3. 脳血管内治療の立場から(脳血管障害の非観血的治療法,<シリーズ>血管・血圧系(5))

概要

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Endovascular treatment has been introduced in the treatment of cerebrovascular disease, such as cerebral aneurysm, arteriovenous malformation, carotid artery stenosis and so on. Although indication for endovascular treatment in patients with cerebral aneurysm remains controversial and long-term results have not yet been established, it is gaining favor as attractive alternatives to surgical clipping. The long-term investigations are important to clarify the significance of this treatment. As the embolization of arteriovenous malformation is often an adjuvant therapy combined with surgical extirpation or radiosurgery, the aim is to optimize the outcome of the following procedure. Although the indication of radiosurgery is expanding based on its excellent results, embolization still plays a role to reduce the size and hemorrhagic risks and to eliminate factors unfavorable for radiosurgery. Stenting for carotid artery stenosis are rapidly evolving as alternatives to carotid endarterectomy (CEA). Recently, stenting for carotid artery stenosis has been performed not only in the high-risk patients of CEA but also in patients amenable to CEA. Several large randomized trials have demonstrated the beneficial effects and safeties of this treatment. Appropriate devices and embolic materials should be developed. However, endovascular treatment may be a promising method to treat cerebrovascular disease.
東京女子医科大学の論文