頸部主幹動脈の動脈硬化性病変に対するPTA治療の経験
「はじめに」1964年, Dotter & Judkinsがpercutaneous transluminal angioplasty (PTA) による治療を考案した. その後, balloon catheterの改良に伴い, 冠動脈に限らず腎動脈や四肢血管の狭窄病変にも応用され, 良好な結果を得てきた. しかし, 脳へ血液を供給する頸部主幹動脈の狭窄病変では, 末梢への塞栓が危惧され, 適用されることがなかった. 1980年にKerberが総頸動脈の狭窄病変をballoon catheterを用いて拡張し, 1981年に椎骨動脈のPTA症例をMotarjemeが報告した. その後,...
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| Published in | 脳卒中の外科 Vol. 21; no. 2; pp. 141 - 147 |
|---|---|
| Main Authors | , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本脳卒中の外科学会
1993
日本脳卒中の外科研究会 |
| Online Access | Get full text |
| ISSN | 0914-5508 1880-4683 |
| DOI | 10.2335/scs1987.21.2_141 |
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| Abstract | 「はじめに」1964年, Dotter & Judkinsがpercutaneous transluminal angioplasty (PTA) による治療を考案した. その後, balloon catheterの改良に伴い, 冠動脈に限らず腎動脈や四肢血管の狭窄病変にも応用され, 良好な結果を得てきた. しかし, 脳へ血液を供給する頸部主幹動脈の狭窄病変では, 末梢への塞栓が危惧され, 適用されることがなかった. 1980年にKerberが総頸動脈の狭窄病変をballoon catheterを用いて拡張し, 1981年に椎骨動脈のPTA症例をMotarjemeが報告した. その後, 頸部主幹動脈の動脈硬化性狭窄病変に対するPTAが数多く試みられている. 我々は11例の頸部主幹動脈の狭窄病変に対し, 再発予防の目的でPTA治療を試みた. 手技や適応について述べるとともに, その後のfollow-up studyから若干の知見を得たので報告する. |
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| AbstractList | 「はじめに」1964年, Dotter & Judkinsがpercutaneous transluminal angioplasty (PTA) による治療を考案した. その後, balloon catheterの改良に伴い, 冠動脈に限らず腎動脈や四肢血管の狭窄病変にも応用され, 良好な結果を得てきた. しかし, 脳へ血液を供給する頸部主幹動脈の狭窄病変では, 末梢への塞栓が危惧され, 適用されることがなかった. 1980年にKerberが総頸動脈の狭窄病変をballoon catheterを用いて拡張し, 1981年に椎骨動脈のPTA症例をMotarjemeが報告した. その後, 頸部主幹動脈の動脈硬化性狭窄病変に対するPTAが数多く試みられている. 我々は11例の頸部主幹動脈の狭窄病変に対し, 再発予防の目的でPTA治療を試みた. 手技や適応について述べるとともに, その後のfollow-up studyから若干の知見を得たので報告する. |
| Author | 藤巻, 広也 宮城, 修 朝倉, 健 宮崎, 瑞穂 根岸, 正敏 高玉, 真 岩井, 丈幸 大江, 千廣 内藤, 功 柴崎, 尚 曲沢, 聡 |
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| References | 13) Motarjeme A, Keifer JW, Zuska AJ : Percutaneous transluminal angioplasty of the vertebral arteries. Radiology 139 : 715-717, 1981 3) Briickmann H, Ringelstein EB, Buchner H, et al : Percutaneous transluminal angioplasty of the vertebral artery. A therapeutic alternative to operative reconstruction of proximal vertebral artery stenoses. J Neurol 233 : 336-339, 1986 6) Dotter CT, Judkins MP : Transluminal treatment of arteriosclerotic obstruction. Description of a new technique and a preliminary report of its application. Circulation 30 : 654-670, 1964 7) Erbstein RA, Wholey MH, Smoot S : Subclavian artery syndrome : Treatment by percutaneous transluminal angioplasty. AJR 151 : 291-294, 1988 4) Courtheoux P, Tournade A, Theron J : Transcutaneous angioplasty of vertebral artery atheromatous ostial stricture. Neuroradiology 27 : 259-264, 1985 12) Mathias K : Perkutane transluminale katheterbehandlung supraaortler Arterienobstruktion. Angiology 3 : 47-50, 1981 5) De Ros Reyes RA, Ausman JI, Disz FG : The surgical management of vertebro-basilar insufficiency. Acta Neurochir (Wien) 68 : 203-216, 1983 15) 高橋明 : 脳血管領域の血管形成術の経験-器質的動脈狭窄閉塞と脳血管攣縮の治療. 脳血管攣縮 (スパズムシンポ講演集) 6 : 90-107, 1991 2) Brown MM, Butler P, Gibbs J, et al : Feasibility of percutaneous transluminal angioplasty for carotid artery stenosis. J Neurol Neurosurg Psychiatry 53 : 238-243, 1990 8) Fischer CM, Gore ON, White PD : Atherosclerosis of the carotid and vertebral arteries. J Neuropathol Exp Neurol 20 : 323-379, 1961 17) Tsai FY, Matovich V, Hieshima G : Percutaneous transluminal angioplasty of the carotid artery. AJNR 7 : 349-358, 1986 1) Brott TG, Labutta RJ, Kempczinski RF : Changing pattern in the practice of carotid endarterectomy in a large metropolitan area. JAMA 255 : 2609-2612, 1986 14) Ringelstein EB, Zeumer H : Delayed reversal of vertebral artery blood flow following