Publications by authors named "Michihisa Umetsu"
The introduction of direct oral anticoagulants (DOACs) has significantly changed the management of deep vein thrombosis (DVT) in Japan. This study aimed to elucidate recent trend0s in the diagnosis and management of DVT following this shift. This retrospective observational study involved 154 patients with acute and subacute DVT, and 96 patients with chronic or unknown-onset DVT, diagnosed between October 1 and 31, 2020, across 29 institutions affiliated with the Japanese Society of Phlebology.
View Article and Find Full Text PDFCancer-associated isolated distal deep vein thrombosis (IDDVT) is a common complication in patients with cancer. The Optimal Duration of Anticoagulation Therapy for Isolated Distal Deep Vein Thrombosis in Patients with Cancer study revealed the superiority of 12- over 3-month edoxaban treatment with respect to thrombotic risk. However, it remains unclear whether D-dimer levels during anticoagulation influence the efficacy of extended anticoagulation.
View Article and Find Full Text PDFBackground: The ONCO DVT study revealed that 12-month edoxaban treatment for cancer-associated isolated distal deep vein thrombosis (IDDVT) was superior to 3-month edoxaban treatment. However, the influence of body weight on efficacy and safety remains unknown.
Objectives: We compared 12-month and 3-month edoxaban treatments in patients with low body weight and cancer-associated IDDVT.
Gait disturbances increase mortality rates in lower extremity artery disease. Changes in gait biomechanics after endovascular therapy for intermittent claudication associated with lower extremity artery disease remain unknown. This prospective study investigated the effect of endovascular therapy on gait biomechanics in intermittent claudication.
View Article and Find Full Text PDFBackground: The risk of recurrent venous thromboembolism (VTE) in patients with isolated distal deep vein thrombosis (IDDVT) is generally low, particularly when IDDVT is asymptomatic. However, cancer patients with IDDVT, even asymptomatic IDDVT, may be at a higher risk of recurrent VTE.
Objectives: To compare the clinical outcomes of cancer patients with asymptomatic and symptomatic IDDVT.
Safety assessment of cyanoacrylate closure for treatment of varicose veins in a large-scale national survey in Japan.
J Vasc Surg Venous Lymphat Disord
March 2025
Objective: Cyanoacrylate closure (CAC) is a minimally invasive technique for treating axial venous reflux. However, the incidence of serious adverse events (AEs) related to CAC is concerning. With an increasing number of patients undergoing CAC and insufficient safety data in Japan, this study aimed to investigate the safety profile of CAC, focusing on the types and incidence of AEs.
View Article and Find Full Text PDFArticle Synopsis
- * In a subgroup analysis of 601 patients, those with anemia showed significantly fewer recurrent venous thromboembolism (VTE) cases with 12-month edoxaban treatment compared to 3 months, while no such reduction was observed in patients without anemia.
- * Overall, 12-month edoxaban treatment was more effective in preventing thrombotic events for both anemia and no-anemia groups, with no significant difference in major bleeding risk between the two treatment durations.
Article Synopsis
- The ONCO DVT study found that a 12-month course of edoxaban is more effective than a 3-month course for preventing thrombotic events in cancer patients with isolated distal deep vein thrombosis (DVT).
- This analysis categorized 601 patients into three groups based on their modified Ottawa score (low, intermediate, high) to determine the effectiveness of extended anticoagulation.
- Results showed that extended treatment significantly reduced thrombotic events in the intermediate and high score groups but not in the low score group, indicating limited benefit for those with a low risk.
Article Synopsis
- - The KUROSIO study examined the use of direct oral anticoagulants (DOACs) as the primary treatment for Japanese patients with acute venous thromboembolism (VTE), involving 993 patients after exclusions.
- - The study found low rates of recurrent symptomatic VTE (3.2%) and major bleeding (2.2%) during the first year of treatment, suggesting DOACs are generally effective and safe.
- - Additionally, chemotherapy and anemia were identified as significant risk factors for experiencing recurrent VTE and major bleeding, respectively.
Edoxaban for 12 vs. 3 months in cancer-associated isolated distal deep vein thrombosis according to different doses: insights from the ONCO DVT study.
Eur Heart J Cardiovasc Pharmacother
August 2024
Article Synopsis
- The ONCO DVT study showed that a 12-month treatment with edoxaban is more effective than a 3-month treatment for preventing blood clots in patients with cancer-associated isolated distal deep vein thrombosis (DVT).
- In a subgroup analysis, both standard (60 mg/day) and reduced (30 mg/day) dosages of edoxaban had lower rates of recurrent blood clots in those treated for 12 months compared to 3 months, but the risk of major bleeding was higher for the standard dose over 12 months.
- Overall, while a longer duration of edoxaban treatment is beneficial for reducing thrombotic risk, there is a cautionary note about increased bleeding risks with the higher dosage over extended periods
Article Synopsis
- * The CAC-AE survey collected data from 1,030 authorized institutions, reporting 16 cases of proximal deep vein thrombosis, 3 cases of pulmonary embolism, and various other complications.
- * The findings highlighted a total of 299 cases of localized phlebitis or allergic reactions, with one postoperative death linked to pulmonary embolism, aiming to present real-world data on CAC-related AEs in Japan.
Article Synopsis
- The CLOT-COVID Study analyzed 2894 hospitalized patients with COVID-19, focusing on 1738 patients with mild cases who didn’t need oxygen at admission.
- Patients were split into two groups: those receiving prophylactic anticoagulation (326 patients) and those who were not (1412 patients).
