Neurological Surgery 脳神経外科50巻4号

2022年07月発行

特集 STA-MCAバイパス術—日本が世界に誇る技を学ぶ Ⅰバイパス術の適応

STA-MCAバイパス術のエビデンスⅠ：その歴史と海外の論文

著者： 吉田和道¹

所属機関： ¹京都大学大学院医学研究科脳神経外科学

ページ範囲：P.735 - P.744

Point
・閉塞性脳血管障害に対する慢性期STA-MCAバイパス術の有効性は，米国で行われた複数の無作為化比較試験（RCT）により否定され，世界的には手術数が減少した．
・わが国で実施されたJET Studyでは有効性が示されており，また，診断と治療の質が担保されたバイパス術の有効性を再評価する海外の研究も散見される．
・現時点では，適応を熟慮した上で経験を積んだ多職種チームと術者により行われるSTA-MCAバイパス術は，妥当な慢性期再発予防治療と言える．
・現在進行中のRCTや，現時点においてエビデンスの少ない急性期バイパスの有効性など，今後の研究に期待される．

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