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the management of someone or something; "the handling of prisoners"; "the treatment of water sewage"; "the right to equal treatment in the criminal justice system" (同)handling
care provided to improve a situation (especially medical procedures or applications that are intended to relieve illness or injury) (同)intervention
a manner of dealing with something artistically; "his treatment of space borrows from Italian architecture"

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〈U〉(人・物の)『取り扱い』,扱い方《+of+名》 / 〈U〉治療;〈C〉(…に対する)治療法《+for+名》

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/09/27 14:34:08」(JST)

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Endovascular surgery is a form of minimally invasive surgery that was designed to access many regions of the body via major blood vessels.

Endovascular techniques were originally pioneered for diagnostic purposes by radiologists. Basic techniques involve the introduction of a catheter percutaneously into a large blood vessel (Seldinger technique). Typically the blood vessel chosen is the femoral artery or a vein found near the groin. Access to the femoral artery for example, is required for coronary, carotid, and cerebral angiographic procedures. The catheter is injected with a radio-opaque dye that can be seen on live X-ray or fluoroscopy. As the dye courses through the blood vessels, characteristic images are seen by experienced viewers and can assist in the diagnosis of diseases such as atherosclerosis, vascular trauma, or aneurysms.

In recent years, however, the development of intravascular balloons, stents and coils have allowed for new therapies as alternatives to traditional surgeries such as Coronary artery bypass surgery (CABG), carotid endarterectomy and aneurysm clipping. Stents and coils are composed of fine wire materials such as platinum, that can be inserted through a thin catheter and expanded into a predetermined shape once they are guided into place.

Endovascular surgery is performed by radiologists, neurologists, neurosurgeons, cardiologists, and vascular surgeons. The field is rapidly growing as its minimally invasive techniques would seem to offer a lower risk of complications compared to traditional highly invasive surgeries. However, as shown by the Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial, the complication rates for some endovascular procedures surpass those present after "aggressive medical management" (i.e., management without surgery).^[1] In the case of SAMMPRIS, the technique in question was intracranial arterial stenting with the use of the Wingspan stent system, with some resulting complications possibly due to "the fact that stenting of the intracranial vasculature is technically more challenging" than stenting of vessels elsewhere.^[2] Other trials examining the comparative effectiveness of endovascular procedures include the Carotid Revascularization Endarterectomy versus Stent Trial (CREST), and International Subarachnoid Aneurysm Trial (ISAT), among others.^{[examples needed]}

Examples of Endovascular Surgery

EVAR, an endovascular treatment for abdominal aortic aneurysm
Carotid stenting, for treatment of carotid artery stenosis

References

^ Chimowitz MI, Lynn MJ, Derdeyn CP, et al. Stenting versus aggressive medical therapy for intracranial arterial stenosis. NEJM. 2011 Sep 15;365(11):993-1003. PMID 21899409
^ Broderick JP. The challenges of intracranial revascularization for stroke prevention. NEJM. 2011 Sep 15;365(11):1054-5. PMID 21899410

External links

RSNA Interventional Radiology. Basics of endovascular techniques.
http://www.endovascular.org/. The Endovascular Forum.
The International Society of Endovascular Specialists (ISES)
The Journal of Endovascular Therapy

UpToDate Contents

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1. 透析シャント狭窄の血管内治療endovascular intervention for the treatment of stenosis in the arteriovenous access [show details]
… Endovascular treatment using angioplasty has become the treatment of choice for arteriovenous (AV) access stenosis; however, not all stenotic lesions require treatment. To qualify for treatment, a stenotic …
2. 成人の急性虚血性脳卒中患者に行う血管内治療での麻酔anesthesia for endovascular therapy for acute ischemic stroke in adults [show details]
…sedation versus GA. In a 2020 analysis of data from the Multicenter Randomized Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN), the use of CS was associated with …
3. 急性虚血性脳卒中患者への機械的血栓除去術mechanical thrombectomy for acute ischemic stroke [show details]
…significant difference in outcomes for endovascular therapy compared with medical therapy . However, there was a nonsignificant trend of benefit with endovascular treatment in both trials . Larger trials are …
4. 下肢血行再建術の血管内治療手技endovascular techniques for lower extremity revascularization [show details]
…femoropopliteal lesions for which endovascular interventions are recommended has increased over the years. The Society for Vascular Surgery (SVS) supports endovascular treatment for lesions up to 15 cm (TASC …
5. 内臓動脈瘤および偽動脈瘤の治療treatment of visceral artery aneurysm and pseudoaneurysm [show details]
…durability of endovascular treatment . Cost effectiveness related to endovascular devices may also have a bearing on the approach to treatment . The following illustrate overall outcomes of VAA management using …

English Journal

The effectiveness of hybrid treatment for sever multiple trauma: a case of multiple trauma for damage control laparotomy and thoracic endovascular repair.

Bunya N1, Harada K2, Kuroda Y3, Toyohara T2, Toyohara T2, Kubota N2, Kakizaki R2, Irifune H2, Uemura S2, Narimatsu E2.
International journal of emergency medicine.Int J Emerg Med.2017 Dec;10(1):18. doi: 10.1186/s12245-017-0145-8. Epub 2017 Jun 5.
PMID 28585119

Endovascular thrombectomy and post-procedural headache.

Khan S1, Amin FM1, Holtmannspötter M2, Hansen K3, Florescu AM1, Fakhril-Din Z1, Petersen JF1, Ghanizada H1, Ayata C4, Gaist D5,6, Ashina M7.
The journal of headache and pain.J Headache Pain.2017 Dec;18(1):10. doi: 10.1186/s10194-017-0719-0. Epub 2017 Jan 28.
PMID 28130625