改訂2版 血栓回収療法Technical Tips

出版社: メディカ出版
著者:
発行日: 2024-03-15
分野: 臨床医学:外科  >  脳神経外科学
ISBN: 9784840484640
電子書籍版: 2024-03-15 (電子書籍版)
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商品紹介

2019年に刊行した好評書の大改訂版。急性期脳梗塞に対する血栓回収療法の実践にあたっては確実なカテーテルテクニックが求められるが、経験豊富な臨床医しか知り得ないTipsも多く存在する。分野の最新トピックスを網羅しつつ、テクニック/ワザに特化した指南書。WEB動画付き。

目次

  • 【I 患者を安全かつ迅速に受け入れる工夫】
    1. 患者搬送(救急車)と院内発症対応のコツ
    2. 患者搬送(ドクターヘリ)と画像転送のポイント
    3. 治療開始までの時間を短縮する病院前診断ツール
    4. 遠隔医療(Join)の活用
    5. 院内体制をどう整備するか?
    6. Task Calc. Stroke「タスカル」の活用

    【II 治療成功のコツ!】
    1. 画像読影のポイント:これだけは見逃すな!
    2. 全身チェック:到着後に最低限確認すべきことは?
    3. 時間短縮:何をどうすればよいのか?
    4. 再開通率上昇:良好な開通を得るコツ
    5. 合併症回避:陥りやすいトラブルと回避のポイント
    6. トラブルシューティング:知っておくべきテクニック
    7. 術後管理:治療後に重要なこと

    【III 部位ごとのテクニックを磨く!】
    1. IC-M1閉塞:あなたならどうする?
    2. M2-3閉塞:あなたならどうする?
    3. BA閉塞:あなたならどうする?
    4. Tandem lesion(頚部IC & MCA)
    5. 動脈硬化性および解離性病変
       1)頚部内頚動脈の閉塞
       2)頭蓋内動脈の閉塞
       3)解離性病変

    【IV シチュエーションごとのテクニックを磨く!】
    1. 大型血栓
    2. 担がん患者
    3. 出血傾向
    4. COVID-19
    5. 屈曲病変
    6. 多発病変
    7. アクセス困難
       1)頚動脈アプローチ
       2)橈骨動脈アプローチ
       3)上腕動脈アプローチ

    【V 治療の選択肢を増やす「裏技」を知る!】
    1. Stent anchoring technique
    2. 遠位にステントを開き,近位から吸引する方法
    3. IC閉塞で対側からの造影
    4. BEMPテクニック
    5. 末梢血管閉塞に対する動注療法
    6. ステントリトリーバーの拡張

    【VI デバイスの特性を知る!】
    1. デバイス総論:血栓回収デバイスの比較
    2. デバイスの比較
       1)頚動脈ステントの特徴(比較)
       2)ステントリトリーバーの特徴(比較)
       3)吸引カテーテルの特徴(比較)
       4)複合治療の特徴(比較)

