Artikel
The relationship of neuroendovascular therapy with neurosurgeon in Japan
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Autoren
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Y. Matsumoto
- Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai, Japan
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R. Kondo
- Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai, Japan
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H. Shimizu
- Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai, Japan
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A. Takahashi
- Department of Neuroendovascular Therapy, Tohoku University Graduate School of Medicine, Sendai, Japan
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T. Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| Veröffentlicht: | 4. Juni 2012 |
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Gliederung
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The aim of this study is to introduce the current status of neuroendovascular therapy (NEVT) in Japan, particularly cerebral aneurysms (ANs) and carotid artery stenosis.
The situation of NEVT in Japan is compared with it in other countries including Germany in this presentation.
Basically, neurosurgeons are taking the lead with NEVT for CNS diseases in Japan though this is done by neuroradiologists in many other countries. Because Japanese neurosurgeons are used to performing cerebral angiography, to operating craniotomies and to managing stroke patients, it is reasonable that NEVTis performed by neurosurgeons in case of emergiencies. Recently, the role of NEVT is becoming the mainstream in the world. In the case of cerebral ANs fields, coil embolization as the treatment was first published by Guglielmi and started an alternative treatment strategy for cerebral ANs since 20 years ago. The Barrow Ruptured Aneurysm Trial in 2011 showed that the policy of “intent to treat” favoring coil embolization resulted in fewer poor outcomes a year and emphasized that high-quality surgical clipping would be available as an alternative treatment modality. The other side in the field of carotid artery stenosis, The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) showed that carotid artery stenting (CAS) and carotid endarterectomy (CEA) had similar short- and longer-term outcomes. It seems that CAS also may take the place of CEA in the near future. In general neurosurgeons have less experience with cerebral angiography itself, which means that it is hard for them to handle the endovascular devices, such as microcatheter, coils and stents. Traditionally, neurosurgeons performed diagnostic cerebral angiography followed by clipping surgery in Japan. And this has continued on into the endovascular treatment by neurosurgeons. These historical issues are grealy different from occidental countries. The Japanese Society of NeuroEndovascular Therapy (JSNET) was established in 2000 and has a splendid specialist qualification system. in fact. JSNET has now about three thousand members composed of over 90% neurosurgeons.
With this presentation we want to inform German doctors about the relationship of NEVT with Japanese neurosurgeons.
