rt-PA認可後の急性期脳梗塞に対する急性期血行再建術の治療戦略 Therapeutic strategy of revascularization for acute ischemic stroke after approval of intravenous rt-PA

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著者

    • 植田 敏浩 UEDA Toshihiro
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center
    • 伊藤 敦史 ITOH Atsushi
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center
    • 正田 大介 SHODA Daisuke
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center
    • 野越 慎司 NOGOSHI Shinji
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center
    • 阿部 新 ABE Arata
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center
    • 小濱 るり子 OBAMA Ruriko
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center
    • 松井 和子 MATSUI Kazuko
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center
    • 中溝 知樹 NAKAMIZO Tomoki
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center
    • 田畑 修 TABATA Osamu
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center
    • 栗田 竜子 KURITA Ryuko
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center
    • 松岡 慈子 MATSUOKA Shizuko
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center
    • 畑 隆志 HATA Takashi
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center
    • 山本 正博 YAMAMOTO Masahiro
    • 横浜市立脳血管医療センター脳卒中診療部 Department of Stroke Diagnostics and Therapeutics, Yokohama Stroke and Brain Center

抄録

We investigated the treatment outcome of revascularization for acute ischemic stroke and reviewed therapeutic strategy of endovascular therapy and intravenous rt-PA therapy after the approval of rt-PA. We performed adaptive determination of revascularization using MRI (DWI/PWI) for all acute stage, and intravenous rt-PA therapy was performed only for confirmed cases in a principal bronchus artery in MRA.<BR>We took intravenous rt-PA therapy for cardioembolic MCA occlusion of less than 3 hours and performed endovascular treatment which were the brain blood vessel expansion technique that we used UK intraarterial injection or a balloon and stent for besides it. As for the treatment strategy of revascularization, that we perform the treatment that conformed to eligibility criteria of intravenous rt-PA therapy is recommended for future acute stage without receiving it for a case of less than 3 hours than the onset. In addition, it should be reviewed adaptation of brain endovascular treatment for the patient beyond three hours by evaluating cerebral circulation dynamics by imaging such as DWI/PWI MR. As for the revascularization, maintenance of early transportation organization of the local acute stroke patient and architecture of inside the hospital organization are important for acute stage after intravenous rt-PA therapy certification.

収録刊行物

  • 脳卒中  

    脳卒中 28(4), 633-639, 2006-12-25 

    The Japan Stroke Society

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各種コード

  • NII論文ID(NAID)
    10018686889
  • NII書誌ID(NCID)
    AN0020186X
  • 本文言語コード
    JPN
  • 資料種別
    SHO
  • ISSN
    09120726
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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