臨牀透析 Vol.23 No.1(2-4)


特集名 透析患者におけるInterventional radiology
題名 [各論]末梢血管とIVR
発刊年月 2007年 01月
著者 東浦 渉 奈良県立医科大学放射線科
著者 吉川 公彦 奈良県立医科大学放射線科
著者 吉田 克法 奈良県立医科大学透析部
【 要旨 】 interventional radiology (以下,IVR) は維持透析患者の末梢動脈閉塞性疾患に対する血行再建術の一つとして重要な役割を果たしている.本稿では,IVRの適応,治療方法と成績について,大動脈・腸骨動脈領域,大腿動脈・膝上膝窩動脈領域および膝下動脈領域に分け概説した.IVRは腸骨動脈領域では有効な治療法として確立されつつあるが,大腿動脈や膝窩動脈および膝下動脈領域では治療体系は確立されてはいない.外科的治療とIVRの併用療法も有効な治療法となることがあり,術前検査をもとに適切な治療計画を立てること,病変の複雑性を理解して合併症対策を十分に行うことが,良好な治療成績を得るうえで重要である.
Theme Interventional Radiology for Dialysis Patients
Title IVR for peripheral arterial occlusion in patients with ESRD
Author Wataru Higashiura Department of Radiology, Nara Medical University Hospital
Author Kimihiko Kichikawa Department of Radiology, Nara Medical University Hospital
Author Katsunori Yoshida Division of Dialysis Unit, Nara Medical University Hospital
[ Summary ] Interventional radiology (IVR) has played an important role in revascularization in peripheral arterial disease (PAD) in patients with end-stage renal disease (ESRD). We discussed the indications, methods and results of IVR for PAD in patients with ESRD. As far as maybe determined, IVR contributes to the treatment of patients with iliac arterial occlusive disease. However, there is no significant evidence as to adequate outcomes with IVR, compared with conventional surgery, in cases with infrainguinal disease. Combined therapy with conventional surgery and IVR is effective for several type of case. To obtain good therapeutic results, it is important to program how to treat ischemic legs in patients with ESRD as well as developing countermeasures for complications.
戻る