- Results showed that those on anticoagulation had higher severity levels during hospitalization and a slightly higher incidence of thrombosis, suggesting that routine use may not be beneficial for all stable patients.
Background: The multicenter, open-label, randomized clinical trial ONCO DVT compared 3-month and 12-month edoxaban treatment regimens for isolated distal deep vein thrombosis (DVT) and suggested potential benefits of prolonged edoxaban treatment in terms of thrombotic risk. However, the risk-benefit balance of prolonged edoxaban treatment in patients with renal function remains unclear.
Objectives: To compare the safety and efficacy of 3-month and 12-month edoxaban treatment regimens in patients with cancer-associated isolated distal DVT and different renal functions.
Background: Information regarding optimal revascularization and digestive tract repair in secondary aortoenteric fistula (sAEF) remains unclear. Thus, reporting treatment outcomes and presenting comprehensive patient details through a structured treatment approach are necessary to establish a treatment strategy for this rare, complex, and fatal condition.
Methods: We performed a single-center retrospective review of consecutive sAEF managed based on our in situ revascularization and intestinal repair strategy.
Article Synopsis
- The study investigates the ideal length of anticoagulation therapy for cancer patients with isolated distal deep vein thrombosis (DVT), comparing 12 months versus 3 months of edoxaban treatment, considering the balance between preventing thrombotic events and the risk of bleeding.
- A multicenter clinical trial included 601 patients, showing that longer treatment (12 months) significantly reduced the risk of recurrent venous thromboembolism (VTE) or VTE-related deaths compared to 3 months (1% vs. 7.2%).
- However, the incidence of major bleeding was slightly higher in the 12-month group (9.5%) versus the 3-month group (7.2%), indicating that while longer treatment is
Article Synopsis
- SiPM-based PET/CT successfully detected a type II endoleak in a 73-year-old man, five years after he underwent endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms.
- The imaging revealed abnormal FDG accumulation near the stent graft, matching findings from a previous CT angiography and indicating possible complications.
- This advanced imaging technique offers higher sensitivity than traditional PET/CT, highlighting the need for further evaluation and alternative imaging options for patients unable to use iodine contrast.
This study aimed to investigate the clinical features of arterial thrombosis and venous thromboembolism (VTE) in coronavirus disease 2019 (COVID-19). The CLOT-COVID Study was a retrospective, multicenter cohort study that enrolled 2,894 consecutively hospitalized patients with COVID-19 among 16 centers in Japan from April 2021 to September 2021. We compared the clinical features of arterial thrombosis and VTE.
View Article and Find Full Text PDFPresence of Helicobacter cinaedi in Atherosclerotic Abdominal Aortic Aneurysmal Wall.
Tohoku J Exp Med
September 2023
Article Synopsis
- * Researchers analyzed DNA samples from 39 AAA patients during surgery, specifically looking for the H. cinaedi-specific gene using nested PCR techniques.
- * Results showed that 23.1% of the patients tested positive for H. cinaedi in their aneurysm walls, marking the first time this bacterium has been identified in non-infectious AAA cases.
Article Synopsis
- The study investigates the association between thrombosis and clinical outcomes in hospitalized COVID-19 patients in Japan, using data from the CLOT-COVID study.
- Patients with thrombosis (55 individuals) experienced significantly higher mortality (23.6% vs. 5.1%) and major bleeding events (23.6% vs. 1.6%) compared to those without thrombosis (2839 individuals).
- Independent risk factors for thrombosis included being male, having elevated D-dimer levels on admission, and severe COVID-19 status, which could help guide treatment decisions for these patients.
Pregnancy-associated deep vein thrombosis (DVT) is a rare disease, and data on anticoagulation therapy are lacking. The present study examined the treatment outcome with unfractionated heparin (UFH) subcutaneous injection in patients with pregnancy-associated DVT. This single-center, retrospective, observational study enrolled 15 patients with pregnancy-associated DVT treated from January 2014 to April 2021.
View Article and Find Full Text PDFArticle Synopsis
- The study focused on understanding the use of prophylactic anticoagulation for COVID-19 patients in Japan, highlighting its clinical management strategies.
- Conducted as a multicenter observational study, it involved 2,894 hospitalized patients, ultimately analyzing 2,889 patients based on their anticoagulation treatment.
- Results revealed that the severity of COVID-19 at admission strongly influenced the use of pharmacological thromboprophylaxis and therapeutic dosing, particularly in patients with comorbidities.
Background: Reports of mortality-associated risk factors in patients with the novel coronavirus disease 2019 (COVID-19) are limited.
Methods: We evaluated the clinical features that were associated with mortality among patients who died during hospitalization (n = 158) and those who were alive at discharge (n = 2,736) from the large-scale, multicenter, retrospective, observational cohort CLOT-COVID study, which enrolled consecutively hospitalized COVID-19 patients from 16 centers in Japan from April to September 2021. Data from 2,894 hospitalized COVID-19 participants of the CLOT-COVID study were analyzed in this study.
Background: The coronavirus disease 2019 (COVID-19) causes extensive coagulopathy and a potential benefit of anticoagulation therapy has been documented for prevention of thromboembolic events. Bleeding events has also been reported as a notable complication; whereas, the incidence, risks, and clinical impact of bleeding remain unclear.
Method: The CLOT-COVID Study was a nationwide, retrospective, multicenter cohort study on consecutive hospitalized patients with COVID-19 in Japan between April 2021 and September 2021.