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A comparison of the prevalence and risk factors of complications in intracranial tumor embolization between the Japanese Registry of NeuroEndovascular Therapy 2 (JR-NET2) and JR-NET3

  • Tomohito HishikawaEmail author
  • Kenji Sugiu
  • Satoshi Murai
  • Yu Takahashi
  • Naoya Kidani
  • Shingo Nishihiro
  • Masafumi Hiramatsu
  • Isao Date
  • Tetsu Satow
  • Koji Iihara
  • Nobuyuki Sakai
  • on behalf of the JR-NET2 and JR-NET3 study groups
Original Article - Tumor - Other
Part of the following topical collections:
  1. Tumor – Other

Abstract

Background

The Japanese Registry of NeuroEndovascular Therapy 2 (JR-NET2) and 3 (JR-NET3) were nationwide surveys that evaluated clinical outcomes after neuroendovascular therapy in Japan. The aim of this study was to compare the prevalence and risk factors of complications of intracranial tumor embolization between JR-NET2 and JR-NET3.

Methods

A total of 1018 and 1545 consecutive patients with intracranial tumors treated with embolization were enrolled in JR-NET2 and JR-NET3, respectively. The prevalence of complications in intracranial tumor embolization and related risk factors were compared between JR-NET2 and JR-NET3.

Results

The prevalence of complications in JR-NET3 (3.69%) was significantly higher than that in JR-NET2 (1.48%) (p = 0.002). The multivariate analysis in JR-NET2 showed that embolization for tumors other than meningioma was the only significant risk factor for complication (odds ratio [OR], 3.88; 95% confidence interval [CI], 1.13–12.10; p = 0.032), and that in JR-NET3 revealed that embolization for feeders other than external carotid artery (ECA) (OR, 3.56; 95% CI, 2.03–6.25; p < 0.001) and use of liquid materials (OR, 2.65; 95% CI, 1.50–4.68; p < 0.001) were significant risks for complications. The frequency of embolization for feeders other than ECA in JR-NET3 (15.3%) was significantly higher than that in JR-NET2 (9.2%) (p < 0.001). Also, there was a significant difference in the frequency of use of liquid materials between JR-NET2 (21.2%) and JR-NET3 (41.2%) (p < 0.001).

Conclusions

Embolization for feeders other than ECA and use of liquid materials could increase the complication rate in intracranial tumor embolization.

Keywords

Complication Embolization Intracranial tumor Risk factors 

Notes

Acknowledgments

JR-NET2: The authors would like to express heartfelt thanks to doctors who devoted their time to this investigation. The JR-NET Study Group: Principle Investigator: Nobuyuki Sakai, Kobe City Medical Center General Hospital, Kobe, Japan; Investigators: Akio Hyodo, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Japan (17C-1, 20C-2); Shigeru Miyachi, Nagoya University, Nagoya, Japan (17C-1, 20C-2); Yoji Nagai, Translational Research Informatics Center, Kobe, Japan (17C-1, 20C-2); Chiaki Sakai, Institute of Biomedical Research and Innovation, Kobe, Japan (17C-1, 20C-2); Tetsu Satoh, National Cerebral and Cardiovascular Center, Suita, Japan (17C-1, 20C-2); Waro Taki, Mie University, Tsu, Japan (17C-1, 20C-2); Tomoaki Terada, Wakayama Rosai Hospital, Wakayama, Japan (17C-1, 20C-2); Masayuki Ezura, Sendai Medical Center, Sendai, Japan (17C-1); Toshio Hyogo, Nakamura Memorial Hospital, Sapporo, Japan (17C-1); Shunji Matsubara, Tokushima University, Tokushima, Japan (17C-1); Kentaro Hayashi, Nagasaki University, Nagasaki Japan (20C-2); Co-Investigators: Toshiyuki Fujinaka, Osaka University, Suita, Japan; Yasushi Ito, Niigata University, Niigata, Japan; Shigeki Kobayashi, Chiba Emergency Medical Center, Chiba, Japan; Masaki Komiyama, Osaka City General Hospital, Osaka, Japan; Naoya Kuwayama, Toyama University, Toyama, Japan; Yuji Matsumaru, Toranomon Hospital, Japan, Yasushi Matsumoto, Konan Hospital, Sendai, Japan; Yuichi Murayama, Jikei Medical University, Tokyo, Japan; Ichiro Nokahara, Kokura Memorial Hospital, Kokura, Japan; Shigeru Nemoto, Jichi Medical University, Shimotsuke, Japan; Koichi Sato, Tokushima Red Cross Hospital, Tokushima, Japan; Kenji Sugiu, Okayama University, Okayama, Japan; Shinichi Yoshimura, Gifu University, Gifu, Japan; and Certified Specialist of Japanese Society of Neuoendovascular Therapy.

