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April 2019 - present
December 2017 - present
April 2016 - September 2016
Publications
Publications (122)
Huntington’s disease (HD) causes progressive neurodegeneration, impairing activities of daily living (ADL). Treatment focuses primarily on symptomatic relief through multidisciplinary approaches. This case report examines the impact of somato-cognitive coordination therapy (SCCT) on ADL in a patient with HD. A woman in her 40s with early-stage HD u...
要旨：仮想現実技術を応用した，体性認知協調療法と呼ばれる新たなリハビリテーション手法が開発され，実用化が進んでいる。これは没入型仮想現実空間内での左右交互の座位リーチング課題を実施することで，運動協調性の異常を検出し適切な動作の学習を促す治療手法である。座位治療にもかかわらず歩行機能の改善が得られることが証明されており，整形・災害外科疾患に関わる多様な運動障害や神経損傷後の機能回復などに幅広く応用されている。
Dear editor, Non-invasive ventilation (NIV) is critical in the treatment of several respiratory diseases [1, 2]. However, interface air leakage and resultant pressure injury from tight-fitting can lead to intolerance or unsuccessful implementation of NIV [3, 4]. In response to these challenges , we have developed a new type of oronasal mask with fu...
Long-term outcome ascertainment can be affected by the follow-up performance and needs to use a different data source for more comprehensive data capture. However, a universal tracking system is absent in Japan, and long-term outcomes are often ascertained through electronic medical records (EMRs), the reliability of which is uncertain. In this stu...
Purpose] Virtual reality (VR) rehabilitation has become popular in the medical field. VR-guided exercises (VR-ge) have demonstrated positive effects on gait and trunk control. Trunk muscle activation, particularly that of the transversus abdominis (TrA), is responsible for these improvements. However, the difference in muscle activation between VR...
はじめに
腰痛はプライマリケア医が遭遇する運動器疾患の中でも最もポピュラーな症状の1つである[1-2]。その治療法は多岐に渡り、腰痛診療ガイドラインにも薬物療法から物理・装具療法、運動療法、認知行動療法、手術を含む多彩な侵襲的アプローチ等が紹介されている。しかしながら、数多くの治療選択肢の存在にも関わらず、症状改善に至らず痛みが慢性化し、機能障害等によって日常生活に支障をきたすケースも多い[1-2]。
一方、近年慢性疼痛の新しい治療選択肢として、仮想現実（Virtual Reality, VR）技術を用いた体性認知協調療法（Somato-Cognitive Coordination Therapy, SCCT）が注目されるようになってきた[3-5]。SCCTは疾患種別に関係なく難治性疼痛の症...
This feasibility study enrolled 20 patients with advanced severe Parkinson’s disease (PD) to evaluate somato-cognitive coordination therapy (SCCT) using virtual reality. Focusing on the safety and tolerability of SCCT, 17 patients (76±9 years old and 64.7% male) completed the 3-month trial. Key observations included absence of adverse events and to...
臥床や過度な安静状態が長期に続くと筋力低下や心肺機能低下など、いわゆる廃用症候群に至る危険が増し機能予後や生命予後が不良になる。そのため、これまで臨床現場では早期離床に繋げるための運動療法等、様々な取り組みに関して効果検証や報告が行われてきた。患者自身の生活機能の低下はそのまま介護負担や医療費の増大という問題にも繋がることから、早期離床に関する取り組みは病院における急性期の介入から始まり、回復期を経た退院後の在宅、或いは介護施設での取り組みまでを含め幅広い症例に対して安全で継続的に治療できることが重要となる。仮想現実（Virtual reality ; VR）とは、広義には人の五感を現物以外の何らかの形で再現する技術を意味する。より一般的には、グラフィック技術を用いて空間を創出、または再現す...
症例は81歳、パーキンソン病の女性でHoehn–Yahrの重症度分類はIV度、レボドパ・カルビドパ経腸用液療法施行中であり構音障害及び歩行機能の改善目的で来院。仮想現実（VR）技術を応用した医療機器「mediVRカグラ🄬」を用い、体性認知協調療法（Somato-Cognitive Coordination Therapy, SCCT）を行った。SCCTは脳再プログラミング療法とも呼ばれ、「関節連関」と呼ばれる意図する動作部位以外に出現する関節の異常運動注目して治療を行う（1-A）1)。１回40分の治療を3回行った結果、ひらがな五十音を発語するのに要する時間が22.4秒から11.3秒に改善し（1-B＆Ｃ）、歩行機能及び上肢機能にも改善を認めた（1-Ｄ）。座位で安全に行えるSCCTは運動失調、歩...
