先端医療シリーズ9 脳神経外科 脳神経外科医のための血管内治療 その実際と今後の展望

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本書の内容は、脳および脊髄領域の血管内外のすべてをカバーしており、執筆者は、それぞれの領域を現場で担当している若手脳神経外科医である。本書は、現在の日本の血管内外科の到達点、生じうる合併症を知り、将来の展望を考える上で有用であると考える。

目次

  • 表紙
  • カラーグラビア
  • 著者一覧
  • 本書を推薦する
  • 本書を推薦する
  • 序文
  • 目次
  • 第1章 機材・材料
  • 1. 機材・材料
  • 1.1 はじめに
  • 1.2 マイクロカテーテル使用時のシステムセットアップ
  • 1.3 シース(カテーテルシースイントロデューサー)
  • 1.4 Yコネクター
  • 1.5 ガイディングカテーテル
  • 1.6 ガイドワイヤー
  • 1.6.1 035inchガイドワイヤー
  • 1.6.2 Exchange用ガイドワイヤー
  • 1.6.3 その他のガイドワイヤー
  • 1.6.4 マイクロガイドワイヤー
  • 1.7 マイクロカテーテル
  • 1.7.1 0ver-the-wire Microcatheters
  • 1.7.2 Flow-guided Microcatheters
  • 1.8 バルーンカテーテル
  • 1.8.1血管閉塞用バルーンカテーテル
  • 1.8.2 マイクロバルーンカテーテル
  • 1.8.3 PTA(血管形成術)用バルーンカテーテル
  • 2. 塞栓物質
  • 2.1 はじめに
  • 2.2 液体塞栓物質
  • 2.2.1 シアノアクリレート系モノマー
  • 2.2.2 EVAL, Eudragit-E, CAP, PVAc
  • 2.2.3 95％エタノール
  • 2.2.4 電気凝固による血栓
  • 2.3 固形塞栓物質
  • 2.3.1 PVA(polyvinyl alcohol)粒子
  • 2.3.2 Pushable coil
  • 2.3.3 Detachable coil
  • 2.3.4 Detachable balloon
  • 2.3.5 Surgical suture
  • 2.3.6 Gelatin sponge (Spongel, Gelfoam),microfibrillar collagen(Avitene)
  • 3. ステント
  • 3.1 はじめに
  • 3.2 ステントの歴史
  • 3.3 ステントの分類
  • 3.3.1 形状、ステントのデザインによる分類
  • 3.3.2 拡張方法、delivery systemによる分類
  • 3.3.3 材質による分類
  • 3.4 頭頚部、脳血管に使用されているステント
  • 3.4.1 Palmaz stent
  • 3.4.2 EasyWall stent
  • 3.4.2.1 EasyWall stentのshorteningについて
  • 3.4.3 SMART stent
  • 3.4.4 AVE S670 stent
  • 3.5 頭頚部血管、脳血管での理想的ステント
  • 4. デバイスの開発と臨床応用
  • 4.1 はじめに
  • 4.2 微粒子塞栓材料
  • 4.3 バルーンカテーテル
  • 4.4 液体塞栓材料
  • 4.5 白金コイル
  • 4.6 おわりに
  • 第2章 周術期の管理・薬剤
  • 1 はじめに
  • 2 周術期の一般的管理
  • 2.1 概論
  • 2.2 術前準備
  • 2.3 術中管理
  • 2.4 術後管理
  • 3 脳血管内手術における薬物治療
  • 3.1 抗凝固療法・抗血小板療法
  • 3.2 血栓溶解剤
  • 3.3 血圧コントロール
  • 3.4 鎮静・鎮痛薬、麻酔薬
  • 3.5 誘発テスト、負荷テスト
  • 3.6 その他
  • 第3章 機能的血管解剖
