Updated on 2024/12/02

Information

 

写真a

 
MORISAKI KOICHI
 
Organization
Kyushu University Hospital Vascular Surgery Assistant Professor
School of Medicine Department of Medicine(Concurrent)
Title
Assistant Professor
Profile
2006年から2年間の初期臨床研修を修了した後、九州大学消化器・総合外科に入局した。大学院に進学し、自家静脈グラフトの内膜肥厚に関する研究を行って学位を取得した。その後は小倉記念病院、九州大学病院、松山赤十字病院にて血管外科としての臨床経験を積んできた。その結果として、日本外科学会専門医、日本心臓血管外科学会専門医・修練指導医、日本脈管学会専門医を取得した。臨床研究としては、腹部大動脈ステントグラフト内挿術後エンドリークのリスク因子、重症虚血肢患者におけるフレイル評価、生命予後に関与する因子、血行再建の術式選択、下肢切断後の断端治癒因子などについて学会発表を行い、海外雑誌へ投稿し論文化を行ってきた。2017年4月より助教として九州大学病院に再赴任となり、血管外科の診療及び後輩の外科医療・手術手技の教育を行っている。また、大学院生の研究、学会発表、論文の指導も行っている。 専門医資格: 日本外科学会専門医 日本心臓血管外科学会専門医・修練指導医 日本脈管学会専門医 日本血管外科学会血管内治療認定医 腹部大動脈ステントグラフト実施医・指導医 胸部大動脈ステントグラフト実施医 下肢静脈瘤血管内レーザー焼灼術 実施医・指導医
External link

Degree

  • Ph.D

Research Interests・Research Keywords

  • Research theme:Treatment outcomes in patients with CLTI

    Keyword:CLTI

    Research period: 2023.4

  • Research theme:Treatment outcomes in patients with abdominal aortic aneurysm and iliac artery aneurysm

    Keyword:Abdominal aortic aneurysm

    Research period: 2023.4

  • Research theme:Abdominal aortic aneurysm, Peripheral arterial disease

    Keyword:AAA, EVAR, CLI, bypass, endovscular

    Research period: 2018.6 - 2022.12

Papers

  • Comparison of Early Outcomes in Patients Who Underwent Common Femoral Thromboendarterectomy with Vein versus Bovine Pericardial Patches

    Okadome, J; Morisaki, K; Matsuda, D; Guntani, A; Kurose, S; Kyuragi, R; Tanaka, S; Iwasa, K; Ito, H; Yoshizumi, T

    ANNALS OF VASCULAR SURGERY   110 ( Pt A )   498 - 504   2025.1   ISSN:0890-5096 eISSN:1615-5947

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  • The Modified Albumin-Bilirubin (ALBI) Grade Reflect the Fate of Limb Prognosis in Patients with Chronic Limb-Threatening Ischemia

    Inoue, K; Kinoshita, G; Yoshino, S; Morisaki, K; Yoshizumi, T

    ANNALS OF VASCULAR SURGERY   108   171 - 178   2024.11   ISSN:0890-5096 eISSN:1615-5947

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    Language:English   Publisher:Annals of Vascular Surgery  

    Background: To examine the influence of liver function on patients with chronic limb-threatening ischemia (CLTI), we classified patients with CLTI after revascularization according to their modified albumin–bilirubin (ALBI) grades. Methods: We retrospectively analyzed single-center data of patients who underwent revascularization for CLTI between 2015 and 2020. Patients were classified with ALBI grades 1, 2a, and 2b and 3 according to the ALBI score, which was calculated, based on serum albumin and total bilirubin levels. The endpoints were the 2-year amputation-free survival (AFS) and 1-year wound healing rates. Results: We included 190 limbs in 148 patients, and 50, 54, and 86 cases were assigned as grade 1, 2a, and 2b and 3, respectively. The 2-year AFS rates for the grade 1, 2a, and 2b and 3 groups were 79 ± 6%, 66% ± 7%, and 45 ± 6%, respectively (P < 0.01). One-year cumulative wound healing rates for grade 1, 2a, and 2b and 3 groups were 68 ± 7%, 69% ± 6%, and 48% ± 5%, respectively (P = 0.01). Multivariate Cox proportional hazard analyses identified age (≥75 years), dependent ambulatory status, and modified ALBI grades 2b and 3 compared with grades 1 and 2a as significant independent predictors of AFS. The dependent ambulatory status and Wound, Ischemia, and foot Infection classification stage 4 were significant negative predictors of wound healing. Conclusions: Many patients with CLTI had high modified ALBI grades, and impaired liver function classified as modified ALBI grade 2b and 3 is a robust negative predictor of AFS.

    DOI: 10.1016/j.avsg.2024.04.021

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  • Spontaneous Inferior Mesenteric Artery Occlusion after Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm and its Impact on Clinical Outcomes.

    Yoshino S, Morisaki K, Aoyagi T, Kinoshita G, Inoue K, Yoshizumi T

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery   2024.10   ISSN:1078-5884

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    DOI: 10.1016/j.ejvs.2024.09.036

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  • Influence of inframalleolar modifier P0/P1 on wound healing in bypass surgery vs endovascular therapy in patients with chronic limb-threatening ischemia

    Morisaki, K; Matsuda, D; Guntani, A; Kinoshita, G; Yoshino, S; Inoue, K; Honma, K; Yamaoka, T; Mii, S; Yoshizumi, T

    JOURNAL OF VASCULAR SURGERY   80 ( 3 )   792 - 799.e1   2024.9   ISSN:0741-5214 eISSN:1097-6809

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    Language:English   Publisher:Journal of Vascular Surgery  

    Objective: This study aimed to compare the influence of inframalleolar (IM) P0/P1 on wound healing in bypass surgery vs endovascular therapy (EVT) in patients with chronic limb-threatening ischemia (CLTI). Methods: We retrospectively analyzed the multicenter data of patients who underwent infra-inguinal revascularization for CLTI between 2015 and 2022. IM P represents target artery crossing into foot, with intact pedal arch (P0) and absent or severely diseased pedal arch (P1). The endpoints were wound healing, limb salvage (LS), and postoperative complications. Results: We analyzed 66 and 189 propensity score-matched pairs in the IM P0 and IM P1 cohorts, respectively. In the IM P0 cohort, the 1-year wound healing rates were 94.5% and 85.7% in the bypass surgery and EVT groups, respectively (P = .092), whereas those in the IM P1 cohort were 86.2% and 66.2% in the bypass surgery and EVT groups, respectively (P < .001). In the IM P0 cohort, the 2-year LS rates were 96.7% and 94.1% in the bypass surgery and EVT groups, respectively (P = .625), and those in the IM P1 cohort were 91.8% and 81.5% in the bypass surgery and EVT groups, respectively (P = .004). No significant differences were observed between the bypass surgery and EVT in terms of postoperative complication rates in either the IM P0 or P1 cohorts. Conclusions: Bypass surgery facilitated better wound healing and LS than EVT in patients with IM P1. Conversely, no differences in wound healing or LS were observed between groups in patients with IM P0. Bypass surgery should be considered a better revascularization strategy than EVT in patients with tissue loss and IM P1 disease.

    DOI: 10.1016/j.jvs.2024.04.040

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  • Treatment Outcomes in Octogenarians with Chronic Limb-Threatening Ischemia after Infrainguinal Bypass Surgery or Endovascular Therapy

    Morisaki, K; Matsuda, D; Guntani, A; Aoyagi, T; Kinoshita, G; Yoshino, S; Inoue, K; Honma, K; Yamaoka, T; Mii, S; Yoshizumi, T

    ANNALS OF VASCULAR SURGERY   106   312 - 320   2024.9   ISSN:0890-5096 eISSN:1615-5947

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    Language:English   Publisher:Annals of Vascular Surgery  

    Background: This study aimed to analyze the clinical outcomes after revascularization for chronic limb-threatening ischemia (CLTI) in patients aged ≥ 80 years and < 80 years. Methods: We retrospectively analyzed multicenter data of 789 patients who underwent infrainguinal revascularization for CLTI between 2015 and 2021. The end points were 2-year overall survival (OS), amputation-free survival (AFS), limb salvage (LS), and postoperative complications. Results: A total of 90 patients aged ≥ 80 years and 200 patients aged < 80 years underwent bypass surgery (BSX), and 205 patients aged ≥ 80 years and 294 patients aged < 80 years underwent endovascular therapy (EVT). Before the propensity score matching, multivariate analyses showed that age ≥ 80 years, lower body mass index and serum albumin levels, nonambulatory status, and end-stage renal disease were independent risk factors for 2-year mortality in the BSX and EVT groups. After propensity score matching, the 2-year OS was better in the < 80 years cohort than in the ≥ 80 years cohort in both the BSX and EVT groups (P = 0.018 and P = 0.035, respectively). There was no difference in the 2-year LS rates between the < 80 years and the ≥ 80 years cohorts in both the BSX and EVT groups (P = 0.621 and P = 0.287, respectively). According to the number of risk factors, except for age ≥ 80 years, there was no difference in the 2-year AFS rates between the < 80 years and ≥ 80 years cohorts for the BSX and EVT groups with 0–1 risk factor (P = 0.957 and P = 0.655, respectively). However, the 2-year AFS rate was poor, especially in the ≥ 80 years cohort in the BSX with 2–4 risk factors (P = 0.015). The Clavien–Dindo ≥ IV complication rates tended to be higher in the ≥ 80 years cohort than in the < 80 years cohort only in the BSX with 2–4 risk factors (P = 0.056). Conclusions: Patients with CLTI aged ≥ 80 years had poorer OS than those aged < 80 years. However, there was no difference in LS between the ≥ 80 years and < 80 years cohorts in both the BSX and EVT groups. Although age ≥ 80 years was associated with poorer OS, patients with 0–1 risk factor may benefit from revascularization, including BSX, because no difference was observed in AFS or Clavien–Dindo ≥ IV complications.

