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  1. C100 医学部/医学系研究科
  2. C100a 雑誌掲載論文
  3. 学術雑誌

Neurologic Deficit After Aortic Arch Replacement: The Influence of the Aortic Atherosclerosis

http://hdl.handle.net/2237/00030813
http://hdl.handle.net/2237/00030813
cf495326-560e-4936-ac71-3a7972e1d149
名前 / ファイル ライセンス アクション
ANNALS-S-18-02922.pdf ANNALS-S-18-02922 (1.1 MB)
Item type 学術雑誌論文 / Journal Article(1)
公開日 2019-10-16
タイトル
タイトル Neurologic Deficit After Aortic Arch Replacement: The Influence of the Aortic Atherosclerosis
言語 en
著者 Tokuda, Yoshiyuki

× Tokuda, Yoshiyuki

WEKO 93722

en Tokuda, Yoshiyuki

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Narita, Yuji

× Narita, Yuji

WEKO 93723

en Narita, Yuji

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Fujimoto, Kazuro

× Fujimoto, Kazuro

WEKO 93724

en Fujimoto, Kazuro

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Mutsuga, Masato

× Mutsuga, Masato

WEKO 93725

en Mutsuga, Masato

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Terazawa, Sachie

× Terazawa, Sachie

WEKO 93726

en Terazawa, Sachie

Search repository
Ito, Hideki

× Ito, Hideki

WEKO 93727

en Ito, Hideki

Search repository
Uchida, Wataru

× Uchida, Wataru

WEKO 93728

en Uchida, Wataru

Search repository
Usui, Akihiko

× Usui, Akihiko

WEKO 93729

en Usui, Akihiko

Search repository
アクセス権
アクセス権 open access
アクセス権URI http://purl.org/coar/access_right/c_abf2
権利
言語 en
権利情報 © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
抄録
内容記述 Background: Postoperative neurologic deficits are associated with severe morbidity in aortic arch replacement. Methods: A group of 198 consecutive patients undergoing isolated total aortic arch replacement with the use of antegrade cerebral perfusion were analyzed for the risk factors for predicting neurologic deficit. With the use of computed tomography, atherothrombotic lesions (defined as extensive intimal thickening exceeding 4 mm) were identified in the proximal aorta (the ascending aorta or aortic arch) in 26.2% of cases and in the distal aorta in 34.9% of cases. Results: Permanent neurologic deficits occurred in 11.1% (including non-disabling stroke confirmed by imaging) and transient neurologic deficits in 8.1% of patients. A univariate analysis identified proximal atherothrombotic aorta (p = 0.0057), distal atherothrombotic aorta (p = 0.032), and retrograde systemic perfusion from the femoral artery in the presence of distal atherothrombotic aorta (p = 0.0022) as risk factors for neurologic deficits. A multivariate logistic regression analysis identified atherothrombotic proximal aorta (odds ratio 2.4, p = 0.033) as the independent risk factor. The presence of carotid stenosis did not affect the rate of neurologic deficit. Intracranial hemorrhagic lesions were found in 23% of permanent neurologic deficit cases. Conclusions: Atherothrombotic lesions found by objectively graded computed tomography were predictors of neurologic deficit. Retrograde perfusion in the presence of a distal atherothrombotic lesion should be avoided whenever possible. Strategies based on the full assessment of the whole aortic morphologic characteristics appear to be mandatory. Anticoagulation therapy should be performed carefully to avoid intracranial hemorrhagic changes.
言語 en
内容記述タイプ Abstract
内容記述
内容記述 ファイル公開:2020-07-01
言語 ja
内容記述タイプ Other
出版者
言語 en
出版者 Elsevier
言語
言語 eng
資源タイプ
資源タイプresource http://purl.org/coar/resource_type/c_6501
タイプ journal article
出版タイプ
出版タイプ AM
出版タイプResource http://purl.org/coar/version/c_ab4af688f83e57aa
DOI
関連タイプ isVersionOf
識別子タイプ DOI
関連識別子 https://doi.org/10.1016/j.athoracsur.2019.01.004
ISSN(print)
収録物識別子タイプ PISSN
収録物識別子 0003-4975
書誌情報 en : The Annals of Thoracic Surgery

巻 108, 号 1, p. 107-114, 発行日 2019-07
著者版フラグ
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