  • 1 はじめに
  • 2 内頚動脈と椎骨・脳底動脈系の遺残血管吻合
  • 3 内頚動脈系の機能的血管解剖
  • 4 眼動脈と外頚動脈系の機能的血管解剖
  • 5 後頭・咽頭動脈系(Occipito-Pharyngeal System)の機能的血管解剖
  • 6 椎骨脳底動脈系の機能的血管解剖
  • 第4章 血管内治療の病理診断
  • 1 はじめに
  • 2 冠動脈
  • 3 大動脈ステントグラフト
  • 4 脳動脈
  • 5 その他の血管
  • 6 おわりに
  • 第5章 画像診断法の進歩
  • 1. DSA
  • 1.1 はじめに
  • 1.2 透視装置の性能
  • 1.3 装置のコントロール
  • 1.4 ロードマップ機能
  • 1.5 回転DSA、3D-DSA
  • 1.6 ポータブルDSA
  • 1.7 計測
  • 1.8 主なメーカーの機種(2000年10月現在)
  • 2. CT
  • 2.1 はじめに
  • 2.2 ルーチンスタデイ
  • 2.3 ヘリカル三次元CT血管撮影(Helical 3D CT Angiography)
  • 2.3.1 データ収集
  • 2.3.2 三次元画像処理
  • 2.3.2.1 Surface Rendering
  • 2.3.2.2 Volume Rendering
  • 2.3.2.3 MPR(multiplaner reformation)
  • 2.3.2.4 MIP(maximal intensity projection)
  • 2.3.2.5 カットモデル
  • 2.3.2.6 仮想内視鏡Virtual Endoscope(VES),fly through
  • 2.3.2.7 実体モデル
  • 2.3.3 適応と限界
  • 2.3.4 3D DSAとの対比
  • 2.4 CBF study
  • 2.4.1 Dynamic CT(ダイナミックCT)
  • 2.4.2 Cold Xe enhanced CT(キセノンCT)
  • 2.5 まとめ
  • 3. MRI:とくに拡散強調画像と脳灌流画像について
  • 3.1 はじめに
  • 3.2 脳血管内治療の領域における従来のMRI検査の役割
  • 3.3 超高速MRIの脳血管内治療領域への応用:Echo-planar imaging(EPI)法の導入
  • 3.4 拡散強調画像(diffusion-weighted imaging:DWI)
  • 3.4.1 拡散強調画像の原理
  • 3.4.2 脳虚血におけるDWI画像の意義
  • 3.4.3 DWIによる脳血管内治療に合併する脳塞栓症のスクリーニング
  • 3.5 灌流画像(perfusion imaging:PI)
  • 3.5.1 MRIによる脳灌流画像の原理
  • 3.5.2 脳血管内治療の領域におけるPIの応用
  • 3.6 おわりに
  • 4. 超音波
  • 4.1 はじめに
  • 4.2 超音波診断機器
  • 4.3 検査法
  • 4.4 病変の評価
  • 4.5 おわりに
  • 5. 血管内脳波
  • 5.1 はじめに
  • 5.2 側頭葉てんかんとその焦点診断
  • 5.3 海綿静脈洞内脳波記録法
  • 5.4 測定例
  • 5.4.1 発作間欠期脳波
  • 5.4.2 発作時脳波
  • 5.5 有用性・問題点・展望
  • 6. SPECT
  • 6.1 はじめに
  • 6.2 脳血流SPECTトレーサーの特徴
  • 6.2.1 123I-IMP
  • 6.2.2 99mTc-ECD
  • 6.3 定量評価
  • 6.4 超急性期脳血管障害の脳血流SPECT
  • 6.4.1 拡散強調画像所見と脳血流SPECT画像所見との比較
  • 6.4.2 超急性期の治療適応
  • 6.4.3 心原性脳塞栓症と脳血流SPECT画像
  • 6.4.4 贅沢灌流(Luxury perfusion)の検出
  • 6.5 皮質枝梗塞
  • 6.6 慢性期
  • 6.7 脳循環予備能の評価