    DOI: 10.1016/j.avsg.2024.04.006

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  • Infra-inguinal bypass surgery vs endovascular revascularization for chronic limb-threatening ischemia in average- and high-risk patients

    Morisaki, K; Matsuda, D; Guntani, A; Kinoshita, G; Yoshino, S; Inoue, K; Honma, K; Yamaoka, T; Mii, S; Yoshizumi, T

    JOURNAL OF VASCULAR SURGERY   80 ( 1 )   204 - 212.e3   2024.7   ISSN:0741-5214 eISSN:1097-6809

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    Language:English   Publisher:Journal of Vascular Surgery  

    Objective: This study aimed to evaluate treatment outcomes after bypass surgery or endovascular therapy (EVT) in average- and high-risk patients with chronic limb-threatening ischemia (CLTI). Methods: We retrospectively analyzed multicenter data of patients who underwent infra-inguinal revascularization for CLTI between 2015 and 2022. A high-risk patient was defined as one with estimated 30-day mortality rate ≥5% or 2-year survival rate ≤50%, as determined by the Surgical Reconstruction vs Peripheral Intervention in Patients With Critical Limb Ischemia (SPINACH) calculator. The amputation-free survival (AFS), limb salvage (LS), wound healing, and 30-day mortality were compared separately for the average- and high-risk patients between the bypass and EVT with propensity score matching. Results: We analyzed 239 and 31 propensity score-matched pairs in the average- and high-risk patients with CLTI. In the average-risk patients, the 2-year AFS and LS rates were 78.1% and 94.4% in the bypass group and 63.0% and 87.7% in the EVT group (P <.001 and P =.007), respectively. The 1-year wound healing rates were 88.6% in the bypass group and 76.8% in the EVT group, respectively (P <.001). The 30-day mortality was 0.8% in the bypass surgery and 0.8% in the EVT group (P =.996). In the high-risk patients, there was no differences in the AFS, LS, and wound healing between the groups (P =.591, P =.148, and P =.074). The 30-day mortality was 3.2% in the bypass group and 3.2% in the EVT group (P =.991). Conclusions: Bypass surgery is superior to EVT with respect to the AFS, LS, and wound healing in the average-risk patients. EVT is a feasible first-line treatment strategy for high-risk patients with CLTI undergoing revascularization, based on the lack of significant differences in the 2-year AFS rate, between the bypass surgery and EVT cohorts.

    DOI: 10.1016/j.jvs.2024.03.025

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  • Perioperative therapeutic antibiotics are beneficial to prevent exacerbation of limb-associated infection after bypass surgery in patients with critical limb-threatening ischemia and foot infection score of ≥1

    Matsubara, Y; Kawanami, S; Kinoshita, G; Kurose, S; Shinichiro, Y; Morisaki, K; Furuyama, T; Yoshizumi, T

    VASCULAR   32 ( 3 )   640 - 647   2024.6   ISSN:1708-5381 eISSN:1708-539X

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    Objective: Postoperative limb infection is associated with a poor prognosis and a low amputation-free survival rate after surgical revascularization in patients with critical limb-threatening ischemia. The Global Vascular Guidelines 2019 recommend antibiotic therapy for patients with deep space foot infection or wet gangrene; however, no study is cited as evidence for this recommendation. The present study was performed to offer new evidence supporting the use of perioperative therapeutic antibiotics in patients with critical limb-threatening ischemia (CLTI) undergoing surgical revascularization. Methods: This single-center retrospective study was performed in Kyushu University Hospital and involved patients with CLTI who underwent surgical revascularization from 2003 to 2021. Ampicillin/sulbactam and cefazolin were defined as preventive antibiotics, and other types were defined as therapeutic antibiotics. Postoperative limb-associated infection was defined as an increased foot infection (fI) score in the Wound, Ischemia, and foot Infection (WIfI) classification system after surgical revascularization. The association between perioperative antibiotic therapy and postoperative limb-associated infection was assessed. Results: Among 286 limbs of 263 patients with CLTI, 27 (9%) limbs developed postoperative limb-associated infection after surgical revascularization. The fI scores were significantly higher in the patients with than without postoperative limb-associated infection (1.0 ± 0.2 vs 0.4 ± 0.1, respectively; p = 0.0033), indicating that an fI score of ≥1 was a risk factor for postoperative limb-associated infection. Perioperative therapeutic antibiotics significantly reduced the incidence of postoperative limb-associated infection compared with preventive antibiotics (0.0% vs. 44.8%, respectively; p = 0.0028) in the patients with CLTI who had an fI score of ≥1 after bypass surgery, although perioperative therapeutic antibiotics were not effective for patients with an fI score of 0. Conclusion: Perioperative therapeutic antibiotics for patients with an fI score of ≥1 are beneficial for reducing the incidence of postoperative limb-associated infection after surgical revascularization.

    DOI: 10.1177/17085381231154608

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  • Validation of JCLIMB, SPINACH, and VQI Calculators for Prediction of Two Year Survival in Patients With Chronic Limb Threatening Ischaemia After Infra-Inguinal Surgical or Endovascular Revascularisation. Reviewed International journal

    Morisaki K, Matsuda D, Guntani A, Kawanami S, Yoshino S, Inoue K, Honma K, Yamaoka T, Mii S, Yoshizumi T.

    Eur J Vasc Endovasc Surg. 2024 May;67(5):777-783. doi: 10.1016/j.ejvs.2023.12.023. Epub 2023 Dec 21. PMID: 38141957   2024.5

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  • Influence of inframalleolar modifier P0/P1 on wound healing in bypass surgery vs endovascular therapy in patients with chronic limb-threatening ischemia Reviewed International journal

    Morisaki K, Matsuda D, Guntani A, Kinoshita G, Yoshino S, Inoue K, Honma K, Yamaoka T, Mii S, Yoshizumi T.

    J Vasc Surg. 2024 Apr 20:S0741-5214(24)01063-2. doi: 10.1016/j.jvs.2024.04.040. Online ahead of print. PMID: 38649101   2024.5

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  • Infra-inguinal bypass surgery vs endovascular revascularization for chronic limb-threatening ischemia in average- and high-risk patients. Reviewed International journal

    Morisaki K, Matsuda D, Guntani A, Kinoshita G, Yoshino S, Inoue K, Honma K, Yamaoka T, Mii S, Yoshizumi T.

    J Vasc Surg. 2024 Mar 24:S0741-5214(24)00505-6. doi: 10.1016/j.jvs.2024.03.025. Online ahead of print. PMID: 38522583   2024.5

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  • Validation of JCLIMB, SPINACH, and VQI Calculators for Prediction of Two Year Survival in Patients With Chronic Limb Threatening Ischaemia After Infra-Inguinal Surgical or Endovascular Revascularisation

    Morisaki, K; Matsuda, D; Guntani, A; Kawanami, S; Yoshino, S; Inoue, K; Honma, K; Yamaoka, T; Mii, S; Yoshizumi, T

    EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY   67 ( 5 )   777 - 783   2024.5   ISSN:1078-5884 eISSN:1532-2165

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    Language:English   Publisher:European Journal of Vascular and Endovascular Surgery  

    Objective: This study aimed to evaluate three survival prediction models: the JAPAN Critical Limb Ischaemia Database (JCLIMB), Surgical Reconstruction Versus Peripheral Intervention in Patients With Critical Limb Ischaemia (SPINACH), and Vascular Quality Initiative (VQI) calculators. Methods: Multicentre data of patients who underwent infrainguinal revascularisation for chronic limb threatening ischaemia between 2018 and 2021 were analysed retrospectively. The prediction models were validated using a calibration plot analysis with the intercept and slope. The discrimination was evaluated using area under the curve (AUC) analysis. The observed two year overall survival (OS) was evaluated by the Kaplan – Meier method. The two year OS predicted by each model at < 50%, 50 – 70%, and > 70% was defined as high, medium, and low risk, respectively. Results: A total of 491 patients who underwent infra-inguinal revascularisation were analysed. The rates of surgical revascularisation, endovascular therapy, and hybrid therapy were 26.5%, 70.1%, and 5.5%, respectively. The average age was 75.6 years, and the percentages of patients with diabetes mellitus and dialysis dependent end stage renal disease were 66.6% and 44.6%, respectively. The tissue loss rate was 85.7%. The intercept and slope were −0.13 and 1.18 for the JCLIMB, 0.11 and 0.82 for the SPINACH, and −0.15 and 1.10 for the VQI. The AUC for the two year OS of JCLIMB, SPINACH, and VQI were 0.758, 0.756, and 0.740, respectively. The observed two year OS rates of low, medium, and high risk using the JCLIMB calculator were 80.1%, 61.1%, and 28.5%, respectively (p < .001), using the SPINACH calculator were 81.0%, 57.0%, and 38.1%, respectively (p < .001), and using the VQI calculator were 77.8%, 45.8%, and 49.6%, respectively (p < .001). Conclusion: The JCLIMB, SPINACH, and VQI survival calculation models were useful, although the OS predicted by the VQI model appeared to be lower than the observed OS.

    DOI: 10.1016/j.ejvs.2023.12.023

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  • Retrograde transvenous thoracic duct embolization for lymphatic leakage after retroperitoneal tumor and lymph node resection: a case report and literature review

    Kinoshita, G; Morisaki, K; Okamoto, D; Aoyagi, T; Yoshino, S; Inoue, K; Yoshizumi, T

    SURGICAL CASE REPORTS   10 ( 1 )   53   2024.3   ISSN:2198-7793

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  • Retrograde transvenous thoracic duct embolization for lymphatic leakage after retroperitoneal tumor and lymph node resection: a case report and literature review(タイトル和訳中)

    Kinoshita Go, Morisaki Koichi, Okamoto Daisuke, Aoyagi Takehiko, Yoshino Shinichiro, Inoue Kentaro, Yoshizumi Tomoharu

    Surgical Case Reports   10   1 of 7 - 7 of 7   2024.3

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    Language:English   Publisher:Springer Berlin Heidelberg  

  • Comparison of limb outcomes between bypass surgery and endovascular therapy in dialysis-dependent and -independent patients with chronic limb-threatening ischemia. Reviewed International journal

    Morisaki K, Guntani A, Matsuda D, Kinoshita G, Kawanami S, Yoshino S, Inoue K, Honma K, Yamaoka T, Mii S, Komori K, Yoshizumi T.