転倒による骨折や外傷に伴う機能制限は生活の質を低下させ、自立を妨げる要因となる[1-2]。生活機能の低下はそのまま介護負担や医療費の増大問題にも繋がることから、転倒予防には幅広い症例に対して安全で継続的に取り組める汎用性が重要となる[1-2]。特にジェネラリストが対峙する転倒問題は高齢者にとどまらず、発達障害や脳性麻痺の小児患者から脳血管障害、パーキンソン病などの神経変性疾患を患う就労世代の成人患者に至るまで、日常診療の多くの患者に関連する重要な課題の1つである。臨床現場ではこれまで転倒を予防するための運動プログラムや、住環境、薬剤の見直し等、様々な取り組みに関して効果検証が行われてきた[1-2]。本項ではその中でもこれまでにない全く新しい転倒予防手法となり得る仮想現実（Virtual Re...
回復期リハビリテーション（回復期リハ）医療では急性期の専門的治療を終え病状が安定した患者に対して、多職種が協同して心身機能の回復や生活活動レベルの改善を図り、患者の社会、家庭への復帰を目的とした様々な取り組みが行われる。一方で超高齢社会の本邦においては回復期リハ医療の主たる対象疾患である脳血管障害等の患者が増加することは想像に難くなく、財政のひっ迫に対して医療費抑制政策をとらざるを得ない状況となっている。それに伴い2006年4月の診療報酬改定でこれまで無期限であった国民皆保険制度下でのリハビリテーション（リハビリ）に日数制限が設けられ、2016年の診療報酬改定では回復期リハ病棟入院料取得の施設基準として効果的かつ効率的な質の高いリハビリの実施が要件として加わった。施設基準要件は2年ごとの診療...
Background
Persistent postural-perceptual dizziness (PPPD) is a newly defined disorder characterized by functional dizziness. Due to its recent discovery, definitive treatment for PPPD has not been established; therefore, this study aimed to assess the effectiveness of virtual reality (VR)-guided, dual-task, trunk balance training for the managemen...
OBJECTIVE
Postoperative atrial fibrillation (POAF) after cardiac surgery is associated with increased mortality. The efficacy of landiolol hydrochloride for POAF prevention after coronary artery bypass grafting and valve surgery has been reported. However, little evidence is available on its role in POAF prevention after aortic root, ascending aort...
An aging population and declining birth rate have resulted in a significant increase in demand for healthcare and put additional burdens on healthcare professionals. Therefore, providing efficient healthcare through digital technology has become a priority. With the aim of improving treatment efficacy, we have developed the medical device, mediVR K...
Virtual reality (VR)-guided exercise therapy using mediVR KAGURA has been reported to improve gait function by extending the arm to spatial targets while sitting. We aimed to investigate toe and trunk–pelvic function and plantar sensation during gait in a postoperative patient with hallux valgus. A 60-year-old woman, whose foot deformities had impr...
Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curable treatment option for adolescent and young adult (AYA) patients with myelodysplastic syndrome (MDS). The study aim was to evaluate epidemiological data and identify prognostic factors for AYA patients with MDS undergoing allogeneic HSCT. Here, 645 patients were selected fr...
Background
Persistent postural-perceptual dizziness (PPPD) is a newly defined disorder of functional dizziness. Due to its recent discovery, definitive treatment for PPPD has not been established; therefore, this study aimed to measure the effectiveness of virtual reality (VR)-guided, dual-task, body trunk balance training using the mediVR KAGURA s...