  • 6.8 結語
  • 第6章 閉塞性疾患
  • 1. 急性脳血管閉塞に対する局所再開通療法
  • 1.1 はじめに
  • 1.2 臨床病型の診断
  • 1.3 心原性脳塞栓症
  • 1.3.1適応症例の選択
  • 1.3.2 閉塞部位による違い
  • 1.3.3 脳血管撮影まで
  • 1.3.4 脳血管撮影
  • 1.3.5 血管内治療
  • 1.3.6 術後管理
  • 1.3.7 治療成績
  • 1.3.8 NINDS studyとの関連
  • 1.4 アテローム血栓性脳梗塞
  • 1.4.1 Therapeutic time windowの判断
  • 1.4.2 適応症例の選択
  • 1.4.3 中大脳動脈閉塞症
  • 1.4.4 頚部内頚動脈閉塞症
  • 1.4.5 椎骨動脈起始部閉塞症
  • 1.4.6 脳底動脈閉塞症
  • 1.4.7 動脈原性脳塞栓症
  • 1.5 まとめ
  • 2. 脳静脈洞血栓症に対する血管内治療
  • 2.1 脳静脈洞血栓症について
  • 2.2 治療
  • 2.2.1 保存的治療法
  • 2.2.2 血管内治療
  • 2.3 静脈洞に対するステント留置術
  • 3. 頚部内頚動脈狭窄症に対する血管内治療
  • 3.1 はじめに
  • 3.2 適応
  • 3.3 術前評価、治療手技および管理
  • 3.3.1 術前評価
  • 3.3.2 術前管理
  • 3.3.3 治療手技および術中管理
  • 3.3.4 計測
  • 3.3.5 バルーンカテーテル、ステントの選択
  • 3.3.6 前拡張
  • 3.3.7 ステント離脱
  • 3.3.8 後拡張
  • 3.3.9 前拡張よりプロテクションを行う場合
  • 3.3.10 術後評価
  • 3.3.11 術後管理
  • 3.3.12 術後検査
  • 3.4 頚動脈PTA/stentingの現状と成績
  • 3.5 今後の課題
  • 3.5.1 狭窄部末梢での塞栓予防
  • 3.5.2 フィルターデバイス(Angioguard)
  • 3.5.3 総頚動脈バルーン閉塞下のPTA/stenting
  • 3.6 再狭窄予防
  • 3.7 結語
  • 4. 椎骨動脈、鎖骨下動脈に対する血管形成術
  • 4.1椎骨動脈に対する血管形成術
  • 4.1.1 症状
  • 4.1.2 治療の適応
  • 4.1.3 方法
  • 4.1.4 問題点
  • 4.1.5 むすび
  • 4.2 鎖骨下動脈に対する血管形成術
  • 4.2.1 症状
  • 4.2.2 診断
  • 4.2.3 治療の適応
  • 4.2.4 方法
  • 4.2.5 むすび
  • 第7章 血管形成術後の再狭窄
  • 1. 冠動脈ステントの再狭窄
  • 1.1 ステント再狭窄のメカニズム
  • 1.1.1 PTCA再狭窄のメカニズム
  • 1.1.2 再狭窄予防
  • 1.1.3 ステント再狭窄のメカニズム
  • 1.2 ステントによる再狭窄予防効果
  • 1.3 血管形態、病変形態別再狭窄予防効果
  • 1.3.1 血管径による再狭窄予防効果
  • 1.3.2 病変の長さによる再狭窄予防効果
  • 1.3.3 慢性完全閉塞病変の再狭窄予防効果
  • 1.3.4 大動脈入口部
  • 1.3.5 分岐部病変
  • 1.4 冠動脈ステントの種類と機能
  • 1.4.1 素材による分類
  • 1.4.2 拡張方法による分類
  • 1.4.3 形状及び製造過程による分類
  • 1.4.4 付加機能による分類
  • 1.5 ステント別再狭窄率
  • 1.6 病変別ステント留置法
  • 1.7 ステント再狭窄の形態
  • 1.8 ステント再狭窄に対する対策
  • 1.8.1 ステント再狭窄の予防
  • 1.8.2 ステント再狭窄に対するインターベンションー再々狭窄の予防
  • 2. 再狭窄に対する遺伝子治療
  • 2.1 はじめに
  • 2.2 血栓凝集予防療法
  • 2.3 血管平滑筋細胞増殖抑制療法