    J Vasc Surg. 2024 Feb;79(2):316-322.e2. doi: 10.1016/j.jvs.2023.09.035. Epub 2023 Oct 5. PMID: 37802402   2024.2

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  • Comparison of limb outcomes between bypass surgery and endovascular therapy in dialysis-dependent and-independent patients with chronic limb-threatening ischemia

    Morisaki, K; Guntani, A; Matsuda, D; Kinoshita, G; Kawanami, S; Yoshino, S; Inoue, K; Honma, K; Yamaoka, T; Mii, S; Komori, K; Yoshizumi, T

    JOURNAL OF VASCULAR SURGERY   79 ( 2 )   316 - 322.e2   2024.2   ISSN:0741-5214 eISSN:1097-6809

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    Language:English   Publisher:Journal of Vascular Surgery  

    Objective: To examine limb salvage (LS) and wound healing in dialysis-dependent and -independent patients with chronic limb-threatening ischemia (CLTI) after infrainguinal bypass surgery or endovascular therapy (EVT). Methods: We retrospectively analyzed the multi-center data of patients who underwent infrainguinal revascularization for CLTI with Wound, Ischemia, and foot Infection (WIfI) stage 2 to 4 between 2015 and 2020. The primary endpoint was LS. The secondary endpoint included wound healing, amputation-free survival (AFS), periprocedural complications, and 2-year survival. Comparison of these outcomes were made after propensity score matching. Results: We analyzed 252 dialysis-dependent (318 limbs) and 305 dialysis-independent (354 limbs) patients. Propensity score matching extracted 202 pairs with no significant differences in characteristics. The LS rate in bypass surgery was better than that in EVT in dialysis-dependent patients (P <.001). There was no significant difference in the LS rates between bypass surgery and EVT in dialysis-independent patients (P =.168). The wound healing rate of bypass surgery was better than that of EVT both dialysis-dependent and -independent patients with CLTI. The AFS rate of bypass surgery was better than that of EVT in dialysis-dependent patients (P <.001). There was no significant difference in the AFS rates between bypass surgery and EVT in dialysis-independent patients (P =.099). There was no significant difference in the occurrence of Clavien-Dindo ≥ IV and V between bypass surgery and EVT in dialysis-dependent and -independent patients. Age ≥75 years, serum albumin levels <3.5 g/dL, and non-ambulatory status were risk factors for 2-year mortality in dialysis-dependent patients. The 2-year survival rates in dialysis-dependent patients with risk factors of 0, 1, 2, and 3 were 82.5%, 67.1%, 49.5%, and 10.2%, respectively (P <.001). Conclusions: For LS and wound healing, bypass surgery was preferred for revascularization in dialysis-dependent patients with WIfI stage 2 to 4. Although dialysis dependency was one of the risk factors for 2-year mortality, dialysis-dependent patients, who have 0 to 1 risk factors, may benefit from bypass surgery, as 2-year survival of >50% is expected.

    DOI: 10.1016/j.jvs.2023.09.035

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  • Evaluation of three nutritional indices as predictors of 2-year mortality and major amputation in patients with chronic limb-threatening ischemia

    Morisaki, K; Matsubara, Y; Kurose, S; Yoshino, S; Furuyama, T

    VASCULAR   31 ( 6 )   1094 - 1102   2023.12   ISSN:1708-5381 eISSN:1708-539X

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    Objective: The present study aimed to examine which nutritional index, such as the controlling nutritional status (CONUT), prognostic nutritional index (PNI), and geriatric nutritional risk index (GNRI), is better for predicting prognosis in patients with chronic limb-threatening ischemia (CLTI) following revascularization. Method: We retrospectively analyzed data of patients who underwent revascularization for CLTI between 2008 and 2020. The endpoints were 2-year overall survival and limb salvage. The optimal cutoff values of 2-year overall survival and major amputation were determined by receiver operating characteristic curve analyses. Result: A total of 238 patients with CLTI and 289 limbs were analyzed. The 2-year overall survival rates were 48.9%, 54.6%, and 53.5% in patients with CONUT score ≥4, PNI score <42.6, and GNRI <98.4 compared with 80.0%, 80.0%, and 78.4% in patients with CONUT score <4, PNI score ≥42.6, and GNRI ≥98.4 (p < 0.01). Age, non-ambulatory status, hemodialysis, and nutritional indices were independent risk factors for 2-year mortality in the multivariate analyses. The 2-year limb salvage rates were 70.1%, 82.2%, and 81.9% in patients with CONUT score ≥7, PNI score <41.9, and GNRI <95.3 compared with 92.8%, 98.3%, and 94.2% in patients with CONUT score <7, PNI score ≥41.9, and GNRI ≥95.3 (p < 0.01). Wound, ischemia, and foot infection stage and each nutritional index (CONUT and PNI) were independent risk factors for major amputation in multivariate analyses. The overall survival and limb salvage rates of patients with malnutrition diagnosed by CONUT score were poor compared with those of normal nutrition or malnutrition diagnosed by PNI and/or GNRI scores. Conclusion: The CONUT, PNI, and GNRI scores can predict the 2-year overall survival in patients with CLTI after revascularization. The CONUT and PNI scores were associated with major amputation.

    DOI: 10.1177/17085381221102801

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  • Bypass Surgery Provides Better Outcomes Compared with Endovascular Therapy in Patients with Chronic Limb-Threatening Ischemia Classified as Indeterminate Category According to the Global Vascular Guidelines

    Yoshino, S; Morisaki, K; Matsuda, D; Guntani, A; Kinoshita, G; Matsubara, Y; Kawanami, S; Yamashita, S; Honma, K; Furuyama, T; Yamaoka, T; Mii, S; Komori, K; Yoshizumi, T

    ANNALS OF VASCULAR SURGERY   97   358 - 366   2023.11   ISSN:0890-5096 eISSN:1615-5947

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    Language:English   Publisher:Annals of Vascular Surgery  

    Background: The present study aimed to determine the preferred initial revascularization procedure between bypass surgery and endovascular therapy (EVT) in patients with chronic limb-threatening ischemia (CLTI) categorized as indeterminate according to the Global Vascular Guidelines (GVG). Methods: We retrospectively analyzed the multicenter data of patients who underwent infrainguinal revascularization for CLTI categorized as indeterminate according to the GVG between 2015 and 2020. The end point was the composite of relief from rest pain, wound healing, major amputation, reintervention, or death. Results: A total of 255 patients with CLTI and 289 limbs were analyzed. Of the 289 limbs, 110 (38.1%) and 179 (61.9%) underwent bypass surgery and EVT, respectively. The 2-year event-free survival rates with respect to the composite end point were 63.4% and 28.7% in the bypass and EVT groups, respectively (P < 0.01). Multivariate analysis revealed that increased age (P = 0.03); decreased serum albumin level (P = 0.02); decreased body mass index (P = 0.02); dialysis-dependent end-stage renal disease (P < 0.01); increased Wound, Ischemia, and foot Infection (WIfI) stage (P < 0.01); Global Limb Anatomic Staging System (GLASS) III (P = 0.04); increased inframalleolar grade (P < 0.01); and EVT (P < 0.01) were independent risk factors for the composite end point. In the WIfI−GLASS 2−III and 4−II subgroups, bypass surgery was superior to EVT with regard to 2-year event-free survival (P < 0.01). Conclusions: Bypass surgery is superior to EVT in terms of the composite end point in patients classified as indeterminate according to the GVG. Bypass surgery should be considered an initial revascularization procedure, especially in the WIfI−GLASS 2−III and 4−II subgroups.

    DOI: 10.1016/j.avsg.2023.05.014

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  • Left Renal Vein Division during Open Surgical Repair for Abdominal Aortic Aneurysm May Cause Long-Term Kidney Remodeling

    Yoshino, S; Matsubara, Y; Kurose, S; Yamashita, S; Morisaki, K; Furuyama, T; Yoshizumi, T

    ANNALS OF VASCULAR SURGERY   96   155 - 165   2023.10   ISSN:0890-5096 eISSN:1615-5947

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    Background: Left renal vein division (LRVD) is a maneuver performed during open surgical repair for abdominal aortic aneurysms. Even so, the long-term effects of LRVD on renal remodeling are unknown. Therefore, we hypothesized that interrupting the venous return of the left renal vein might cause renal congestion and fibrotic remodeling of the left kidney. Methods: We used a murine left renal vein ligation model with 8-week-old to 12-week-old wild-type male mice. Bilateral kidneys and blood samples were harvested postoperatively on days 1, 3, 7, and 14. We assessed the renal function and the pathohistological changes in the left kidneys. In addition, we retrospectively analyzed 174 patients with open surgical repairs between 2006 and 2015 to assess the influence of LRVD on clinical data. Results: Temporary renal decline with left kidney swelling occurred in a murine left renal vein ligation model. In the pathohistological assessment of the left kidney, macrophage accumulation, necrotic atrophy, and renal fibrosis were observed. In addition, Myofibroblast-like macrophage, which is involved in renal fibrosis, was observed in the left kidney. We also noted that LRVD was associated with temporary renal decline and left kidney swelling. LRVD did not, however, impair renal function in long-term observation. Additionally, the relative cortical thickness of the left kidney in the LRVD group was significantly lower than that of the right kidney. These findings indicated that LRVD was associated with left kidney remodeling. Conclusions: Venous return interruption of the left renal vein is associated with left kidney remodeling. Furthermore, interruption in the venous return of the left renal vein does not correlate with chronic renal failure. Therefore, we suggest careful follow-up of renal function after LRVD.

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  • Treatment outcomes between bypass surgery and endovascular therapy in patients with chronic limb-threatening ischemia classified as bypass-preferred category based on Global Vascular Guidelines. Reviewed International journal

    Morisaki K, Matsuda D, Guntani A, Matsubara Y, Kinoshita G, Kawanami S, Yamashita S, Honma K, Furuyama T, Yamaoka T, Mii S, Komori K, Yoshizumi T.

