多発性頭頚部主幹動脈閉塞性病変に対する血管内手術

概要

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Therapeutic strategies for patients with multiple occlusive lesions of the major cephalic arteries are still controversial. We examined the therapeutic results of endovascular surgeries for the patients with multiple occlusive lesions of the major cephalic arteries. Twenty-one patients with multiple occlusive lesions of the major cephalic arteries (internal carotid artery and vertebral artery) were treated with vascular reconstructive surgeries between April 1997 and March 2000. We performed 31 endovascular surgeries (27 stenting, 4 PTA) and 15 surgeries (7 STA-MCA anastomosis, 8 CEA). Fluctuated symptoms and TIA due to hemodynamic compromise improved in 11 patients, although only 3 patients improved on the NIH stroke scale. Renal functional disturbance occurred after CEA in 1 patient. There were no complications after endovascular surgeries. In the follow-up period, 1 patient developed a minor stroke in untreated arterial territory, and 1 patient died due to heart failure. Our results suggest that endovascular surgery is a feasible and comparatively safe method in the treatment of patients with multiple occlusive lesions of the major cephalic arteries.
一般社団法人日本脳卒中の外科学会の論文