BRAIN and NERVE－神経研究の進歩61巻9号

2009年09月発行

特集 脳血管障害治療の進歩

脳動脈ステント

著者： 坂井信幸¹ 坂井千秋²

所属機関： ¹神戸市立医療センター中央市民病院脳神経外科／脳卒中センター ²財団法人先端医療振興財団先端医療センター病院脳血管内治療

ページ範囲：P.1023 - P.1028

文献概要

はじめに

　ステントは，主に金属でできた筒状の機器の総称で，内側から支持して管腔構造を保つ機器のことを言う。Stentという19世紀の歯科医の名前が語源で，歯科では歯と歯の間を支える器具のことを言うそうである。脳血管疾患を扱う者には縁が薄いが，胆管や食道などにもステントは応用されており，管腔構造を保つことによって治療目的を果たす医療機器と理解するのが妥当である。

　さて，ステントは頭蓋外を含めた脳動脈疾患に対して積極的に応用されるようになってきたが，一口に脳動脈ステントと言っても，目的（対象疾患）が違えば構造も異なる。脳動脈ステントの使用目的は，狭窄病変の治療と脳動脈瘤の治療の2つに分かれる。その対象部位は，頭蓋外頸動脈，腕頭および鎖骨下動脈，椎骨動脈起始部，起始部を除く椎骨動脈，頭蓋内動脈に分けて理解すべきである。

　構造にはバルーン拡張型および自己拡張型という2つの種類がある。また，主に頭蓋外頸動脈用の自己拡張型ステントと頭蓋内動脈用の自己拡張型ステントは，ステントそのものもデリバリーシステムもまったく異なる。本稿では，まず現在開発されて脳動脈に応用されているステントを紹介し，次にそれぞれの疾患にどう応用され今後どう展開されるかを解説することにする。

参考文献

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