    J Vasc Surg. 2023 Aug;78(2):475-482.e1. doi: 10.1016/j.jvs.2023.04.006. Epub 2023 Apr 17. PMID: 37076109   2023.8

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  • Risk Factors for Major Amputation in Chronic Limb-Threatening Ischemia Patients Classified as Wound, Ischemia, and Foot Infection Stage 4 following Infrainguinal Revascularization

    Morisaki, K; Guntani, A; Matsuda, D; Matsubara, Y; Kinoshita, G; Kawanami, S; Yamashita, S; Honma, K; Yamaoka, T; Mii, S; Komori, K; Furuyama, T; Yoshizumi, T

    ANNALS OF VASCULAR SURGERY   94   246 - 252   2023.8   ISSN:0890-5096 eISSN:1615-5947

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    Background: To evaluate limb salvage outcomes and risk factors for major amputation in chronic limb-threatening ischemia (CLTI) patients classified as stage 4 per the wound, ischemia, and foot infection (WIfI) classification following infrainguinal revascularization. Methods: We retrospectively analyzed multicenter data of patients who had undergone infrainguinal revascularization for CLTI between 2015 and 2020. The endpoint was secondary major amputation defined as an above- or below-knee amputation following infrainguinal revascularization. Results: We analyzed 243 patients with CLTI and 267 limbs. Bypass surgery was performed in 14 (25.5%) and 120 (56.6%) limbs from the secondary major amputation and limb salvage groups, respectively (P < 0.01). Endovascular therapy (EVT) was performed in 41 limbs (74.5%) in the secondary major amputation group and 92 limbs (43.4%) in the limb salvage group (P < 0.01). The average serum albumin levels were 3.0 ± 0.6 and 3.4 ± 0.5 g/dL in the secondary major amputation and limb salvage groups, respectively (P < 0.01). The percentage of congestive heart failure (CHF) was 36.4% and 14.2% in secondary major amputation and limb salvage groups, respectively (P < 0.01). The number of limbs with infra-malleolar (IM) P0, P1, and P2 were 4 (7.3%), 37 (67.3%), and 14 (25.5%), respectively, in the secondary major amputation group and 58 (27.4%), 140 (66.0%), and 14 (6.6%), respectively, in the limb salvage group (P < 0.01). Limb salvage rates at 1 year were 91.0% and 68.6% in the bypass and EVT groups, respectively (P < 0.01). Limb salvage rates at 1 year in patients with IM P0, P1, and P2 were 91.8%, 79.9%, and 53.1%, respectively (P < 0.01). Multivariate analysis revealed that serum albumin level [hazard ratio (HR), 0.56; 95% confidence interval (CI), 0.36–0.89; P = 0.01], hypertension (HR, 0.39; 95% CI, 0.21–0.75; P < 0.01), CHF (HR, 2.10; 95% CI, 1.09–4.05; P = 0.03), wound grade (HR, 1.72; 95% CI, 1.03–2.88; P = 0.04), IM P (HR, 2.08; 95% CI, 1.27–3.42; P < 0.01), and EVT (HR, 3.31; 95% CI, 1.77–6.18; P < 0.01) as independent risk factors for secondary major amputation being required. Conclusions: Among CLTI patients with WIfI stage 4, the limb salvage rate was poor in those with IM P1-2 following infrainguinal EVT. Low serum albumin levels, CHF, high wound grade, IM P1-2, and EVT were independent risk factors for CLTI patients requiring major amputation.

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  • Treatment outcomes between bypass surgery and endovascular therapy in patients with chronic limb-threatening ischemia classified as bypass-preferred category based on Global Vascular Guidelines

    Morisaki, K; Matsuda, D; Guntani, A; Matsubara, Y; Kinoshita, G; Kawanami, S; Yamashita, S; Honma, K; Furuyama, T; Yamaoka, T; Mii, S; Komori, K; Yoshizumi, T

    JOURNAL OF VASCULAR SURGERY   78 ( 2 )   475 - +   2023.8   ISSN:0741-5214 eISSN:1097-6809

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    Objective: The aim of this study was to examine outcomes between bypass surgery and endovascular therapy (EVT) in patients with chronic limb-threatening ischemia (CLTI), classified as bypass-preferred according to the Global Vascular Guidelines (GVG). Methods: We retrospectively analyzed the multi-center data of patients who underwent infrainguinal revascularization for CLTI with Wound, Ischemia, and foot Infection (WIfI) Stage 3 to 4 and Global Limb Anatomical Staging System (GLASS) Stage III, which is classified as bypass-preferred category by the GVG between 2015 and 2020. The endpoints were limb salvage and wound healing. Results: We analyzed 301 patients and 339 limbs following 156 bypass surgeries and 183 EVTs. The 2-year limb salvage rates were 92.2% in the bypass surgery group and 76.3% in the EVT group, respectively (P <.01). The 1-year wound healing rates were 86.7% in the bypass surgery group and 67.8% in the EVT group (P <.01). Multivariate analysis shows decreased serum albumin level (P <.01), increased wound grade (P =.04), and EVT (P <.01) were risk factors for major amputation. Decreased serum albumin level (P <.01), increased wound grade (P <.01), GLASS infrapopliteal grade (P =.02), inframalleolar (IM) P grade (P =.01), and EVT (P <.01) were risk factors for impaired wound healing. Subgroup analysis of limb salvage in patients after EVT, decreased serum albumin level (P <.01), increased wound grade (P =.03), increased IM P grade (P =.04), and congestive heart failure (P <.01) were risk factors for major amputation. According to scoring by existence of these risk factors, 2-year limb salvage rates following EVT were 83.0% and 42.8% for the total score of 0 to 2 and of 3 to 4, respectively (P <.01). Conclusions: Bypass surgery provides better limb salvage and wound healing in patients with WIfI Stage 3 to 4 and GLASS Stage III, which is classified as bypass-preferred category by the GVG. In patients after EVT, serum albumin level, wound grade, IM P grade, and congestive heart failure were related to major amputation. Although bypass surgery may be considered as initial revascularization procedure in patients classified as bypass-preferred category, in case that EVT has to be selected, relatively acceptable outcomes can be expected in patients with less of these risk factors.

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  • Impact of ambulatory status change on survival in patients with chronic limb-threatening ischemia undergoing infrainguinal surgical or endovascular revascularization

    Morisaki, K; Guntani, A; Kinoshita, G; Kawanami, S; Yamashita, S; Matsubara, Y; Furuyama, T; Mii, S; Komori, K; Yoshizumi, T

    JOURNAL OF VASCULAR SURGERY   78 ( 1 )   193 - +   2023.7   ISSN:0741-5214 eISSN:1097-6809

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    Objective: This study aimed to evaluate the influence of change in ambulatory status on the prognosis of patients with chronic limb-threatening ischemia (CLTI) undergoing infrainguinal bypass surgery or endovascular therapy (EVT). Methods: We retrospectively analyzed data from two vascular centers for patients who underwent revascularization for CLTI between 2015 and 2020. The primary endpoint was overall survival (OS), and the secondary endpoints were changes in ambulatory status and postoperative complications. Results: Throughout the study, 377 patients and 508 limbs were analyzed. In the preoperative nonambulation cohort, the average body mass index (BMI) was lower in the postoperative nonambulatory group than in the postoperative ambulatory group (P <.01). The percentage of cerebrovascular disease (CVD) was higher in the postoperative nonambulatory group than in the postoperative ambulatory group (P =.01). In the preoperative ambulation cohort, the average controlling nutritional status (CONUT) score was higher in the postoperative nonambulatory group than in the postoperative ambulatory group (P <.01). There was no difference in the bypass percentage and the EVT in the preoperative nonambulation (P =.32) and ambulation (P =.70) cohorts. According to the change in ambulatory status before and after revascularization, the 1-year OS rates were 86.8% in the ambulatory → ambulatory group, 81.1% in the nonambulatory → ambulatory group, 54.7% in the nonambulatory → nonambulatory group, and 23.9% in the ambulatory → nonambulatory group (P <.01). On multivariate analysis, increased age (P =.04), higher Wound, Ischemia, and foot Infection stage (P =.02), and increased CONUT score (P <.01) were independent risk factors for the decline in ambulatory status in patients with preoperative ambulation. In patients with preoperative nonambulation, increased BMI (P <.01) and absence of CVD (P =.04) were independent factors related to the improved ambulatory status. The percentages of postoperative complications were 31.0% and 17.0% in the preoperative nonambulation and the preoperative ambulation in the overall cohort (P <.01). Preoperative nonambulatory status (P <.01), CONUT score (P <.01), and bypass surgery (P <.01) were risk factors for postoperative complications. Conclusions: Improved ambulatory status is associated with better OS in patients with preoperative nonambulatory status after infrainguinal revascularization for CLTI. Although patients with preoperative nonambulatory status have a risk of postoperative complication, some may benefit from revascularization if they have no factors such as low BMI and CVD, improving their ambulatory status.

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  • Bypass Surgery Provides Better Outcomes Compared with Endovascular Therapy in the Composite Endpoint Comprising Relief from Rest Pain, Wound Healing, Limb Salvage, and Survival after Infra-inguinal Revascularisation in Patients with Chronic Limb Threatening Ischaemia. Invited Reviewed International journal

    Morisaki K, Matsubara Y, Kurose S, Yoshino S, Furuyama T

    Eur J Vasc Endovasc Surg. 2022 Apr;63(4):588-593.   2023.6

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  • Risk Factors for Major Amputation in Chronic Limb-Threatening Ischemia Patients Classified as Wound, Ischemia, and Foot Infection Stage 4 following Infrainguinal Revascularization. Invited Reviewed International journal

    Morisaki K, Guntani A, Matsuda D, Matsubara Y, Kinoshita G, Kawanami S, Yamashita S, Honma K, Yamaoka T, Mii S, Komori K, Furuyama T, Yoshizumi T.

    Ann Vasc Surg. 2023 Mar 2:S0890-5096(23)00110-3. doi: 10.1016/j.avsg.2023.02.010. Online ahead of print.   2023.6

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  • Global Limb Anatomic Staging System Inframalleolar Modifier Predicts Limb Salvage and Wound Healing in Patients with Chronic Limb Threatening Ischaemia Undergoing Endovascular Infrainguinal Revascularisation. Invited Reviewed International journal

    Morisaki K, Matsuda D, Matsubara Y, Kurose S, Yoshino S, Kinoshita G, Honma K, Yamaoka T, Furuyama T, Yoshizumi T.

    Eur J Vasc Endovasc Surg. 2023 Mar;65(3):391-397.   2023.6

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  • Impact of ambulatory status change on survival in patients with chronic limb-threatening ischemia undergoing infrainguinal surgical or endovascular revascularization. Invited Reviewed International journal

    Morisaki K, Guntani A, Kinoshita G, Kawanami S, Yamashita S, Matsubara Y, Furuyama T, Mii S, Komori K, Yoshizumi T.