近年さまざまな医療分野でデジタル技術革新の事例がみられるようになっている．この流れはリハビリテーション（以下リハ）領域においても例外ではなく，特に仮想現実（virtual reality；VR）やその類似技術としての拡張現実（augmented reality；AR），混合現実（mixed reality；MR）技術に注目が集まっている．これらVR，AR，MR は，リハ領域ではヘッドマウントディスプレイ（HMD）等を用いて視覚および聴覚情報を提供する装置を指すことが多い．本稿では特に応用事例の多いVR に注目しつつ，筆者らが大阪大学との産学連携活動を通して開発したリハ用VR 医療機器「mediVR カグラ」の概要から適応および臨床効果，ならびに各種症状の改善機序等に関する理論根拠を示したい．
Fludarabine and a myeloablative dose of busulfan (Flu/Bu4) can improve prognosis after allogeneic hematopoietic stem cell transplantation (HSCT) with melphalan (Mel). We investigated the prognostic impact of adding Mel to Flu/Bu4 by comparing between Flu/Bu4/Mel and Flu/Bu4 groups. This study included 846 propensity score (PS)-matched patients who...
Background
Prediction of atrioventricular block (AVB) resolution after steroid therapy in patients with cardiac sarcoidosis (CS) is difficult.
Methods
We identified 24 patients with CS and complete or advanced AVB receiving steroid therapy. AVB resolution was assessed by reviewing surface electrocardiogram and the percentage of ventricular pacing...
Objective
Data on statin for patients with aortic stenosis (AS) who underwent transcatheter aortic valve implantation (TAVI) are limited. The present study aimed to evaluate the impact of statin on midterm mortality of TAVI patients.
Design
Observational study.
Setting
This study included patients with AS from a Japanese multicentre registry who...
◎ 仮想現実（VR）技術の医療応用は30 年以上の歴史があるものの，その効果はきわめて限定的であった．
◎ われわれは大学での産学連携活動を通して，まったく新しいアプローチのVR リハビリテーション用医療機器の開発に成功した．
◎ このVR 機器「mediVR カグラ Ⓡ」は歩行（姿勢）・上肢・認知・内耳機能障害および疼痛の改善手段として応用が進んでいる．
◎ 近年では病院などでのリハビリテーションにおける新型コロナウイルス感染症対策としても注目されており，また遠隔リハビリテーション機器としての応用も進められている．
Objectives
Patients with haemoptysis often experience daily physical and mental impairment. Bronchial artery embolisation is among the first-line treatment options used worldwide; however, no evidence exists regarding the health-related quality of life (HRQoL) after bronchial artery embolisation. Therefore, this study aimed to evaluate the effects...
The 4-Fr catheter system is not recommended for invasive functional assessment of coronary artery stenosis, because it tends to distort the aortic waveform. This study aimed to identify the incidence of aortic waveform distortion and a feasible method for correct diagnosis of coronary artery stenosis with a 4-Fr catheter. We retrospectively investi...
Background
Delirium is associated with high mortality after cardiac surgery. However, evidence on the epidemiology of delirium in patients with acute decompensated heart failure (ADHF) is limited. This study aimed to assess the incidence and prognostic impact of delirium in patients with ADHF.
Methods
This single-center prospective observational s...
Background/purpose:
Hamstring tendon autografts are commonly used for double-bundle anterior cruciate ligament reconstruction (DB-ACLR). If the volume of the semitendinosus (ST) tendon is insufficient, the gracilis (G) tendon is also harvested. Additional harvesting of the G autograft can affect patients' short-term postoperative outcome, such as...
Aims: Acute decompensated heart failure (ADHF) can occur early after transcatheter aortic valve implantation (TAVI), but the risk factors or mechanisms associated with it have not been fully determined. This hypothesis-generating study aimed to investigate the clinical indices associated with the development of ADHF within 72 hours after TAVI and t...
Background: Fractional flow reserve (FFR) derived from coronary CT angiography (FFRCT) values were recently recommended to be measured 1-2 cm distal to the stenosis for clinical decision making given potential overestimation of ischemia by FFRCT values at far-distal segments, though supporting data is lacking. Objective: This study evaluated the di...
