiya、Misaki Kouichi、Uchiyama Naoyuki、Kamide Tomoya、Nambu Iku、Yoshikawa Akifumi、Tsuchiya Shunsuke、Nakada Mitsutoshi
    • Journal Title

      British Journal of Neurosurgery

      Volume: 11 Issue: 6 Pages: 1-5

    • DOI

      10.1080/02688697.2021.2024502

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Comparison of endovascular therapy for ruptured cerebral aneurysm during spasm and non-spasm period2022

    • Author(s)
      Kamide T, Misaki K, Tsutsui T, Nambu I, Yoshikawa A, Nakada M
    • Journal Title

      Asian J Neurosurg

      Volume: 17 Issue: 03 Pages: 412-415

    • DOI

      10.1055/s-0042-1750782

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Panhypopituitarism caused by an unruptured giant cavernous internal carotid artery aneurysm compressing the pituitary gland treated with a flow-diverting stent: A case report2022

    • Author(s)
      Oikawa N, Misaki K, Aono D, Nambu I, Hayashi Y, Uchiyama N, Nakada M
    • Journal Title

      Surg Neurol Int

      Volume: 26 Pages: 378-378

    • DOI

      10.25259/sni_548_2022

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Multiple Endovascular Treatments for Hemorrhagic Cerebral Proliferative Angiopathy: A Case Report2022

    • Author(s)
      Shomura Keijiro、Kamide Tomoya、Misaki Kouichi、Tsutsui Taishi、Nambu Iku、Uchiyama Naoyuki、Nakada Mitsutoshi
    • Journal Title

      Case Reports in Neurology

      Volume: 14 Issue: 3 Pages: 433-440

    • DOI

      10.1159/000527559

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Prediction of Post-Embolization Recurrence of Anterior Communicating Aneurysms with A1 Segment Asymmetry by Fluid Dynamic Analysis2021

    • Author(s)
      Kouichi Misaki, Takehiro Uno, Iku Nambu, Akifumi Yoshikawa, Tomoya Kamide, Naoyuki Uchiyama, Mitsutoshi Nakada
    • Journal Title

      Journal of Neuroendovascular Therapy

      Volume: 15 Issue: 2 Pages: 71-76

    • DOI

      10.5797/jnet.oa.2020-0021

    • NAID

      130007988670

    • ISSN
      1882-4072, 2186-2494
    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Inflow Hemodynamics of Intracranial Aneurysms: A Comparison of Computational Fluid Dynamics and 4D Flow Magnetic Resonance Imaging2021

    • Author(s)
      Misaki Kouichi、Futami Kazuya、Uno Takehiro、Nambu Iku、Yoshikawa Akifumi、Kamide Tomoya、Nakada Mitsutoshi
    • Journal Title

      Journal of Stroke and Cerebrovascular Diseases

      Volume: 30 Issue: 5 Pages: 105685-105685

    • DOI

      10.1016/j.jstrokecerebrovasdis.2021.105685

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Usefulness of 2D-Perfusion Analysis for the Assessment of Unilateral Cervical Internal Carotid Artery Stenosis2021

    • Author(s)
      Yoshikawa Akifumi、Uno Takehiro、Nambu Iku、Kamide Tomoya、Misaki Kouichi、Nakada Mitsutoshi
    • Journal Title

      Journal of Neuroendovascular Therapy

      Volume: 15 Issue: 9 Pages: 583-588

    • DOI

      10.5797/jnet.oa.2020-0132

    • NAID

      130008090518

    • ISSN
      1882-4072, 2186-2494
    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Hemodynamic factor evaluation using computational fluid dynamics analysis for de novo bleb formation in unruptured intracranial aneurysms2021

    • Author(s)
      Uno Takehiro、Misaki Kouichi、Futami Kazuya、Nambu Iku、Yoshikawa Akifumi、Kamide Tomoya、Uchiyama Naoyuki、Nakada Mitsutoshi
    • Journal Title

      Neurological Sciences

      Volume: 43 Issue: 3 Pages: 1849-1857

    • DOI

      10.1007/s10072-021-05482-x

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Ocular ischemic syndrome due to severe internal carotid artery stenosis improved by intracranial stent placement: A case report2021

    • Author(s)
      Uchida Wataru、Kamide Tomoya、Uno Takehiro、Yoshikawa Akifumi、Misaki Kouichi、Nakada Mitsutoshi
    • Journal Title

      Surgical Neurology International

      Volume: 12 Pages: 294-294

    • DOI

      10.25259/sni_361_2021

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Presentation] 脳血管内治療の手技完遂率から評価する専門医資格の質2023

