鎖骨下動脈高度狭窄における同側椎骨動脈の超音波ドプラ波形に関する12症例報告
「はじめに」鎖骨下動脈盗血は, 鎖骨下動脈 (subclavian artery : SCA) が椎骨動脈分岐部より近位側で狭窄して椎骨動脈 (vertebral artery : VA) に逆流が起こり, 引き起こされる病態である. 無症候性のものは鎖骨下動脈盗血現象 (subclavian artery steal phenomenon : SSP) で, 症候性のものは鎖骨下動脈盗血症候群 (subclavian artery steal syndrome : SSS) という. SSSでは上肢の症状, 脳幹部の症状, 血管雑音などの症状があり, 理学所見として20mmHg以上の収縮期血...
Saved in:
| Published in | Neurosonology Vol. 30; no. 1; pp. 18 - 22 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Kurashiki
一般社団法人日本脳神経超音波学会
01.01.2017
日本脳神経超音波学会 Japan Science and Technology Agency |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0917-074X 1884-3336 |
| DOI | 10.2301/neurosonology.30.18 |
Cover
| Abstract | 「はじめに」鎖骨下動脈盗血は, 鎖骨下動脈 (subclavian artery : SCA) が椎骨動脈分岐部より近位側で狭窄して椎骨動脈 (vertebral artery : VA) に逆流が起こり, 引き起こされる病態である. 無症候性のものは鎖骨下動脈盗血現象 (subclavian artery steal phenomenon : SSP) で, 症候性のものは鎖骨下動脈盗血症候群 (subclavian artery steal syndrome : SSS) という. SSSでは上肢の症状, 脳幹部の症状, 血管雑音などの症状があり, 理学所見として20mmHg以上の収縮期血圧の左右差が有名である. 基本的治療は保存療法で外科治療の適応になるものは少ない. われわれは, 鎖骨下動脈狭窄があり盗血の疑いで入院し外科治療としてステントに至った症例について, VAの超音波所見の特徴を検討したので報告する. |
|---|---|
| AbstractList | 「はじめに」鎖骨下動脈盗血は, 鎖骨下動脈 (subclavian artery : SCA) が椎骨動脈分岐部より近位側で狭窄して椎骨動脈 (vertebral artery : VA) に逆流が起こり, 引き起こされる病態である. 無症候性のものは鎖骨下動脈盗血現象 (subclavian artery steal phenomenon : SSP) で, 症候性のものは鎖骨下動脈盗血症候群 (subclavian artery steal syndrome : SSS) という. SSSでは上肢の症状, 脳幹部の症状, 血管雑音などの症状があり, 理学所見として20mmHg以上の収縮期血圧の左右差が有名である. 基本的治療は保存療法で外科治療の適応になるものは少ない. われわれは, 鎖骨下動脈狭窄があり盗血の疑いで入院し外科治療としてステントに至った症例について, VAの超音波所見の特徴を検討したので報告する. Introduction: Proximal stenosis of the subclavian artery (SCA) shows progression to subclavian steal syndrome (SSS)/phenomenon (SSP), characterized by retrograde flow in the ipsilateral vertebral artery (VA). Here we describe the clinical manifestations and ultrasound findings of ipsilateral VA in patients with high-grade stenosis of the SCA, and the role of VA ultrasound in percutaneous transluminal angioplasty (PTA) stenting of the SCA. Patients: Twelve patients (male: 10, female: 2; age: 17-86 yr) were selected from among inpatients with SCA stenosis treated in our department between 2009 and 2015. Results: The affected vessel was the left in 8 cases and the right in 4. The causes of stenosis were atherosclerosis in 10 cases, congenital in 1, and arteritis in 1. The symptoms were dizziness, faintness, syncope, diplopia, dysarthria, rest pain, coldness and arm claudication on effort. The cases were divided into SSS (n=7), SSP (n=2), and SCA stenosis only (n=3). The Doppler flow patterns were classified as normal antegrade (n=3), bunny waveform (n=0), alternating (n=6), reverse (n=2), and not detected (n=1). Ten of the patients underwent PTA stenting and 2 conservative therapy. Conclusions: Alternating and reverse flow patterns in the VA might lead to the surgical indication for PTA-stenting of SCA. |
