Faculty Profiles - SAITO Ryuta

Papers - SAITO Ryuta

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A Case of Ruptured Middle Portion Posterior Communicating Artery Aneurysm with Ipsilateral Internal Carotid Artery Occlusion Treated by Superficial Temporal Artery-Middle Cerebral Artery Anastomosis and Endovascular Treatment Reviewed

HACHIYA Kei, IMAI Tasuku, OYAMA Takahiro, KAWABATA Teppei, NODA Tomoyuki, SAITO Ryuta, MAKI Hideki

Surgery for Cerebral Stroke Vol. 52 ( 2 ) page： 123 - 128 2024

Language：Japanese Publisher：The Japanese Society on Surgery for Cerebral Stroke

We report a case of low-flow bypass and endovascular coiling for ruptured middle portion posterior communicating artery (PCoA) aneurysm with an ipsilateral internal carotid artery occlusion. A male in his 70s, who presented with headache was referred to our hospital. Brain computed tomography (CT) and CT angiography showed subarachnoid hemorrhage and a cerebral aneurysm in the middle portion of the PCoA, along with an ipsilateral internal carotid artery occlusion. First, we performed a right superficial temporal artery–middle cerebral artery bypass to minimize the risk of perioperative cerebral ischemia and symptomatic vasospasm; subsequently, coil embolization through the posterior circulation was performed. The patient showed a successful recovery at the 3-month follow-up and showed no recurrence 4 years after the treatment. Coil embolization for the middle portion in a PCoA aneurysm has a risk of parent artery occlusion and can result in an incomplete occlusion owing to the small diameter of the PCoA. However, the combination of bypass surgery with coil embolization can be an effective treatment option. This approach reduces the likelihood of perioperative ischemic stroke, symptomatic vasospasm, and recurrence, particularly when the pathogenesis of the aneurysm is hemodynamic stress caused by an occluded artery.

DOI： 10.2335/scs.52.123

CiNii Research

A Case Report and Review of Surgical Treatment for a Lumbar Disc Herniation with Sciatica in Pregnancy

Hamasaki Hajime, Yoshida Mitsuhiro, Nakabayashi Kiyo, Aimi Yuri, Ishida Mamoru, Terao Kazuichi, Saito Ryuta

Spinal Surgery Vol. 38 ( 1 ) page： 61 - 65 2024

Authorship：Last author Language：Japanese Publisher：The Japanese Society of Spinal Surgery

Use of drugs and radiological diagnoses are restricted for lumbar disc herniation during pregnancy. Fluoroscopy is avoided as much as possible. We report a case of lumbar disc herniation in a pregnant woman who underwent surgery. A 32-year-old woman, 16 weeks pregnant, who presented to an orthopedic clinic with left lower back and limb pain lasting for a month. Lumbar magnetic resonance imaging showed left posterolateral lumbar disc herniation at L5/S1. Conservative management failed, and she could not tolerate this uncontrollable intense pain until delivery ; therefore, the patient was referred to our department for surgery. She was not paralyzed but was unable to walk because of severe pain. The left straight leg raising test result was <30°. The preoperative Japan Orthopedic Association (JOA) score was 8/29. After consultation with an anesthesiologist and an obstetrician/gynecologist at our hospital, we decided to check the fetal heart sounds and echo findings before and after surgery. Surgery was performed under intravenous anesthesia using the standard Love’s method. The intraoperative position was prone on a four-point trestle table. The vertebral level was checked once, taking care not to irradiate the pelvic cavity. Postoperatively, the sciatica disappeared, the JOA score improved to 29 points, and the patient was discharged without symptoms on the eighth postoperative day. During pregnancy, radiation exposure must be avoided as much as possible, considering its influence on the fetus. As the weeks of pregnancy progress, surgery in the left lateral position is recommended to avoid elevating the intra-abdominal pressure or compressing the inferior vena cava. In our case, the patient’s body shape was almost the same as before she became pregnant. Therefore, we concluded the patient could undergo surgery in the prone position. In cases of herniated discs with severe pain that do not respond to conservative treatment, surgery is extremely useful and safe even during pregnancy.

DOI： 10.2531/spinalsurg.38.61

CiNii Research

T cell exhaustion and challenges of CAR-T cell therapy for solid tumors Invited

Kuramitsu Shunichiro, Yamaguchi Junya, Nohira Shota, Ohno Masasuke, Fujita Mitsugu, Saito Ryuta

Japanese Journal of Transplantation and Cellular Therapy Vol. 13 ( 1 ) page： 33 - 41 2024

Authorship：Last author Language：Japanese Publisher：Japanese Society for Transplantation and Cellular Therapy

CD19-redirected chimeric antigen receptor (CAR) T cell therapy has achieved remarkable success in hematological malignancies. However, targeting solid tumor is still challenging. T cell exhaustion is one of the major barriers in tumor microenvironment of solid tumors. In this review, we summarize the multifaceted mechanisms of T cell exhaustion and describe a new insight of CAR T cell exhaustion characterized by a T to NK like transition. Furthermore, the strategies to overcome T cell exhaustion to improve the efficacy of CAR T cell therapy will be addressed.

