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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/2237/109985494bbda-7b05-475b-81c7-76023a45e2ea
名前 / ファイル | ライセンス | アクション |
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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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× 岡本, 剛× 小林, 望× 小島, 隆生× 服部, 健一× 飯塚, 宏× 吉田, 純× Miyachi, Shigeru× Okamoto, Takeshi× Kobayashi, Nozomu× Kojima, Takao× Hattori, Kenichi× Iizuka, Hiroshi× Yoshida, Jun |
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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 |
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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 |