| Author | 吉金, 努 永井, 秀政 江田, 大武 秋山, 恭彦 中右, 博也 宮嵜, 健史 辻, 将大 中川, 史生 神原, 瑞樹 萩原, 伸哉 |
| Author_xml | – sequence: 1 fullname: 吉金, 努 organization: 島根大学医学部脳神経外科 – sequence: 1 fullname: 中右, 博也 organization: 島根大学医学部脳神経外科 – sequence: 1 fullname: 永井, 秀政 organization: 島根大学医学部脳神経外科 – sequence: 1 fullname: 神原, 瑞樹 organization: 島根大学医学部脳神経外科 – sequence: 1 fullname: 秋山, 恭彦 organization: 島根大学医学部脳神経外科 – sequence: 1 fullname: 宮嵜, 健史 organization: 島根大学医学部脳神経外科 – sequence: 1 fullname: 萩原, 伸哉 organization: 島根大学医学部脳神経外科 – sequence: 1 fullname: 辻, 将大 organization: 島根大学医学部脳神経外科 – sequence: 1 fullname: 江田, 大武 organization: 島根大学医学部脳神経外科 – sequence: 1 fullname: 中川, 史生 organization: 島根大学医学部脳神経外科 |
| BookMark | eNpVkcFOFEEQhjsGE1fkCTx6nrW6ena652iIoAkJF0i8dXqaXpzN0IMzuweO40JUhhA4AHrSEEMQoomBEGOiLzMMy7yFLWs0HuqvOnz1V_LXXTJhU2sIuU-hjQzoQ2sGWZqnNk3S5bU2gzYVt0iLCuF7jLFggrQgpNwD7j-7Q6byPI6AYgChD9gittneb06OL7-Vdbl3vf66OX1bfz8alZ9HJ-tVcVoVm1WxW70s652tuji_-rjt4DFZFV-uLzaa92dXZ4fV8E01PKiGn9xc_zh0i82-03dukeLo4NXlz7L-8LXe3bxHbndVkpupP32SLM48Xph-4s3Nzz6dfjTn9Rig74lAC7pkhK981EqbIEAa6A4G3W4YCYgQQx4Bah4h06YjOBM6DAG4y8NwQDZJHox9V7P0xcDkfdlLB5l1JyUNMUCOCL6jZsfUilmKtUpSm8TW_EO15TfhSgTKJQADoK51XFHhBH_nj0II5zQzdurlfbVs5GoWr6hsTaqsH-vEyP9-JBlIeiPiL6Cfq0z2FPsFwnW0cw |
| ContentType | Journal Article |
| Copyright | 2017 日本脳神経超音波学会 Copyright Japan Science and Technology Agency 2017 |
| Copyright_xml | – notice: 2017 日本脳神経超音波学会 – notice: Copyright Japan Science and Technology Agency 2017 |
| CorporateAuthor | 島根大学医学部脳神経外科 |
| CorporateAuthor_xml | – name: 島根大学医学部脳神経外科 |
| DOI | 10.2301/neurosonology.30.18 |
| DatabaseTitleList | |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1884-3336 |
| EndPage | 22 |
| ExternalDocumentID | cn7neuro_2017_003001_005_0018_00223012888 article_neurosonology_30_1_30_18_article_char_ja |
| GroupedDBID | .55 123 2WC AL- ALMA_UNASSIGNED_HOLDINGS CS3 JMI JSF KQ8 MOJWN OK1 RJT X7M |
| ID | FETCH-LOGICAL-j3024-86c81de84a42cace66216c526ff9b80b2297b02c7b23ce58738c99007301e7023 |
| ISSN | 0917-074X |
| IngestDate | Sat Sep 20 13:41:43 EDT 2025 Thu Jul 10 16:14:43 EDT 2025 Wed Sep 03 06:29:14 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | true |
| Issue | 1 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j3024-86c81de84a42cace66216c526ff9b80b2297b02c7b23ce58738c99007301e7023 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/neurosonology/30/1/30_18/_article/-char/ja |
| PQID | 1926272204 |
| PQPubID | 2028960 |
| PageCount | 5 |
| ParticipantIDs | proquest_journals_1926272204 medicalonline_journals_cn7neuro_2017_003001_005_0018_00223012888 jstage_primary_article_neurosonology_30_1_30_18_article_char_ja |
