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  1. C100 医学部/医学系研究科
  2. C100a 雑誌掲載論文
  3. 学術雑誌

脳動静脈奇形に対する血管内治療の有用性とpitfall

http://hdl.handle.net/2237/10998
http://hdl.handle.net/2237/10998
5494bbda-7b05-475b-81c7-76023a45e2ea
名前 / ファイル ライセンス アクション
miyachi_543.pdf miyachi_543.pdf (1.1 MB)
Item type 学術雑誌論文 / Journal Article(1)
公開日 2009-01-30
タイトル
タイトル 脳動静脈奇形に対する血管内治療の有用性とpitfall
言語 ja
その他のタイトル
その他のタイトル Effectiveness and Pitfall of Embolization for Cerebral Arteriovenous Malformations
言語 en
著者 宮地, 茂

× 宮地, 茂

WEKO 26129

ja 宮地, 茂

Search repository
岡本, 剛

× 岡本, 剛

WEKO 26130

ja 岡本, 剛

Search repository
小林, 望

× 小林, 望

WEKO 26131

ja 小林, 望

Search repository
小島, 隆生

× 小島, 隆生

WEKO 26132

ja 小島, 隆生

Search repository
服部, 健一

× 服部, 健一

WEKO 26133

ja 服部, 健一

Search repository
飯塚, 宏

× 飯塚, 宏

WEKO 26134

ja 飯塚, 宏

Search repository
吉田, 純

× 吉田, 純

WEKO 26135

ja 吉田, 純

Search repository
Miyachi, Shigeru

× Miyachi, Shigeru

WEKO 26136

en Miyachi, Shigeru

Search repository
Okamoto, Takeshi

× Okamoto, Takeshi

WEKO 26137

en Okamoto, Takeshi

Search repository
Kobayashi, Nozomu

× Kobayashi, Nozomu

WEKO 26138

en Kobayashi, Nozomu

Search repository
Kojima, Takao

× Kojima, Takao

WEKO 26139

en Kojima, Takao

Search repository
Hattori, Kenichi

× Hattori, Kenichi

WEKO 26140

en Hattori, Kenichi

Search repository
Iizuka, Hiroshi

× Iizuka, Hiroshi

WEKO 26141

en Iizuka, Hiroshi

Search repository
Yoshida, Jun

× Yoshida, Jun

WEKO 26142

en Yoshida, Jun

Search repository
アクセス権
アクセス権 open access
アクセス権URI http://purl.org/coar/access_right/c_abf2
権利
言語 ja
権利情報 日本脳神経外科コングレス
権利
言語 ja
権利情報 本文データは学協会の許諾に基づきCiNiiから複製したものである
キーワード
主題Scheme Other
主題 arteriovenous malformation
キーワード
主題Scheme Other
主題 treatment strategy
キーワード
主題Scheme Other
主題 pitfall
キーワード
主題Scheme Other
主題 embolization
抄録
内容記述 脳動静脈奇形(AVM)の根治的治療としての摘出術およびradiosurgeryの術前処置としての血管内治療(塞栓術) は, 以前より需要は減少しているが, 依然としてhigh grade AVMに対する位置づけは高く, 特に(1)nidusの縮小と血流の減少, (2)後治療に不適切な要素の排除, (3)付随する動脈瘤の処置の3点については塞栓術の果たす役割は大きい.また遺残, 再発例に対しても低侵襲である塞栓術の有用性がある.塞栓術の基本的な考え方は, 不十分な治療であっても最終治療までに症状増悪や出血をきたさないことである.そのためにはさまざまな診断ツールやテストの活用による機能的血管解剖の理解, 後治療に対応する血管内手術デザイン, 再開通予防のためのnidus embolization, 危機管理に基づく周術期ケアが必要である.
言語 ja
内容記述タイプ Abstract
抄録
内容記述 The use of embolization for cerebral arteriovenous malformations (AVMs) as the pretreatment of surgical extirpation and radiosurgery has recently diminished due to the passive application to asymptomatic patients and growing preference for radiosurgery based on its superior results. However, the embolization still plays an important role in some difficult AVMs. It is particularly significant in terms of the following : (1) reduction of nidus size and shunt flow, (2) elimination of inappropriate factors so as to achieve the maximum effect of the secondary treatments, (3) treatment for associated aneurysms posing high risk of rupture. The basic concept of AVM embolization is not to pursue total AVM obstruction by embolization alone but to avoid rebleeding and deteriorations of symptoms by targeted embolization. To perform a safe and effective embolization, the following points are thought to be very important : (1) understanding the angioarchitecture of the functional brain using various functional imagings and provocative tests, (2) an embolization design and strategy proportionate to the secondary treatments, (3) nidus embolization with materials that pose the least risk of recanalization, and (4) assuring appropriate perioperative care based on the principles of risk management. In spite of taking such precautions the rate of compcliaions was 13.9%, and the morbid-mortality rate was 4.9% in our series. Two patients with an angiographic cure of temporooccipital AVMs suffered from extensive intracerebral bleeding 6 and 8 years after radiosurgery. Therefore, we should reconsider the multi-modality treatment strategy of AVM, including embolization, and reevaluate its efficacy based on the risk-benefit assessments.
言語 en
内容記述タイプ Abstract
出版者
言語 ja
出版者 日本脳神経外科コングレス
言語
言語 jpn
資源タイプ
資源タイプresource http://purl.org/coar/resource_type/c_6501
タイプ journal article
出版タイプ
出版タイプ VoR
出版タイプResource http://purl.org/coar/version/c_970fb48d4fbd8a85
関連情報
関連タイプ isVersionOf
識別子タイプ URI
関連識別子 http://ci.nii.ac.jp/naid/110003813960/
ISSN
収録物識別子タイプ PISSN
収録物識別子 0917950X
書誌情報 ja : 脳神経外科ジャーナル

巻 14, 号 6, p. 393-400, 発行日 2005-06
フォーマット
application/pdf
著者版フラグ
値 publisher
URI
識別子 http://hdl.handle.net/2237/10998
識別子タイプ HDL
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