staged carotid artery stentingの頸部血管エコーによる血流速度の変化
「はじめに」頸部血管エコー検査において, 頸動脈狭窄があると収縮期最大血流速度(peak systolic velocity: PSV)が上昇する. 狭窄度 North American Symptomatic Carotid Endarterectomy Trial (NASCET)法70%でPSVは200～230cm/s以上とする指標は広く普及しており, 臨床的に非常に有用である. 狭窄度が進行すればPSVはさらに上昇するが, 一方で高度狭窄から閉塞に至るまでにターニングポイントを迎え, 偽閉塞となれば血流速度は低下し, 最終的には血流がなくなり血流速度の測定ができなくなると考えられる....
Saved in:
| Published in | Neurosonology Vol. 32; no. 3; pp. 124 - 128 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人日本脳神経超音波学会
2019
日本脳神経超音波学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0917-074X |
| DOI | 10.2301/neurosonology.32.124 |
Cover
| Abstract | 「はじめに」頸部血管エコー検査において, 頸動脈狭窄があると収縮期最大血流速度(peak systolic velocity: PSV)が上昇する. 狭窄度 North American Symptomatic Carotid Endarterectomy Trial (NASCET)法70%でPSVは200～230cm/s以上とする指標は広く普及しており, 臨床的に非常に有用である. 狭窄度が進行すればPSVはさらに上昇するが, 一方で高度狭窄から閉塞に至るまでにターニングポイントを迎え, 偽閉塞となれば血流速度は低下し, 最終的には血流がなくなり血流速度の測定ができなくなると考えられる. しかし, このターニングポイントが存在することを実臨床において示した報告は, 渉猟しうるかぎりない. 頸動脈狭窄症に対する頸動脈ステント術(carotid artery stenting: CAS)は, 汎用されている手術法である. そのなかで, 術前の脳血流検査において misery perfusion を示す患者に対し staged CASが行われている. |
|---|---|
| AbstractList | 「はじめに」頸部血管エコー検査において, 頸動脈狭窄があると収縮期最大血流速度(peak systolic velocity: PSV)が上昇する. 狭窄度 North American Symptomatic Carotid Endarterectomy Trial (NASCET)法70%でPSVは200～230cm/s以上とする指標は広く普及しており, 臨床的に非常に有用である. 狭窄度が進行すればPSVはさらに上昇するが, 一方で高度狭窄から閉塞に至るまでにターニングポイントを迎え, 偽閉塞となれば血流速度は低下し, 最終的には血流がなくなり血流速度の測定ができなくなると考えられる. しかし, このターニングポイントが存在することを実臨床において示した報告は, 渉猟しうるかぎりない. 頸動脈狭窄症に対する頸動脈ステント術(carotid artery stenting: CAS)は, 汎用されている手術法である. そのなかで, 術前の脳血流検査において misery perfusion を示す患者に対し staged CASが行われている. |
| Author | 石原, 秀行 貞廣, 浩和 岡, 史朗 杉本, 至健 鈴木, 倫保 |
| Author_xml | – sequence: 1 fullname: 岡, 史朗 organization: 山口大学医学部附属病院脳神経外科 – sequence: 1 fullname: 貞廣, 浩和 organization: 山口大学医学部附属病院脳神経外科 – sequence: 1 fullname: 杉本, 至健 organization: 山口大学医学部附属病院脳神経外科 – sequence: 1 fullname: 鈴木, 倫保 organization: 山口大学医学部附属病院脳神経外科 – sequence: 1 fullname: 石原, 秀行 organization: 山口大学医学部附属病院脳神経外科 |
| BookMark | eNpVkM1Kw0AUhWdRwVr7Bi76Aq13_jLJUopWoeCmgrthkk5qSjqRJF1015-Nomu3WhApCN2IIOLbhKp9C9OqiJtz4HL4LnxbqGAioxHawVAjFPCu0f04SiIThVFnUKOkhgkroCI4WFRBsNNNVE6SwAVMLHAYkCJqJanq6HbFU3GUBu2KilMdDypJqk0amE42mi_vXpaT2ed0-DGfZuNZNn7KJm_Z6DEbX2Tjq_z-_jxaDm8Xrw_5eHF_ubi-2UYbvgoTXf7pEjo52G_VD6vN48ZRfa9Z7RLBedXXXFtgYRuI6zAibLAtnwnAlsUtwX3V5lq7zHWpwJwT39ceU8p1bMtzGQhMS6jxze3pduCpMDJhYLTsRv3Y5H-lZ8TaiCSAHQlACdC8iMwFsFXYlIONgf-Rumsf8jwOeioeyFxH4IVa_hMrKZF0FSvK78I7U7HsKvoFP6ONfw |
| ContentType | Journal Article |
| Copyright | 2019 日本脳神経超音波学会 |
| Copyright_xml | – notice: 2019 日本脳神経超音波学会 |
| CorporateAuthor | 山口大学医学部附属病院脳神経外科 |
| CorporateAuthor_xml | – name: 山口大学医学部附属病院脳神経外科 |