percutaneous transluminal angioplasty for subclavian steal syndrome. Neuroradiology 26 : 189-198, 1984 10) Kachel R, Basche S, Heerklotz I : Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery. Neuroradiology 33 : 191-194, 1991 11) Kerber CW, Cromwell LD, Loehden OL : Catheter dilatation of proximal carotid stenosis during distal bifurcation endarterectomy. AJNR 1 : 348-349, 1980 9) Imparato AM, Riles TS, Gorstein F : The carotid bifurcation plaque : Pathologic findings associated with cerebral ischemia. Stroke 10 : 238-245, 1979 16) Theron J, Me lancon D, Ethier R : “Pre”subclavian steal syndromes and their treatment by angioplasty. Neuroradiology 27 : 265-270, 1985 |
| References_xml | – reference: 9) Imparato AM, Riles TS, Gorstein F : The carotid bifurcation plaque : Pathologic findings associated with cerebral ischemia. Stroke 10 : 238-245, 1979 – reference: 6) Dotter CT, Judkins MP : Transluminal treatment of arteriosclerotic obstruction. Description of a new technique and a preliminary report of its application. Circulation 30 : 654-670, 1964 – reference: 7) Erbstein RA, Wholey MH, Smoot S : Subclavian artery syndrome : Treatment by percutaneous transluminal angioplasty. AJR 151 : 291-294, 1988 – reference: 2) Brown MM, Butler P, Gibbs J, et al : Feasibility of percutaneous transluminal angioplasty for carotid artery stenosis. J Neurol Neurosurg Psychiatry 53 : 238-243, 1990 – reference: 1) Brott TG, Labutta RJ, Kempczinski RF : Changing pattern in the practice of carotid endarterectomy in a large metropolitan area. JAMA 255 : 2609-2612, 1986 – reference: 12) Mathias K : Perkutane transluminale katheterbehandlung supraaortler Arterienobstruktion. Angiology 3 : 47-50, 1981 – reference: 5) De Ros Reyes RA, Ausman JI, Disz FG : The surgical management of vertebro-basilar insufficiency. Acta Neurochir (Wien) 68 : 203-216, 1983 – reference: 11) Kerber CW, Cromwell LD, Loehden OL : Catheter dilatation of proximal carotid stenosis during distal bifurcation endarterectomy. AJNR 1 : 348-349, 1980 – reference: 15) 高橋明 : 脳血管領域の血管形成術の経験-器質的動脈狭窄閉塞と脳血管攣縮の治療. 脳血管攣縮 (スパズムシンポ講演集) 6 : 90-107, 1991 – reference: 17) Tsai FY, Matovich V, Hieshima G : Percutaneous transluminal angioplasty of the carotid artery. AJNR 7 : 349-358, 1986 – reference: 8) Fischer CM, Gore ON, White PD : Atherosclerosis of the carotid and vertebral arteries. J Neuropathol Exp Neurol 20 : 323-379, 1961 – reference: 13) Motarjeme A, Keifer JW, Zuska AJ : Percutaneous transluminal angioplasty of the vertebral arteries. Radiology 139 : 715-717, 1981 – reference: 10) Kachel R, Basche S, Heerklotz I : Percutaneous transluminal angioplasty (PTA) of supra-aortic arteries especially the internal carotid artery. Neuroradiology 33 : 191-194, 1991 – reference: 4) Courtheoux P, Tournade A, Theron J : Transcutaneous angioplasty of vertebral artery atheromatous ostial stricture. Neuroradiology 27 : 259-264, 1985 – reference: 16) Theron J, Me lancon D, Ethier R : “Pre”subclavian steal syndromes and their treatment by angioplasty. Neuroradiology 27 : 265-270, 1985 – reference: 3) Briickmann H, Ringelstein EB, Buchner H, et al : Percutaneous transluminal angioplasty of the vertebral artery. A therapeutic alternative to operative reconstruction of proximal vertebral artery stenoses. J Neurol 233 : 336-339, 1986 – reference: 14) Ringelstein EB, Zeumer H : Delayed reversal of vertebral artery blood flow following percutaneous transluminal angioplasty for subclavian steal syndrome. Neuroradiology 26 : 189-198, 1984 |
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| Title | 頸部主幹動脈の動脈硬化性病変に対するPTA治療の経験 |
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