| PublicationCentury | 2000 |
| PublicationDate | 20170101 |
| PublicationDateYYYYMMDD | 2017-01-01 |
| PublicationDate_xml | – month: 01 year: 2017 text: 20170101 day: 01 |
| PublicationDecade | 2010 |
| PublicationPlace | Kurashiki |
| PublicationPlace_xml | – name: Kurashiki |
| PublicationTitle | Neurosonology |
| PublicationTitleAlternate | 神経超音波医学 |
| PublicationYear | 2017 |
| 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 Japan Science and Technology Agency |
| 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 – name: Japan Science and Technology Agency |
| References | 4)von Reutern GM, Pourcelot L: Cardiac cycle-dependent alternating flow in vertebral arteries with subclavian artery stenoses. Stroke 1978; 9: 229-236. 12)櫛田晃子，本田玲子，辻村久美子，他：椎骨動脈パルスドプラ検査の有用性，鎖骨下動脈盗血現象症例を中心に．超音波検査技術2004; 29: 505-510. 14)津浦光晴，寺田友昭，田中優子，他：鎖骨下動脈，椎骨動脈狭窄病変に対する血行再建術．脈管学 2010; 50: 737-743. 9)Courneya DL, Carroll BA: Vertebral artery pre-steal waveform. The bunny waveform. Radiology 1995; 197(Suppl): 336. 2)Contorni L: The vertebro-vertebral collateral circulation in obliteration of the subclavian artery at its origin [in Italian]. Minerva Chir 1960; 15: 268-271. 6)Yip PK, Liu HM, Hwang BS, et al.: Subclavian steal phenomenon: a correlation between duplex sonographic and angiographic findings. Neuroradiology 1992; 34: 279-282. 3)Mozersky DJ, Barnes RW, Sumner DS, et al.: Hemodynamics of innominate artery occlusion. Ann Surg 1973; 178: 123-127. 10)Kalaria VG, Jacob S, Irwin W, et al.: Duplex ultrasonography of vertebral and subclavian arteries. J Am Soc Echocardiogr 2005; 18: 1107-1111. 8)Ritter MA, Ringelstein EB: The Venturi effect and cerebrovascular ultrasound. Cerebrovasc Dis 2002; 14: 98-104. 11)渡邉聖樹，平野照之，永沼雅基，他：鎖骨下動脈狭窄に対する血管拡張術施行中の椎骨動脈血流波形変化．Neurosonology 2006; 19: 79-82. 13)Kliewer MA, Hertzberg BS, Kim DH, et al.: Vertebral artery Doppler waveform changes indicating subclavian steal physiology. AJR Am J Roentgenol 2000; 174: 815-819. 7)Sakima H, Wakugawa Y, Isa K, et al.: Correlation between the degree of left subclavian artery stenosis and the left vertebral artery waveform by pulse Doppler ultrasonography. Cerebrovasc Dis 2011; 31: 64-67. 1)斉藤こずえ：椎骨動脈，日本脳神経超音波学会ほか（監）：頸部血管超音波検査ガイドライン．Neurosonology 2006; 19: 62-64. 5)Ringelstein EB, Zeumer H: Delayed reversal of vertebral artery blood flow following percutaneous transluminal angioplasty for subclavian steal syndrome. Neuroradiology 1984; 26: 189-198. |
