Percutaneous Transluminal Thrombotransfer Therapy for the Proximal ICA Obstruction Due to Large Emboli; Report of Two Cases.
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Embolism of the internal carotid artery (ICA) is associated with high mortality. At present, local thrombolytic therapy is performed against the occlusion of the proximal ICA but clinical outcome is worse than that against the occlusions of the middle cerebral artery (MCA) and basilar artery (BA). There are no alternative effective treatments for proximal ICA occlusion. In this study we applied the novel technique of thrombotransfer, designed to scrape out proximal ICA thrombus into the external carotid artery (ECA) using a percutaneous transcatheter angioplasty (PTA) balloon. We applied this treatment to two patients with proximal ICA embolism associated with atrial fibrillation. Both conformed to Rankin's stroke scale (RSS) grade V. The second patient also had a MCA embolism. We used 3-mm diameter PTA balloons in both patients. We also subsequently applied super-selective thrombolytic therapy to the second patient for an M1 occlusion. Within one week following the treatment, both patients showed marked improvement and recovery to RSS grade 0. Thrombotransfer therapy was applied in two patients with acute phase embolic brain ischemia due to proximal ICA occlusion. This treatment requires no thrombolytic agents, and the procedure is technically easy, quick and safe, making it suitable for the treatment of proximal ICA occlusion.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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