  • 2.3.1 細胞周期調節療法
  • 2.3.1.1 アンチセンス型核酸を用いた再狭窄予防
  • 2.3.1.2 デコイ型核酸を用いた再狭窄予防
  • 2.3.1.3 リボザイム型核酸を用いた再狭窄予防
  • 2.3.2 自殺療法
  • 2.3.3 細胞内シグナル遮断療法
  • 2.4 内皮再生療法(リモデリング療法)
  • 2.5 おわりに
  • 3. 再狭窄に対する放射線治療
  • 3.1 はじめに
  • 3.2 再狭窄の発症機序と放射線治療
  • 3.3 血管内放射線治療に用いられる核種
  • 3.4 血管内治療用器具
  • 3.5 治療手技の実際
  • 3.6 臨床知験の成績
  • 3.6.1 冠動脈における成績
  • 3.6.2 末梢血管における成績
  • 3.7 被曝線量
  • 3.7.1 患者被曝
  • 3.7.2 術者被曝
  • 3.7.3 被曝線量を減らすためには
  • 3.8 血管内放射線治療の問題点
  • 3.9 脳神経外科領域への応用
  • 3.10 法律上の問題点と今後の展望
  • 第8章 脳動脈瘤
  • 1. 母血管閉塞
  • 1.1 はじめに
  • 1.2 balloon occlusion test
  • 1.3 適応
  • 1.4 周術期管理
  • 1.5 治療法
  • 1.6 大、巨大動脈瘤
  • 1.7 解離性動脈瘤
  • 1.8 症例
  • 1.9 合併症とその対策
  • 2. 破裂脳動脈瘤(瘤内塞栓術)
  • 2.1 はじめに
  • 2.2 血管内治療の利点
  • 2.3 血管内治療の欠点
  • 2.4 セットアップ
  • 2.5 術中管理
  • 2.6 手技
  • 2.6.1 マイクロカテーテルの操作
  • 2.6.2 coilの選択
  • 2.6.3 coil挿入時の注意
  • 2.6.4 終了時の判断
  • 2.7 neckが大きな動脈瘤での塞栓術
  • 2.8 各動脈瘤の塞栓術
  • 2.8.1 前交通動脈瘤
  • 2.8.2 内頚動脈瘤
  • 2.8.3 中大脳動脈瘤
  • 2.8.4 椎骨動脈-後下小脳動脈分岐部動脈瘤
  • 2.8.5 脳底動脈瘤
  • 2.8.6 上小脳動脈分岐部
  • 2.9 合併症の対応
  • 2.9.1 虚血の合併症
  • 2.9.2 術中破裂
  • 2.9.2.1 全身管理
  • 2.9.2.2 血管内での対処
  • 2.10 結語
  • 3. 未破裂脳動脈瘤に対する血管内治療
  • 3.1 はじめに
  • 3.2 適応
  • 3.3 方法(使用器材)
  • 3.4 種々の工夫(補助手段)
  • 3.5 合併症とその対策
  • 3.6 今後の展望
  • 4. 脳血管攣縮
  • 4.1 はじめに
  • 4.2 本法の適応
  • 4.3 使用機器
  • 4.4 周辺機器
  • 4.5 方法
  • 4.6 代表例
  • 4.6.1 PTA列
  • 4.6.2 IA例
  • 4.7 結果
  • 4.8 報告例
  • 4.9 考察
  • 4.10 まとめ
  • 5. 脳動脈瘤に対する血管内治療:今後の展望
  • 5.1 はじめに
  • 5.2 GDCのLimitation
  • 5.3 Morphological factor
  • 5.4 Biological factor
  • 5.5 血管内治療とTissue Engineering
  • 5.6 Flow dynamic factor
  • 5.7 液体塞栓物質
  • 5.8 DSAからrealtime Interventional MRIへ
  • 5.9 終わりに
  • 第9章 血管奇形
  • 1. 脳動静脈奇形塞栓術の術中治療戦略
  • 1.1 はじめに
  • 1.2 脳神経外科領域における血管内治療の特殊性と対策
  • 1.3 脳動静脈奇形の塞栓術
  • 1.4 脳動静脈奇形に対する塞栓術の適応
  • 1.5 設備
  • 1.6 用具
  • 1.6.1 microcatheter