| References_xml | – reference: 8)Ritter MA, Ringelstein EB: The Venturi effect and cerebrovascular ultrasound. Cerebrovasc Dis 2002; 14: 98-104. – reference: 10)Kalaria VG, Jacob S, Irwin W, et al.: Duplex ultrasonography of vertebral and subclavian arteries. J Am Soc Echocardiogr 2005; 18: 1107-1111. – reference: 2)Contorni L: The vertebro-vertebral collateral circulation in obliteration of the subclavian artery at its origin [in Italian]. Minerva Chir 1960; 15: 268-271. – reference: 3)Mozersky DJ, Barnes RW, Sumner DS, et al.: Hemodynamics of innominate artery occlusion. Ann Surg 1973; 178: 123-127. – reference: 9)Courneya DL, Carroll BA: Vertebral artery pre-steal waveform. The bunny waveform. Radiology 1995; 197(Suppl): 336. – reference: 1)斉藤こずえ：椎骨動脈，日本脳神経超音波学会ほか（監）：頸部血管超音波検査ガイドライン．Neurosonology 2006; 19: 62-64. – reference: 14)津浦光晴，寺田友昭，田中優子，他：鎖骨下動脈，椎骨動脈狭窄病変に対する血行再建術．脈管学 2010; 50: 737-743. – reference: 7)Sakima H, Wakugawa Y, Isa K, et al.: Correlation between the degree of left subclavian artery stenosis and the left vertebral artery waveform by pulse Doppler ultrasonography. Cerebrovasc Dis 2011; 31: 64-67. – reference: 4)von Reutern GM, Pourcelot L: Cardiac cycle-dependent alternating flow in vertebral arteries with subclavian artery stenoses. Stroke 1978; 9: 229-236. – reference: 6)Yip PK, Liu HM, Hwang BS, et al.: Subclavian steal phenomenon: a correlation between duplex sonographic and angiographic findings. Neuroradiology 1992; 34: 279-282. – reference: 13)Kliewer MA, Hertzberg BS, Kim DH, et al.: Vertebral artery Doppler waveform changes indicating subclavian steal physiology. AJR Am J Roentgenol 2000; 174: 815-819. – reference: 11)渡邉聖樹，平野照之，永沼雅基，他：鎖骨下動脈狭窄に対する血管拡張術施行中の椎骨動脈血流波形変化．Neurosonology 2006; 19: 79-82. – reference: 12)櫛田晃子，本田玲子，辻村久美子，他：椎骨動脈パルスドプラ検査の有用性，鎖骨下動脈盗血現象症例を中心に．超音波検査技術2004; 29: 505-510. – reference: 5)Ringelstein EB, Zeumer H: Delayed reversal of vertebral artery blood flow following percutaneous transluminal angioplasty for subclavian steal syndrome. Neuroradiology 1984; 26: 189-198. |
| SSID | ssib012609402 ssib005059357 ssib050594756 ssib004261862 ssib058494377 ssib000961632 ssib002004365 ssj0038460 |
| Score | 2.0888884 |
| Snippet | 「はじめに」鎖骨下動脈盗血は, 鎖骨下動脈 (subclavian artery : SCA) が椎骨動脈分岐部より近位側で狭窄して椎骨動脈 (vertebral artery : VA) に逆流が起こり, 引き... Introduction: Proximal stenosis of the subclavian artery (SCA) shows progression to subclavian steal syndrome (SSS)/phenomenon (SSP), characterized by... |
| SourceID | proquest medicalonline jstage |
| SourceType | Aggregation Database Publisher |
| StartPage | 18 |
| SubjectTerms | Atherosclerosis Indication Pain Patients Quality subclavian artery stenosis subclavian steal syndrome Syncope Ultrasonic imaging ultrasound Veins & arteries vertebral artery |
| Title | 鎖骨下動脈高度狭窄における同側椎骨動脈の超音波ドプラ波形に関する12症例報告 |
| URI | https://www.jstage.jst.go.jp/article/neurosonology/30/1/30_18/_article/-char/ja http://mol.medicalonline.jp/library/journal/download?GoodsID=cn7neuro/2017/003001/005&name=0018-0022j https://www.proquest.com/docview/1926272204 |