DOI： 10.7889/tct-23-029

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Initial Treatment Experience with Clazosentan for Cerebral Vasospasm after Subarachnoid Hemorrhage

WATANABE Toru, ARAKI Yoshio, UDA Kenji, IENAGA Junpei, KATO Nobuyasu, ISOZAWA Yuichiro, SAKAI Yosuke, TSUKADA Tetsuya, ISHIKAWA Takayuki, SAKAMOTO Yusuke, MURAOKA Shinsuke, NAGATANI Tetsuya, SEKI Yukio, SAITO Ryuta

Surgery for Cerebral Stroke Vol. 52 ( 4 ) page： 258 - 264 2024

Language：Japanese Publisher：The Japanese Society on Surgery for Cerebral Stroke

Clazosentan is used to suppress the onset of cerebral vasospasm, delayed cerebral ischemia (DCI), and new cerebral infarctions after subarachnoid hemorrhage. Here we retrospectively examine our initial experience using this drug in our department. Evaluation items included patient background factors, clinical characteristics, spasms on imaging, DCI/new cerebral infarction, complications associated with fluid retention, and other complications. Thirty-two patients were included; among them, clazosentan was administered to 25. In the clazosentan group, 10 patients (31%) exhibited spasms on imaging, one (4%) experienced DCI, and four (16%) had a new cerebral infarction. Complications associated with fluid retention occurred in 13 patients (52%). Although differences were observed in the phase III study in patient background factors, clinical characteristics, and concomitant medications, clazosentan effectively prevented DCI and new cerebral infarctions. Additional cases should be examined to establish an ideal body fluid management protocol.

DOI： 10.2335/scs.52.258

CiNii Research

Brain tumor surgeries for pediatric/adolescent and young adult patients

Kumabe Toshihiro, Shibahara Ichiyo, Kanamori Masayuki, Saito Ryuta, Sonoda Yukihiko, Endo Hidenori

The Japanese Journal of Pediatric Hematology / Oncology Vol. 61 ( 3 ) page： 238 - 244 2024

Language：Japanese Publisher：The Japanese Society of Pediatric Hematology / Oncology

The authors present a case of ependymoma, which is a rare surgical disease. To determine the significance of ependymoma surgery, we evaluated the frequency of repeat ependymoma surgeries proportionate to that of 235 neuroepithelial tumors/341 surgeries performed by the first author between 1997 and 2023. Repeat ependymoma surgeries accounted for 10/92 (11%) cases with WHO grades 2 and 3 (32 of 136 repeat surgeries [24%]). Ependymoma surgery to achieve local tumor control is of great significance. The treatment of pediatric/adolescent and young adult brain tumors aims to prolong the prognosis and reduce the treatment side effects. Therefore, neurosurgeons must maximize tumor resection while minimizing surgical morbidity, if surgery contributes to local tumor control.

DOI： 10.11412/jspho.61.238

CiNii Research

てんかんの分類と症候学

前澤聡, 齋藤竜太

脳神経外科速報 Vol. 34(3) page： 286 - 292 2024

薬剤抵抗性てんかんにおける視床,及び脳内深部構造の病態関与についての神経回路画像解析と神経修飾治療による病態制御の可能性の検討

前澤聡, Bagarinao E., 夏目淳, 臼井直敬, 齋藤竜太

てんかん治療研究振興財団研究年報 Vol. 35 page： 37 - 46 2024

Hemifacial spasm caused by multiple vascular attachments due to remote compression effects of a dermoid cyst in the cerebellar hemisphere: illustrative case. Reviewed International journal Open Access

Kento Hirayama, Takafumi Tanei, Takenori Kato, Toshinori Hasegawa, Eiji Ito, Yusuke Nishimura, Ryuta Saito

