無症候性頸部内頸動脈狭窄症に対するステント留置術(<特集>無症候性内頸動脈狭窄)

概要

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We have performed carotid artery stenting (CAS) for 327 patients with ICA stenosis in our institutes using various embolic protection devices since 1997. After establishment of embolic protection methods in 1999, we have performed CAS for 114 asymptomatic carotid stenosis of more than 60%, according to the criteria of ACAS trial. In this paper, we report our initial results (perioperative complication, morbidity/mortality at 30 days after CAS, changes in stenosis ratio), rate of re-stenosis, and midterm results in cases followed more than 3 years after CAS. The mean preoperative stenosis ratio, 75.6%, remarkably decreased to 5.6% after CAS. The morbidity/motality rate at 30 days after CAS was 0.8% (1/114 cases). In 22 cases, followed up more than 3 years after CAS, no ipsilateral ischemic stroke was encountered. CAS for asymptomatic carotid stenosis is an effective and safe treatment to alleviate stenosis and prevent future ischemic stroke as well as carotid endarterectomy (CEA). Randomized controlled trials, based on the natural history of carotid stenosis, are needed in the near future to establish the indication of CAS for asymptomatic carotid stenosis.
日本脳卒中の外科学会の論文
2006-09-30