Neurological Surgery 脳神経外科51巻2号

2023年03月発行

特集 新時代を迎えた脳血管内治療—文献レビューで学ぶ進歩とトレンド Ⅲ 虚血性病変

頚動脈狭窄〈適応と成績編〉

著者： 佐藤徹¹²

所属機関： ¹近畿大学医学部脳神経外科 ²近畿大学病院脳卒中センター

ページ範囲：P.295 - P.304

Point
・頚動脈ステント留置術（CAS）のエビデンスは頚動脈内膜剝離術（CEA）との比較で示されてきた．術者基準の妥当化，脳保護デバイス（EPD）の使用，そして手技およびデバイスへの習熟によりその安全性が確立した．
・『脳卒中治療ガイドライン2021』では，症候性および無症候性の高度狭窄において，CEAの代替療法としてCASを考慮することは妥当とされている．
・わが国では，術者の質の担保，EPDのほぼ全例での使用に加え，術前プラーク診断による適応決定がCASの好成績につながったと考えられる．

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