  • 1.6.2 塞栓物質
  • 1.6.2.1 固体物質
  • 1.6.2.2 液体物質
  • 1.6.2.3 塞栓物質の解説
  • 1.7 麻酔
  • 1.7.1 局所麻酔
  • 1.7.2 全身麻酔
  • 1.8 塞栓術中モニター
  • 1.8.1 流入動脈圧(feeder pressure)
  • 1.8.2 頚静脈球部酸素飽和度(Sj O2)
  • 1.8.3 運動誘発電位(motor evoked potential;MEP)
  • 1.9 塞栓術の実際
  • 1.10 術後管理と注意点
  • 1.11 治療の合併症
  • 1.11.1 catheter操作による出血
  • 1.11.2 正常動脈の閉塞による合併症(梗塞)
  • 1.11.3 出血
  • 1.12 治療のコツ
  • 1.13 代表症例
  • 1.14 おわりに
  • 2. 脳動静脈奇形・集学的治療
  • 2.1 はじめに
  • 2.2 治療戦略の決定
  • 2.3 根治的治療としての塞栓術
  • 2.3.1 塞栓物質
  • 2.3.2 塞栓方法
  • 2.3.3 術後管理とfollow-up
  • 2.4 Radiosurgery前の塞栓術
  • 2.4.1 塞栓物質
  • 2.4.2 塞栓方法
  • 2.4.3 塞栓術からradiosurgeryまでのインターバル
  • 2.4.4 Follow-up
  • 2.5 観血的手術前の塞栓術
  • 2.5.1 塞栓物質
  • 2.5.2 塞栓方法
  • 2.5.3 塞栓から手術までのインターバル
  • 2.6 姑息的治療としての塞栓術
  • 2.7 AVMに付随した動脈瘤の治療
  • 2.8 まとめ
  • 3. 脊髄動静脈奇形の血管内治療
  • 3.1 はじめに
  • 3.2 脊髄動静脈奇形の分類
  • 3.3 治療戦略
  • 3.4 血管内治療の実技
  • 3.5 結語
  • 4. 海綿静脈洞部硬膜動静脈瘻
  • 4.1 病因
  • 4.2 分類
  • 4.3 症状
  • 4.4 解剖
  • 4.5 治療適応
  • 4.6 治療
  • 4.6.1 保存的治療
  • 4.6.2 塞栓術
  • 4.6.2.1 経動脈的塞栓術
  • 4.6.2.2 経静脈的塞栓術
  • 4.6.2.3 Anterior approach
  • 4.6.2.4 Posterior approach
  • 4.6.2.5 SOVの直接穿刺法
  • 4.6.2.6 外科的方法
  • 4.6.2.7 塞栓術の合併症
  • 4.6.3 放射線治療
  • 4.6.3.1 定位的放射線治療
  • 5. その他の硬膜動静脈瘻
  • 5.1 はじめに
  • 5.2 分類
  • 5.3 部位別にみた血管内治療
  • 5.3.1 横・S状静脈洞部
  • 5.3.1.1 分類と治療戦略
  • 5.3.1.2 塞栓術
  • 5.3.1.3 フォローアップ
  • 5.3.2 上矢状洞部
  • 5.3.2.1 治療戦略
  • 5.3.2.2 塞栓術
  • 5.3.2.3 経静脈的及び直接穿刺による塞栓術
  • 5.3.2.4 フォローアップ
  • 5.3.3 テント部
  • 5.3.3.1 治療戦略
  • 5.3.3.2 塞栓術
  • 5.3.4 その他の部位
  • 5.3.4.1 頭蓋i頸椎移行部
  • 5.3.4.2 下錐体静脈洞部及びmarginal sinus
  • 5.3.4.3 前頭蓋底部
  • 5.4 その他の治療法
  • 6. ガレン大動脈瘤およびその類似疾患
  • 6.1 はじめに
  • 6.2 ガレン大動脈瘤
  • 6.2.1 発生学的背景および血管構築
  • 6.2.2 臨床症状
  • 6.2.3 治療
  • 6.2.4 水頭症
  • 6.3 先天性硬膜動静脈瘻
  • 6.4 新生児期の血管撮影および血管内手術
  • 6.4.1 新生児期の血管撮影の特異点
  • 第10章 脳腫瘍
  • 1. 腫瘍塞栓術