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

I 患者を安全かつ迅速に受け入れる工夫

P.16 掲載の参考文献
1) Broderick JP, et al : Interventional Management of Stroke (IMS) III Investigators : Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J Med 368 : 893-903, 2013
2) Berkhemer OA, et al : MR CLEAN Investigators : A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke. N Engl J Med 372 : 11-20, 2015
3) Goyal M, et al : HERMES collaborators. Endovascular thrombectomy after large-vessel ischaemic stroke : a meta-analysis of individual patient data from five randomised trials. Lancet 387 : 1723-31, 2016
4) Albers GW, et al : Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. N Engl J Med 378 : 708-18, 2018
5) Nogueira RG, et al : Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct. N Engl J Med 378 : 11-21, 2018
6) Yoshimura S, et al : Endovascular Therapy for Acute Stroke with a Large Ischemic Region. N Engl J Med 386 : 1303-13, 2022
7) Huo X, et al : Trial of Endovascular Therapy for Acute Ischemic Stroke with Large Infarct. N Engl J Med 388 : 1272-83, 2023
8) Sarraj A, et al : Trial of Endovascular Thrombectomy for Large Ischemic Strokes. N Engl J Med 388 : 1259-71, 2023
9) Tao C, et al : Trial of Endovascular Treatment of Acute Basilar-Artery Occlusion. Engl J Med 387 : 1361-72, 2022
10) Jovin TG, et al : Trial of Thrombectomy 6 to 24 Hours after Stroke Due to Basilar-Artery Occlusion. N Engl J Med 387 : 1373-84, 2022
11) de la Ossa NP, et al : Effect of Direct Transportation to Thrombectomy-Capable Center vs Local Stroke Center on Neurological Outcomes in Patients With Suspected Large-Vessel Occlusion Stroke in Nonurban Areas The RACECAT Randomized Clinical Trial. JAMA 327 : 1782-94, 2022
12) Cumbler E : In-Hospital Ischemic Stroke. Neurohospitalist 5 : 173-81, 2015
P.21 掲載の参考文献
1) Powers WJ, et al : Guidelines for the Early Management of Patients With Acute IschemicStroke : 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke : A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 50 : e344-418, 2019
2) Uchida K, et al : Clinical Prediction Rules to Classify Types of Stroke at Prehospital Stage. Stroke 49 : 1820-7, 2018
3) Suzuki K, et al : Emergent Large Vessel Occlusion Screen Is an Ideal Prehospital Scale to Avoid Missing Endovascular Therapy in 4. Acute Stroke. Stroke 49 : 2096-101, 2018
4) Chalela JA, et al : Safety of air medical transportation after tissue plasminogen activator administration in acute ischemic stroke. Stroke 30 : 2366-8, 1999
5) Ishihara H, et al : Safety and Time Course of Drip-and-Ship in Treatment of Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 26 : 2477-81, 2017
P.25 掲載の参考文献
1) Uchida K, et al : Clinical Prediction Rules to Classify Types of Stroke at Prehospital Stage. Stroke 49 : 1820-7, 2018
2) Araki H, et al : Effect of region-wide use of prehospital stroke triage scale on management of patients with acute stroke. J Neurointerv Surg 14 : 677-82, 2022
3) Uchida K, et al : Simplified Prehospital Prediction Rule to Estimate the Likelihood of 4 Types of Stroke : The 7-Item Japan Urgent Stroke Triage (JUST-7) Score. Prehosp Emerg Care 25 : 465-74, 2021
4) Uchida K, et al : Development of Machine Learning Models to Predict Probabilities and Types of Stroke at Prehospital Stage : the Japan Urgent Stroke Triage Score Using Machine Learning (JUST-ML). Transl Stroke Res 13 : 370-81, 2022
P.29 掲載の参考文献
1) Berkhemer OA, et al : A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med 372 : 11-20, 2015
2) Tekle WG, et al : Drip-and-ship thrombolytic treatment paradigm among acute ischemic stroke patients in the United States. Stroke 43 : 1971-4, 2012
3) J ASPECT STUDY研究データより https://j-aspect.jp/index.php
4) Morris S, et al : Impact and sustainability of centralising acute stroke services in English metropolitan areas : retrospective analysis of hospital episode statistics and stroke national audit data. BMJ 364 : 11, 2019
5) Osanai T, et al : Efficacy of 'drive and retrieve' as a cooperative method for prompt endovascular treatment for acute ischemic stroke. J Neurointerv Surg 11 : 757-61, 2019
6) Yet M, et al : Cost Effectiveness of Drive and Retrieve System in Hokkaido for Acute Ischemic Stroke Patient Treatment Using Geographic Information System. Stroke Cerebrovasc Dis 28 : 2292-301, 2019
7) Jahan R, et al : Association between time to treatment with endovascular reperfusion therapy and outcomes in patients with acute ischemic stroke treated in clinical practice. JAMA 322 : 252-63, 2019
8) Puetz V, et al : Reliability of brain CT evaluation by stroke neurologists in telemedicine. Neurology 80 : 332?8, 2013
9) Demaerschalk BM, et al : CT interpretation in a telestroke network : agreement among a spoke radiologist, hub vascular neurologist, and hub neuroradiologist. Stroke 43 : 3095?7, 2012