仮想現実（virtual reality, VR）技術は医療現場ではヘッドマウントディスプレイ（head mounted display, HMD）を装着することで視覚及び聴覚情報を置き換える装置を指すことが多い（図1）。近年, リハビリテーション領域におけるVR技術の応用事例に関する報告が増えている。本邦においても, 大阪大学における産学連携活動によって生まれたリハビリテーション用VR医療機器（mediVRカグラ🄬, 株式会社mediVR, 豊中市, 日本）の販売が2019年3月から開始となる等, 今後益々VR技術の医療現場における応用が進むことが期待される。本コラムでは, VR技術の慢性疼痛患者に期待される効果を中心にその医学的理論根拠を解説する。
株式会社mediVR では仮想現実技術を用いたリハビリテーション支援用医療機器の開発及び製造販売を行っている。本特集ではニーズの掘り起こしから開発理論,上市から臨床効果に至るまでの弊社の取り組みを紹介することによって,読者が医療機器開発の一連の流れを理解し,医工連携活動を行う際の一助となるような情報提供を行いたい。
Background:The Japanese Ministry of Health, Labour and Welfare has tried to promote telemedicine since 2018, but faces difficulties in increasing the use of telemedicine partly due to a lack of clinical evidence. This study investigated the disease control status and safety of telemedicine, which, in Japan, is provided under the National Health Ins...
理学療法士の未来が変わる．そんなことを感じさせる医療機器が登場した．仮想現実（virtual reality：VR）技術を応用して歩行に必要な姿勢バランスと二重課題型の認知処理能力を定量的に可視化し，セラピストがより適切に治療介入を行えるようにしたリハビリテーション用医療機器「mediVRカグラ」の導入施設が増えている．
mediVRカグラは，座位で行うトレーニングで歩行機能が改善することが最大の特徴で，一見するとごく一般的なVRゲームのようにしか見えないが，その開発に神経内科医や理学療法士，作業療法士が深く関与している点が既存のVR製品とは明確に異なる．その結果はまさに目を見張る効果であり，姿勢バランス制御系の脳内モデルの再構築だけでなく，これまで改善が難しかった注意障害を中心とした認知機...
Introduction
Fludarabine and a myeloablative dose of intravenous busulfan with or without total body irradiation (Flu/Bu4) is a widely accepted myeloablative conditioning regimen with reduced toxicity for allogeneic hematopoietic stem cell transplantation (HSCT) that has been able to expand the indications for allogeneic HSCT while maintaining the...
Hangovers are associated with negative economic consequences due to decreased job performance or frequent visits to physicians. Thus, a new strategy for the alleviation of hangover-related symptoms is needed to avoid this detriment to the society. The purpose of this nationwide randomised, double-blind, placebo-controlled physicians’ trial was to e...
Herein, we report two cases of erratic coil migration from the bronchial artery to the bronchus after bronchial artery embolization (BAE). Neither patient exhibited haemoptysis recurrence, but chest radiographs revealed that part of the coil had disappeared. In Case 1, the patient coughed up the coil 4.5 years after BAE. We performed repeat BAE to...
Pre-procedural valvuloarterial impedance (Zva) is considered as a useful predictor of mortality in patients diagnosed as having severe aortic stenosis (AS) who undergo transcatheter aortic valve implantation (TAVI). However, the prognostic significance of post-procedural Zva remains unclear. We aimed to evaluate the prognostic significance of Zva a...
Background:
Virtual reality (VR) technology has been recently introduced in a variety of clinical settings, such as physical, occupational, cognitive, and psychological rehabilitation or training. However, the clinical efficacy of VR rehabilitation compared with traditional training techniques remains to be elucidated.
Case:
A 90-year-old man un...
Background
Reduced muscle strength and physical performance are prevalent in patients of maintenance hemodialysis (MHD), and deleterious changes in these parameters are associated with increased mortality.
Methods
This retrospective observational study included 306 patients, who received a 6-month resistance exercise program during hemodialysis, t...
Objectives
In this study, we sought to investigate the association between revolution speed of rotational atherectomy (RA) and debulking area assessed by frequency domain‐optical coherence tomography (FD‐OCT).
Background
The number of patients with severe calcified coronary artery disease requiring treatment with calcium ablation, such as RA, is i...
Though second allogenic haematopoietic stem cell transplantation (HSCT) is considered a curative treatment option after myelodysplastic syndrome (MDS) relapse, scant epidemiological data are available. We investigated the outcomes and prognostic factors of second allogenic HSCT in 99 patients with MDS who relapsed after the first HSCT. The median a...
Objectives
The objective was to evaluate the safety, feasibility, and accuracy of the jailed‐pressure wire technique using a durable optical fiber‐based pressure wire with high‐pressure dilatation using a non‐compliant balloon after main vessel stenting.
