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動脈内ステントの適応決定に関する研究

动脉内支架适应证确定的研究

基本信息

批准号：
12770497
负责人：
北島美香
金额：
$ 1.34万
依托单位：
Kumamoto University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Encouragement of Young Scientists (A)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2001
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-12770497/
关键词：
閉塞性動脈硬化症ステント PTA Interventional Radiology 腸骨動脈 IVR(Interventional Radiology)

项目摘要

平成13年度も引き続き、完全閉塞、バルーンPTA後の再発、高度の石灰化や壁不整を伴う病変などに対しては最初からステント挿入(primary stenting)、それ以外の狭窄病変に対してはまずバルーンPTAを行い、バルーンPTA後の高度の内膜解離や有意の圧較差が残存した場合のみに引き続きステント挿入を行なった(secondary stenting)。骨盤・四肢領域では、バルーンPTAもしくはステント留置を91病変に試みた。狭窄部の圧較差を測定し、10mmHg以上の圧較差が存在した場合は効果不十分と判定した。また圧較差が軽度の場合は、ミリスロール0.05mg/生理食塩水10mlを狭窄部の近位から動注し、薬剤負荷を行い有意の圧較差かどうか判定した。91病変中ステント留置を行ったのは47病変であり、内secondary stentingは10病変のみであった。治療後の観察期間は1-36ヶ月(平均14.6±10.4ヶ月)である。ステント治療群において再発に対して追加治療を要したのは2病変であり、再狭窄に対するステント内へのステント留置、薬剤自己中止後のステント閉塞に対する溶解療法の1例ずつであった。一方PTA群では追加治療としてステント挿入を行った例が2病変、臨床的に再発が疑われて追加治療を予定している病変が3例あり、これらは打ち切りとした。経過観察において、バルーンPTA群とステント挿入群問に開存率の有意な差は認められなかった。完全閉塞例、バルーンPTA後の再発例、バルーンPTAで効果が不十分な例に対して、ステント挿入は有効な治療法である。しかし、バルーンPTAを試みた狭窄病変においてsecondary stentingが必要だったものは13.0%に過ぎず、今後さらに長期予後を含めて検討する必要はあるものの、複雑でない狭窄病変の場合はまずバルーンPTAを試みるのが望ましいと考えられた。

In 2013, there were three major diseases: primary stenting, secondary stenting, primary stenting, secondary stenting, secondary sten Pelvis, limbs, etc. When the pressure difference of the narrow part is measured, or when the pressure difference of more than 10mmHg is present, the result is not very good. If the pressure difference is too high, the test result shall be 0.05mg/physiological water 10ml, the test result shall be determined according to the pressure difference in the vicinity of the narrow part, the test result shall be determined according to the pressure difference in the middle of the test. 91 disease in the stay of 47 disease, internal secondary stenting of 10 disease The observation period after treatment ranged from 1 to 36 months (mean 14.6±10.4 months). The treatment group was reactivated and additional treatment was required. The treatment group was reactivated and reactivated. The treatment group was reactivated and reactivated. The treatment group was reactivated and reactivated. One side PTA group is added to the treatment, and the other two cases are added to the clinical treatment. In the past, the PTA group was divided into three groups: the first group was divided into three groups: the second group was divided into three groups: the third group was divided into three groups: the third group was divided into three groups: the fourth group was divided into four groups: the fourth group was divided into three groups: the fourth group was divided into four groups: the fourth group was divided into three groups: the fourth group was divided into four groups: the fourth group was divided into three groups: the fourth group was divided into four groups: the fourth group was divided into four groups: the fourth group was divided into three groups: the fourth group was divided into four groups: the fourth group was divided into four groups: the fourth group was divided into three groups: the fourth group was divided into four groups; the fourth group was divided into three groups: the fourth group was divided into four groups: the fourth group was divided into four groups; the fourth group was divided into four groups: the fourth group Complete cases, re-development after PTA, partial PTA results are not very good, and treatment methods are not available. The second Stenting is necessary for 13.0% of stenosis cases, and the third Stenting is necessary for 13.0% of stenosis cases.