Journal of neurosurgery. Case lessons Vol. 6 ( 23 ) 2023.12

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Dermoid cysts located laterally in the posterior fossa are rare. The authors report the case of a dermoid cyst in the cerebellar hemisphere presenting with hemifacial spasm (HFS) caused by multiple vascular attachments due to remote compression effects. OBSERVATIONS: A 48-year-old man presented with left HFS. Computed tomography showed a mass lesion in the left cerebellar hemisphere with calcification and erosion of skull bone. Magnetic resonance imaging showed no contrast enhancement of the lesion and a dural defect. The lesion compressed the brainstem and cerebellopontine cistern, but no vascular attachments to the facial nerve were seen. Tumor removal and microvascular decompression were performed. The lesion was composed of soft tissue containing oil-like liquid and hairs, and the border of the cerebellar arachnoid was clear. There were multiple vascular attachments to the root exit zone, facial nerve, and brainstem. After displacing these arteries, the intraoperative abnormal muscle response disappeared. Histopathological findings showed stratified squamous epithelium, keratin flakes, calcifications, and hairs. The HFS disappeared completely and has remained absent for 27 months. LESSONS: The dermoid cyst originating from occipital bone compressed the cerebellar hemisphere, displacing multiple vessels and leading to HFS. Tumor removal and the removal of all vascular factors can completely resolve HFS.

DOI： 10.3171/CASE23592

Endoscopic debulking canalization for optic pathway glioma with obstructive hydrocephalus. Reviewed International journal

Kazuhito Takeuchi, Fumiharu Ohka, Yuichi Nagata, Eiji Ito, Hideyuki Harada, Ryuta Saito

Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery Vol. 39 ( 12 ) page： 3421 - 3425 2023.12

Language：English Publishing type：Research paper (scientific journal)

Optic pathway gliomas (OPGs) are benign tumors that can stop growing or even shrink. In recent years, surgical resection has not been considered the first-line treatment because of its high risk of complications. Chemotherapy is the mainstay of treatment for growing OPGs. Surgical treatment for OPGs with obstructive hydrocephalus is required. Ventriculoperitoneal shunting is effective for all types of hydrocephalus. However, long-term management is required, especially in pediatric cases, and there is a risk of shunt-related complications over a long lifespan. Debulking surgery for OPGs allows us to avoid shunt placement by creating a waterway and releasing the hydrocephalus. To reduce the surgical risk and invasiveness, we used an endoscopic canalization technique with a small-diameter cylinder. In this article, we present a case of endoscopic canalization of an obstructive hydrocephalus caused by OPGs in a 14-year-old female to illustrate our surgical technique.(Trial registration Registry name and number: Efficacy and safety of the neuro-endoscopic treatment for brain tumors (2019-0254)).

DOI： 10.1007/s00381-023-06053-5

Clinical Efficiency of an Artificial Intelligence-Based 3D-Angiography for Visualization of Cerebral Aneurysm: Comparison with the Conventional Method. Reviewed International journal Open Access

Kojiro Ishikawa, Takashi Izumi, Masahiro Nishihori, Takahiro Imaizumi, Shunsaku Goto, Keita Suzuki, Kinya Yokoyama, Fumiaki Kanamori, Kenji Uda, Yoshio Araki, Ryuta Saito

Clinical neuroradiology Vol. 33 ( 4 ) page： 1143 - 1150 2023.12

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: Artificial intelligence (AI)-based three-dimensional angiography (3D-A) was reported to demonstrate visualization of cerebral vasculature equivalent to that of three-dimensional digital subtraction angiography (3D-DSA). However, the applicability and efficacy of the AI-based 3D‑A algorithm have not yet been investigated for 3D-DSA micro imaging. In this study, we evaluated the usefulness of the AI-based 3D‑A in 3D-DSA micro imaging. MATERIALS AND METHODS: The 3D-DSA micro datasets of 20 consecutive patients with cerebral aneurysm (CA) were reconstructed with 3D-DSA and 3D‑A. Three reviewers compared 3D-DSA and 3D‑A in terms of qualitative parameters (degrees of visualization of CA and the anterior choroidal artery [AChA]) and quantitative parameters (aneurysm diameter, neck diameter, parent vessel diameter, and visible length of AChA). RESULTS: Qualitative evaluation of diagnostic potential revealed that visualization of CA and the proximal to middle parts of the AChA with 3D‑A was equal to that with conventional 3D-DSA; in contrast, visualization of the distal part of the AChA was lower with 3D‑A than with 3D-DSA. Further, regarding quantitative evaluation, the aneurysm diameter, neck diameter, and parent vessel diameter were comparable between 3D‑A and 3D-DSA; in contrast, the visible length of the AChA was lower with 3D‑A than with 3D-DSA. CONCLUSIONS: The AI-based 3D‑A technique is feasible and evaluable visualization of cerebral vasculature with respect to quantitative and qualitative parameters in 3D-DSA micro imaging. However, the 3D‑A technique offers lower visualization of such as the distal portion of the AChA than 3D-DSA.

