Current Status of Endovascular Therapy for Intracranial Artery Stenosis from the Results of a Nationwide Survey
Current Status of Endovascular Therapy for Intracranial Artery Stenosis from the Results of a Nationwide Survey
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从全国调查结果看颅内动脉狭窄血管内治疗现状
DOI：
10.5797/jnet.oa.2019-0009
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
S. Yoshimura
中科院分区：
文献类型：
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作者：
Toshinori Takagi;Y. Matsumoto;R. Itabashi;Kenichi Sato;S. Yoshimura
目的：本研究旨在调查日本颅内动脉狭窄（ICAS）的治疗现状。研究方法：对日本神经血管内治疗学会（JSNET）的一名成员进行了问卷调查，并通过电子邮件收集了有关ICAS治疗次数和治疗策略的数据。结果：从261家（25.8%）拥有JSNET成员的医院收到了回复。2017年1月1日至12月31日，ICAS的血管内治疗数量为783例。其中，89.8%的病例出现症状性病变，30.3%的ICAS病例是在急性闭塞再灌注后诊断的。在急性大血管闭塞（ALVO）再灌注后检测到的ICAS治疗策略中，除抗血小板治疗外，23.8%的病例采用抗血小板治疗，70.4%的病例采用血管内治疗。在涉及对药物治疗抵抗的症状性重度ICAS伴脑血流（CBF）受损的病例中，97.8%的医生建议进行干预。然而，在没有CBF损害的情况下，建议干预的医生比例下降到53.1%。相反，对于无CBF损伤的无症状ICAS，超过95%的医生选择药物治疗。结论：在涉及症状性ICAS对CBF损伤的药物治疗耐药的病例中，建议干预的医生比例在日本相当高。30%的ICAS病例是在ALVO再灌注后诊断的。
Objective: The purpose of this study was to investigate the current status of treatment for intracranial artery stenosis (ICAS) in Japan. Methods: A questionnaire was administered to a member of the Japanese Society for Neuroendovascular Therapy (JSNET), and data regarding the number of treatments for ICAS and the treatment strategies employed were collected via e-mail. Results: Responses were received from 261 hospitals (25.8%) with JSNET members. From January 1 to December 31, 2017, the number of endovascular treatments for ICAS was 783. Among them, symptomatic lesions were seen in 89.8% of the cases, and 30.3% of ICAS cases were diagnosed after the reperfusion of an acute occlusion. Among the treatment strategies for ICAS detected after the reperfusion of an acute large-vessel occlusion (ALVO), antiplatelet therapy was utilized in 23.8% of cases and endovascular therapy was utilized in 70.4% of cases, in addition to antiplatelet therapy. In cases involving symptomatic severe ICAS resistant to medical treatment with cerebral blood flow (CBF) impairment, 97.8% of physicians suggested intervention. However, in cases without CBF impairment, the percentage of physicians who suggested intervention decreased to 53.1%. In contrast, for asymptomatic ICAS without CBF impairment, more than 95% of physicians selected medical treatment. Conclusion: In cases involving symptomatic ICAS resistant to medical treatment with CBF impairment, the rate of physicians who suggested intervention was quite high in Japan. Thirty percent of ICAS cases were diagnosed after the reperfusion of an ALVO.