ＣＥＡの安全性の向上　　頚動脈内膜剥離術における内シャント挿入の工夫―ガイドワイヤーを用いて―:―ガイドワイヤーを用いて―

概要

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Carotid endarterectomy (CEA) is a standard treatment for the internal carotid artery stenosis, but the routine use of internal shunt tube during CEA is controversial. The carotid bifurcation of Japanese is reported to be higher than that of Europeans. Therefore, it is somewhat difficult to insert the internal shunt into the internal carotid artery. The purpose of this study is to clarify the usefulness and feasibility of using a guide-wire to insert an internal shunt tube into internal carotid artery. Between 2007 and 2009, 24 CEAs for 24 consecutive patients with internal carotid artery stenosis were performed in our institute. We routinely used an internal shunt tube. Twenty-two CEAs were performed using the internal shunt tube. Internal shunt tubes were not used for 2 near-occlusion CEA cases. For 11 of the CEAs, we used a 3.5-inch guide-wire to insert the internal shunt tube. We compared the time required to insert the tube in the guide-wire group and the without guide-wire group. The average time required for the guide-wire group was 6.8 minutes, and the without guide-wire group required 9.5 minutes. The guide-wire group required significantly (P<0.05) less time than the without guide-wire group. We consider using a guide-wire during the insertion of the internal shunt tube for CEA to be useful.
一般社団法人日本脳卒中の外科学会の論文