DOI： 10.1007/s00062-023-01325-8

Lateral Lumbar Interbody Fusion within Three-level for Patients with Neurological Symptoms due to Vertebral Fragility Fractures in the Lumbar Spine Reviewed Open Access

Nagashima, Y, Nishimura, Y, Kanemura, T, Hata, N, Satake, K, Akahori, S, Ishii, M, Tanei, T, Takayasu, M, Saito, R

Neurologia Medico-Chirurgica Vol. 63 ( 12 ) page： 548 - 554 2023.12

Language：English Publishing type：Research paper (scientific journal) Publisher：The Japan Neurosurgical Society

There is a lack of agreement on whether minimally invasive lateral lumbar intervertebral fusion (LLIF) is a suitable treatment option for vertebral fragility fractures (VFFs). Hence, we sought to evaluate the efficacy and safety of LLIF in the management of VFF with neurological deficits in the lumbar spine. Between April 2015 and March 2020, we conducted a retrospective observational study of patients with VFF treated with three-level or less LLIF. The participants had previously received conservative treatment but had not been able to control their neurological symptoms. To assess the outcomes of the LLIF procedures, the patients were followed up for a minimum of 1 year. Clinical and radiological results, which include the timing and location of the bony fusion, were analyzed. The study involved 19 patients with 23 vertebral fracture levels. The residual height of the fractured vertebra was found to be 57.0 ± 12.3% of the height of the adjacent level. The mean Japanese Orthopedic Association score significantly improved postoperatively. Postoperative radiological parameters were significantly maintained at 1 year, and lumbar lordosis was maintained at the last follow-up (45.0 ± 26.7). In total 31 LLIF levels, bone fusion was observed in four levels at 6 months postoperatively, in 16 levels at 1 year, and in 23 levels at the last follow-up. The facet joint had the highest bony fusion location. LLIF within three levels can be safely performed in certain VFF cases with sufficient residual vertebral height.

DOI： 10.2176/jns-nmc.2023-0064

山口純矢, 大岡史治, 齋藤竜太

日本臨床 Vol. 81 ( 増刊9 臨床脳腫瘍学 ) page： 244 - 246 2023.12

大岡史治, 山口純矢, 齋藤竜太

日本臨床 Vol. 81 ( 増刊9 臨床脳腫瘍学 ) page： 455 - 460 2023.12

Deep learning based identification of pituitary adenoma on surgical endoscopic images: a pilot study Reviewed

Yutaro Fuse, Kazuhito Takeuchi, Noriaki Hashimoto, Yuichi Nagata, Yusuke Takagi, Tetsuya Nagatani, Ichiro Takeuchi, Ryuta Saito

Neurosurgical Review Vol. 46 ( 1 ) page： 291 2023.11

Difference of coil distribution made by finishing coils in large size aneurysm model with radiolucent coils. Reviewed Open Access

Hiroki Matsuno, Takashi Izumi, Masahiro Nishihori, Shunsaku Goto, Yoshio Araki, Kinya Yokoyama, Kenji Uda, Ryuta Saito

Nagoya journal of medical science Vol. 85 ( 4 ) page： 725 - 732 2023.11

Language：English Publishing type：Research paper (scientific journal)

We conducted a study to understand the characteristics of the finishing coils to select the appropriate coil for the final stage of embolization. Consequently, experimental embolization was performed on a 10 mm spherical silicone aneurysm filled with radiolucent coils, which simulated a volume embolization ratio of 20%. Nine different coils (i-ED complex ∞ SilkySoft, SilkySoft, ExtraSoft, V-Trak HyperSoft helical, Barricade 10 complex finishing, Optima complex 10 soft, Target 360 Ultra, Galaxy G3 mini, and Axium prime 3D ExtraSoft) were analyzed six times at random. After each coil insertion, indices that include area, Feret diameter, circularity, and centroid center of mass were calculated using biplane x-ray images. Furthermore, these data were analyzed using the spring constant k, which represents the stiffness of the coil. In multiple comparisons, a significant difference was observed in the area analysis. The i-ED complex ∞ SilkySoft was more widespread than Target 360 Ultra (p < 0.05). However, no significant differences were observed in the other indices. The spring constant k value of Target 360 Ultra was 2.5 times larger than that of the i-ED complex ∞ SilkySoft, and it negatively correlated with the area index rather than with the other indices. Notably, it was suggested that the smaller the spring constant k, the wider the distribution of the finishing coils. Although there was little difference between the coils, some coils had characteristics suggesting that good embolization could be expected using appropriate finishing coils.

DOI： 10.18999/nagjms.85.4.725

DISSECTING THE INTRA- AND INTER-TUMORAL HETEROGENEITY UNDERLYING GLIOBLASTOMA PATHOGENESIS UTILIZING MULTI-OMICS ANALYSIS

Nakashima, T; Funakoshi, Y; Yajima, H; Yamamoto, R; Sugihara, Y; Nambu, S; Arakawa, Y; Tanaka, S; Ishida, J; Saito, R; Hanaya, R; Yoshimoto, K; Narita, Y; Suzuki, H