    • Author(s)
      見崎孝一、宇野豪洋、筒井泰史、上出智也、中田光俊
    • Organizer
      第48回日本脳卒中学会学術集会
    • Related Report
      2023 Research-status Report
  • [Presentation] 循環器病対策推進時代における石川県及び大学病院の脳卒中医療体制整備2023

    • Author(s)
      見崎孝一
    • Organizer
      脳卒中Expert Meeting
    • Related Report
      2023 Research-status Report
    • Invited
  • [Presentation] PSCコア施設における脳卒中治療医の疲労度調査と診療体制構築の課題2023

    • Author(s)
      見崎孝一、上出智也、筒井泰史、髙田 翔、中田光俊
    • Organizer
      第82回日本脳神経外科学会学術総会
    • Related Report
      2023 Research-status Report
  • [Presentation] 脳血管撮影検査の評点法による血管内治療の習熟度を示す因子2023

    • Author(s)
      見崎孝一、髙田 翔、筒井泰史、上出智也、中田光俊
    • Organizer
      第39回日本脳神経血管内治療学会学術集会
    • Related Report
      2023 Research-status Report
  • [Presentation] 脳血管撮影検査の教育的評点法による習熟に要する経験数の解析2022

    • Author(s)
      見崎孝一、筒井泰史、南部育、上出智也、中田光俊
    • Organizer
      第47回日本脳卒中学会学術集会
    • Related Report
      2022 Research-status Report
  • [Presentation] 診断と治療に難渋した硬膜動静脈瘻の1例2022

    • Author(s)
      見崎孝一
    • Organizer
      第11回富山ホタルイカカンファレンス
    • Related Report
      2022 Research-status Report
  • [Presentation] Scoring system to assess proficiency in cerebral angiography for neuroendovascular surgery education2022

    • Author(s)
      Misaki K, Uno T, Tsutsui T, Kamide T, Nakada M
    • Organizer
      The 16th Congress of World Federation of interventional and Therapeutic neuroradiology
    • Related Report
      2022 Research-status Report
    • Int'l Joint Research
  • [Presentation] 脳血管障害関連てんかんの治療について2022

    • Author(s)
      見崎孝一
    • Organizer
      第95回 石川脳血管障害研究会 ミニレクチャー
    • Related Report
      2022 Research-status Report
    • Invited
  • [Presentation] 脳血管内治療教育のための脳血管撮影検査の評点法による習熟度の数値化2022

    • Author(s)
      見崎孝一、宇野豪洋、筒井泰史、上出智也、中田光俊
    • Organizer
      第81回日本脳神経外科学会学術総会
    • Related Report
      2022 Research-status Report
  • [Presentation] 定量的解析による脳血管撮影習熟度の放射線被曝抑制効果2022

    • Author(s)
      見崎孝一、上出智也、筒井泰史、宇野豪洋、中田光俊
    • Organizer
      第38回NPO法人日本脳神経血管内治療学会学術総会
    • Related Report
      2022 Research-status Report
  • [Presentation] Educational scoring system for endovascular neurosurgeons2021

    • Author(s)
      Misaki K, Nambu I, Tsutsui T, Kamide T, Nakada M
    • Organizer
      The 2021 Congress of Neurological Surgeons Annual Meeting
    • Related Report
      2021 Research-status Report
  • [Presentation] Pipeline治療2021

    • Author(s)
      見崎孝一
    • Organizer
      第1回FlowerJapan北陸研究会
    • Related Report
      2021 Research-status Report
  • [Presentation] 脳血管内治療教育のための脳血管撮影検査の点数化による習熟度の評価2021

    • Author(s)
      見崎孝一、南部育、吉川陽文、上出智也、中田光俊
    • Organizer
      第80回脳神経外科学会学術総会
    • Related Report
      2021 Research-status Report
  • [Presentation] コイル塞栓後の再発因子である高圧力は親血管とネックの形状で予測できる2021

    • Author(s)
      見崎孝一、南部育、筒井泰史、上出智也、中田光俊
    • Organizer
      第37回NPO法人日本脳神経血管内治療学会学術総会
    • Related Report
      2021 Research-status Report
  • [Presentation] 評点法による血管内手術の教育システム2021

    • Author(s)
      見崎孝一、南部育、筒井泰史、上出智也、中田光俊
    • Organizer
      第37回NPO法人日本脳神経血管内治療学会学術総会
    • Related Report
      2021 Research-status Report

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Published: 2021-04-28   Modified: 2024-12-25  

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