  • 1.1 はじめに
  • 1.2 主な対象疾患
  • 1.2.1 髄膜腫meningioma
  • 1.2.2 Juvenile angiofibloma
  • 1.2.3 Chemodectoma
  • 1.3 塞栓物質
  • 1.3.1 Polyvinyl alcohol (PVA)particle
  • 1.4 症例呈示
  • 1.5 合併症
  • 2. 悪性脳腫瘍に対する動注化学療法
  • 2.1 はじめに
  • 2.2 抗癌剤動注の意義
  • 2.3 抗癌剤動注の適応疾患
  • 2.4 術前検査および前処置
  • 2.5 投与方法
  • 2.6 投与薬剤
  • 2.7 Blood brain barrier disruption
  • 2.8 合併症
  • 2.9 治療成績
  • 2.10 最近行われた動注化学療法の多施設試験
  • 2.11 まとめと展望
  • 第11章 頭頚部疾患
  • 1. 内頚動脈海綿静脈洞棲
  • 1.1 はじめに
  • 1.2 病因
  • 1.3 症状
  • 1.4 術前検査:血管造影で確認すべきポイント
  • 1.5 治療
  • 1.5.1 離脱式バルーンによる瘻孔閉鎖
  • 1.5.2 コイルによる経動脈的または静脈的塞栓
  • 1.6 合併症
  • 2. 頭頚部血管病変(血管奇形、血管腫、鼻出血)の血管内治療
  • 2.1 血管奇形及び血管腫の分類
  • 2.2 血管腫
  • 2.3 血管奇形
  • 2.3.1 静脈性血管奇形(venous malformation)
  • 2.3.2 毛細血管性血管奇形(capillary malfor mation)
  • 2.3.3 動静脈奇形(動静脈瘻も含む)
  • 2.3.4 リンパ性血管奇形(lymphatic malformation)
  • 2.4 鼻出血に対する血管内治療
  • 2.4.1 鼻出血(epistaxis)の分類
  • 2.4.2 鼻腔の血管解剖
  • 2.4.3 血管内治療
  • 2.4.3.1 非外傷性の鼻出血
  • 2.4.3.2 外傷性の鼻出血
  • 3. 顔面けいれん
  • 3.1 はじめに
  • 3.2 診断
  • 3.2.1 臨床症状
  • 3.2.2 原因
  • 3.2.3 臨床診断
  • 3.2.4 画像診断
  • 3.2.5 機能的診断
  • 3.2.5.1方法
  • 3.2.5.2 結果
  • 3.3 治療
  • 第12章 脳血管内治療の位置付け-特に直達手術との使い分けについて-
  • 1 はじめに
  • 2 脳動脈瘤
  • 2.1 椎骨動脈瘤
  • 2.2 脳底動脈瘤
  • 2.3 内頸動脈瘤
  • 2.4 その他の部位の動脈瘤
  • 2.5 脳血管攣縮
  • 2.6 重症クモ膜下出血例
  • 2.7 高齢者における破裂脳動脈瘤
  • 3 脳動静脈奇形(AVM)
  • 4 閉塞性脳血管障害
  • 4.1 局所再開通療法
  • 4.2 血管形成術、ステント留置術
  • 第13章 各種製品の臨床評価
  • 1. ガンマナイフ治療の進歩
  • 1.1 ガンマナイフの開発、変遷
  • 1.2 ガンマナイフ治療のための画像診断-脳腫瘍
  • 1.3 ガンマナイフ治療のための画像診断-脳動静脈奇形
  • 1.4 集学的治療-脳動静脈奇形
  • 2. 止血デバイスについて
  • 2.1 はじめに
  • 2.2 止血デバイスは必要か？
  • 2.3 止血デバイスの種類
  • 2.4 プロスター使用の実際
  • 2.5 プロスターの臨床成績
  • 2.6 まとめ
  • 技術資料編
  • OEC Mobile DSAについて
  • 1 はじめに
  • 2 高画質
  • 3 回転陽極型X線管
  • 4 大容量メモリー
  • 5 おわりに
  • Cutting BalloonTM
  • 1 はじめに
  • 2 Cutting BalloonTMの構造 / 改良
  • 3 使用方法
  • 4 拡張機序