Background
Fractional flow reserve (FFR) information can help interventionists determine wheth...
Background:
Little evidence is available regarding the risk of peri-procedural stroke detected by diffusion-weighted magnetic resonance imaging (DW-MRI) after transcatheter aortic valve replacement (TAVR). Our purpose was to evaluate stroke risk after TAVR using DW-MRI by enrolling consecutive patients who underwent transfemoral TAVR and post-proc...
nts
Introduction
Myelodysplastic syndrome (MDS) is clinically and biologically heterogeneous. Although the pathobiology of MDS is complex and not fully understood, the development of MDS involves a series of genetic changes, which influence hematopoietic growth and differentiation, resulting in the accumulation of abnormal cells and the impairment...
Introduction
Myelodysplastic syndrome (MDS) represent a group of clonal myeloid stem cell disorder with a heterogeneous spectrum of presentation. Although allogeneic hematopoietic stem cell transplantation (HSCT) was the well-studied and only curative treatment option for patients with MDS, relapse remains a major drawback like other hematological...
Objectives
Novel automated computed tomography (CT) software (Valve ASSIST 2) has been developed for transcatheter aortic valve implantation (TAVI), which not only provides three‐dimensional (3D) reconstruction of multidetector (MD) CT images, but also enables intraprocedural real‐time fusion of fluoroscopic and MDCT images. We aimed to clarify the...
Objective: The ability to walk is one of the most important basic functional activities of daily living, and the number of patients with walking disability who need rehabilitation is increasing worldwide. The purpose of this first-in-man study was to evaluate the safety and feasibility of an off-label, tailor-made, dual-task rehabilitation program...
Objectives
The aim of this study was to investigate the 2-year prognostic impact of N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels at discharge following transcatheter aortic valve implantation (TAVI).
Design
Multicentre prospective observational study.
Settings
Seven institutions from multicentre, observational registry of symptoma...
Objectives:
In recognition of the significant impairment caused by haemoptysis on a patient's quality of life, bronchial artery embolisation has been introduced worldwide as one of the first-line treatment options. Since little evidence is available on the mechanisms of recurrent haemoptysis after super-selective bronchial artery coil embolisation...
Primary graft failure can be a cause of early morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT), as it leads to a high risk of severe infections and bleeding. Splenomegaly is associated with primary graft failure in patients of myelofibrosis, but the association between splenomegaly and outcomes after HSCT in p...
The representation of women in Japanese academic medicine is not evident. We aimed to assess trends related to the proportion of female first authors in Japanese cardiovascular journals.
We reviewed original research articles in 6 journals published in English by Japanese societies between
2006 and 2015 related to cardiovascular fields. We conducte...
Goals:
The purpose of this study was to investigate and summarize our experience of a standardized strategy using computed tomography (CT) followed by colonoscopy for the assessment of colonic diverticular hemorrhage with focus on a comparison of CT and colonoscopy findings in patients with colonic diverticular hemorrhage.
Background:
Colonic di...
Background
Six risk factors for screw cutout after internal fixation of intertrochanteric fractures have been reported. The purpose of the present study was to evaluate and compare the impact of the 6 risk factors of screw cutout to clarify the most important one.
Methods
We enrolled 8 consecutive patients who had screw cutout and 48 random contro...
Background
Even with abundant evidence for osmotic demyelination in patients with hyponatremia, the risk factors for overcorrection have not been fully investigated. Therefore the purpose of this study is to clarify the risks for overcorrection during the treatment of chronic profound hyponatremia.
Methods
This is a single-center retrospective obs...
Objective:
There is no detailed information available about trend in the morphological change after conservative medical treatment in patients with symptomatic spontaneous isolated superior mesenteric artery dissection (SISMAD).
Methods:
We enrolled 27 consecutive patients with symptomatic SISMAD who underwent conservative medical treatment betw...
Background
The International Liaison Committee on Resuscitation (ILCOR) periodically updates the consensus recommendations for cardiopulmonary resuscitation to improve the outcomes of out‐of‐hospital cardiac arrest (OHCA). However, little is known about the differences in outcomes of witnessed OHCA following the publication of the ILCOR 2010 and th...
Background Little is known about the recent proportion and trends of randomised controlled trials (RCTs) published in Japanese cardiovascular journals.
