Sakai Nobuyuki, Uchida Kazutaka, Iihara Koji, Satow Tetsu, Ezura Masayuki, Hyodo Akio, Miyachi Shigeru, Miyamoto Susumu, Nagai Yoji, Nishimura Kunihiro, Toyoda Kazunori, Yoshimura Shinichi, Imamura Hirotoshi, Sakai Chiaki, Matsumaru Yuji
Department of Neurosurgery, Kobe City Medical Center General Hospital.
Department of Neurosurgery, Hyogo College of Medicine.
Neurol Med Chir (Tokyo). 2019 Mar 15;59(3):106-115. doi: 10.2176/nmc.oa.2018-0267. Epub 2019 Mar 7.
This study, following Japanese Registry of NeuroEndovascular Treatment 1 and 2 (JR-NET 1 & 2), shows an annual trend of cases including adverse events and clinical outcomes at 30 days after NET. JR-NET3 was registered by 749 cumulative total number of physicians, certified by the Japanese Society of Neuroendovascular Therapy in 166 centers, between 2010 and 2014. Medical information about the patients was anonymized and retrospectively registered through a website. A total of 40,177 patients were recruited, 632 patients were excluded because data of preprocedural status were not available. So we analyzed 39,545 patients retrospectively. The proportion of octogenarians is increasing year-by-year and 14.7% in 2014 compared with 10.4% in 2010. Most frequent target disease is intracranial aneurysm. For the proportion of the treatment of intracranial aneurysm, 50.0% in 2010, but that has decreased to 44.8% in 2014. However, number of procedures were increased from 3150 in 2010 to 3419 in 2014. Although before the positive clinical evidence of mechanical thrombectomy for acute ischemic stroke (AIS) was established, the proportion of endovascular treatment for AIS increased 13.8% in 2014 compared with 6.3% in 2010. The number of patients requiring neuroendovascular treatment in Japan is increasing since 2010-2013, but that declined a little in 2014 caused by study operation suspended at the end of 2013. The outcomes of such therapy are clinically acceptable. Details of each type of treatment will be investigated in sub-analyses of the database.
本研究遵循日本神经血管内治疗登记处1和2(JR-NET 1和2),展示了神经血管内治疗(NET)后30天内包括不良事件和临床结果在内的病例年度趋势。2010年至2014年期间,JR-NET3由749名累计医生登记,这些医生在166个中心获得日本神经血管内治疗学会认证。患者的医疗信息经过匿名处理,并通过网站进行回顾性登记。共招募了40177名患者,632名患者因术前状态数据不可用而被排除。因此,我们对39545名患者进行了回顾性分析。八十多岁老人的比例逐年增加,2014年为14.7%,而2010年为10.4%。最常见的目标疾病是颅内动脉瘤。颅内动脉瘤治疗的比例在2010年为50.0%,但在2014年已降至44.8%。然而,手术数量从2010年的3150例增加到2014年的3419例。尽管在急性缺血性卒中(AIS)机械取栓的阳性临床证据确立之前,AIS血管内治疗的比例在2014年为13.8%,而2010年为6.3%。自2010 - 2013年以来,日本需要神经血管内治疗的患者数量一直在增加,但在2014年有所下降,原因是2013年底研究手术暂停。这种治疗的结果在临床上是可以接受的。每种治疗类型的详细信息将在数据库的子分析中进行研究。