| 1. |
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., Risk Factors for Major Amputation in Chronic Limb-Threatening Ischemia Patients Classified as Wound, Ischemia, and Foot Infection Stage 4 following Infrainguinal Revascularization.
, Ann Vasc Surg. 2023 Mar 2:S0890-5096(23)00110-3. doi: 10.1016/j.avsg.2023.02.010. Online ahead of print., 2023.06. |
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Morisaki K, Guntani A, Kinoshita G, Kawanami S, Yamashita S, Matsubara Y, Furuyama T, Mii S, Komori K, Yoshizumi T., Impact of ambulatory status change on survival in patients with chronic limb-threatening ischemia undergoing infrainguinal surgical or endovascular revascularization.
, J Vasc Surg. 2023 Mar 16:S0741-5214(23)00469-X. doi: 10.1016/j.jvs.2023.03.024. Online ahead of print., 2023.06. |
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Morisaki K, Matsubara Y, Kurose S, Yoshino S, Yamashita S, Nakayama K, Furuyama T., Analysis of prognostic factors for postoperative complications and reinterventions after open surgical repair and endovascular aneurysm repair in patients with abdominal aortic aneurysm.
, Ann Vasc Surg. 2021 Nov;77:172-181. , 2021.11. |
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Morisaki K, Matsubara Y, Furuyama T, Kurose S, Yoshino S, Yamashita S, Mori M., Effects of Antithrombotic Therapy on Abdominal Aortic Aneurysm Sac Size after Endovascular Repair in Patients with Favorable Neck Anatomy.
, J Vasc Interv Radiol. 2022 Feb;33(2):113-119. , 2022.02. |
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Morisaki K, Matsubara Y, Kurose S, Yoshino S, Furuyama T., Effect of abdominal aortic aneurysm sac shrinkage after endovascular repair on long-term outcomes between favorable and hostile neck anatomy.
, J Vasc Surg. 2022 Mar 18:S0741-5214(22)00451-7., 2022.03. |
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Koichi Morisaki, Rei Shibata, Noriko Takahashi, Noriyuki Ouchi, Yoshihiko Maehara, Toyoaki Murohara, Kimihiro Komori, Pioglitazone prevents intimal hyperplasia in experimental rabbit vein grafts, Journal of Vascular Surgery, 10.1016/j.jvs.2011.06.081, 54, 6, 1753-1759, 2011.12, Background: Intimal hyperplasia is a major obstacle to patency after vein grafting. Several clinical trials revealed that pioglitazone, a peroxisome proliferator-activated receptor-γ ligand, exerts beneficial actions on cardiovascular complications. We investigated whether pioglitazone modulates intimal hyperplasia in experimental rabbit autologous vein grafts. Methods: Male Japanese White rabbits were randomly divided into two groups: one group received pioglitazone as food admixture at a concentration of 0.01%, and the other did not (control). One week later, each group underwent reversed autologous vein bypass grafting of the right common carotid artery using ipsilateral external jugular vein. Pioglitazone therapy was continued after surgery and until harvest. Intimal hyperplasia of the grafted vein was assessed at 28 days. Two weeks after implantation, proliferative cells in the neointima were identified by immunohistochemical staining with Ki-67 monoclonal antibody. To determine apoptotic cells, we performed terminal deoxynucleotidyl transferase-mediated deoxyuride-5′-triphosphate nick-end labeling (TUNEL) staining. Blood samples were collected at 28 days after implantation for measuring metabolic parameters such as plasma glucose and total cholesterol. Adiponectin levels were determined by Western blot analysis. Finally, we assessed adiponectin-related signaling pathway, 5′ adenosine monophosphate-activated protein kinase (AMPK), and extracellular signal-regulated kinase (ERK) in the grafted vein by Western blot analysis. Results: Treatment with pioglitazone markedly inhibited intimal hyperplasia of carotid interposition-reversed jugular vein grafts in the pioglitazone group (0.54 ± 0.04 mm 2) vs control (0.93 ± 0.04 mm 2; n = 7; P <.01 pioglitazone treatment reduced the number of ki-67-positive proliferating cells in neointima vein grafts at days after implantation group vs controls p frequency tunel-positive apoptotic was enhanced by also increased plasma levels adiponectin a vascular protective hormone and led to an increase phosphorylation ampk decrease erk grafted vein. conclusions: attenuates intimal hyperplasia graft autologous bypass grafting its ability suppress cell proliferation enhance apoptosis. could represent therapeutic target for prevention failure grafting.. id="gencho_ronbuns10117729" class="qir_handle_link"> |
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Koichi Morisaki, Takuya Matsumoto, Yutaka Matsubara, Kentaro Inoue, Yukihiko Aoyagi, Daisuke Matsuda, Shinichi Tanaka, Jun Okadome, Yoshihiko Maehara, Elective endovascular vs. open repair for abdominal aortic aneurysm in octogenarians, Vascular, 10.1177/1708538115594967, 24, 4, 348-354, 2016.08, Purpose: The purpose of this study was to investigate the operative mortality and short-term and midterm outcomes of treatment of abdominal aortic aneurysm in Japanese patients over 80 years of age. Methods: Between January 2007 and December 2011, 207 patients underwent elective repair of infrarenal abdominal aortic aneurysms. Comorbidities, operative morbidity and mortality, midterm outcomes were analyzed retrospectively. Results: The average age (endovascular aneurysm repair, 84.4 ± 0.3; open, 82.8 ± 0.3, P |