10) Sairanen T, et al : Two years of Finnish Telestroke : thrombolysis at spokes equal to that at the hub. Neurology 76 : 1145-52, 2011
11) Zaidi SF, et al : Telestroke-guided intravenous tissue-type plasminogen activator treatment achieves a similar clinical outcome as thrombolysis at a comprehensive stroke center. Stroke 42 : 3291-3, 2011
12) Kepplinger J, et al : Safety and efficacy of thrombolysis in telestroke : A systematic review and meta-analysis. Neurology 87 : 1344-51, 2016
13) Munich SA, et al : Mobile Real-time Tracking of Acute Stroke Patients and Instant, Secure Inter-team Communication-the Join App. Neurointervention 12 : 69-76, 2017
14) Martins SCO, et al : Validation of a Smartphone Application in the Evaluation and Treatment of Acute Stroke in a Comprehensive Stroke Center. Stroke 51 : 240-6, 2020
15) Komatsu T, et al : Using a Smartphone Application for the Accurate and Rapid Diagnosis of Acute Anterior Intracranial Arterial Occlusion : Usability Study. J Med Internet Res 23 : e28192, 2021
16) Takao H, et al : A Smartphone Application as a Telemedicine Tool for Stroke Care Management. Neurol Med Chir 61 : 260-7, 2021
17) Sakai K, et al : Reliability of Smartphone for Diffusion-Weighted Imaging-Alberta Stroke Program Early Computed Tomography Scores in Acute Ischemic Stroke Patients : Diagnostic Test Accuracy Study. J Med Internet Res 22 : e15893, 2020
18) Sakai K, et al : Communication-type smartphone application can contribute to reducing elapsed time to reperfusion therapy. Neurol Sci 42 : 4563-8, 2021
19) 藤田浩二ほか : 地方二次救急病院における脳神経救急診療への遠隔画像診断支援アプリ「JOIN」導入効果. Journal of Japan Society of Neurological Emergencies & Critical Care 3 : 34-41, 2021
P.35 掲載の参考文献
1) Fransen PS, et al : Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands Investigators. Time to Reperfusion and Treatment Effect for Acute Ischemic Stroke : A Randomized Clinical Trial. JAMA Neurol 73 : 190-6, 2016
2) Goyal M, et al : SWIFT PRIME investigators. : Analysis of Workflow and Time to Treatment and the Effects on Outcome in Endovascular Treatment of Acute Ischemic Stroke : Results from the SWIFT PRIME Randomized Controlled Trial. Radiology 279 : 888-97, 2016
3) Menon BK, et al : Analysis of Workflow and Time to Treatment on Thrombectomy Outcome in the Endovascular Treatment for Small Core and Proximal Occlusion Ischemic Stroke (ESCAPE) Randomized, Controlled Trial. Circulation 133 : 2279-86, 2016
4) Ribo M, et al : REVASCAT Trial Investigators : Association Between Time to Reperfusion and Outcome Is Primarily Driven by the Time From Imaging to Reperfusion. Stroke 47 : 999-1004, 2016
5) 日本脳卒中学会, 日本脳神経外科学会, 日本脳神経血管内治療学会 : 経皮経管的脳血栓回収用機器 適正使用指針 第2版, 2015
6) Goyal M, et al : HERMES collaborators. : Endovascular thrombectomy after large-vessel ischaemic stroke : a meta-analysis of individual patient data from five randomised trials. Lancet 387 : 1723-31, 2016
7) McTaggart RA, et al : Standards and Guidelines Committee of the Society of NeuroInterventional Surgery (SNIS) : Initial hospital management of patients with emergent large vessel occlusion (ELVO) : report of the standards and guidelines committee of the Society of NeuroInterventional Surgery. J Neurointerv surg 9 : 316-23, 2017
8) Iizuka S, et al : Conctruction of a training system for SCU neurses who began to support endovascular treatment for acute ischemic stroke. JNET 11 : 181-5, 2017
P.40 掲載の参考文献
1) 厚生労働省 R2 患者調査の概況 https://www.mhlw.go.jp/toukei/saikin/hw/kanja/20/index.html
2) 厚生労働省 R2 国民医療費の概況 https://www.mhlw.go.jp/toukei/saikin/hw/k-iryohi/20/index.html
3) Khatri P, et al : IMS III Trialists. Time to angiographic reperfusion and clinical outcome after acute ischaemic stroke : an analysis of data from the Interventional Management of Stroke (IMS III) phase 3 trial. Lancet Neurol 13 : 567-74, 2014
4) Goyal M, et al : HERMES collaborators. Endovascular thrombectomy after large-vessel ischaemic stroke : a meta-analysis of individual patient data from five randomised trials. Lancet 23 : 1723-31, 2016
5) 日本脳卒中学会脳卒中ガイドライン委員会 : 日本脳卒中学会 脳卒中治療ガイドライン 2021. 協和企画, 東京, 2021
6) 小山裕司ほか : 急性期脳梗塞治療支援シス テムの取り組み, 情報処理学会 論文誌 (IPSJ Journal) 57 : 1390-8, 2016
7) Matsumoto S, et al : A Visual Task Management Application for Acute Ischemic Stroke Care. Front Neurol 10 : 1118, 2019
8) Ohta T, et. al : Optimizing in-hospital triage for large vessel occlusion using a novel clinical scale (GAI2AA). Neurology Nov 93 : e1997-2006, 2019
9) Matsumoto S, et al : Reduced Workflow Times for Reperfusion Therapy After Acute Ischemic Stroke Using a Visual Task Management Application. Stroke : Vascular and Interventional Neurology, 2023

