Prevention of Transient Ischemic Attack (TIA)
Ensuring Safety Through Early Treatment

Transient ischemic attack (TIA) is a warning sign of cerebral infarction. Early detection and treatment of cervical and cerebral vascular stenosis are performed to prevent cerebral infarction through bypass surgery or stent placement.

Providing Medical Institution

Kishiwada Tokushukai Hospital

〒596-0042
4-27-1 Kamoricho, Kishiwada City

https://kishiwada.tokushukai.or.jp/en/

Specialty

**Cardiovascular Surgery:**
1. Coronary Artery Disease
2. Heart Valve Disease
3. Aortic Aneurysm
4. Aortic Dissection
5. Arteriosclerosis Obliterans
6. Arterial Thrombosis
7. Complications of Myocardial Infarction
- Ischemic Cardiomyopathy
- Left Ventricular Rupture
- Left Ventricular Aneurysm
- Ventricular Septal Rupture
- Papillary Muscle Dysfunction (Mitral Regurgitation)
8. Infective Endocarditis
9. Intracardiac Tumors

**Cardiology:**
1. Ischemic Heart Disease (e.g., Angina, Myocardial Infarction)
2. Lower Limb Arteriosclerosis Obliterans
3. Arrhythmia
4. Heart Valve Disease
5. Aortic Stenosis
6. Mitral Regurgitation

**Lower Gastrointestinal Surgery**
*Da Vinci Si - Robot-Assisted Surgery*
1. Malignant Diseases
2. Surgical Treatment of Small and Large Intestine Diseases
3. Primarily Surgical and Medical Treatments for Colon and Rectal Cancer
4. Robot-Assisted Surgery
5. Laparoscopic Surgery
6. Multimodal Therapy Combining Surgery, Chemotherapy, and Radiation Therapy
7. Systemic Chemotherapy for Unresectable Colorectal Cancer

**Breast Surgery:**
1. Breast-Conserving Surgery
2. Mastectomy
3. Sentinel Lymph Node Biopsy
4. Lymph Node Dissection
5. Breast Reconstruction Using Autologous Tissue

**Neurosurgery:**
1. Stroke
2. Cerebral Hemorrhage
3. Subarachnoid Hemorrhage
4. Cerebral Infarction
5. Head Trauma
6. Traumatic Intracranial Hematoma
7. Skull Fracture
8. Chronic Subdural Hematoma
9. Brain and Spinal Cord Tumors
10. Acoustic Neuroma
11. Pituitary Tumor
12. Meningioma
13. Metastatic Brain Tumors
14. Functional Neurological Disorders
15. Facial Spasm
16. Trigeminal Neuralgia
17. Epilepsy
18. Normal Pressure Hydrocephalus

**Urology**
*Da Vinci Si - Robot-Assisted Surgery*
1. Robot-Assisted Laparoscopic Radical Prostatectomy
2. Prostate Cancer
3. Renal Cancer
4. Upper Urinary Tract Cancer
5. Urolithiasis (Urinary Stones)

**Radiology:**
1. Comprehensive Imaging Diagnosis (X-ray, Ultrasound, CT, MRI, Angiography, PET)
2. Liver Tumors
3. Gastrointestinal Hemorrhage
4. Arterial Embolization for Hemoptysis and Traumatic Hemorrhage
5. Transcatheter Venous Embolization for Gastric Varices
6. Intra-Arterial Chemotherapy for Cancer
7. Reservoir Placement
8. CT-Guided Biopsy (Interventional Radiology - IVR)
9. TomoTherapy - Radixact

**Dialysis**
*Travel Hemodialysis* (Available for Individual Travelers Only, Not for Groups)

**Other**
*Second Opinion* (In-person Only, Online Not Available)

Eligibility Criteria/Exclusions for Treatment

Admission Criteria 1. Medical Information: - Diagnosis (e.g., transient ischemic attack, carotid artery stenosis, cerebral vascular stenosis) - Detailed symptoms (e.g., weakness in limbs, speech impairment, vision disturbances) - Examination results from other institutions (e.g., MRI, MRA, carotid ultrasound) - Presence of comorbidities (e.g., hypertension, diabetes, heart disease) 2. History of Treatment: - History of cerebrovascular treatments (e.g., bypass surgery, stent placement) - Current medications (e.g., anticoagulants, antiplatelet agents) - Presence of allergies or adverse drug reactions 3. Age and Physical Fitness: - Evaluation of whether elderly patients or those with comorbidities can withstand surgery or treatment - Suitability for general or local anesthesia 4. Renal Function: - Assessment of renal function is required due to potential use of contrast agents 5. Severity and Urgency of Symptoms: - Frequency and timing of transient ischemic attacks or cerebral vascular stenosis - Assessment of whether there is a high risk of cerebral infarction and whether urgent intervention is needed 6. Other Conditions: - Ability to follow treatment instructions for blood pressure management and thrombosis prevention - Willingness and ability to cooperate in lifestyle improvement and follow-up monitoring

Precautions / Contraindications

【Precautions and Contraindications】

1. Cases Not Suitable for Treatment:
- In cases of impaired renal function, the use of contrast agents may not be feasible, limiting catheter-based treatment.
- Difficulty in discontinuing antiplatelet or anticoagulant medications increases the risk of bleeding and may restrict treatment options.
- Severe cardiopulmonary dysfunction or insufficient physical strength to tolerate surgery may also render treatment unsuitable.

2. Contraindications Related to General or Local Anesthesia:
- Patients with comorbidities that complicate the management of breathing or circulation during anesthesia require careful consideration of anesthesia methods.
- A history of allergies or hypersensitivity reactions to medications necessitates prior confirmation of the drugs to be used.

3. Treatment Risks and Complications:
- Surgical or catheter-based treatment carries risks of complications such as bleeding, thrombus formation, and cerebral infarction, with intracranial complications potentially having severe consequences.
- Risks such as arterial dissection or vascular rupture may occur, and regular postoperative follow-up is crucial.

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# 【Important Pre-Treatment Information】

1. Preoperative Preparation:
- Follow medical instructions regarding the discontinuation of antiplatelet or anticoagulant medications and ensure proper medication management before treatment.
- Preoperative tests (e.g., blood tests, MRI, ultrasound) are essential for accurate diagnosis and treatment planning.

2. Postoperative Care and Follow-Up:
- Monitor for risks such as bleeding, thrombus formation, or infection, and contact a medical institution immediately if abnormalities occur.
- Follow-up after bypass surgery or stent placement is necessary, and adhering to postoperative instructions and regular visits is crucial.

3. Lifestyle and Rehabilitation:
- Postoperative adjustments to exercise and lifestyle habits are recommended, with activities guided by medical advice.
- Focus on cerebrovascular health through smoking cessation, a balanced diet, and moderate exercise.

4. Hospitalization and Follow-Up Schedule:
- Confirm the length of hospitalization and rehabilitation period in advance and plan accordingly.
- Continue regular follow-up visits after discharge to monitor progress appropriately.

5. Emergency Response:
- If severe headache, vision impairment, or limb paralysis occurs after discharge, contact a medical institution immediately.
- Confirm the contact details of a medical facility or physician available for emergencies in advance.