Methods and results This study retrospectively reviewed all original research articles published between 2006 and 2015 in six English-language journals issued by societies related to cardiovascular...
Background:
Idiopathic spinal subarachnoid hemorrhage (IS-SAH), defined as spinal SAH without apparent cause, is extremely rare. The objective of the present study was to establish a consensus on the diagnosis and management of IS-SAH.
Methods:
We enrolled 5 consecutive cases of IS-SAH at our institution, and we enrolled 19 previously published...
There are very few epidemiological studies on Japanese patients with deep vein thrombosis (DVT). In particular, mortality rate differences in Japanese DVT patients with and without malignancy have rarely been evaluated. To elucidate these differences, we enrolled 211 patients who had been diagnosed with de-novo acute DVT of the pelvis or lower extr...
Background
In this study, we sought to investigate the 2‐year prognostic impact of B‐type natriuretic peptide (BNP) levels at discharge, following transcatheter aortic valve replacement.
Methods and Results
We enrolled 1094 consecutive patients who underwent transcatheter aortic valve replacement between 2013 and 2016. Study patients were stratifi...
Background/purpose:
The efficacy of low-dose trimethoprim-sulfamethoxazole (TMP-SMX) may be acceptable for the treatment of pneumocystis pneumonia (PCP) in non-human immunodeficiency virus (HIV)-infected patients, with a low incidence of adverse reactions. This study is aimed to evaluate the efficacy and safety of such a regimen for the treatment...
Predicting severe acute GvHD (aGvHD) after allogeneic hematopoietic stem cell transplantation (HSCT) is challenging but critical. Mild aGvHD may have a favorable impact on relapse, whereas severe aGvHD is associated with poor outcomes. The aim of this study was to evaluate whether elevated eosinophil count in the bone marrow (BM) at 1 month after H...
Objectives:
The aim of this study was to compare the ability of conventional versus computed tomography angiography (CTA) to predict procedural success and 30-min wire crossing rates in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions.
Background:
Coronary CTA can be used to assess the morphology of CTO lesions....
Allogeneic stem cell transplantation (SCT) from an HLA-matched sibling donor (MSD) is a post-remission treatment that offers a potential cure for adults with cytogenetically normal acute myeloid leukemia in their first complete remission (CN-AML/CR1). However, the best alternative in the absence of an MSD remains unclear. The aim of this study was...
Using a novel combined angiography-computed tomography (CT) system, we evaluated the impact of the intra-aortic root position of a right coronary artery (RCA) catheter on its coaxiality. We retrospectively enrolled 19 patients who underwent CT scans during bilaterally engaged percutaneous coronary intervention (PCI). Coaxiality was defined as the a...
Objectives: Evidence on the safety and long-term efficacy of super-selective bronchial artery embolization (ssBAE) using platinum coils in patients with hemoptysis is insufficient. The objective of the present study was to evaluate the safety and the 3-year post-procedure hemoptysis-free survival rate of de-novo elective ssBAE using platinum coils...
Background: Balloon aortic valvuloplasty (BAV) is resurging as a bridge treatment in patients with severe aortic stenosis (AS) with a dissemination of transcatheter aortic valve implantation. However, the significantly high periprocedural mortality and complication rates still limit the indications of BAV. Further efforts are needed to improve the...
Aims
To evaluate and compare outcomes and impacts of delay of time to cardiovascular resuscitation (CPR) by type of first documented rhythm in pediatric patients with out-of-hospital cardiac arrest (OHCA).
Methods and Results
We enrolled 3,968 pediatric (aged<18 years) OHCA patients whose events were witnessed between 2005 and 2012 from a prospect...
Objectives: To evaluate the short-term and long-term prognostic impacts of acute phase coronary collaterals
to occluded infarct-related arteries (IRA) after ST-elevation myocardial infarction (STEMI) in the
percutaneous coronary intervention (PCI) era.
Design: A prospective observational study.
Setting: Osaka Acute Coronary Insufficiency Study (OAC...
Background: There is no definite consensus regarding the management of symptomatic isolated celiac artery dissection (ICAD), and the effect of conservative medical treatment has never been evaluated.
Methods and Results: We enrolled 13 consecutive symptomatic ICAD patients without signs of arterial rupture between 2006 and 2015. All patients receiv...