2018 Fiscal Year Final Research Report
Multifaceted diagnostic approach for unstable carotid artery plaque with MRI and blood biomarker
| Project/Area Number |
15K10299
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Neurosurgery
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| Research Institution | Kyoto University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
久米 典昭 神戸学院大学, 薬学部, 教授 (20252455)
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| Research Collaborator |
Okada Tomohisa
Matsumoto Masayasu
Iihara Koji
Okada Yasushi
Toyoda Kazunori
Takahashi Jun
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| Project Period (FY) |
2015-04-01 – 2019-03-31
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| Keywords | 頚動脈狭窄 / 不安定プラーク / プラーク性状 / MRIプラークイメージ / 血液バイオマーカー |
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| Outline of Final Research Achievements |
The aim of this study is to establish diagnostic approach for patients with asymptomatic carotid artery stenosis who have higher risk for future ischemic events and are likely to benefit from surgical treatment. Asymptomatic patients with MRI-confirmed intraplaque hemorrhage were followed up under contemporary medical treatment for 3 years.
This study is now going on because the number of patients enrolled in the initially scheduled period did not reach the target amount. At the time of February 28th 2019, 60 patients were followed for the average of 11.9 months and 5 patients have met primary endpoint. The annual ischemic event rate in this study is 8.3% which is much higher than the reported event rate of <1% by contemporary medical therapy for asymptomatic carotid stenosis. The final results of this study is expected to provide valuable information for the establishment of appropriate treatment strategy for patients with asymptomatic carotid stenosis.
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| Free Research Field |
脳神経外科 動脈硬化 画像診断
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| Academic Significance and Societal Importance of the Research Achievements |
無症候性頚動脈狭窄症は近年の内科治療成績の向上に伴い、一般的には内科治療が推奨されている。本研究の中間結果は、無症候性狭窄の中でも非侵襲的画像診断であるMRIでプラーク内出血を有する病変においては、一般に報告される内科治療成績に比べて約10倍程度脳梗塞発症リスクが高いことが示されている。最新の多面的内科治療によっても虚血発症を防ぎ得ない「真に外科治療を必要とする一部の無症候性病変」を非侵襲的な方法で正確に抽出できる可能性が高く、脳梗塞の確実な予防による健康寿命の延伸と, 高額な侵襲的治療の減少による医療費の削減が両立できると期待される。
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