  • 5 Cutting BalloonTMが有用とされる病変
  • 5.1 ステント内再狭窄病変
  • 5.2 小血管
  • 5.3 入口部病変
  • 5.4 分岐部病変
  • 5.5 ステント留置の前拡張
  • 6 多施設における無作為割付臨床試験(REDUCE trial)
  • 6.1 REDUCE1
  • 6.2 REDUCE2
  • 6.3 REDUCE3
  • 7 今後の展望
  • 血管内視鏡の現状と今後の展望
  • 1 はじめに
  • 2 血管内視鏡システム
  • 3 血管内視鏡の手技
  • 4 血管内視鏡の課題
  • 4.1 カテーテル技術の課題
  • 4.2 診断技術の課題
  • 5 まとめ
  • MRAの最近の進歩について
  • 1 はじめに
  • 2 MRAの撮像法
  • 2.1 表示法
  • 2.2 撮影法
  • 2.2.1 Time-of-flight(TOF)法
  • 2.2.2 Phase-contrast (PC)法
  • 2.2.3 Infusion-MRA
  • 最近の3D画像と血管内治療
  • 1 はじめに
  • 2 3次元画像処理システムRT 3D Angio Virtuoso
  • 3 フルスケール・ボリューム・レンダリング・テクニック(VRT)
  • PTAバルーンカテーテル 最近の進歩
  • 1 はじめに
  • 2 開発の流れ
  • 2.1 PTAバルーン材質
  • 2.2 PTAバルーンのシャフト構造
  • 2.3 PTAバルーンの性能
  • 3 製品の特徴
  • 3.1 PTAバルーンカテーテル
  • 3.2 PTCAバルーンカテーテル
  • 3.3 脳血管内用バルーンカテーテル
  • 4 まとめ
  • Equinox Occlusion Balloon Catheterについて
  • 1 はじめに
  • 2 開発の経緯
  • 3 特徴
  • 4 使用方法
  • 5 注意
  • 6 おわりに
  • 抗凝固剤と抗血小板剤について～アルガトロバン・塩酸チクロピジン～
  • 1 アルガトロバン
  • 1.1 開発の経緯
  • 1.2 製品の特徴
  • 1.3 今後の展望
  • 2 塩酸チクロピジン
  • 2.1 開発の経緯
  • 2.2 製品の特徴
  • 2.3 今後の展望
  • テルモ社製血管造影用ガイドワイヤーについて
  • 1 はじめに
  • 2 開発経緯
  • 3 構造
  • 4 頭部領域への展開
  • 5 頭部領域への新たな展開
  • 6 今後の医療器開発
  • DSAの血管内治療における役割と今後の展望
  • 1 はじめに
  • 2 DSAの歴史と原理
  • 2.1 DSAの歴史
  • 2.2 DSA装置の構成
  • 2.3 DSA画像処理
  • 3 血管内治療に有用なDSAの機能
  • 3.1 透視画像処理
  • 3.2 参照画像機能
  • 3.3 画像解析
  • 3.4 回転DSA
  • 4 今後の展望
  • 4.1 3次元構造の把握
  • 4.2 血流動態の把握
  • 5 まとめ
  • 抗血栓性コーティング材料 東レ"アンスロン(R)"
  • 1 はじめに
  • 2 抗血栓性材料としてのアンスロン
  • 2.1 ヘパリンの溶出挙動
  • 2.2 ヘパリンの内部からの補給
  • 2.3 アンスロンの化学構造と分子設計
  • 2.4 ヘパリンの溶出速度の支配因子
  • 3 アンスロン新製品の特長
  • 3.1 アンギオカテーテル
  • 4 おわりに
  • 点滴静注用塩酸ドパミン製剤「カタボン・Low/Hi」について
  • 1 はじめに
  • 1.1 ドパミンの歴史
  • 1.2 ドパミンの特徴
  • 1.2.1 ドパミンの作用発現時間と持続時間
  • 1.2.2 ドパミンの薬理作用
  • 1.2.3 ドパミンの化学変化
  • 2 カタボン・Low/Hiの特徴
  • 2.1 開発の経緯
  • 2.2 製剤的特徴
  • 2.3 投与量の換算(投与量表)