II 治療成功のコツ !

P.46 掲載の参考文献
1) Hacke W, et al : Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second European-Australasian Acute Stroke Study Investigators. Lancet 352 : 1245-51, 1998
2) Barber PA, et al : Validity and reliability of a quantitative computed tomography score in predicting outcome of hyperacute stroke before thrombolytic therapy. ASPECTS Study Group. Alberta Stroke Programme Early CT Score. Lancet 355 : 1670-4, 2000
3) 日本脳卒中学会, 日本脳神経外科学会, 日本脳神経血管内治療学会 : 経皮経管的脳血栓回収用機器 適正使用指針 第5版. 脳卒中誌掲載予定 https://jns-official.jp/topics/20231128/17457 (2023年12月閲覧)
4) Powers WJ, et al : 2018 Guidelines for the Early Management of Patients with Acute Ischemic Stroke : A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 49 : e46-110, 2018
5) Warach SJ, et al : Acute Stroke Imaging Research Roadmap III Imaging Selection and Outcomes in Acute Stroke Reperfusion Clinical Trials : Consensus Recommendations and Further Research Priorities. Stroke 47 : 1389-98, 2016
6) Ciccone A, et al : Endovascular treatment for acute ischemic stroke. N Engl J Med 368 : 904-13, 2013
7) McTaggart RA, et al : Alberta stroke program early computed tomographic scoring performance in a series of patients undergoing computed tomography and MRI : reader agreement, modality agreement, and outcome prediction. Stroke 46 : 407-12, 2015
8) Yoshimura S, et al : Endovascular Therapy for Acute Stroke with a Large Ischemic Region. N Engl J Med 386 : 1303-13, 2022
9) Kimura K, et al : M1 susceptibility vessel sign on T2* as a strong predictor for no early recanalization after IV-t-PA in acute ischemic stroke. Stroke 40 : 3130-2, 2009
10) Azizyan A, et al : Fluid-attenuated inversion recovery vascular hyperintensities : an important imaging marker for cerebrovascular disease. AJNR Am J Neuroradiol 32 : 1771-5, 2011
11) Thomalla G, et al : MRI-Guided Thrombolysis for Stroke with Unknown Time of Onset. N Engl J Med 379 : 611-22, 2018
12) Nogueira RG, et al : Thrombectomy 6 to 24 Hours after Stroke with a Mismatch between Deficit and Infarct. N Engl J Med 378 : 11-21, 2018
13) Albers GW, et al : Thrombectomy for Stroke at 6 to 16 Hours with Selection by Perfusion Imaging. N Engl J Med 378 : 708-18, 2018
P.51 掲載の参考文献
1) 日本脳卒中学会 脳卒中医療向上・社会保険委員会 静注血栓溶解療法指針改訂PT : 静注血栓溶解 (rt-PA) 療法適正治療指針 第三版, 2023年9月追補
2) The American Heart Association in collaboration with the international Liaison Committee on Resuscitation : Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Part 7 : the era of reperfusion : section 2 : acute stroke. Circulation 102 : 204-16, 2000
3) Koga M, et al : Diagnosis of internal carotid artery stenosis greater than 70% with power Doppler duplex sonography. AJNR Am J Neuroradiol 22 : 413-7, 2001
4) Kimura K, et al : Duplex carotid sonography in distinguishing acute unilateral atherothrombotic from cardioembolic carotid artery occlusion. AJNR Am J Neuroradiol 18 : 1447-52, 1977
5) Yasaka M, et al : Ultrasonic evaluation of the site of carotid axis occlusion in patients with acute cardioembolic stroke. Stroke 23 : 420-2, 1992
6) Solitaire FR 血栓除去デバイス添付文書. 2017年11月改訂 (第4版)
7) トレボプロクロットリトリーバー添付文書. 2017年1月改訂 (第3版)
8) Revive SE 血栓除去デバイス添付文書. 2016年1月 (第1版)
9) Penumbraシステム添付文書. 2017年7月改訂 (第8版)
10) McTaggart RA, et al : Initial hospital management of patients with emergent large vessel occlusion (ELVO) : report of the standards and guidelines committee of the Society of Neurointerventional Surgery. J Neurointerv Surg 9 : 316-23, 2017
