Amaurosis fugaxにおける経静脈digital subtraction angiographyの有用性について

Value of intravenous digital subtraction angiography for amaurosis fugax

　Amaurosis fugaxを主訴とする13歳から79歳までの12症例に経静脈digital subtrac-tion angiography （IVDSA）を行い5例（42％）の頸動脈領域に狭窄または閉塞が認められた．その中の4例はチクロピジンなどの血小板凝集抑制剤の投与で，一過性暗冥発作の再発を抑制することができた．

　網膜動脈閉塞症8例，網膜静脈閉塞症2例と虚血性視神経症1例にもIVDSAを試みたが，頸動脈領域の血管病変を証明することができたのは，網膜中心動脈閉塞症の1例にとどまった．

　IVDSAは，外来でも安全に行うことのできる検査で，眼科領域でもAmaurosis fugaxなどの血管性病変の原因究明の手段としての有用性は高い．

We performed intravenous digital subtraction angiography (IVDSA) in 12 cases of amaurosis fugax to evaluate the arteries in the head and neck region. We could detect stenosis or irregularity in the arterial wall in 5 cases (46%). These 5 cases were treated with surgical or medical antiplatelet therapy. Amaurosis fugax disappeared in all treated cases.

We also performed IVDSA in 11 cases withobstructive retinal vascular diseases. Stenosis of internal carotid artery was detected in one case (9%).

IVDSA proved thus to be of value in detecting abnormalities of carotid artery and its tributaries.While it is unlikely that IVDSA will replace conven-tional intraarterial angiography, IVDSA is much safer than direct arterial puncture and does not require admission in hospital.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(7) : 741-744, 1987