| DOI | 10.2301/neurosonology.32.124 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EndPage | 128 |
| ExternalDocumentID | cn7neuro_2019_003203_002_0124_01283508105 article_neurosonology_32_3_32_124_article_char_ja |
| GroupedDBID | .55 123 2WC AL- ALMA_UNASSIGNED_HOLDINGS CS3 JMI JSF KQ8 MOJWN OK1 RJT X7M |
| ID | FETCH-LOGICAL-j2755-fe5e6061802b94278086f4701665675fad5eeb4bb371552ffec4aab986cb40713 |
| ISSN | 0917-074X |
| IngestDate | Thu Jul 10 16:14:47 EDT 2025 Wed Sep 03 06:29:33 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | true |
| Issue | 3 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j2755-fe5e6061802b94278086f4701665675fad5eeb4bb371552ffec4aab986cb40713 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/neurosonology/32/3/32_124/_article/-char/ja |
| PageCount | 5 |
| ParticipantIDs | medicalonline_journals_cn7neuro_2019_003203_002_0124_01283508105 jstage_primary_article_neurosonology_32_3_32_124_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 2019 |
| PublicationDateYYYYMMDD | 2019-01-01 |
| PublicationDate_xml | – year: 2019 text: 2019 |
| PublicationDecade | 2010 |
| PublicationTitle | Neurosonology |
| PublicationTitleAlternate | 神経超音波医学 |
| PublicationYear | 2019 |
| Publisher | 一般社団法人日本脳神経超音波学会 日本脳神経超音波学会 |
| Publisher_xml | – name: 一般社団法人日本脳神経超音波学会 – name: 日本脳神経超音波学会 |
| References | 15)Yasaka M, Omae T, Tsuchiya T, et al.: Ultrasonic evaluation of the site of carotid axis occlusion in patients with acute cardioembolic stroke. Stroke 1992; 23: 420-422. 8)Egashira Y, Enomoto Y, Yamauchi K, et al.: Tailored Strategies in Carotid Artery Stenting to Avoid Periprocedural Complications. Acta Neurochir Suppl 2018; 129: 101-106. 5)Sitzer M, Fürst G, Fischer H, et al.: Between-method correlation in quantifying internal carotid stenosis. Stroke 1993; 24: 1513-1518. 7)Yadav JS, Wholey MH, Kuntz RE, et al.: Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med 2004; 351: 1493-1501. 9)Uchida K, Yoshimura S, Shirakawa M, et al.: Experience of Staged Angioplasty to Avoid Hyperperfusion Syndrome for Carotid Artery Stenosis. Neurol Med Chir (Tokyo) 2015; 55: 824-829. 3)Arous EJ, Baril DT, Robinson WP, et al.: Institutional differences in carotid artery duplex diagnostic criteria result in significant variability in classification of carotid artery stenoses and likely lead to disparities in care. Circ Cardiovasc Qual Outcomes 2014; 7: 423-429. 4)Bowman JN, Olin JW, Teodorescu VJ, et al.: Carotid artery pseudo-occlusion: does end-diastolic velocity suggest need for treatment? Vasc Endovascular Surg 2009; 43: 374-378. 6)Brott TG, Hobson RW 2nd, Howard G, et al.: Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med 2010; 363: 11-23. 