Endarterectomy for Mild Cervical Carotid Artery Stenosis in Patients With Ischemic Stroke Events Refractory to Medical Treatment

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概要

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• A 62-year-old man and a 44-year-old man with unilateral cervical carotid artery stenosis (less than 50% with echolucent plaque and ulceration) suffered recurrent ischemia stroke events despite treatment with antiplatelet and anticoagulation drugs. Carotid endarterectomy (CEA) was performed under transcranial Doppler monitoring for the detection of micro-emboli using a microscope inserted through a skin incision to minimize pressure on the carotid arteries. The atheroma plaque included an ulcer with fresh thrombi in both patients. Both patients awoke from anesthesia without new neurological deficits, and no ischemic stroke events have recurred since CEA. Endarterectomy is an effective method for preventing stroke in patients with severe carotid stenosis (>70%), but the efficacy of this procedure for mild carotid stenosis (<50%) remains uncertain, regardless of carotid plaque characteristics. The present cases suggest that even mild stenosis of the cervical carotid artery may result in ischemic stroke events that are refractory to medical treatment if the stenosis is associated with echolucent plaque with ulceration. Endarterectomy is recommended to prevent further stroke in such patients.

• 社団法人 日本脳神経外科学会の論文
• 2008-05-15

著者

• OGAWA Akira

  Department of Neurosurgery, Iwate Medical University School of Medicine

• OGASAWARA Kuniaki

  Department of Neurosurgery, Iwate Medical University School of Medicine

• INOUE Takashi

  Department of Neurosurgery, School of Medicine, Iwate Medical University

• Ogasawara Kuniaki

  岩手医科大学 脳神経外科

• Ogasawara Kuniaki

  Department Of Neurosurgery Iwate Medical University

• Kobayashi Masakazu

  Department of Cardiology, Nagoya University Graduate School of Medicine

• SAITO Hideo

  Department of Urology, Tohoku University Hospital

• Kobayashi Masakazu

  Departmdepartment Of Cardiology Nagoya University Graduate School Of Medicine

• Ogawa Akira

  Department Of Neurosurgery Iwate Medical University

• SUGA Yasunori

  Department of Neurosurgery, Iwate Medical University

• Kobayashi Masakazu

  Department Of Neurosurgery Iwate Medical University

• Saito Hideo

  Department Of Chemistry Graduate School Of Pure And Applied Sciences University Of Tsukuba

• Saitoh Hideo

  Department Of Neurosurgery Iwate Medical University

• Suga Yasunori

  Department Of Neurosurgery Iwate Medical University

• Ogawa Akira

  Department Of Biochemistry Gunma University Graduate School Of Medicine

• Ogawa Akira

  Department Of Neurosurgery Iwate Medical University School Of Medicine

• Ogawa Akira

  Department Of Applied Chemistry Graduate School Of Engineering The University Of Tokyo

• Ogawa Akira

  Department Of Neurosurgery Central Clinical Laboratory Iwate Medical University

• Inoue Takashi

  Department Of Neurosurgery Iwate Medical University

• Inoue Takashi

  Department Of Neurosurgery Kohnan Hospital

• Inoue Takashi

  Department Of Anatomy Kyoto Prefectural University Of Medicine

• Inoue Takashi

  Department Of Agricultural Engineering Faculty Of Agriculture Hokkaido University

• OGAWA Akira

  Department of Neurosurgery, Iwate Medical University

• OGASAWARA Kuniaki

  Department of Neurosurgery, Iwate Medical University

• INOUE Takashi

  Department of Agricultural Chemistry, Faculty of Agriculture, The University of Tokyo

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