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- 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.

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