P.57 掲載の参考文献
1) McTaggart RA, et al : Initial hospital management of patients with emergent large vessel occlusion (ELVO) : report of the standards and guidelines committee of the Society of NeuroInterventional Surgery. J Neurointervent Surg 9 : 316-23, 2017
2) Jauch EC, et al : Guidelines for the early management of patients with acute ischemic stroke : a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 44 : 870-947, 2013
3) Fonarow GC, et al : Improving Door-to-Needle Times in Acute Ischemic Stroke. The Design and Rationale for the American Heart Association/American Stroke Association's Target : Stroke Initiative. Stroke 42 : 2983-9, 2011
4) Shams T, et al : Society of Vascular and Interventional Neurology (SVIN) Stroke Interventional Laboratory Consensus (SILC) Criteria : A 7M Management Approach to Developing a Stroke Interventional Laboratory in the Era of Stroke Thrombectomy for Large Vessel Occlusions. Intervent Neurol 5 : 1-28, 2016
5) Uchida K, et al : Clinical Prediction Rules to Classify Types of Stroke at Prehospital Stage. Japan Urgent Stroke Triage (JUST) Score. Stroke 49 : 1820-7, 2018
6) Ota T, et al : Regionwide retrospective survey of acute mechanical thrombectomy in Tama, suburban Tokyo : A preliminary report. J Stroke Cerebrovasc Dis 27 : 3350-5, 2018
7) Ng FC, et al : Deconstruction of Interhospital Transfer Workflow in Large Vessel Occlusion. Real-World Data in the Thrombectomy Era. Stroke 48 : 1976-9, 2017
8) Ota T, et al : Impact of onset-to-groin puncture time within three hours on functional outcomes in mechanical thrombectomy for acute large-vessel occlusion. Interv Neuroradiol 24 : 162-7, 2018
P.63 掲載の参考文献
1) Chueh JY, et al : Risk of distal embolization with stent retriever thrombectomy and ADAPT. J Neurointerv Surg 8 : 197-202, 2016
2) Brinjikji W, et al : Impact of balloon guide catheter on technical and clinical outcomes : a systematic review and meta-analysis. J Neurointerv Surg 10 : 335-9, 2018
3) Campbell BC, et al : Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med 372 : 1009-18, 2015
4) Goyal M, et al : Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med 372 : 1019-30, 2015
5) 岩崎清隆. 血栓回収デバイスSolitaireに関する医工学研究 update. BSNET 2018
6) 岩崎清隆. 急性期脳梗塞に対する血栓回収デバイスSolitaire(TM) 2に関する医工学研究. BSNET 2017
7) Haussen DC, et al : Optimizating Clot Retrieval in Acute Stroke : The Push and Fluff Technique for Closed-Cell Stentrievers. Stroke 46 : 2838-42, 2015
8) Turk AS, et al : Initial clinical experience with the ADAPT technique : A direct aspiration first pass technique for stroke thrombectomy. J Neurointerv Surg 10 (Suppl 1) : i20-5, 2018
9) Lapergue B, et al : Effect of Endovascular Contact Aspiration vs Stent Retriever on Revascularization in Patients With Acute Ischemic Stroke and Large Vessel Occlusion : The ASTER Randomized Clinical Trial. JAMA 318 : 443-52, 2017
10) Kang DH, et al : Switching strategy for mechanical thrombectomy of acute large vessel occlusion in the anterior circulation. Stroke 44 : 3577-9, 2013
11) McTaggart RA, et al : Continuous aspiration prior to intracranial vascular embolectomy (CAPTIVE) : a technique which improves outcomes. J Neurointerv Surg 9 : 1154-9, 2017
12) Maus V, et al : Maximizing First-Pass Complete Reperfusion with SAVE. Clin Neuroradiol 28 : 327-38, 2018
P.67 掲載の参考文献
1) Bass DI, et al : Endovascular management of iatrogenic dissection into the petrous segment of the internal carotid artery during mechanical thrombectomy for acute stroke. J Clin Neurosci 71 : 273-4, 2020