14)Heyer EJ, Mergeche JL, Connolly ES Jr: Middle cerebral artery pulsatility index and cognitive improvement after carotid endarterectomy for symptomatic stenosis. J Neurosurg 2014; 120: 126-131. 13)Yan Z, Yang M, Niu G, et al.: Analysis of Hemodynamic Changes in Early Stage after Carotid Stenting by Transcranial Doppler-A Preliminary Study. Ann Vasc Surg 2017; 45: 85-91. 10)Kim KM, Watabe H, Hayashi T, et al.: Quantitative mapping of basal and vasareactive cerebral blood flow using split-dose 123I-iodoamphetamine and single photon emission computed tomography. Neuroimage 2006; 33: 1126-1135. 2)Koga M, Kimura K, Minematsu K, et al.: Diagnosis of internal carotid artery stenosis greater than 70% with power Doppler duplex sonography. AJNR Am J Neuroradiol 2001; 22: 413-417. 1)Grant EG, Benson CB, Moneta GL, et al.: Carotid artery stenosis: grayscale and Doppler ultrasound diagnosis―Society of Radiologists in Ultrasound consensus conference. Ultrasound Q 2003; 19: 190-198. 12)Fujimoto S, Toyoda K, Inoue T, et al.: Diagnostic impact of transcranial color-coded real-time sonography with echo contrast agents for hyperperfusion syndrome after carotid endarterectomy. Stroke 2004; 35: 1852-1856. 11)Ogasawara K, Inoue T, Kobayashi M, et al.: Cerebral hyperperfusion following carotid endarterectomy: diagnostic utility of intraoperative transcranial Doppler ultrasonography compared with single-photon emission computed tomography study. AJNR Am J Neuroradiol 2005; 26: 252-257. |
| References_xml | – reference: 3)Arous EJ, Baril DT, Robinson WP, et al.: Institutional differences in carotid artery duplex diagnostic criteria result in significant variability in classification of carotid artery stenoses and likely lead to disparities in care. Circ Cardiovasc Qual Outcomes 2014; 7: 423-429. – reference: 10)Kim KM, Watabe H, Hayashi T, et al.: Quantitative mapping of basal and vasareactive cerebral blood flow using split-dose 123I-iodoamphetamine and single photon emission computed tomography. Neuroimage 2006; 33: 1126-1135. – reference: 13)Yan Z, Yang M, Niu G, et al.: Analysis of Hemodynamic Changes in Early Stage after Carotid Stenting by Transcranial Doppler-A Preliminary Study. Ann Vasc Surg 2017; 45: 85-91. – reference: 7)Yadav JS, Wholey MH, Kuntz RE, et al.: Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med 2004; 351: 1493-1501. – reference: 12)Fujimoto S, Toyoda K, Inoue T, et al.: Diagnostic impact of transcranial color-coded real-time sonography with echo contrast agents for hyperperfusion syndrome after carotid endarterectomy. Stroke 2004; 35: 1852-1856. – reference: 5)Sitzer