Urgent Stenting for Patients With Acute Stroke Due to Atherosclerotic Occlusive Lesions of the Cervical Internal Carotid Artery
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概要
- 論文の詳細を見る
Acute symptomatic occlusion of the cervical internal carotid artery (ICA) can be treated by intravenous administration of tissue plasminogen activator, percutaneous transluminal angioplasty, and carotid endarterectomy. Carotid artery stenting (CAS) is now indicated for cervical ICA stenosis, but the safety and the efficacy of urgent CAS have not been established. We retrospectively reviewed 10 patients treated by urgent CAS for atherosclerotic occlusive lesions of cervical ICA with acute stroke. Five patients had complete occlusions and five had near total occlusions. Five of the 10 patients had intracranial tandem occlusions. Indication for urgent CAS was determined by mismatch of diffusion-weighted and perfusion-weighted magnetic resonance imaging findings. Stents were successfully deployed in all lesions. Three of five patients with concomitant intracranial tandem occlusions were treated by additional intraarterial fibrinolysis after the CAS. Intracranial artery occlusions were completely recanalized in one patient, and partially recanalized in two by fibrinolysis. Hyperperfusion syndrome did not occur in any of the patients. A favorable outcome (modified Rankin Scale≤1) was obtained in all of the five patients with isolated cervical ICA occlusion and one of the five patients with intracranial tandem occlusions. Urgent CAS is a safe and effective treatment in patients with isolated cervical ICA occlusion. Treatment of intracranial tandem occlusions is an issue that must be resolved.
- 社団法人 日本脳神経外科学会の論文
- 2008-02-15
著者
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Shimizu Tatsuya
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
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MIYAMOTO Naoko
Department of Medicinal Chemistry, Center for Frontier Research in Medicinal Science and 21st Centur
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Naito Isao
Department Of Neurosurgery Geriatrics Research Institute And Hospital
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Miyamoto Naoko
Department Of Medicinal Chemistry Center For Frontier Research In Medicinal Science 21st Century Coe
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Miyamoto Naoko
Department Of Neurosurgery Geriatrics Research Institute And Hospital
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Shimizu Tatsuya
Department Of Cardiovascular Medicine Graduate School Of Medicine University Of Tokyo
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TAKATAMA Shin
Department of Neurosurgery, Geriatrics Research Institute and Hospital
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IWAI Tomoyuki
Department of Neurosurgery, Geriatrics Research Institute and Hospital
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SHIMAGUCHI Hidetoshi
Department of Neurosurgery, Geriatrics Research Institute and Hospital
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Takatama Shin
Department Of Neurosurgery Geriatrics Research Institute And Hospital
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Iwai Tomoyuki
Department Of Neurosurgery Geriatrics Research Institute And Hospital
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Shimaguchi Hidetoshi
Department Of Neurosurgery Geriatrics Research Institute And Hospital
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Shimizu Tatsuya
Department Of Neurosurgery Geriatrics Research Institute And Hospital
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Shimizu Tatsuya
Department Of Cardiology Jr Tokyo General Hospital
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Shimizu Tatsuya
Department Of Biochemistry And Molecular Biology Nippon Medical School
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