2) Nakahara M, et al : Iatrogenic intracranial vessel dissection during mechanical thrombectomy rescued by emergent stenting : 2 case reports. Radiol Case Rep 16 : 835-42, 2021
P.74 掲載の参考文献
1) Balami JS, et al : Complications of endovascular treatment for acute ischemic stroke : Prevention and management. Int J Stroke 13 : 348-61, 2018
2) Humphries W, et al : Distal aspiration with retrievable stent assisted thrombectomy for the treatment of acute ischemic stroke. J Neurointerv Surg 7 : 90-4, 2015
P.79 掲載の参考文献
1) 一般社団法人日本脳卒中学会 脳卒中ガイドライン委員会 : 脳卒中治療ガイドライン 2021. 協和企画, 東京, 2021
2) Petersen NH, et al : Blood Pressure Trajectory Groups and OutcomeAfter Endovascular Thrombectomy : A Multicenter Study. Stroke 53 : 1216-25, 2022
3) Nam HS, et al : OPTIMAL-BP Trial Investigators. Intensive vs Conventional Blood Pressure Lowering After Endovascular Thrombectomy in Acute Ischemic Stroke : The OPTIMAL-BP Randomized Clinical Trial. JAMA 330 : 832-42, 2023
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6) Fischer U, et al : Early versus Later Anticoagulation for Stroke with Atrial Fibrillation. N Engl J Med 29 : 2411-21, 2023
7) Paciaroni M, et al : Early Recurrence and Cerebral Bleeding in Patients With Acute Ischemic Stroke and Atrial Fibrillation : Effect of Anticoagulation and Its Timing : The RAF Study. Stroke 46 : 2175, 2015
8) Azoulay L, et al : Initiation of warfarin in patients with atrial fibrillation : early effects on ischaemic strokes. Eur Heart J 35 : 1881-7, 2014
9) Naruto N, et al : Dual energy computed tomography for the head. Jpn J Radiol 36 : 69-80, 2018
10) Lee LJ, et al : Impact on stroke subtype diagnosis of early diffusion-weighted magnetic resonance imaging and magnetic resonance angiography. Stroke 31 : 1081-9, 2000
11) Sporns PB, et al : Ischemic Stroke : Histological Thrombus Composition and Pre-Interventional CT Attenuation Are Associated with Intervention Time and Rate of Secondary Embolism. Cerebrovasc Dis 44 : 334-50, 2017
12) Heo JH, et al : Pathophysiologic and therapeutic perspectives based on thrombus histology in stroke. J Stroke 22 : 64-75, 2020
13) Takaya Y, et al : Importance of saline contrast transthoracic echocardiography for evaluating large right-to-left shunt in patent foramen ovale associated with cryptogenic stroke. Int J Cardiovasc Imaging 38 : 515-20, 2022
14) Wang Y, et al : Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med 369 : 11-9, 2013
15) Johnston SC, et al : Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA. N Engl J Med 379 : 215-25, 2018
16) Pan Y, et al : Risks and benefits of clopidogrel-aspirin in minor stroke or TIA : Time course analysis of CHANCE. Neurology 16 : 1906-11, 2017
17) Blanco M, et al : Statin treatment withdrawal in ischemic stroke : a controlled randomized study. Neurology 69 : 904-10, 2007
18) Hoshino T, et al : Prognostic Role of Hypertriglyceridemia in Patients With Stroke of Atherothrombotic Origin. Neurology 98 : e1660-9, 2022
19) Goldstein B, et al : Stroke Prevention by Aggressive Reduction in Cholesterol Levels Investigators. Statin treatment and stroke outcome in the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial. Stroke 40 : 3526-31, 2009
20) Torbey MT, et al : Intensive Versus Standard Treatment of Hyperglycemia in Acute Ischemic Stroke Patient : A Randomized Clinical Trial Subgroups Analysis. Stroke 53 : 1510-5, 2022