JR-NET3: The JR-NET3 Study Group: Co-Principle investigator: Nobuyuki Sakai, Kobe City Medical Center General Hospital, Kobe, Japan; Koji Iihara, Kyushu University, Fukuoka, Japan; Tetsu Satow, National Cerebral and Cardiovascular Center, Suita, Japan; Investigators; Masayuki Ezura, Sendai Medical Center, Sendai, Japan; Akio Hyodo, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan; Shigeru Miyachi, Aichi Medical University, Aichi, Japan; Susumu Miyamoto, Kyoto University, Kyoto, Japan; Yoji Nagai, Kobe University, Kobe, Japan; Kunihiro Nishimura, National Cerebral and Cardiovascular Center, Suita, Japan; Kazunori Toyoda, National Cerebral and Cardiovascular Center, Suita, Japan; Co-investigators: Toshiyuki Fujinaka, Osaka Medical Center, Osaka, Japan; Toshio Higashi, Fukuoka University, Fukuoka, Japan; Masaru Hirohata, Kurume University, Kurume, Japan, Japan; Akira Ishii, Kyoto University, Kyoto, Japan; Hirotoshi Imamura, Kobe City Medical Center General Hospital, Kobe, Japan; Yasushi Ito, Shinrakuen Hospital, Niigata, Japan; Naoya Kuwayama, Toyama University, Toyama, Japan; Hidenori Oishi, Juntendo University, Tokyo, Japan; Yuji Matsumaru, Tsukuba University, Tsukuba, Japan; Yasushi Matsumoto, Konan Hospital, Sendai, Japan; Ichiro Nakahara, Fujita Medical University, Aichi, Japan; Chiaki Sakai, Hyogo College of Medicine, Nishinomiya, Japan; Kenji Sugiu, Okayama University, Okayama, Japan; Tomoaki Terada, Showa University Fujigaoka Hospital, Kanagawa, Japan; Shinichi Yoshimura, Hyogo College of Medicine, Nishinomiya, Japan; and Certified Specialist of Japanese Society of Neuroendovascular Therapy.

Funding

JR-NET2 was supported by research grants for cardiovascular diseases (17C-1, 20C-2) from the Ministry of Health, Labor, and Welfare of Japan. JR-NET3 was supported in part by a Grant-in-Aid (Junkanki-Kaihatsu H24-4-3) from the National Cerebral and Cardiovascular Center, Japan, and by Hatazaki Foundation, Kobe, Japan.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study protocols of JR-NET2 and JR-NET3 were approved by the institutional review board at Kobe City Medical Center General Hospital.

Informed consent

Because this was a retrospective noninvasive study, written informed consent was not obtained from patients.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Tomohito Hishikawa
    • 1
    Email author
  • Kenji Sugiu
    • 1
  • Satoshi Murai
    • 1
  • Yu Takahashi
    • 1
  • Naoya Kidani
    • 1
  • Shingo Nishihiro
    • 1
  • Masafumi Hiramatsu
    • 1
  • Isao Date
    • 1
  • Tetsu Satow
    • 2
  • Koji Iihara
    • 3
  • Nobuyuki Sakai
    • 4
  • on behalf of the JR-NET2 and JR-NET3 study groups
  1. 1.Department of Neurological SurgeryOkayama University Graduate School of Medicine, Dentistry and Pharmaceutical SciencesOkayamaJapan
  2. 2.Department of NeurosurgeryNational Cerebral and Cardiovascular CenterOsakaJapan
  3. 3.Department of Neurosurgery Graduated School of Medical SciencesKyusyu UniversityFukuokaJapan
  4. 4.Department of NeurosurgeryKobe City Medical Center General HospitalKobeJapan

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