| Volume | 30 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | Neurosonology:神経超音波医学, 2017, Vol.30(1), pp.18-22 |
| journalDatabaseRights | – providerCode: PRVAFT databaseName: Open Access Digital Library customDbUrl: eissn: 1884-3336 dateEnd: 99991231 omitProxy: true ssIdentifier: ssj0038460 issn: 0917-074X databaseCode: KQ8 dateStart: 19880101 isFulltext: true titleUrlDefault: http://grweb.coalliance.org/oadl/oadl.html providerName: Colorado Alliance of Research Libraries |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3Na9RAFA-lgggifmK1Sg_muJrMJJmZkybblKJUEFroLWymu4cFV9H24m1tRe2WYg-2elKKiLYoSEVE0H8m3bb7X_jeS7KbfiBWYZl9O_ObmTfvTXbem8yHYVzxtGIVz7ZLTEtecuSULlWgY5WEa0_puObEFm0fG7vtjU44Nyfdyb7-hcKqpZnp-Kp-dOC-kn_RKsSBXnGX7CE02y0UIoAG_UIIGobwr3RshsqUoak8JHzf9KUZOmYgTRmYoYuhcs0QfoLBKAkDMRKTAgBDLoEYfxgJyA6wkINpibCUkH5GKJsIlpWsLFOWqQrbDCCXZ_oOctJjY3_tackhxgSeKV0EqxEz4JgdQp8RBj4qI5TICF8VMMD8cA5OWVUogW6MUl1WbYYtg2KkIMGEGfu-ZQY2tQObWLTP6awScEHSPTzcJ8kALkQicKnVf-CfAEFaBzDZnfXMZaZIYwLrha5NeBCX34OR9lAhkEJl57BhU_mUjJX28FCzhVkwxUd5Ex54FriEBZIVJBTw3da41HFGcjwwhLEe6i5QxakgW-yZCsq7mEW6BW7LVCyJF5sJHSoXCeqfGIMP8kK1I1GmXNQ1UH6HlDGJlkoug1SKk83IrEjX4ubjbvY-rvj_kg6i2YCcmmPprvW9Az04zjjQN4qd4ioHA0D27JruatPs-Yx2oSMO3i8FMsoBuNExqoO3dYQJz8P7UG7dKTgrygPnpbAGga5v2D0ZIQuHb7p4W2ZvTYHNPDyrspuOyU7h7gXwBJTDRXe6iINnQDPEuezSM9Ow5dcOaDdY0HXwJ_GgkON303e86Vk7-4xMspzHTxonMpd3yE-bf8roq1dOG0fHskU9Z4xGZ3G5s_Zh83ur3Xq5M_ess_6q_eP9duvT9tpc0lxPmvNJcyl53Gq_WGg3v269WwRwikyan3e-Pem82djaWE1mnyezK8nsR6DbP1chY2cZwteQ0WbbK083f7Xab7-0l-bPGhMj4Xh5tJRdA1Oqc_AgStLT4FRXpVNxmK7oKmjG9rTLvFpNxdKKGVMitpgWMeO66krBpQYbm2yXqgCf5JzR37jXqJ43hmwnjh2pBb4Jc3SNVbTj8pgzzmscHqjqgHE9FWJ0Pz3rJzps3xkwbuySfpQNFw8j3RBUSIRPLh7JDA4CfLm4qlhG6EtxdBakHDAGc4X1ctt4rqtgzHIu_DePF41jvX-PQaN_-sFM9RK4VtPxZerxvwHjeT9m |
| 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=%E9%8E%96%E9%AA%A8%E4%B8%8B%E5%8B%95%E8%84%88%E9%AB%98%E5%BA%A6%E7%8B%AD%E7%AA%84%E3%81%AB%E3%81%8A%E3%81%91%E3%82%8B%E5%90%8C%E5%81%B4%E6%A4%8E%E9%AA%A8%E5%8B%95%E8%84%88%E3%81%AE%E8%B6%85%E9%9F%B3%E6%B3%A2%E3%83%89%E3%83%97%E3%83%A9%E6%B3%A2%E5%BD%A2%E3%81%AB%E9%96%A2%E3%81%99%E3%82%8B12%E7%97%87%E4%BE%8B%E5%A0%B1%E5%91%8A&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%90%89%E9%87%91%2C+%E5%8A%AA&rft.au=%E4%B8%AD%E5%8F%B3%2C+%E5%8D%9A%E4%B9%9F&rft.au=%E6%B0%B8%E4%BA%95%2C+%E7%A7%80%E6%94%BF&rft.au=%E7%A5%9E%E5%8E%9F%2C+%E7%91%9E%E6%A8%B9&rft.date=2017-01-01&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=30&rft.issue=1&rft.spage=18&rft.epage=22&rft_id=info:doi/10.2301%2Fneurosonology.30.18&rft.externalDocID=article_neurosonology_30_1_30_18_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 |