臨床神経学

<教育講演(3)―1>

脳梗塞再開通療法の最新適正治療方針

星野 晴彦

東京都済生会中央病院内科・神経内科・脳卒中センター〔〒108―0073 港区三田1―4―17〕

Thrombolytic therapy with intravenous tissue plasminogen activator (IV tPA) is initiated within 3 hours from the onset of ischemic stroke now. Following the publication of the results of ECASS III in 2008, IV tPA treatment has been initiated within 4.5 hours abroad. Expanding the therapeutic time window from 3 to 4.5 hours had been applied, but not approved yet in Japan. Evidence of mechanical intraarterial (IA) thrombectomy within 8 hours is not sufficient. Since a mismatch between PWI and DWI is very attractive for selecting patients for recanalization, the standardization of neuroimaging analysis must be established. For efficacious and safe recanalization, it is necessary to select patients based on accurate information on neuroimages and to establish the most useful therapy (IV tPA and/or IA thrombectomy) for each patient.
Full Text of this Article in Japanese PDF (224K)

(臨床神経, 52:882−884, 2012)
key words:経静脈tPA血栓溶解療法,経動脈血栓除去,症候性頭蓋内出血,ミスマッチ,ペナンブラ

(受付日:2012年5月25日)