| 8. |
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine, Outcomes of Endovascular Therapy for Infrarenal Aortic Occlusion of TASC II D Classification, Annals of Vascular Surgery, 10.1016/j.avsg.2017.02.005, 43, 203-209, 2017.01, Background This study aimed to investigate the treatment outcomes of endovascular therapy (EVT) in patients with infrarenal aortic occlusive disease. Methods Between January 2012 and December 2015, 11 patients with infrarenal aortic occlusion of Trans-Atlantic Inter-Society Consensus II D classification were treated. Procedural results, complications, and midterm results were analyzed retrospectively. Results The technical success was 81.8%. The procedural time was 118.3 ± 60.9 min, and the median length of hospitalization was 2 days (range, 1–40 days). Contrast-induced nephropathy occurred in 1 patient with EVT, but hemodialysis was not necessary. Primary patency of EVT at 2 years was 100%, and there were no reinterventions. Conclusions The endovascular approach for infrarenal aortic occlusion is feasible and midterm patency is favorable.. |
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Koichi Morisaki, Takuya Matsumoto, Yutaka Matsubara, Kentaro Inoue, Yukihiko Aoyagi, Daisuke Matsuda, Shinichi Tanaka, Jun Okadome, Yoshihiko Maehara, Prognostic factor of the two-year mortality after revascularization in patients with critical limb ischemia, Vascular, 10.1177/1708538116651216, 25, 2, 123-129, 2017.04, Purposes: The aim of this study was to evaluate the risk factors for the two-year survival after revascularization of critical limb ischemia. Methods: Between 2008 and 2012, 142 patients underwent revascularization. A retrospective analysis was performed to measure the risk factor. Results: A total 85 patients underwent surgical revascularization, 31 patients underwent endovascular therapy while 26 patients underwent hybrid therapy. By multivariate analysis, the following variables were considered to be risk factors: ejection fraction |
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Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine, Atsushi Guntani, Preoperative risk factors for aneurysm sac expansion caused by type 2 endoleak after endovascular aneurysm repair, Vascular, 10.1177/1708538117702787, 25, 5, 533-541, 2017.10, Purpose: The objective of this study was to investigate the preoperatively definable risk factors which predict the aneurysm sac expansion caused by persistent type 2 endoleak after endovascular aneurysm repair. Methods: Between 2008 and 2014, retrospective analysis was performed to examine the predictive risk factors for aneurysm sac enlargement caused by persistent type 2 endoleak, which was defined as a continuous endoleak present for more than six months. Aneurysm sac expansion was diagnosed if the maximum transverse diameter increased by 5 mm or more compared with the preoperative measurement. Results: During the study period, endovascular aneurysm repair was performed in 211 patients with abdominal aortic aneurysm and common iliac artery aneurysm. Sac enlargement for type 2 endoleaks was observed in 20 patients (9.5%). The presence of more than five patent lumbar arteries flowing into aneurysm sac in the preoperative computed tomography (hazard ratio, 3.37; 95% confidence interval, 1.24–10.8; p = 0.017) was a predictive factor for sac expansion caused by persistent type 2 endoleak on Cox regression analysis. The presence of a patent inferior mesenteric artery was not associated with the sac expansion caused by persistent type 2 endoleak. Conclusions: The presence of more than five lumbar arteries flowing into the aneurysm sac was a preoperative risk factor for sac expansion caused by persistent type 2 endoleak.. |
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Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine, Bypass Surgery after Endovascular Therapy for Infrapopliteal Lesion Is Not a Poor Outcome Compared with Initial Bypass Surgery by Vascular Surgeons, Annals of Vascular Surgery, 10.1016/j.avsg.2017.06.045, 45, 35-41, 2017.11, Background It is unclear whether prior endovascular therapy (EVT) adversely affects bypass surgery. The aim of this study is to investigate treatment outcomes between initial bypass (bypass-first) and bypass surgery after EVT (EVT-first). Methods We conducted a retrospective analysis of critical limb ischemia patients undergoing infrapopliteal bypass between November 2006 and December 2015. Graft patency, limb salvage (LS), amputation-free survival (AFS), and overall survival (OS) were examined between bypass-first and EVT-first groups. Results The subjects in this study were 75 patients and 82 limbs in the bypass-first group and 24 