Repeated Thrombus Formation Immediately Following Carotid Endarterectomy
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概要
- 論文の詳細を見る
A 56-year-old male presented with thrombus formation manifesting as cerebral embolic infarction suspected to be caused by hemostasis at the carotid bifurcation, not by the intimal abnormalities or hematological disorders. Thrombus repeatedly and reproducibly appeared at the same area in spite of carotid endarterectomy (CEA). Ultrasonography demonstrated a stenotic lesion of the cervical carotid bifurcation. Medical treatment reduced the stenosis, but the thrombus was repeatedly formed at the same area of the cervical carotid bifurcation. CEA was performed. Histological examination of the specimen found only the underlying thin intima consisting of mild fibrous atheromatic change without ulceration or vascular dissection. Ultrasonography following CEA showed reduced blood flow, indicating hemostasis, and moyamoya appearance in that area. The thrombus had recurred in spite of the medical treatment with anti-platelet agent. This repeated thrombus was gradually dissolved and reduced with anticoagulant therapy. Thrombus causing cerebral embolic stroke and originating at the cervical carotid bifurcation is usually due to the intimal atherosclerotic change such as ulcer formation or vascular dissection. The thrombus in this case was probably formed by hemostasis at the cervical carotid bifurcation and CEA was not effective to prevent recurrence.
- 日本脳神経外科学会の論文
- 2003-04-15
著者
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KASHIWABA Takeshi
Kashiwaba Neurosurgical Hospital
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Yoshimoto Tetsuyuki
Kashiwaba Neurosugery Hospital
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Yoshizumi Takeshi
Kashiwaba Neurosugery Hospital
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Kashiwaba Takeshi
Kashiwaba Neurosurgery Hospital
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Aoyama Takeshi
Kashiwaba Neurosurgical Hospital
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Yoshimoto Tetsuyuki
Kashiwaba Neurosurgical Hospital
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SHIRASAKA Tomohide
Kashiwaba Neurosurgical Hospital
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Kunihara Takashi
Department Of Cardiovascular Surgery Hokkaido University Hospital
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Kunihara Takashi
北海道大学病院 循環器外科
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