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Multicenter Study
. 2024 Aug 15;64(8):309-315.
doi: 10.2176/jns-nmc.2024-0011. Epub 2024 Jun 5.

Trends and Progress in Neuroendovascular Treatment in Japan: Japanese Registry of Neuroendovascular Therapy (JR-NET) 4. Main Report

Nobuyuki Sakai  1 , Satoru Fujiwara  1 , Kazutaka Uchida  2 , Koji Iihara  3 , Hirotoshi Imamura  3 , Akira Ishii  4 , Yuji Matsumaru  5 , Chiaki Sakai  1 , Tetsu Satow  6 , Shinichi Yoshimura  2 , Yasushi Matsumoto  7 , Hidenori Oishi  8 , Naoto Kimura  9 , Masayuki Ezura  10 , Tatsufumi Nomura  11 , Shinzo Ota  12 , Akio Hyodo  13 , Fuminori Shimizu  14 ; Japanese Registry of Neuroendovascular Therapy (JR-NET) Investigators
Affiliations
Multicenter Study

Trends and Progress in Neuroendovascular Treatment in Japan: Japanese Registry of Neuroendovascular Therapy (JR-NET) 4. Main Report

Nobuyuki Sakai et al. Neurol Med Chir (Tokyo). .

Abstract

We reported the main results of the Japanese Registry of Neuroendovascular Therapy (JR-NET) 4, a nationwide surveillance of therapy (NET) in Japan from January 2015 to December 2019. JR-NET 4 registered consecutive patients who underwent NETs by Japan Society of Neuroendovascular Therapy (JSNET) -certified specialists. The primary endpoint was functional independence (mRS score of 0-2) at 30 days post-NET, with secondary endpoints focusing on technical success and major adverse events within 30 days.A total of 63,230 patients and 60,354 NET procedures from 166 participating centers were analyzed. During the study period, NET cases have consistently increased, with an increase in the proportion of elderly patients. A significant trend shift was observed in the distribution of NET procedures, with endovascular treatment for acute ischemic stroke that showed a dramatic increase in 5 years. This trend aligns with key randomized clinical trials from 2015 that presented the efficacy of this treatment. Clinical outcomes at 30 days posttreatment revealed that endovascular treatment for acute ischemic stroke and other NETs maintained safety and effectiveness despite varying prevalence of functional independence between target diseases. The study also observed a steady increase in emergency treatment cases, reflecting the increase in acute ischemic stroke, a time-sensitive medical condition.This comprehensive surveillance highlights the trend of NET practices in Japan, driven by clinical evidence and advancements in treatment devices. Although these findings were specific to Japan, they offer valuable insights into the broader trends in NETs and acute stroke care.

Keywords: clinical outcome; endovascular treatment; nationwide surveillance; registry study; safety endpoint.

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Conflict of interest statement

All authors who are members and nonmembers of the Japan Neurosurgical Society (JNS) have registered self-reported COI disclosure statements through the JNS website. Nobuyuki Sakai reports a research grant from Biomedical Solutions, Medtronic, Terumo, and TG Medical; lecturer's fees from Asahi-Intec, Biomedical Solutions, Daiichi-Sankyo, Kaneka, Medtronic, and Terumo; membership on the advisory boards for Johnson & Johnson, Medtronic and Terumo outside the submitted work. Other coauthors have no conflict of interest for this manuscript.

Figures

Fig. 1
Fig. 1
Annual changes during JR-NET 4. (A) Distribution of patients’ age during JR-NET 4. (B) The types of neuroendovascular procedures. (C) Proportion of elective and emergency procedures of neuroendovascular procedures. JR-NET: Japanese Registry of Neuroendovascular Therapy
Fig. 2
Fig. 2
Proportions of modified Rankin scale (mRS) scores before and after procedures.
Fig. 3
Fig. 3
Proportions of modified Rankin scale (mRS) scores at 30 days after each procedure.
Fig. 4
Fig. 4
Adverse events associated with each procedure.
See this image and copyright information in PMC

References

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