頸部内頸動脈完全閉塞症に対する直達手術—Fogartyカテーテルを用いた血栓内膜剔除術を行った1例

Surgical Treatment of Extracranial Internal Carotid Occulusion:A Case of Thrombo-Endarterectomy using Fogarty Catheter

Ⅰ．はじめに

　頸部内頸動脈完全閉塞症の1例の発症早期に，頸部内頸動脈血栓内膜剔除術とFogartyカテーテル^7）を用いた内頸動脈内血栓剔出術を行って，何ら合併症もなく血行を再開させることに成功し，著しい臨床症状の改善を認めたので，症例の概略と手術手技を述べ，手術の適応について考察する．

A 61-year-old female had a sudden onset of right hemiplegia with motor aphasia. She had a same reversible attack 14 years prior to admission. In the course of hospitalization, her neurological disturbances had gradually recovered, but still lasted.

A left common carotid angiogram taken 19 hours later showed a total occulusion of the left internal carotid artery and a marked stenosis of the external carotid artery at the bifurcation. The short proximal stump of I.C.A. with a tapered end beyond the bifurcation. The portion of siphon was visualized by colaterall circulation through ipsilateral ophthalmic artery.