M, Fürst G, Fischer H, et al.: Between-method correlation in quantifying internal carotid stenosis. Stroke 1993; 24: 1513-1518. – reference: 11)Ogasawara K, Inoue T, Kobayashi M, et al.: Cerebral hyperperfusion following carotid endarterectomy: diagnostic utility of intraoperative transcranial Doppler ultrasonography compared with single-photon emission computed tomography study. AJNR Am J Neuroradiol 2005; 26: 252-257. – reference: 1)Grant EG, Benson CB, Moneta GL, et al.: Carotid artery stenosis: grayscale and Doppler ultrasound diagnosis―Society of Radiologists in Ultrasound consensus conference. Ultrasound Q 2003; 19: 190-198. – reference: 9)Uchida K, Yoshimura S, Shirakawa M, et al.: Experience of Staged Angioplasty to Avoid Hyperperfusion Syndrome for Carotid Artery Stenosis. Neurol Med Chir (Tokyo) 2015; 55: 824-829. – reference: 4)Bowman JN, Olin JW, Teodorescu VJ, et al.: Carotid artery pseudo-occlusion: does end-diastolic velocity suggest need for treatment? Vasc Endovascular Surg 2009; 43: 374-378. – reference: 6)Brott TG, Hobson RW 2nd, Howard G, et al.: Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med 2010; 363: 11-23. – reference: 8)Egashira Y, Enomoto Y, Yamauchi K, et al.: Tailored Strategies in Carotid Artery Stenting to Avoid Periprocedural Complications. Acta Neurochir Suppl 2018; 129: 101-106. – reference: 14)Heyer EJ, Mergeche JL, Connolly ES Jr: Middle cerebral artery pulsatility index and cognitive improvement after carotid endarterectomy for symptomatic stenosis. J Neurosurg 2014; 120: 126-131. – reference: 2)Koga M, Kimura K, Minematsu K, et al.: Diagnosis of internal carotid artery stenosis greater than 70% with power Doppler duplex sonography. AJNR Am J Neuroradiol 2001; 22: 413-417. – reference: 15)Yasaka M, Omae T, Tsuchiya T, et al.: Ultrasonic evaluation of the site of carotid axis occlusion in patients with acute cardioembolic stroke. Stroke 1992; 23: 420-422. |
| SSID | ssib012609402 ssib005059357 ssib050594756 ssib004261862 ssib058494377 ssib000961632 ssib002004365 ssj0038460 |
| Score | 2.1715596 |
| Snippet | 「はじめに」頸部血管エコー検査において, 頸動脈狭窄があると収縮期最大血流速度(peak systolic velocity: PSV)が上昇する. 狭窄度 North American Symptomatic Carotid... |
| SourceID | medicalonline jstage |
| SourceType | Publisher |
| StartPage | 124 |
| SubjectTerms | duplex ultrasonography peak systolic velocity staged CAS |
| Title | staged carotid artery stentingの頸部血管エコーによる血流速度の変化 |
| URI | https://www.jstage.jst.go.jp/article/neurosonology/32/3/32_124/_article/-char/ja http://mol.medicalonline.jp/en/journal/download?GoodsID=cn7neuro/2019/003203/002&name=0124-0128j |
