超急性期脳梗塞に対する血 ... - rescue-japan.jp

1 Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism (RESCUE)- japan Registry RESCUE japan 501-1194 1-1 RESCUE- japan 058-230-6271, FAX: 058-230-6272, E : 2010 5 12 0 .. 3 1.. 4 2.. 4 3.. 4 4.. 6 5.. 6 6.. 7 7.. 7 8.. 10 9.. 10 10.. 10 11.. 11 12.. 11 13.. 12 14.. 13 15.. 14 16.. 14 17.. 15 18.. 15 19.. 15 20.. 16 21.. 18 22.. 26 0. 90 modified Rankin Scale 1. 2. 24 3. 20 1 14 2 120 90 10 RESCUE 1 4 1.

2 2. recombinant tissue plasminogen activator: rt-PA 3-5% rt-PA [1] rt-PA [2, 3] [4-7] Merci Penumbra [8, 9] MELT- japan [10] rt-PA 24 rt-PA 3. NIH Stroke Scale rt-PA rt-PA CT/MRI ASPECTS score ASPECTS-DWI score ASIST japan 24 8 J-ACT II Modified Mori I.

3 Modified Mori [11] Grade 0 Grade 1 RESCUE 1 5 Grade 2 50% Grade 3 50% IMS II TICI [12] AOL [3] II. TICI [12] 0 1 2A 2B 3 III. AOL [3] 0 1 2 3 SITS-MOST HI 1 HI 2 mass effect PH 1 mass effect 30% PH 2 mass effect 30% PHr 1 mass effect PHr 2 mass effect HI: hemorrhagic infarction, PH: parenchymal hematoma, PHr.

4 Remote parenchymal hematoma NIHSS 4 modified Rankin Scale( RS) [13] RESCUE 1 6 0 1 2 3 4 5 6 4. 1) 2010 7 1 2011 6 30 2) 24 3) ICA ICA A1 A2 M1 * M1 * M2 M3 VA BA P1 Pcom P2 M1 5mm M1 5mm M1 4) 5. RESCUE- japan (1) FAX E (2) (3) 1 1 FAX E (4) (URL ID ) RESCUE 1 7 (1) (2) URL (3) (4) 6.

5 Rt-PA 1) rt-PA rt-PA 2) ) ) 7. NIH Stroke Scale rt-PA 1 24 8 7 2 modified Rankin Scale 90 10 RESCUE 1 8 24 8 MRA rt-PA 3 MRA CTA 16-24 2 MRA mRS NIHSS (MRA,CTA, DSA) ASPECTS-CT ASPECTS-DWI rt-PA 1 14 (1) rt-PA TICI AOL.

6 3 (1) rt-PA balloon angioplasty, mechanical disruption , mechanical disruption ( ), , (Merci), urokinase,rt-PA TICI AOL (2) rt-PA balloon angioplasty, mechanical disruption mechanical disruption , Merci RESCUE 1 9 UK,rt-PA TICI AOL SITS-MOST (3) (NIHSS) rt-PA 1 24 8 7 1 24 CT/MRI ASPECTS-CT ASPECTS-DWI Modified Mori SITS-MOST SITS-MOST CT NIHSS 4 WBC Hb, Plt, BUN, Cre, Glu, CRP, PT-INR / rt-PA 24( 8 rt-PA 2 120 1.)

7 90 10 2. ( ) ( ) RESCUE 1 10 3. (mRS) ( ) 4. 5. ( ) 6. 1 2 3 14 120 24 8 7 1 90 10 (1) (mRS) NIHSS (4) (CT MRI) (6) (DSA, MRA, CTA) (2) (5) [ ] (3) (1) (2) MRA Modified Mori TICI, AOL (3) (4)

8 Rt-PA 3 (5) rt-PA rt-PA (6) 24 8 CT MRI 8. 1,000 2010 7 1 2011 9 30 9. 90 10 mRS 0-2 (1) 24 (2) 90 10 mRS 0-1 (3) 7 NIHSS (4) RESCUE 1 11 (5) 24 CT NIHSS 4 (6) 90 10 (7) 10. 50 1 20 1 1000 rt-PA 1) 90 ( 10) modified Rankin Scale 0-2 95% 2) 95% 11.

9 CRF 3 7 1 14 90 10 120 RESCUE 1 12 1 CRF CRF 12. 13.

10 2008 10 59 WMA ( 19 8 16 ) 20 7 31 1) 2) 3) 4) 5) 6) 7) RESCUE 1 13 8) 9) 10) 1) 2) 3) 4) 5) 6) 1) 2) 3) 4) 5)