patients and 24 limbs in the EVT-first group. The average age was higher in EVT-first group (P = 0.03). The percentage of inframalleolar bypass was higher in the EVT-first group (P = 0.002). Primary patency at 1 and 2 years was 72.0% and 67.5% for the bypass-first group and 53.1% and 47.2% for the EVT-first group, respectively (P = 0.04). Inframalleolar bypass was a risk factor for lower primary patency (hazard ratio 3.07, 95% confidence interval 1.18–8.51, P = 0.02) in multivariate analysis, while there were no differences in secondary patency, LS, AFS, and OS. Conclusions Bypass surgery after EVT has lower primary patency rates in comparison with primary bypass in patients submitted to infrapopliteal revascularization. Although very heterogeneous study population with a lot of bias in the indication of the revascularization, LS, OS and AFS are not affected by previous EVT.. |
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Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine, Influence of frailty on treatment outcomes after revascularization in patients with critical limb ischemia, Journal of Vascular Surgery, 10.1016/j.jvs.2017.04.048, 66, 6, 1758-1764, 2017.12, Objective It is unclear whether frailty adversely affects treatment outcomes in patients with critical limb ischemia (CLI). The aim of this study was to investigate the influence of frailty on CLI patients after revascularization. Methods Patients undergoing infrapopliteal revascularization between 2007 and 2015 were retrospectively analyzed. The patient was defined as CLI frail when two or more of the following were present: low Geriatric Nutritional Risk Index, low skeletal muscle mass index, or nonambulatory status. The primary study end point was 2-year amputation-free survival (AFS). To analyze the diagnostic criteria of frailty, the CLI Frailty Index was compared with a modified Frailty Index using a receiver operating characteristic area under the curve. The secondary end points were occurrence of Clavien-Dindo class IV complications and 30-day or hospital mortality. Results During the study period, 266 patients and 325 limbs underwent infrapopliteal revascularization. The AFS rate 1 year and 2 years after revascularization was 81.8% and 72.9% for the CLI frail− group vs 45.8% and 34.0% for the CLI frail+ group (P <.001 respectively. multivariate analysis revealed that the cli frailty index ratio confidence interval p and hemodialysis ci were risk factors for afs years after revascularization. area under curve was compared with modified only found to be a factor morbidity or hospital mortality conclusions is in patients this result could prove useful prognostic prediction decision-making selection of bypass surgery endovascular therapy as first treatment strategy.. id="gencho_ronbuns10117723" class="qir_handle_link"> |
| 13. |
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Risk factors for wound complications and 30-day mortality after major lower limb amputations in patients with peripheral arterial disease, Vascular, 10.1177/1708538117714197, 26, 1, 12-17, 2018.02, Purpose: Risk factors for wound complications or 30-day mortality after major amputation in patients with peripheral arterial disease remain unclear. We investigated the outcomes of major amputation in patients with peripheral arterial disease. Methods: Patients who underwent major amputation from 2008 to 2015 were retrospectively analyzed. The main outcome measures were risk factors for wound complications and 30-day mortality after major lower limb amputations. Major amputation was defined as above-knee amputation or below-knee amputation. Wound complications were defined as surgical site infection or wound dehiscence. Results: In total, 106 consecutive patients underwent major amputation. The average age was 77.3 ± 11.2 years, 67.9% of patients had diabetes mellitus and 35.8% were undergoing hemodialysis. Patients who underwent primary amputation constituted 61.9% of the cohort, and the proportions of above-knee amputation and below-knee amputation were 66.9% and 33.1%, respectively. The wound complication rate was 13.3% overall, 10.3% in above-knee amputation, and 19.5% in below-knee amputation. Multivariate analysis showed that the risk factors for wound complications were female sex (hazard ratio, 4.66; 95% confidence interval, 1.40–17.3; P = 0.01) and below-knee amputation (hazard ratio, 4.36; 95% confidence interval, 1.20–17.6; P = 0.03). The 30-day mortality rate was 7.6%, pneumonia comprised the most frequent cause of 30-day mortality, followed by sepsis and cardiac death. Multivariate analysis showed that a low serum albumin concentration (hazard ratio, 3.87; 95% confidence interval, 1.12–16.3; P = 0.03) was a risk factor for 30-day mortality. Conclusions: Female sex and below-knee amputation were risk factors for wound complications. A low serum albumin concentration was a risk factor for 30-day mortality after major amputation in Japanese patients with peripheral arterial disease.. |
