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Neurological Surgery No Shinkei Geka Volume 20, Issue 5 （May 1992）

Neurological Surgery 脳神経外科 20巻5号（1992年5月発行）

Japanese English

症例

冠動脈狭窄と頸部内頸動脈狭窄を合併した1症例 Carotid Stenosis Complicated by Coronary Disease;A case report 坂口一朗 ¹ , 森脇恵太 ¹ , 保田晃宏 ¹ , 黒岩敏彦 ¹ , 志熊道夫 ¹ , 太田富雄 ¹ , 下村裕章 ² , 河村慧四郎 ² , 竹内栄一即 ³ , 多根一之 ³ , 西田進一 ⁴ , 杉岡靖 ⁴ Ichiro SAKAGUCHI ¹ , Keita MORIWAKI ¹ , Akihiro YASUDA ¹ , Toshihiko KUROIWA ¹ , Michio SIGUMA ¹ , Tomio OHTA ¹ , Hiroaki SIMOMURA ² , Keishiro KAWAMURA ² , Eiichi TAKEUCHI ³ , Kazuyuki TANE ³ , Sinichiro NISIDA ⁴ , Yasusi SUGIOKA ⁴ ¹大阪医科大学脳神経外科 ²大阪医科大学第3内科 ³西大阪病院脳神経外科 ⁴西大阪病院循環器内科 ¹Department of Neurosurgery, Osaka Medical School ²The Third Division, Department of Internal Medicine, Osaka Medical School ³Department of Neurosurgery, Nishi-Osaka Hospital ⁴Division of Cardiovascular Medicine, Department of Internal Medicine, Nishi-Osaka Hospital キーワード： Carotid stenosis , Coronary disease , CEA , PTCA Keyword: Carotid stenosis , Coronary disease , CEA , PTCA pp.605-610

発行日 1992年5月10日 Published Date 1992/5/10

DOI https://doi.org/10.11477/mf.1436900467

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Abstract 文献概要
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I．はじめに

　高齢化の進むわが国において，虚血性脳血管障害は年年増加する傾向にある。その主な原因である動脈硬化症は，単に脳血管だけでなく，冠動脈や四肢の動脈など全身の血管性病変である。今回われわれは，虚血性心疾患を伴った頸部内頸動脈狭窄症に対し，先ず経皮的冠動脈形成術（percutaneous transluminal coronary angio—piasty；以下PTCAと略す）施行後，頸部内頸動脈血栓内膜剥離術（carotid endarterectomy；以下CEAと略す）を行い，良好な経過をとった症例を経験したので若干の文献的考察を加えて報告する．

Abstract

A 66-year-old-man with carotid stenosis complicated by coronary disease is reported. He suffered from mild motor weakness on the right side and speech distur-bance. Radiological examination revealed 90% stenosis at the cervical portion of the left internal carotid artery, and two-vessel coronary disease. In order to prevent in-traoperative cardiac stroke, initial percutaneous coron-ary angioplasty (PTCA), was performed and the subse-quent carotid endarterectomy (CEA) was performed successfully. Preoperative symptoms gradually improv-ed and he was discharged as ambulatory.

Because atherosclerosis is always systemic, patients with carotid artery disease should be examined for coronary disease. We recommend greater use of coro-nary angiography and, when a lesion is found, the use of PTCA, which is a safer method in terms of prevent-ing intraoperative cardiac stroke of CEA than any other method.