    J Vasc Surg. 2023 Mar 16:S0741-5214(23)00469-X. doi: 10.1016/j.jvs.2023.03.024. Online ahead of print.   2023.6

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  • Bypass Surgery Provides Better Wound Healing than Endovascular Treatment in Global Limb Anatomic Staging System Inframalleolar Modifier P1

    Morisaki, K; Matsuda, D; Matsubara, Y; Yamaoka, T; Furuyama, T; Yoshizumi, T

    EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY   65 ( 5 )   758 - 759   2023.5   ISSN:1078-5884 eISSN:1532-2165

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  • Global Limb Anatomic Staging System Inframalleolar Modifier Predicts Limb Salvage and Wound Healing in Patients with Chronic Limb Threatening Ischaemia Undergoing Endovascular Infrainguinal Revascularisation

    Morisaki, K; Matsuda, D; Matsubara, Y; Kurose, S; Yoshino, S; Kinoshita, G; Honma, K; Yamaoka, T; Furuyama, T; Yoshizumi, T

    EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY   65 ( 3 )   391 - 397   2023.3   ISSN:1078-5884 eISSN:1532-2165

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    Objective: This study aimed to analyse the influence of the Global Anatomic Staging System (GLASS) and inframalleolar (IM) disease on the treatment outcomes of patients with chronic limb threatening ischaemia (CLTI) who undergo endovascular treatment (EVT) Methods: Data of patients who underwent infrainguinal endovascular therapy (EVT) for CLTI between 2015 and 2019 at two centres were analysed retrospectively. The endpoints were major amputation, major adverse limb events (MALE), and wound healing. Results: Overall, 276 patients and 340 limbs were analysed. The number of revascularisations for an infrapopliteal lesion was 48 (70.6%), 63 (63.0%), and 142 (82.6%) in the GLASS I, GLASS II, and GLASS III stages, respectively (p < .001). There was no statistically significant difference in limb salvage among the GLASS stages (p = .78). The limb salvage rates at one year were 94.6%, 88.0%, and 70.0% in the IM P0 P1, and P2 groups, respectively (p < .001). Multivariable analysis showed that Wound, Ischemia, and foot Infection (WIfI) stage, and IM grade were risk factors for major amputation. The freedom from MALE rates at two years were 60.5%, 45.3%, and 41.1% in the GLASS I, II, and III stages, respectively (p = .003) and 64.1%, 43.5%, and 18.4% in the IM P0, P1, and P2 groups, respectively (p < .001). Multivariable analysis demonstrated that WIfI stage, GLASS stage, IM grade, and infrapopliteal revascularisation were risk factors for MALE. There was no significant difference in wound healing among GLASS I – III (p = .75). The wound healing rates at 365 days were 78.6%, 68.6%, and 42.0% in the IM P0, P1, and P2 groups, respectively (p = .065). Multivariable analysis showed that WIfI stage and IM P2 were risk factors for incomplete wound healing. Conclusion: GLASS IM was associated with major amputation, MALE, and wound healing, while GLASS stage was associated with only MALE.

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  • Interleukin-38 suppresses abdominal aortic aneurysm formation in mice by regulating macrophages in an IL1RL2-p38 pathway-dependent manner

    Kurose, S; Matsubara, Y; Yoshino, S; Yoshiya, K; Morisaki, K; Furuyama, T; Hoshino, T; Yoshizumi, T

    PHYSIOLOGICAL REPORTS   11 ( 2 )   e15581   2023.1   ISSN:2051-817X

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    Macrophages play crucial roles in abdominal aortic aneurysm (AAA) formation through the inflammatory response and extracellular matrix degradation; therefore, regulating macrophages may suppress AAA formation. Interleukin-38 (IL-38) is a member of the IL-1 family, which binds to IL-36 receptor (IL1RL2) and has an anti-inflammation effect. Because macrophages express IL1RL2, we hypothesized that IL-38 suppresses AAA formation by controlling macrophages. We assessed a C57BL6/J mouse angiotensin II-induced AAA model with or without IL-38 treatment. RAW 264.7 cells were cultured with tumor necrosis factor-α and treated with or without IL-38. Because p38 has important roles in inflammation, we assessed p38 phosphorylation in vitro and in vivo. To clarify whether the IL-38 effect depends on the p38 pathway, we used SB203580 to inhibit p38 phosphorylation. IL1RL2+ macrophage accumulation along with matrix metalloproteinase (MMP)-2 and -9 expression was observed in mouse AAA. IL-38 reduced the incidence of AAA formation along with reduced M1 macrophage accumulation and MMP-2 and -9 expression in the AAA wall. Macrophage activities including inducible nitric oxide, MMP-2, and MMP-9 production and spindle-shaped changes were significantly suppressed by IL-38. Furthermore, we revealed that inhibition of p38 phosphorylation diminished the effects of IL-38 on regulating macrophages to reduce AAA incidence, indicating the protective effects of IL-38 depend on the p38 pathway. IL-38 plays protective roles against AAA formation through regulation of macrophage accumulation in the aortic wall and modulating the inflammatory phenotype. Using IL-38 may be a novel therapy for AAA patients.

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  • Gut dysbiosis and bacterial translocation in the aneurysmal wall and blood in patients with abdominal aortic aneurysm

    Nakayama, K; Furuyama, T; Matsubara, Y; Morisaki, K; Onohara, T; Ikeda, T; Yoshizumi, T

    PLOS ONE   17 ( 12 )   e0278995   2022.12   ISSN:1932-6203

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    Inflammation plays a part in the development of abdominal aortic aneurysm (AAA), and the gut microbiota affects host inflammation by bacterial translocation. The relationship between abdominal aortic aneurysm and the gut microbiota remains unknown. This study aimed to detect bacterial translocation in the aneurysmal wall and blood of patients with abdominal aortic aneurysm, and to investigate the effect of the gut microbiota on abdominal aortic aneurysm. We investigated 30 patients with abdominal aortic aneurysm from 2017 to 2019. We analysed the aneurysmal wall and blood using highly sensitive reverse transcription-quantitative polymerase chain reaction, and the gut microbiota was investigated using next-generation sequencing. In the 30 patients, bacteria were detected by reverse transcription-quantitative polymerase chain reaction in 19 blood samples (detection rate, 63%) and in 11 aneurysmal wall samples (detection rate, 37%). In the gut microbiota analysis, the Firmicutes/Bacteroidetes ratio was increased. The neutrophil-lymphocyte ratio was higher (2.94 ± 1.77 vs 1.96 ± 0.61, P < 0.05) and the lymphocyte-monocyte ratio was lower (4.02 ± 1.25 vs 5.86 ± 1.38, P < 0.01) in the bacterial carrier group than in the bacterial non-carrier group in blood samples. The volume of intraluminal thrombus was significantly higher in the bacterial carrier group than in the bacterial non-carrier group in aneurysmal wall samples (64.0% vs 34.7%, P < 0.05). We confirmed gut dysbiosis and bacterial translocation to the blood and aneurysmal wall in patients with abdominal aortic aneurysm. There appears to be a relationship between the gut microbiota and abdominal aortic aneurysm.

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  • A systematic review of management of ureteroarterial fistula

    Ebata, Y; Morisaki, K; Matsubara, Y; Kurose, S; Yoshino, S; Nakayama, K; Kawakubo, E; Furuyama, T; Mori, M

    JOURNAL OF VASCULAR SURGERY   76 ( 5 )   1417 - +   2022.11   ISSN:0741-5214 eISSN:1097-6809

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    Objective: Ureteroarterial fistula (UAF) is lethal condition. However, no consensus has been reached regarding the diagnosis and treatment of UAF owing to its rarity. The aim of our report was to present an actual case of UAF and systematically review the symptoms, risk factors, diagnosis, and treatment of this condition. Methods: The case study was of a 52-year-old woman who had experienced a massive hemorrhage during urinary stent replacement. For the systematic review of studies of UAF, those written in English and reported from 1939 to 2020 were searched for on PubMed using the keywords “uretero-arterial fistula,” “arterio-ureteral fistula,” and “hematuria.” Results: We included 121 studies with 235 patients (mean age, 66.0 years; 139 women [59.1%]) in our review. UAF had occurred most frequently in the common iliac artery (n = 112; 47.7%). Almost all patients (n = 232; 98.7%) had complained of hematuria. The risk factors for UAF were pelvic surgery (n = 205; 87.2%), the long-term use of urinary stents (n = 170; 72.3%), oncologic radiotherapy (n = 107; 45.5%), and malignancy (n = 159; 67.7%). Although computed tomography can detect various useful findings such as extravasation, pseudoaneurysm, hydronephrosis, and opacification of ureters, it was diagnostically useful for only one third of the cases. Angiography was useful for the diagnoses of UAF for 124 (66.3%) of the 187 patients (79.6%) who had undergone angiography. With regard to treatment, endovascular approaches have been widely used in recent years because their invasiveness is lesser than that of open surgical repair. In the era of endovascular therapy, the indications for open surgical repair include ureteral-intestinal fistula, abscess formation, and graft infection after endovascular therapy. Conclusions: Computed tomography can be recommended as the first examination for patients with risk factors for UAF because of its usefulness. Subsequently, angiography should be considered because UAF can be treated using an endovascular approach after diagnostic angiography. The diagnosis and treatment of UAF can often be difficult; therefore, the important first step of diagnosis is suspecting the occurrence of UAF and using a multidisciplinary approach.

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  • Effect of abdominal aortic aneurysm sac shrinkage after endovascular repair on long-term outcomes between favorable and hostile neck anatomy

    Morisaki, K; Matsubara, Y; Kurose, S; Yoshino, S; Furuyama, T

    JOURNAL OF VASCULAR SURGERY   76 ( 4 )   916 - 922   2022.10   ISSN:0741-5214 eISSN:1097-6809

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    Objective: The aim of the present study was to analyze the influence of abdominal aortic aneurysm sac shrinkage on the long-term outcomes after endovascular aneurysm repair (EVAR) between patients with favorable and hostile neck anatomy. Methods: In the present study, we retrospectively analyzed data from 268 patients with fusiform aneurysm and sac behavior who had been evaluated for ≥1 year after EVAR. Hostile neck anatomy was defined as a proximal aneurysmal neck length of <10 mm or proximal neck angle of ≥60°. The primary end point was sac shrinkage, and the secondary end points included reintervention and a composite of rupture, type Ia endoleak, and late open conversion. Results: No differences were found in sac shrinkage between the patients with favorable and hostile neck anatomy (P =.47). Multivariate analysis revealed that an occluded inferior mesenteric artery (P =.04), the presence of posterior thrombus (P <.01), and no antiplatelet therapy (P =.01) were positive factors for sac shrinkage. The reintervention-free survival rate was better for patients with sac shrinkage compared with those without sac shrinkage regardless of the proximal neck anatomy (P <.01). The event-free survival rate of the composite end point at 5 and 10 years was 97.5% and 83.5% for patients with favorable neck anatomy and 86.8% and 81.0% for those with hostile neck anatomy, respectively (P =.02). In the subgroup with sac shrinkage, the event-free survival rates at 5 and 10 years were 98.7% and 98.7% for those with favorable neck anatomy and 92.7% and 82.4% for those with hostile neck anatomy, respectively (P =.02). In contrast, the event-free survival for patients without sac shrinkage did not differ between those with favorable and hostile neck anatomy (P =.08). Multivariate analysis showed that a hostile neck anatomy (hazard ratio, 3.32; 95% confidence interval, 1.26-8.80; P =.02) and no sac shrinkage (hazard ratio, 3.88; 95% confidence interval, 1.25-12.0; P =.02) were significant risk factors for the composite end point of rupture, type Ia endoleak, and late open conversion. Conclusions: Proximal neck anatomy did not affect sac shrinkage after EVAR. Sac shrinkage has been a good surrogate marker of better long-term outcomes after EVAR for patients with favorable neck anatomy. In contrast, critical events such as rupture and type Ia endoleak can occur even after sac shrinkage has been achieved in patients with hostile neck anatomy.

