雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Neurological Surgery No Shinkei Geka Volume 27, Issue 9 （September 1999）

Neurological Surgery 脳神経外科 27巻9号（1999年9月発行）

Japanese English

研究

頸部内頸動脈狭窄性病変に対する自己拡張型ステント（Wallstent^®）を併用した経皮的血管形成術の経験と問題点 Self-expanding Stent (Wallstent^®) Supported Angioplasty for Carotid Artery Stenosis 荒川芳輝 ¹ , 石井暁 ¹ , 上野泰 ¹ , 菊田健一郎 ¹ , 善積秀幸 ¹ , 後藤泰伸 ¹ , 西崎順也 ² , 森本将史 ³ , 佐藤徹 ³ , 光藤和明 ⁴ , 山形専 ¹ Yoshiki ARAKAWA ¹ , Akira ISHII ¹ , Yasushi UENO ¹ , Ken-ichiro KIKUTA ¹ , Hideyuki YOSHIZUMI ¹ , Yasunobu GOTO ¹ , Jun-ya NISHIZAKI ² , Masafumi MORIMOTO ³ , Tetsu SATOW ³ , Kazuaki MITSUDO ⁴ , Sen YAMAGATA ¹ ¹倉敷中央病院脳神経外科 ²国立循環器病センター脳血管外科 ³京都大学脳神経外科 ⁴倉敷中央病院循環器内科 ¹Department of Neurosurgery, Kurashiki Central Hospital ²Department of Cerebrovacular Surgery, National Cardiovascular Center ³Department of Neurosurgery, Kyoto University Medical School ⁴Department of Cardiology, Kurashiki Central Hospital キーワード： percutaneous transluminal angioplasty , carotid artery stenosis , stent , cerebral infarction Keyword: percutaneous transluminal angioplasty , carotid artery stenosis , stent , cerebral infarction pp.817-823

発行日 1999年9月10日 Published Date 1999/9/10

DOI https://doi.org/10.11477/mf.1436901774

PDF(8341KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

I．はじめに

　近年，血管内治療として頸部内頸動脈狭窄性病変に経皮的血管形成術（percutaneous transluminalangioplasty：PTA）が行われつつあるが，PTAだけでは十分な拡張が得られなかったり，PTA時の塞栓症，再狭窄等の問題がある^{8,9,11,13,18,21,23）}．また頸部頸動脈狭窄性病変に対しては頸動脈血栓内膜剥離術（carotid endarterectomy：CEA）が有用性を認められた治療法として存在している^4,5,16）．こうした中，血管内治療においては，冠血管の狭窄性病変におけるステント併用PTAの有用性が認められ^6），頸部内頸動脈狭窄性病変に対してもステント併用PTAの報告がなされている^3,17,22）．

　今回われわれは頸部内頸動脈狭窄性病変に対して自己拡張型ステントを併用した経皮的血管形成術を行い良好な結果を得たので，その初期成績，合併症，再狭窄率について文献的考察を加え報告する．

We reported the preliminary results of percutaneous transluminal angioplasty (PTA) supported with aself-expanding stent (Wallstent^®) for the cervical internal carotid artery (IC) stenosis in 6 patients (7lesions).

All were male aged from 60 to 79 (mean 70.8). Three patients were symptomatic and 3 were asymp-tomatic. The procedure was attempted in patients with severe IC stenosis according to criteria of NAS-CET, ECST or ACAS studies and with high risk if carotid endarterectomy (CEA) were performed.

In all cases, vascular access was from the femoral artery and angioplasty was performed without cere-bral protection.

Successful angioplasty was obtained in all cases with no mortality. Stenosis was improved from 82.7%(74-90%) to 17.4% (10-33%). Perioperative complications were seen in only one case with TIA duringthe postdilatation period, which was supposed to be clue to a distal embolism.

The preliminary results of PTA supported with self-expanding stent for severe IC stenosis were excel-lent. These results suggested that some patients with severe IC stenosis can be treated safely and effective-ly by stent-supported PTA. However, it is necessary to mark the indications clear and strict, and to followup these lesions after the procedure, because of the possibility of perioperative ischemic complications andrestenosis.