頚動脈ステント留置術 : —血管造影と頚動脈エコーの併用—

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PURPOSE: This study was conducted to assess the usefulness of ultrasonography combined with angiography for carotid stent placement.MATERIALS AND METHODS: Six patients who underwent carotid stent placement between June and December 2002 were examined by ultrasonography using a SONOLINE Elegla machine (Siemens) with a 5.1-9.0-MHz linear probe. Smart Stent (Cordis) was used for all patients. Ultrasonographic examination including longitudinal and transverse views of the common and internal carotid arteries was done before and after pre-balloon dilatation, after stenting, and before and after post-balloon dilatation. The change in the form of plaque was evaluated at the time of both pre-balloon dilatation and post-balloon dilatation. We decided the positioning of the stent under ultrasonographic guidance, but placed the stent under fluoroscopic guidance.RESULTS: It was easier to position the balloon and stent relative to the plaque using ultrasonography than using angiography. The change in plaque form resulting from extension and contraction of the balloon was directly observed. It was possible to decide the position of the stent based on the grade of atherosclerotic change in the carotid artery and also to evaluate the adjustment of the stent in the carotid artery.CONCLUSION: Combined use of angiography and ultrasonography for stent placement is practicable and convenient.

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