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  • 1-Year Outcomes of Thromboendarterectomy vs Endovascular Therapy for Common Femoral Artery Lesions: CAULIFLOWER Study Results

    Nakama T., Takahara M., Iwata Y., Fujimura N., Yamaoka T., Suzuki K., Obunai K., Tan M., Shibata T., Horie K., Sasaki S., Akamatsu D., Takahashi H., Yamamoto Y., Yasuto H., Aihara H., Uchiyama H., Kodama T., Tabata M., Ohara H., Matsubara K., Kamiya Y., Sekimoto Y., Igari K., Umemoto T., Jujo K., Matsui A., Shintani Y., Kotani S., Hozawa K., Hideto Y., Ueshima D., Ozaki D., Hayakawa N., Doijiri T., Tobita K., Shimogawara T., Mouri S., Araki H., Yamauchi Y., Anzai H., Shintani T., Hayashi M., Kato T., Shinozaki N., Banno H., Kojima T., Fujihara M., Iida O., Hata Y., Kawasaki D., Nakamura J., Kimura M., Tsubakimoto Y., Yamaguchi S., Ichihashi S., Tanaka H., Kobayashi T., Furuyama T., Morisaki K., Makoto S., Imoto Y., Doi H., Suematsu N., Ito H., Okadome J., Kyuragi R., Ogata K., Hayashi K., Fujii T., Isogai N., Karashima E.

    JACC: Cardiovascular Interventions   15 ( 14 )   1453 - 1463   2022.7   ISSN:19368798

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    Background: Thromboendarterectomy (TEA) is the gold-standard treatment for common femoral artery (CFA). However, because of its low invasiveness and short hospitalization duration, CFA endovascular therapy (EVT) is performed in real-world practice. However, the clinical benefits and appropriate target population for CFA EVT remain unclear. Objectives: The aims of this study were to compare the clinical outcomes of TEA with those of EVT in patients with symptomatic CFA diseases and to identify the adequate target population for CFA EVT. Methods: A total of 1,193 consecutive patients who underwent EVT (n = 761) or TEA (n = 432) for CFA were identified and retrospectively reviewed from a registry of 66 institutions. The primary outcome was 1-year primary patency compared between EVT and TEA using propensity score matching. An interaction analysis was performed to explore the appropriate target population for CFA EVT. Results: After propensity score matching, the 1-year primary patency rate was significantly higher in the TEA group (82.3% vs 96.6%; P < 0.001), whereas perioperative complications were more frequently observed in the TEA group (P = 0.047). Nonambulatory status attenuated the HR of EVT vs TEA for restenosis risk (P = 0.021), whereas the presence of nodular calcification significantly increased the HR (P = 0.040). In the EVT subgroup analysis for restenosis risk, stent use showed the lowest HR compared with plain balloon angioplasty and drug-coated balloon angioplasty (P < 0.001). Conclusions: TEA showed superior 1-year patency compared with EVT in a nationwide multicenter study. Nonambulatory status attenuated the superiority, whereas the presence of nodular calcification enhanced it.

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  • Pitavastatin-Incorporated Nanoparticles for Chronic Limb Threatening Ischemia: A Phase I/IIa Clinical Trial

    Matsumoto Takuya, Yoshino Shinichiro, Furuyama Tadashi, Morisaki Koichi, Nakano Kaku, Koga Jun-ichiro, Maehara Yoshihiko, Komori Kimihiro, Mori Masaki, Egashira Kensuke

    Journal of Atherosclerosis and Thrombosis   29 ( 5 )   731 - 746   2022.5   ISSN:13403478 eISSN:18803873

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    <p><b>Aim:</b> To assess the results of a phase I/IIa open-label dose-escalation clinical trial of 5-day repeated intramuscular administration of pitavastatin-incorporated poly (lactic-co-glycolic acid) nanoparticles (NK-104-NP) in patients with chronic limb threatening ischemia (CLTI).</p><p><b>Methods:</b> NK-104-NP was formulated using an emulsion solvent diffusion method. NK-104-NP at four doses (nanoparticles containing 0.5, 1, 2, and 4 mg of pitavastatin calcium, n=4 patients per dose) was investigated in a dose-escalation manner and administered intramuscularly into the ischemic limbs of 16 patients with CLTI. The safety and therapeutic efficacy of treatment were investigated over a 26-week follow-up period.</p><p><b>Results:</b> No cardiovascular or other serious adverse events caused by NK-104-NP were detected during the follow-up period. Improvements in Fontaine and Rutherford classifications were noted in five patients (one, three, and one in the 1-, 2-, and 4-mg dose groups, respectively). Pharmacokinetic parameters including the maximum serum concentration and the area under the blood concentration–time curve increased with pitavastatin treatment in a dose-dependent manner. The area under the curve was slightly increased at day 5 compared with that at day 1 of treatment, although the difference was not statistically significant.</p><p><b>Conclusions:</b> This is the first clinical trial of pitavastatin-incorporated nanoparticles in patients with CLTI. Intramuscular administration of NK-104-NP to the ischemic limbs of patients with CLTI was safe and well tolerated and resulted in improvements in limb function.</p>

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  • 包括的高度慢性下肢虚血におけるピタバスタチン封入ナノ粒子 第I/IIa相臨床試験(Pitavastatin-Incorporated Nanoparticles for Chronic Limb Threatening Ischemia: A Phase I/IIa Clinical Trial)

    Matsumoto Takuya, Yoshino Shinichiro, Furuyama Tadashi, Morisaki Koichi, Nakano Kaku, Koga Jun-ichiro, Maehara Yoshihiko, Komori Kimihiro, Mori Masaki, Egashira Kensuke

    Journal of Atherosclerosis and Thrombosis   29 ( 5 )   731 - 746   2022.5   ISSN:1340-3478

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    包括的高度慢性下肢虚血患者16例(男性10例、女性6例、平均72.4±11.1歳)を対象に、ピタバスタチン封入ナノ粒子製剤(NK-104-NP)の有効性と安全性について検討した。対象は慢性重症虚血肢に対するNK-104-NPの医師主導治験に登録されたFontaine分類がIIIまたはIV度の患者で、広範な組織喪失を有するRutherford分類6群の患者は除外した。患者をピタバスタチンカルシウムとして0.5、1、2、4mgを含有するNK-104-NPを反復筋肉内投与するNP0.5群、NP1群、NP2群、NP4群の4群に分類した。平均追跡期間は26週で、4例が死亡した。いずれも非治療関連死で、NK-104-NPによる心血管疾患または重篤な有害事象は皆無であった。ピタバスタチンの血漿中および尿中薬物濃度は用量依存的に増加した。ピタバスタチンの代謝物であるラクトン体の最高血中濃度も用量依存的に増加した。投与5日後の血中濃度-時間曲線下面積(AUC)は初日に比べて上昇したが、統計的に有意でなかった。体重、体温、血圧等の生理学的検査および心機能検査で変化は見られず、足関節上腕血圧比に有意な変化はなかった。

  • Iliac Artery Aneurysms Expand in Quadratically Proportion to the Diameter

    Shinichiro, Y; Matsubara, Y; Furuyama, T; Kurose, S; Yamashita, S; Morisaki, K; Mori, M

    ANNALS OF VASCULAR SURGERY   82   258 - 264   2022.5   ISSN:0890-5096 eISSN:1615-5947

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    Background: Iliac artery aneurysms (IAAs) are life-threatening once ruptured. Although some studies have revealed the pathology of IAAs, clinical information on IAAs is still limited. Moreover, previous studies were conducted in Western countries; thus, we aimed to identify the natural history of iliac artery aneurysms in a Japanese cohort. The purpose of this study was to investigate the IAA expansion rate in a Japanese cohort to consider the management of small IAAs and to identify indications for surgical intervention. Methods: Patients with iliac artery aneurysms were retrospectively reviewed. The primary outcome was the expansion rate of IAAs. We also investigated the correlation between expansion rate and patients’ characteristics. Natural histories, including surgical interventions and rupture, were also assessed. Results: The mean expansion rate in our study was 1.59 ± 1.16 mm/year. There was a positive correlation between expansion rate and aneurysm diameter, which was estimated by y = 0.0052 × (X − 23.270)2 + 0.0632 × X − 0.0517, where y is the expansion rate, and X is aneurysm diameter. The freedom from surgical intervention rate of IAAs was 85.5% at 1 year, 54.0% at 3 years, and 41.5% at 5 years. No factors, except initial aneurysm diameter, were revealed as independent predictors of surgical intervention. We experienced one ruptured IAA, which showed unexpected rapid growth from 30.1 mm to 56.3 mm over 15 months during conservative management. This case demonstrated that IAAs ≥30 mm should be carefully followed up and considered for surgical intervention. Conclusions: We conclude that larger aneurysms have greater expansion rates. Because IAAs ≥30 mm carry a risk of rapid expansion resulting in rupture, careful follow-up, and surgical intervention should be performed if iliac artery aneurysms are ≥30 mm in diameter.

