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文献詳細

雑誌文献

Neurological Surgery 脳神経外科48巻12号

2020年12月発行

文献概要

総説

Telestroke

著者: 石原秀行1 鈴木倫保2

所属機関: 1山口大学医学部脳神経外科 2山口大学医学部先進温度神経生物学講座

ページ範囲:P.1107 - P.1114

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Ⅰ.はじめに
 現代の電信機器の発展は目覚ましい.1990年代のインターネットと携帯電話の普及,2000年代後半からのスマートフォンやタブレットの普及と時を同じくして,脳梗塞急性期治療に革命が起きた.それは,recombinant tissue-type plasminogen activator(rt-PA)療法と脳血管内治療による再開通療法である.しかしながら,それらの高い有効性にもかかわらず,脳梗塞発症患者数に対する実施率は低い.これは,発症した患者の多くが,それら専門的治療を行う施設へ搬入されていないからである.
 専門的治療に常時対応できる施設は限られる.脳梗塞急性期治療では,時間が転帰を左右する最大の因子であるため,24時間体制で診療提供できる施設間ネットワークの構築が不可欠であり,ネットワークを構築する施設が担う機能を明確にする必要がある.脳卒中における遠隔医療(telestroke)は,このネットワーク構築に非常に有効であり,標準治療の均てん化には欠かすことができないものとなっている.

参考文献

1) Demaerschalk BM, Bobrow BJ, Raman R, Ernstrom K, Hoxworth JM, Patel AC, Kiernan TEJ, Aguilar MI, Ingall TJ, Dodick D W, Meyer BC;Stroke Team Remote Evaluation Using a Digital Observation Camera(STRokE DOC)in Arizona-The Initial Mayo Clinic Experience(AZ TIME)Investigators:CT interpretation in a telestroke network:agreement among a spoke radiologist, hub vascular neurologist, and hub neuroradiologist. Stroke 43:3095-3097, 2012
2) Demaerschalk BM, Berg J, Chong BW, Gross H, Nystrom K, Adeoye O, Schwamm L, Wechsler L, Whitchurch S:American Telemedicine Association:Telestroke Guidelines. Telemed J E Health 23:376-389, 2017
3) Handschu R, Scibor M, Willaczek B, Nückel M, Heckmann JG, Asshoff D, Belohlavek D, Erbguth F, Schwab S;STENO Project:Telemedicine in acute stroke:remote video-examination compared to simple telephone consultation. J Neurol 255:1792-1797, 2008
4) Heffner DL, Thirumala PD, Pokharna P, Chang YF, Wechsler L:Outcomes of spoke-retained telestroke patients versus hub-treated patients after intravenous thrombolysis:telestroke patient outcomes after thrombolysis[published correction appears in Stroke 47:e19, 2016]. Stroke 46:3161-3167, 2015
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6) Meyer BC, Raman R, Hemmen T, Obler R, Zivin JA, Rao R, Thomas RG, Lyden PD:Efficacy of site-independent telemedicine in the STRokE DOC trial:a randomised, blinded, prospective study. Lancet Neurol 7:787-795, 2008
7) Müller-Barna P, Hubert GJ, Boy S, Bogdahn U, Wiedmann S, Heuschmann PU, Audebert HJ:TeleStroke units serving as a model of care in rural areas:10-year experience of the TeleMedical project for integrative stroke care. Stroke 45:2739-44, 2014
8) Pfefferkorn T, Holtmannspötter M, Schmidt C, Bender A, Pfister HW, Straube A, Mayer TE, Brückmann H, Dichgans M, Fesl G:Drip, ship, and retrieve:cooperative recanalization therapy in acute basilar artery occlusion. Stroke 41:722-726, 2010
9) Schwamm LH, Audebert HJ, Amarenco P, Chumbler NR, Frankel MR, George MG, Gorelick PB, Horton KB, Kaste M, Lackland DT, Levine SR, Meyer BC, Meyers PM, Patterson V, Stranne SK, White CJ;American Heart Association Stroke Council;Council on Epidemiology and Prevention;Interdisciplinary Council on Peripheral Vascular Disease;Council on Cardiovascular Radiology and Intervention:Recommendations for the implementation of telemedicine within stroke systems of care:a policy statement from the American Heart Association. Stroke 40:2635-2660, 2009
10) Silverman IE, Beland DK, Chhabra J, McCullough LD:The “drip-and-ship” approach:starting Ⅳ t-PA for acute ischemic stroke at outside hospitals prior to transfer to a regional stroke center. Conn Med 69:613-620, 2005
11) Wechsler LR, Demaerschalk BM, Schwamm LH, Adeoye OM, Audebert HJ, Fanale CV, Hess DC, Majersik JJ, Nystrom KV, Reeves MJ, Rosamond WD, Switzer JA;American Heart Association Stroke Council;Council on Epidemiology and Prevention;Council on Quality of Care and Outcomes Research:Telemedicine Quality and Outcomes in Stroke:A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 48:e3-e25, 2017
12) Zaidi SF, Jumma MA, Urra XN, Hammer M, Massaro L, Reddy V, Jovin T, Lin R, Wechsler LR:Telestroke-guided intravenous tissue-type plasminogen activator treatment achieves a similar clinical outcome as thrombolysis at a comprehensive stroke center. Stroke 42:3291-3293, 2011

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1251

印刷版ISSN:0301-2603

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