Non-Surgical Stroke Treatment
Minimizing the Burden on the Body

Endovascular treatment for stroke without surgery is a minimally invasive method that reduces the burden on the body and enables faster recovery. Using catheters, brain blood vessels are treated safely from the inside, allowing for discharge within a short period.

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

Eligibility Criteria 1. Medical Information: - Diagnosis (e.g., cerebral aneurysm, cerebral infarction, stroke) - Detailed symptoms (e.g., headache, impaired consciousness, limb paralysis) - Test results from other facilities (e.g., CT, MRI, angiography) - Presence of comorbidities (e.g., diabetes, hypertension, kidney disease) 2. Treatment History: - History of cerebrovascular treatments (e.g., catheterization, surgery) - Current medications (e.g., anticoagulants, antiplatelet drugs) - Allergies or adverse drug reactions 3. Age and Physical Condition: - Confirmation of physical fitness for treatment in elderly patients or those with comorbidities - Evaluation of eligibility for general anesthesia, including assessments of lung and cardiac function 4. Treatment Duration and Schedule: - Treatment schedule (e.g., hospitalization period, post-treatment follow-up) - Need for outpatient visits and follow-up monitoring 5. Kidney Function: - Confirmation of adequate kidney function, as contrast agents may be required 6. Urgency: - Determination of whether urgent intervention is needed for cases such as ruptured cerebral aneurysms or acute cerebral infarction 7. Other Conditions: - Suitability for antiplatelet medication and management of pre-treatment drug regimens

Precautions / Contraindications

Precautions and Contraindications

1. Cases Not Suitable for Treatment:
- Severe renal dysfunction may make the use of contrast agents difficult, rendering the treatment contraindicated.
- Anatomical issues in the blood vessels or severe stenosis that make catheter insertion challenging.
- Patients for whom antiplatelet medication is contraindicated (e.g., those with extremely high bleeding risks) may face limited treatment options due to increased thrombotic risk.

2. Contraindications Related to General Anesthesia:
- Patients with reduced cardiopulmonary function or underlying conditions that prevent tolerance to general anesthesia.
- A history of drug allergies requires prior verification of medications to be used.

3. Risk of Complications:
- There is a risk of complications such as bleeding, thrombosis, or cerebral infarction during or after the procedure. Complications in the brain can result in severe symptoms.
- The introduction of foreign materials (e.g., catheters, stents) into blood vessels carries risks of infection and thrombosis.

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Pre-Procedure Instructions

1. Preoperative Preparation:
- Follow the doctor’s instructions regarding the discontinuation of antiplatelet or anticoagulant medications.
- Undergo all necessary preoperative tests, including blood tests, CT, MRI, and kidney function tests.

2. Postoperative Care and Risks:
- Postoperatively, there is a risk of bleeding, infection, and thrombosis; report any abnormalities to a medical institution immediately.
- Regular follow-up and monitoring during the postoperative period are essential; attend all scheduled outpatient visits.

3. Lifestyle Precautions:
- After treatment, there may be restrictions on physical activities and daily habits; follow the doctor’s advice and engage in activities within safe limits.
- Adopt a healthy lifestyle, including smoking cessation and a balanced diet, to manage the risk of arteriosclerosis.

4. Hospitalization and Follow-Up Schedule:
- Confirm the duration of hospitalization and the schedule for follow-up visits and postoperative monitoring in advance.
- Regular follow-up and examinations are required even after discharge.

5. Emergency Response:
- After discharge, if you experience symptoms such as headache, nausea, visual disturbances, or paralysis, contact a medical institution immediately.
- Ensure that you are aware of the contact information for emergency medical facilities and the attending physician in case urgent action is needed.