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  • Bypass Surgery Provides Better Outcomes Compared with Endovascular Therapy in the Composite Endpoint Comprising Relief from Rest Pain, Wound Healing, Limb Salvage, and Survival after Infra-inguinal Revascularisation in Patients with Chronic Limb Threatening Ischaemia

    Morisaki, K; Matsubara, Y; Kurose, S; Yoshino, S; Furuyama, T

    EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY   63 ( 4 )   588 - 593   2022.4   ISSN:1078-5884 eISSN:1532-2165

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    Objective: The present study aimed to determine the factors related to relief from rest pain, wound healing, major adverse limb events (MALEs), and prognosis after infrainguinal revascularisation in patients with chronic limb threatening ischaemia (CLTI). Methods: The data of patients who underwent infrainguinal revascularisation for CLTI between 2010 and 2020 was analysed retrospectively. The endpoint was the composite of relief from rest pain, wound healing, MALE, or death. Results: A total of 234 limbs in 187 patients with CLTI were analysed. Of the 234 limbs, 149 (63.7%) underwent bypass surgery and 85 (36.3%) underwent endovascular therapy (EVT). The event free survival rates with respect to the composite endpoint at two years were 30.4% in the EVT and 48.5% in the bypass groups, respectively (p = .005). The event free survival rates at two years were 56.7% in bypass surgery and 29.5% in EVT in the indeterminate subgroup (p = .051). Multivariable analysis revealed that age (hazard ratio [HR] 1.03; 95% confidence interval [CI] 1.01 – 1.05; p < .001), coronary artery disease (CAD) (HR 1.45; 95% CI 1.01 – 2.07; p = .042), haemodialysis (HR 1.74; 95% CI 1.22 – 2.48; p = .002), Wound, Ischaemia and foot Infection stage (HR 1.34; 95% CI 1.07 – 1.68; p = .012), Global Limb Anatomical Staging System stage (HR 1.31; 95% CI 1.01 – 1.72; p = .043), EVT (HR 1.90; 95% CI 1.31 – 2.74; p < .001), Geriatric Nutritional Risk Index (HR 0.98; 95% CI 0.97 – 0.99; p = .021), and non-ambulatory status (HR 1.89; 95% CI 1.31 – 2.74; p < .001) were risk factors for the composite endpoint. Conclusion: Bypass surgery is superior to EVT with respect to the composite endpoint including relief from rest pain, wound healing, MALE, or death. Bypass surgery may be considered as the treatment of choice, instead of EVT, in patients in the indeterminate group according to the Global Vascular Guidelines preferred revascularisation method.

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  • Validation of the GLASS Staging Systems in Patients With Chronic Limb-Threatening Ischemia Undergoing De Novo Infrainguinal Revascularization

    Morisaki, K; Matsubara, Y; Yoshino, S; Kurose, S; Yamashita, S; Furuyama, T; Mori, M

    ANNALS OF VASCULAR SURGERY   81   378 - 386   2022.4   ISSN:0890-5096 eISSN:1615-5947

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    Objectives: The Global Limb Anatomic Staging System (GLASS) was proposed for evaluating the anatomic complexity of arterial disease in patients with chronic limb-threatening ischemia (CLTI). We aimed to examine the relationship between GLASS stage and treatment outcomes after infrainguinal revascularization in patients with CLTI. Methods: We retrospectively analyzed data of patients undergoing infrainguinal revascularization for CLTI between 2010 and 2018 to examine whether GLASS stage affects the limb salvage, wound healing, and overall survival (OS). Results: Throughout the study period, 153 CLTI patients and 190 limbs with Fontaine classification III and IV were analyzed for major amputation and OS, and 125 patients and 157 limbs of Fontaine classification IV were analyzed for wound healing. The number of patients with WIfI stage 1, 2, 3, and 4 was 14 (7.4%), 44 (23.2%), 65 (34.2%), and 67 (53.3%), respectively. The number of patients with GLASS stage I, II, and III was 23 (12.1%), 48 (25.3%), and 119 (62.6%), respectively. Among the 190 limbs, the number subject to bypass surgery, endovascular therapy, and hybrid therapy was 132 (69.5%), 39 (20.5%), and 19 (10.0%), respectively. A multivariate analysis showed that only WIfI stage and inframalleolar (IM) disease were risk factors for major amputation and impaired wound healing. There was no relationship between GLASS stage and limb salvage or wound healing. A multivariate analysis revealed that age, geriatric nutritional risk index and GLASS stage were risk factors for 2-year OS (P < 0.01). Patients with all risk factors had a poor prognosis (35.3% at 2 years). Conclusion: WIfI stage and IM disease predicted limb salvage and wound healing after infrainguinal revascularization in patients with CLTI. Although GLASS stage did not affect limb salvage or wound healing, it was a prognostic factor for poor OS. The GLASS staging could be useful for deciding between bypass surgery and endovascular therapy in prediction of prognosis.

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  • Internal Iliac Artery Aneurysm Ruptures with No Visualized Endoleak 2 Years after Endovascular Repair

    Harada Ayumi, Morisaki Koichi, Kurose Shun, Yoshino Shinichiro, Yamashita Sho, Furuyama Tadashi, Mori Masaki

    Annals of Vascular Diseases   15 ( 1 )   45 - 48   2022.3   ISSN:1881641X eISSN:18816428

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    <p>We report a case of an 83-year-old man with a ruptured internal iliac artery (IIA) aneurysm after endovascular repair, which was treated via the ligation of IIA and tight suture of the aneurysm sac. Although there were no findings of obvious endoleak after endovascular treatment, the IIA aneurysm increased in size and eventually ruptured. We presumed that pressure to IIA aneurysm via the embolized IIA led to rupture. Aneurysm sac expansion may lead to a rupture despite no endoleak being detected; therefore, close follow-up or re-intervention must be considered. Tight embolization of IIA may prevent endotension in the same case.</p>

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  • Effect of abdominal aortic aneurysm sac shrinkage after endovascular repair on long-term outcomes between favorable and hostile neck anatomy. Invited Reviewed International journal

    Morisaki K, Matsubara Y, Kurose S, Yoshino S, Furuyama T.

    J Vasc Surg. 2022 Mar 18:S0741-5214(22)00451-7.   2022.3

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  • 血管内治療の2年後にエンドリークが確認できない内腸骨動脈瘤の破裂(Internal Iliac Artery Aneurysm Ruptures with No Visualized Endoleak 2 Years after Endovascular Repair)

    Harada Ayumi, Morisaki Koichi, Kurose Shun, Yoshino Shinichiro, Yamashita Sho, Furuyama Tadashi, Mori Masaki

    Annals of Vascular Diseases   15 ( 1 )   45 - 48   2022.3   ISSN:1881-641X

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    症例は83歳男性で、右内腸骨動脈(IIA)動脈瘤を呈した。高血圧、心房細動、慢性心疾患などの既往があり、ワルファリン服用歴があった。AMPLATZE.R Vascular Plug IIを用いた右IIAの塞栓術後、総腸骨動脈から外腸骨動脈へのステントグラフト挿入などのIIA動脈瘤治療のための血管内治療を受けた。初回治療から2年後、CT検査により動脈瘤は徐々に拡大し、直径50mmとなった。血管造影ではエンドリークを認めなかった。その1ヵ月後、貧血が検出され、CT検査により右IIA動脈瘤の周囲に血腫を認めたが、エンドリークの所見はなかった。全身麻酔下で後腹膜アプローチによる待機的開腹手術を行った。右IIA動脈瘤の前部に破裂孔を認めた。総腸骨動脈と外腸骨動脈はクランプされていなかった。動脈瘤嚢を切開し、管腔内血栓を除去した。動脈瘤周囲の新鮮血腫は可能な限り除去した。前回の血管内治療で右IIAに展開したAMPLATZER Vascular Plug IIを抜去した。IIA遠位部を縫合し、動脈瘤嚢を強固に縫合した。貧血は改善し、開腹手術後のCT検査では血腫の拡大は認めなかった。

  • Effects of Antithrombotic Therapy on Abdominal Aortic Aneurysm Sac Size after Endovascular Repair in Patients with Favorable Neck Anatomy. Invited Reviewed International journal

    Morisaki K, Matsubara Y, Furuyama T, Kurose S, Yoshino S, Yamashita S, Mori M.

    J Vasc Interv Radiol. 2022 Feb;33(2):113-119.   2022.2

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  • Effects of Antithrombotic Therapy on Abdominal Aortic Aneurysm Sac Size after Endovascular Repair in Patients with Favorable Neck Anatomy

    Morisaki, K; Matsubara, Y; Furuyama, T; Kurose, S; Yoshino, S; Yamashita, S; Mori, M

    JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY   33 ( 2 )   113 - 119   2022.2   ISSN:1051-0443 eISSN:1535-7732

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    Purpose: To evaluate the influence of antiplatelet or anticoagulant therapy on sac behavior after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Materials and Methods: This study retrospectively analyzed data from patients with favorable neck anatomy who underwent EVAR between 2007 and 2019. Patients with ruptured AAA and ≤1 year of sac behavior evaluation were excluded. Sac shrinkage after 1 year, persistent type II endoleak, and late sac expansion were examined. Results: In total, 182 patients with favorable neck anatomy were included in this study. A multivariable analysis identified an occluded inferior mesenteric artery (IMA; P = .049), the presence of a posterior thrombus (P = .009), and no antiplatelet therapy (P = .012) as factors positively associated with sac shrinkage at 1 year. Persistent type II endoleak was detected in 56 (30.8%) patients, with patent IMA (P = .006), the lack of a posterior thrombus (P = .004), the number of patent lumbar arteries (P = .004), and antiplatelet therapy (P = .039) being identified as significant risk factors. The multivariable analysis identified a larger initial AAA diameter (P < .001), the lack of a posterior thrombus (P = .038), and antiplatelet and anticoagulant therapies (P = .038 and P = .003, respectively) as risk factors for late sac expansion. Conclusions: After EVAR in patients with favorable neck anatomy, antiplatelet therapy is associated with the lack of sac regression at 1 year, whereas antiplatelet and anticoagulant therapies are risk factors for late sac expansion.

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  • Analysis of prognostic factors for postoperative complications and reinterventions after open surgical repair and endovascular aneurysm repair in patients with abdominal aortic aneurysm. Invited Reviewed International journal

    Morisaki K, Matsubara Y, Kurose S, Yoshino S, Yamashita S, Nakayama K, Furuyama T.

