頚動脈狭窄 病態診断と治療選択
頚動脈内膜剝離術の有効性が確立した後, そのハイリスク症例に頚動脈ステント留置術が行われ, 両者のランダム化比較試験が複数報告されている. しかし, これらのランダム化比較試験は, 症候の有無と, 狭窄度のみに基づいて治療方法の決定がなされる. より良好な治療結果を得るために, それらに加えてプラーク性状や脳血流評価も重要である. 術前に頚動脈エコー, MRI, CTA, 脳血管造影, 脳血流検査などで, プラークイメージングやアクセスルート, および脳血流が評価され, 不安定プラーク症例や高度石灰化病変, および大動脈などアクセスルートの評価に有効である. 頚動脈狭窄症の治療は病態診断に基づ...
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| Published in | 脳神経外科ジャーナル Vol. 30; no. 11; pp. 764 - 772 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人日本脳神経外科コングレス
2021
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0917-950X 2187-3100 |
| DOI | 10.7887/jcns.30.764 |
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| Abstract | 頚動脈内膜剝離術の有効性が確立した後, そのハイリスク症例に頚動脈ステント留置術が行われ, 両者のランダム化比較試験が複数報告されている. しかし, これらのランダム化比較試験は, 症候の有無と, 狭窄度のみに基づいて治療方法の決定がなされる. より良好な治療結果を得るために, それらに加えてプラーク性状や脳血流評価も重要である. 術前に頚動脈エコー, MRI, CTA, 脳血管造影, 脳血流検査などで, プラークイメージングやアクセスルート, および脳血流が評価され, 不安定プラーク症例や高度石灰化病変, および大動脈などアクセスルートの評価に有効である. 頚動脈狭窄症の治療は病態診断に基づいた安全な治療法の選択が重要である. |
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| AbstractList | 頚動脈内膜剝離術の有効性が確立した後, そのハイリスク症例に頚動脈ステント留置術が行われ, 両者のランダム化比較試験が複数報告されている. しかし, これらのランダム化比較試験は, 症候の有無と, 狭窄度のみに基づいて治療方法の決定がなされる. より良好な治療結果を得るために, それらに加えてプラーク性状や脳血流評価も重要である. 術前に頚動脈エコー, MRI, CTA, 脳血管造影, 脳血流検査などで, プラークイメージングやアクセスルート, および脳血流が評価され, 不安定プラーク症例や高度石灰化病変, および大動脈などアクセスルートの評価に有効である. 頚動脈狭窄症の治療は病態診断に基づいた安全な治療法の選択が重要である. |
| Author | 内田, 和孝 白川, 学 山田, 清文 吉村, 紳一 |
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| Copyright | 2021 日本脳神経外科コングレス |
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| Snippet | 頚動脈内膜剝離術の有効性が確立した後, そのハイリスク症例に頚動脈ステント留置術が行われ, 両者のランダム化比較試験が複数報告されている. しかし, これらのランダム... |
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| SubjectTerms | carotid artery stenosis carotid artery stenting carotid endarterectomy |
| Subtitle | 病態診断と治療選択 |
| Title | 頚動脈狭窄 |
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