  • 2.4 キット製品としての有用性
  • 3 カタボン・Low/Hiの効能・効果、用法・用量など
  • 3.1 効能・効果
  • 3.2 用法・用量
  • 3.3 禁忌を含む使用上の注意など(抜粋)
  • 4 カタボン・Low/Hiの臨床成績
  • 5 今後の展望
  • 5.1 低用量ドパミン
  • 5.2 脳神経外科領域でのドパミン
  • 5.3 今後の展望
  • 電子走査型血管内超音波診断装置ln-Vision
  • 1 はじめに
  • 2 電子スキャン方式
  • 3 血流のカラー表示
  • 4 In-Visionの特徴
  • ボストン・サイエンティフィック社マイクロカテーテルの変遷
  • 1 はじめに
  • 2 ボストン・サイエンティフィック社マイクロカテーテルの歴史
  • 2.1 概要
  • 2.2 Target Therapeutics(ターゲットセラピューティクス)社創立
  • 2.3 Tracker18(トラッカー18)が開発されるまで
  • 2.4 Tracker(トラッカーユニボディ、トラッカー10、 トラッカー38)
  • 2.5 Fas Tracker(ファス トラッカー)
  • 2.6 Fas Tracker18MX(ファス トラッカー18MX)
  • 2.7 Turbo Tracker18(ターボトラッカー18)
  • 2.8 Renegade18(レネゲード18)
  • 2.9 Excelsior1018(エクセルシオ1018)
  • 2.10 Spinnaker(スピネーカー)
  • 3 今後の展望
  • Detach Coil System(DCS)について
  • 1 商品開発のポリシー＆コンセプト
  • 2 製品の特徴と効果
  • 2.1 DCSデザイン
  • 2.2 コイルデザイン別に見た特徴
  • 3 今後の展開
  • 4 まとめ
  • 企業一覧
  • 和文索引
  • 欧文索引
  • 奥付

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。

第1章 機材・材料

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第2章 周術期の管理・薬剤

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第3章 機能的血管解剖

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第4章 血管内治療の病理診断

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第5章 画像診断法の進歩

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第6章 閉塞性疾患

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第7章 血管形成術後の再狭窄

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第8章 脳動脈瘤

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第9章 血管奇形

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第10章 脳腫瘍

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第11章 頭頚部疾患

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第13章 各種製品の臨床評価

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技術資料編

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