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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

脳動静脈奇形の血管内治療 : 適応,治療方針,臨床結果

http://hdl.handle.net/2237/10999
http://hdl.handle.net/2237/10999
542890a0-ea6a-4507-a239-4616541123cb
名前 / ファイル ライセンス アクション
miyachi_544.pdf miyachi_544.pdf (742.7 kB)
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 脳動静脈奇形の血管内治療 : 適応,治療方針,臨床結果
言語 ja
その他のタイトル
その他のタイトル Endovascular Treatment of AVMs : Indication, Strategy and Clinical Results
言語 en
著者 宮地, 茂

× 宮地, 茂

WEKO 26143

ja 宮地, 茂

Search repository
根来, 真

× 根来, 真

WEKO 26144

ja 根来, 真

Search repository
鈴木, 宰

× 鈴木, 宰

WEKO 26145

ja 鈴木, 宰

Search repository
服部, 光爾

× 服部, 光爾

WEKO 26146

ja 服部, 光爾

Search repository
小林, 望

× 小林, 望

WEKO 26147

ja 小林, 望

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小島, 隆生

× 小島, 隆生

WEKO 26148

ja 小島, 隆生

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吉田, 純

× 吉田, 純

WEKO 26149

ja 吉田, 純

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Miyachi, Shigeru

× Miyachi, Shigeru

WEKO 26150

en Miyachi, Shigeru

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Negoro, Makoto

× Negoro, Makoto

WEKO 26151

en Negoro, Makoto

Search repository
Suzuki, Osamu

× Suzuki, Osamu

WEKO 26152

en Suzuki, Osamu

Search repository
Hattori, Kouji

× Hattori, Kouji

WEKO 26153

en Hattori, Kouji

Search repository
Kobayashi, Nozomu

× Kobayashi, Nozomu

WEKO 26154

en Kobayashi, Nozomu

Search repository
Kojima, Takao

× Kojima, Takao

WEKO 26155

en Kojima, Takao

Search repository
Yoshida, Jun

× Yoshida, Jun

WEKO 26156

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 embolization
キーワード
主題Scheme Other
主題 indication
キーワード
主題Scheme Other
主題 treatment strategy
抄録
内容記述 脳動静脈奇形(arteriovenous malformation;AVM)の治療オプションの一つとしての血管内治療(塞栓術)について,治療結果を検討するとともに,現状をアンケートにて調査してそれに基づく治療適応および治療方針のガイドラインを作成した.基本的に塞栓術は摘出術またはradiosurgeryの前治療として行われるが, 特に出血のリスクファクターのあるもの(intranidal aneurysmやdrainageの異常など)やhigh flow fistulaを有するものは,後治療に対して十分な意義があると考えられた.またradiosurgery前や深部のAVMで,出血源と考えられる動脈瘤を合併する場合には,動脈瘤の塞栓術は重要であると思われた.ただし,われわれのシリーズでも塞栓術による永続性合併症は4%あり,他の治療のみで根治可能な症例に対する塞栓術の適応は慎重に考慮すべきと思われる.
言語 ja
内容記述タイプ Abstract
抄録
内容記述 We reviewed 70 arteriovenous malformations (AVMs) treated with embolization over 5 years and investigated the treatment strategies for virtual AVMs simulating various types and situations with a quetionnaire sent to 17 affiliated hospitals. Of 70 patients with AVMs, 14 underwent postembolization surgical removal, and 47 underwent radiosurgery. Four patients were cured with total occlusion of their AVM by embolization alone. 61 patients achieved a more than 70% occlusion of the nidus. We observed 12 complications including 3 permanent and 9 temporary. Based on these data, we created the chart of treatment strategy for AVMs. There is an absolute indication of embolization for large, high flow AVMs as well as possible bleeding sourses such as intranidal or feeder aneurysms. Deep-seated feeders must be embolized presurgically along with fistulous or high-flow feeders, and fistulous and meningeal feeders should be treated before radiosurgery. The nidus must be packed with embolic materials with no risk of recanalization. The responses to a questionnaire revealed the tendency of less aggressive surgical extirpation for difficult AVMs, and more dependence on radiosurgery with or without embolization. The general strategy with more than 70% of consensus was following three: 1) radiosurgery for small AVM without bleeding, 2) embolization plus radiosurgery for large AVM with ischemic events, and for large, eloquent one and deep-seated one with minor hemorrhage, 3) surgical removal for small, middle-sized AVM with large hematoma except for middle-sized eloquent and deep-seated ones. Although the improvements in radiosurgery may narrow the indication of embolization, it still plays an important role for high grade AVMs by enhancing the effectiveness of the secondary treatment. The inidicaiton of embolization should be decided taking various factors about the angioarchitecture of AVMs as well as the patients' situations into considerations. The safest multi-axial method should be used for the benefit of patients with AVMs.
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/110003813660/
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 11, 号 10, p. 660-667, 発行日 2002-10
フォーマット
application/pdf
著者版フラグ
値 publisher
URI
識別子 http://hdl.handle.net/2237/10999
識別子タイプ HDL
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