III 部位ごとのテクニックを磨く !

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4) Schartz DA, et al : A Meta-analysis of Combined Aspiration Catheter and Stent Retriever versus Stent Retriver Alone for Large-Vessel Occlusion Ischemic Stroke. AJNR Am J Neuroradiol 43 : 568-74, 2022
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6) Goto S, et al : A Stent-Retrieving into an Aspiration Catheter with Proximal Balloon (ASAP) Technique : A Technique of Mechanical Thrombectomy. World Neurosurg 109 : e468-75, 2018
7) Massari F, et al : ARTS (Aspiration-Retriever Technique for Stroke) : Initial clinical experience. Interv Neuroradiol 22 : 352-32, 2016
8) McTaggart RA, et al : Continuous aspiration prior to intracranial vascular embolectomy (CAPTIVE) : a technique which improves outcomes. J Neurointerv Surg 9 : 1154-9, 2017
9) Maus, V, et al : Maximizing First-Pass Complete Reperfusion with SAVE. Clin Neuroradiol 28 : 327-38, 2018
10) Singh J, et al : Anchor technique : Use of stent retrievers as an anchor to advance thrombectomy catheters in internal carotid artery occlusions. Interv Neuroradiol 21 : 707-9, 2015
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3) 西秀久ほか : "テクニックを磨く! M2-3 閉塞 : あなたならどうする? ". 血栓回収療法Technical Tips. 吉村紳一編. メディカ出版, 92-8, 2019
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IV シチュエーションごとのテクニックを磨く !

P.137 掲載の参考文献
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3) 傳和眞ほか : 腫瘍塞栓子が左房内に存在した肺癌・心房細動併存の脳塞栓症の1剖検例. 臨床神経 60 : 597-602, 2020
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4) Yi Sun, et al : New stress-induced hyperglycaemia markers predict prognosis in patients after mechanical thrombectomy. BMC Neurol 23 : 132, 2023
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V 治療の選択肢を増やす「裏技」を知る !

P.188 掲載の参考文献
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P.204 掲載の参考文献
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VI デバイスの特性を知る !

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