| Volume | 32 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | Neurosonology:神経超音波医学, 2019, Vol.32(3), pp.124-128 |
| journalDatabaseRights | – providerCode: PRVAFT databaseName: Open Access Digital Library issn: 0917-074X databaseCode: KQ8 dateStart: 19880101 customDbUrl: isFulltext: true dateEnd: 99991231 titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html omitProxy: true ssIdentifier: ssj0038460 providerName: Colorado Alliance of Research Libraries |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpR1da9RAMJQTRBHxE7-5B_eppG6y2WT3zc31jiJUEFroW0hyiXjgKXp90Kf2-qLos69aECkIfRFBxH9zVO2_cGY2ucuJD1ahbOc2szOzs5vdmcl-OM5N7pVR5mntpgXnblCWwtVZyd2iFDzl2o_6OW4UXr0brqwHdzbkxkKr1Vi1tDnKlvLnf9xX8i-tCnnQrrhL9ggtOyUKGQBD-0IKLQzpX7UxWHb3wWDEq3dGD_qLtDzz2SK0G13_wLoC7ERmuqyrmeEsVggowQwAihkPVzl0I0QAGJF9ekRALAgQLO7UdOLqkapxVNygE7JYIhqy4Ez3WFey2DATNsSQzIDpqhFQHWbvmK0tYzolBIx_u3tGGJJMMt1FIKYCwCwOmZLIAxigiCGmxq8oxjHxWAaudUciMXwUEvoSofXwNxTUIEE0Q1OYrUlIIGOExadaGZJYQ4U7M3wgsEx1IUqmY_EVUxEJRrowcoavUW9xUOOrqTycNBuwuAcUm0GYxiBPzxXpWSEdYIfqgUwSWJPAVhlaErLBP-RFWpwKicUDEvCI2iWlEmVQm2kGeD0MQtv1r_VcN4slz0IhNHF5did7ZQN5dsP-79MruKs4vQ6bHWJJ-EvTwnMHl1evRTKHngg_EZhAmaTGwA2GyQC8nGN-BPYiLq2413ASdAhOQ-PbP12bMB8EUI1DLyXeUjn7lu-Bx66D2SF3-Dho3HkAFrgORDQN0wiwyCkyW-vPbrjFut_6U83BdB3Q637SOfXQfly1h9w07NS1M87pysFsG1vps87CID3nHF-tltCcd9bsoNGuBo22HTTa9aAx2d4_fPflcGfv5-7Wj_3dyXhvMv402fk22f44Gb-YjF9B_vfP24dbbw--fgDkg_cvD16_ueCs97prnRW3ulrFHfiRlG5ZyCIEU15xP9N42w5XYRlE4P-BfxfJMu3LosiCLBMRntGIS8uCNM20CvMMQ0DiotMaPhoWl5y2VxSFL_1-LlUWBLpIRRikWaGL3Od5xPPLzm2rn-SxPT8nOXLHABJzmk2qMfhpkg8jopLgS4nnHPtcwD8_4UgGjW8BHij4kFf-X4qrzgnkYuOv15zW6MlmcR08klF2gzrsL4f1A_E |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=staged+carotid+artery+stenting%E3%81%AE%E9%A0%B8%E9%83%A8%E8%A1%80%E7%AE%A1%E3%82%A8%E3%82%B3%E3%83%BC%E3%81%AB%E3%82%88%E3%82%8B%E8%A1%80%E6%B5%81%E9%80%9F%E5%BA%A6%E3%81%AE%E5%A4%89%E5%8C%96&rft.jtitle=Neurosonology%3A%E7%A5%9E%E7%B5%8C%E8%B6%85%E9%9F%B3%E6%B3%A2%E5%8C%BB%E5%AD%A6&rft.au=%E5%B2%A1%2C+%E5%8F%B2%E6%9C%97&rft.au=%E8%B2%9E%E5%BB%A3%2C+%E6%B5%A9%E5%92%8C&rft.au=%E6%9D%89%E6%9C%AC%2C+%E8%87%B3%E5%81%A5&rft.au=%E9%88%B4%E6%9C%A8%2C+%E5%80%AB%E4%BF%9D&rft.date=2019&rft.pub=%E4%B8%80%E8%88%AC%E7%A4%BE%E5%9B%A3%E6%B3%95%E4%BA%BA%E6%97%A5%E6%9C%AC%E8%84%B3%E7%A5%9E%E7%B5%8C%E8%B6%85%E9%9F%B3%E6%B3%A2%E5%AD%A6%E4%BC%9A&rft.issn=0917-074X&rft.volume=32&rft.issue=3&rft.spage=124&rft.epage=128&rft_id=info:doi/10.2301%2Fneurosonology.32.124&rft.externalDocID=article_neurosonology_32_3_32_124_article_char_ja |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0917-074X&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0917-074X&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0917-074X&client=summon |