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Koichi Morisaki, Tadashi Furuyama, Yutaka Matsubara, Kentaro Inoue, Shun Kurose, Shinichiro Yoshino, Ken Nakayama, Sho Yamashita, Keiji Yoshiya, Ryosuke Yoshiga, Yoshihiko Maehara, 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, Vascular, 10.1177/1708538119836005, 27, 4, 405-410, 2019.08, Objectives: CLI Frailty is a useful diagnostic criterion of frailty in patients with critical limb ischemia (CLI). It is important to evaluate not only comorbidities but also frailty in decision making to select the type of treatment for CLI patients. The purposes of our study were to externally validate the CLI Frailty Index and to evaluate the modified CLI Frailty Index by measurement of skeletal muscle mass using computed tomography. Methods: Patients who underwent preoperative computed tomography examination and infrainguinal revascularization between 2002 and 2015 were retrospectively analyzed. A patient was defined as CLI Frailty (+), if two or more of the following criteria were present: low Geriatric Nutritional Risk Index (GNRI), low skeletal muscle mass index (SMI) evaluated by prediction equations, and non-ambulatory status. For the modified CLI Frailty Index, skeletal muscle area was measured by computed tomography instead of prediction equations. Results: During the study period, 226 patients with CLI underwent revascularization; we included 127 patients and excluded 99 patients who were treated only with iliac revascularization or did not undergo CT scans. The overall survival at two years after revascularization was 83.6% for the CLI Frailty (−) group versus 63.2% for the CLI Frailty (+) group (P =.02). The overall survival at two years after revascularization was 89.7% for the modified CLI Frailty (−) group versus 60.5% for the modified CLI Frailty (+) group (P <.01 multivariate analysis including cli frailty revealed that hemodialysis ci p and cerebrovascular disease were risk factors for overall survival two years after revascularization. in modified diabetes mellitus conclusions: both the indexes useful predicting two-year of patients with infrainguinal although measurement skeletal muscle mass using computed tomography may accurately predict smi prediction is effective who did not undergo preoperative ct.. id="gencho_ronbuns10117721" class="qir_handle_link"> |
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Koichi Morisaki, Tadashi Furuyama, Keiji Yoshiya, Shun Kurose, Shinichiro Yoshino, Ken Nakayama, Sho Yamashita, Eisuke Kawakubo, Takuya Matsumoto, Masaki Mori, Frailty in patients with abdominal aortic aneurysm predicts prognosis after elective endovascular aneurysm repair, Journal of Vascular Surgery, 10.1016/j.jvs.2019.09.052, 72, 1, 138-143, 2020.07, Objective: The diagnostic criteria for frailty in patients with abdominal aortic aneurysm (AAA) are undefined. Our purpose was to examine the influence of new diagnostic criteria for frailty on overall survival after endovascular aneurysm repair (EVAR). Methods: We retrospectively analyzed data for patients undergoing EVAR between 2007 and 2015. Isolated common iliac artery aneurysm and ruptured AAA were excluded. Patients were defined as having frailty when they had at least two of low Geriatric Nutritional Risk Index, sarcopenia, or nonambulatory status. We examined whether frailty affected overall survival, postoperative complications, and reintervention. Results: Over the study period, 349 patients underwent EVAR. Thirty-three patients were excluded. The 5-year overall survival after EVAR was 76.7% for the frailty-negative group vs 43.1% for the frailty-positive group (P <.01 age frailty-positive status and current cancer therapy were risk factors for overall survival. positive frailty was the only factor postoperative complications. forty-two patients underwent reintervention. outside instructions use a reintervention after evar. conclusions: assessing in with aaa is useful determining survival complications.. id="gencho_ronbuns10117720" class="qir_handle_link"> |
| 16. |
Koichi Morisaki, Tadashi Furuyama, Yutaka Matsubara, Kentaro Inoue, Shun Kurose, Shinichiro Yoshino, Ken Nakayama, Sho Yamashita, Keiji Yoshiya, Masaki Mori, Thigh sarcopenia and hypoalbuminemia predict impaired overall survival after infrainguinal revascularization in patients with critical limb ischemia, Vascular, 10.1177/1708538120913745, 28, 5, 542-547, 2020.10, Objective: This study was performed to determine whether thigh sarcopenia can serve as a clinically relevant predictor of postoperative complications and overall survival after revascularization in patients with critical limb ischemia. Methods: Patients who underwent preoperative computed tomography followed by infrainguinal revascularization from 2006 to 2015 were retrospectively analyzed. An axial computed tomography image was obtained at the midpoint of a line extending from the superior border of the patella to the greater trochanter of the femur. The thigh muscle area and bone area were measured. Thigh sarcopenia was defined as thigh muscle area/thigh bone area of |