    Ann Vasc Surg. 2021 Nov;77:172-181.   2021.11

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  • Thigh sarcopenia and hypoalbuminemia predict impaired overall survival after infrainguinal revascularization in patients with critical limb ischemia Reviewed

    Koichi Morisaki, Tadashi Furuyama, Yutaka Matsubara, Kentaro Inoue, Shun Kurose, Shinichiro Yoshino, Ken Nakayama, Sho Yamashita, Keiji Yoshiya, Masaki Mori

    Vascular   28 ( 5 )   542 - 547   2020.10

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    DOI: 10.1177/1708538120913745

  • Frailty in patients with abdominal aortic aneurysm predicts prognosis after elective endovascular aneurysm repair Reviewed

    Koichi Morisaki, Tadashi Furuyama, Keiji Yoshiya, Shun Kurose, Shinichiro Yoshino, Ken Nakayama, Sho Yamashita, Eisuke Kawakubo, Takuya Matsumoto, Masaki Mori

    Journal of Vascular Surgery   72 ( 1 )   138 - 143   2020.7

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    DOI: 10.1016/j.jvs.2019.09.052

  • External validation of CLI Frailty Index and assessment of predictive value of modified CLI Frailty Index for patients with critical limb ischemia undergoing infrainguinal revascularization Reviewed

    Koichi Morisaki, Tadashi Furuyama, Yutaka Matsubara, Kentaro Inoue, Shun Kurose, Shinichiro Yoshino, Ken Nakayama, Sho Yamashita, Keiji Yoshiya, Ryosuke Yoshiga, Yoshihiko Maehara

    Vascular   27 ( 4 )   405 - 410   2019.8

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    DOI: 10.1177/1708538119836005

  • Risk factors for wound complications and 30-day mortality after major lower limb amputations in patients with peripheral arterial disease Reviewed

    Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa

    Vascular   26 ( 1 )   12 - 17   2018.2

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    DOI: 10.1177/1708538117714197

  • Influence of frailty on treatment outcomes after revascularization in patients with critical limb ischemia Reviewed

    Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine

    Journal of Vascular Surgery   66 ( 6 )   1758 - 1764   2017.12

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    DOI: 10.1016/j.jvs.2017.04.048

  • Bypass Surgery after Endovascular Therapy for Infrapopliteal Lesion Is Not a Poor Outcome Compared with Initial Bypass Surgery by Vascular Surgeons Reviewed

    Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine

    Annals of Vascular Surgery   45   35 - 41   2017.11

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    DOI: 10.1016/j.avsg.2017.06.045

  • Preoperative risk factors for aneurysm sac expansion caused by type 2 endoleak after endovascular aneurysm repair Reviewed

    Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine, Atsushi Guntani

    Vascular   25 ( 5 )   533 - 541   2017.10

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    DOI: 10.1177/1708538117702787

  • Prognostic factor of the two-year mortality after revascularization in patients with critical limb ischemia Reviewed

    Koichi Morisaki, Takuya Matsumoto, Yutaka Matsubara, Kentaro Inoue, Yukihiko Aoyagi, Daisuke Matsuda, Shinichi Tanaka, Jun Okadome, Yoshihiko Maehara

    Vascular   25 ( 2 )   123 - 129   2017.4

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    DOI: 10.1177/1708538116651216

  • Outcomes of Endovascular Therapy for Infrarenal Aortic Occlusion of TASC II D Classification Reviewed

    Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine

    Annals of Vascular Surgery   43   203 - 209   2017.1

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    DOI: 10.1016/j.avsg.2017.02.005

  • Elective endovascular vs. open repair for abdominal aortic aneurysm in octogenarians Reviewed

    Koichi Morisaki, Takuya Matsumoto, Yutaka Matsubara, Kentaro Inoue, Yukihiko Aoyagi, Daisuke Matsuda, Shinichi Tanaka, Jun Okadome, Yoshihiko Maehara

    Vascular   24 ( 4 )   348 - 354   2016.8

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    DOI: 10.1177/1708538115594967

  • Pioglitazone prevents intimal hyperplasia in experimental rabbit vein grafts Reviewed

    Koichi Morisaki, Rei Shibata, Noriko Takahashi, Noriyuki Ouchi, Yoshihiko Maehara, Toyoaki Murohara, Kimihiro Komori

    Journal of Vascular Surgery   54 ( 6 )   1753 - 1759   2011.12

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    DOI: 10.1016/j.jvs.2011.06.081

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Presentations

  • 第47回日本血管外科学術総会 シンポジウム10. 創傷・全身状態からみた重症虚血肢患者の治療戦略 Influence of WIfI classification and Frailty on treatment outcomes in CLI patients undergoing infrapopliteal revascularization Koichi Morisaki, Tadashi Furuyama, Shun Kurose, Shinichiro Yoshino, Ken Nakayama, Sho Yamashita, Keiji Yoshiya, Masaki Mori 第60回 日本脈管学会総会 会長要望演題:II型エンドリークへの対応 EVAR後Type2エンドリークに対する追加治療症例の検討 九州大学大学院消化器・総合外科 森﨑 浩一、黒瀬 俊、吉野 伸一郎、中山 謙、川久保 英介、古山 正、森 正樹

    第47回日本血管外科学術総会 シンポジウム10. 創傷・全身状態からみた重症虚血肢患者の治療戦略 Influence of WIfI classification and Frailty on treatment outcomes in CLI patients undergoing infrapopliteal revascularization Koichi Morisaki, Tadashi Furuyama, Shun Kurose, Shinichiro Yoshino, Ken Nakayama, Sho Yamashita, Keiji Yoshiya, Masaki Mori 第60回 日本脈管学会総会 会長要望演題:II型エンドリークへの対応 EVAR後Type2エンドリークに対する追加治療症例の検討 九州大学大学院消化器・総合外科 森﨑 浩一、黒瀬 俊、吉野 伸一郎、中山 謙、川久保 英介、古山 正、森 正樹

    2018.6 

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    Event date: 2018.6 - 2022.6

    Language:Japanese  

    Country:Japan  

  • 腹部大動脈瘤に対するステントグラフト後の瘤径縮小に関与する因子の検討

    森崎浩一、黒瀬俊、吉野伸一郎、松原裕、古山正

    第50回 日本血管外科学会学術総会  2023.6 

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    Event date: 2023.6

    Language:Japanese  

    Country:Japan  

  • WIfI Stage4に対する血行再建後の下肢大切断に関与する因子の検討

    森崎浩一、松田大介、郡谷篤史、河波政吾、木下豪、松原裕、山下勝、本間健一、山岡輝年、三井信介、古森公浩、古山正、吉住朋晴

    第63回 日本脈管学会総会  2023.6 

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    Event date: 2023.6

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  • 創傷治癒と救肢からみた術式選択におけるInfra-malleolar/Pedal diseaseの意義

    森崎 浩一、松田 大介、郡谷 篤史、河波 政吾、木下 豪、山下 勝、松原 裕、本間 健一、古山 正、 山岡 輝年、三井 信介、古森 公浩、吉住 朋晴

    第53回 日本心臓血管外科学会学術総会  2023.3 

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    Event date: 2023.3

    Language:Japanese   Presentation type:Symposium, workshop panel (public)  

    Country:Japan  

  • 包括的高度慢性下肢虚血(CLTI)に対する外科的血行再建とADL・生命予後に関する検討

    森崎 浩一、黒瀬 俊、吉野 伸一郎、松原 裕、古山 正

    第52回 日本心臓血管外科学会学術集会  2022.3 

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    Event date: 2022.3

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  • 腹部大動脈瘤に対する開腹人工血管置換術と腹部ステントグラフト内挿術の治療成績

    森崎 浩一, 黒瀬 俊, 吉野 伸一郎, 山下 勝, 古山 正, 森 正樹

    第49回 日本血管外科学会学術総会  2021.5 

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    Event date: 2021.5

    Language:Japanese  

    Country:Japan  

  • 重症虚血肢に対する集学的治療 CLTI患者に対する鼠経靱帯以下の血行再建の治療成績とWIfI分類・GLASS分類の関連に関する検討

    森崎 浩一, 古山 正, 黒瀬 俊, 吉野 伸一郎, 山下 勝, 森 正樹

    第121回 日本外科学会定期学術集会  2021.4 

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    Event date: 2021.4

    Language:Japanese  

    Country:Japan  

  • JSVSの新しいyouth committeeによる血管外科教育・研修の将来展望(Future perspective for education and training of vascular surgery by a new youth committee of JSVS)

    Kikuchi Shinsuke, Shirasu Takuro, Miyake Keisuke, Omori Makiko, Shimogawara Tatsuya, Ichikawa Yohei, Uchiyama Hidetoshi, Orimoto Yuki, Kuwada Noriaki, Sano Masaki, Shibata Tsuyoshi, Natsume Kayoko, Fukushima Soichiro, Matsubara Yutaka, Morisaki Koichi, Obara Hideaki

    日本血管外科学会雑誌  2023  (NPO)日本血管外科学会

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    Language:English  

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Professional Memberships

  • 日本外科学会、日本心臓血管外科学会、日本血管外科学会、日本脈管学会

Research Projects

  • 新規抗炎症性サイトカインIL38が腹部大動脈瘤形成に及ぼす影響と機序の解明

    Grant number:23K08272  2023 - 2026

    日本学術振興会  科学研究費助成事業  基盤研究(C)

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    Authorship:Principal investigator  Grant type:Scientific research funding

  • 糖尿病に着目した腹部大動脈瘤の病態解析~DPP-4阻害薬の瘤形成抑制効果の検討~

    Grant number:17K16596  2017 - 2019

    科学研究費助成事業  若手研究(B)

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    Authorship:Principal investigator  Grant type:Scientific research funding

  • 細胞周期関連遺伝子ShugoshinのCKOマウスにおける血管病変の分子機能解析

    Grant number:26861111  2014 - 2016

    科学研究費助成事業  若手研究(B)

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    Authorship:Principal investigator  Grant type:Scientific research funding

Class subject

  • 循環器 腹部・末梢血管

    2023.10 - 2024.3   Second semester

  • 医療経営・管理学専攻講義「外科学」

    2023.4 - 2023.9   First semester

Outline of Social Contribution and International Cooperation activities

  • 研究結果を学会発表および国際論文に投稿することで、医学の進歩、社会への貢献を行っている。

Specialized clinical area

  • Biology / Medicine, Dentistry and Pharmacy / Surgical Clinical Medicine / Cardiovascular Surgery

Clinician qualification

  • Specialist

    日本心臓血管外科学会、日本血管外科学会、日本脈管学会

  • Specialist

    Japan Surgical Society(JSS)

Year of medical license acquisition

  • 2006

Notable Clinical Activities

  • 下肢の慢性動脈閉塞症、腹部大動脈瘤に対して外科治療と血管内治療、それぞれの利点を生かしながら治療を行っている。 また、その治療成績について九州大学及び関連施設のデータをまとめ、学会発表、英文論文として積極的に発表している。