徳島大学 教育・研究者情報データベース(EDB)

1. 桑山 一行

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2. 西 京子([徳島大学.病院.中央診療施設等.卒後臨床研修センター])

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3. 里見 淳一郎

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4. 山本 伸昭([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.内科系.臨床神経科学])

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5. 永廣 信治

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(英) Treatment strategy for acute ischemic stroke with internal carotid artery occlusion in the stroke care unit of Tokushima University Hospital

(日) 徳島大学病院脳卒中センターでの内頚動脈急性閉塞に対する治療戦略

(日) Objective : Strokes related to acute internal carotid artery (ICA) occlusion are associated with extremely poor prognosis. Recently, some studies have reported that the prognosis has been getting better by treating with intra-arterial endovascular therapy. We sought to evaluate clinical outcomes in patients with acute ischemic stroke attributable to ICA occlusion treated with intraarterial endovascular therapy or otherwise. Methods : We reviewed 44 patients who underwent treatment with intra-arterial endovascular therapy or otherwise in our stroke care unit (SCU) from January, 2011 to May, 2014. We compared the prognosis of patients in the 2 treatment groups (endovascular group, n＝23 vs nonendovascular group, n＝21). Results : The rate of good prognosis (modified Rankin Score of ≦2) was significantly higher in the endovascular group than non-endovascular group (17．4% vs0%，p＝0．045). The rate of patients who had extreme improvements of National Institutes of Health Stroke Scale (NIHSS) ≧8 was higher in the endovascular group than non-endovascular group (30．4% vs14．3%). Concerning the improvement of NIHSS ≧8, recombinant tissue-type plasminogen activator (rt-PA) or the left side ICA occlusion were associated significantly (p＝0．019, p＝0．042, respectively). Although the hypothesis that endovascular therapy could contribute to extreme improvements of NIHSS wasn't proved (p＝0．202), there was one case that NIHSS was dramatically improved from 22 to 0 by endovascular therapy. Conclusions : Intra-arterial endovascular therapy of ICA occlusion might result in improved clinical outcomes for indicated cases.

1. (英) ICA occlusion
2. (英) intra-arterial endovascular therapy
3. (英) recombinant tissue-type plasminogen activator (rt-PA)