Coumans J V, Watson V E, Picken C A, McGrail K M
Department of Neurosurgery, Georgetown University Hospital, Washington, DC 20007, USA.
J Neurosurg. 1999 Mar;90(3):567-70. doi: 10.3171/jns.1999.90.3.0567.
Although the use of carotid artery stents is increasing, the management of recurrent stenosis after their placement is undefined. The authors report on a patient who underwent two left carotid endarterectomies followed by left carotid angioplasty and stent placement for recurrent stenosis. A third symptomatic recurrence was subsequently managed by placement of a saphenous vein interposition graft from the common carotid artery to the distal cervical internal carotid artery. The patient remained without hemispheric or retinal ischemia at his 5-month follow-up visit. Interposition grafting should be considered as a treatment option for carotid restenosis after initial endarterectomy and stent placement.
尽管颈动脉支架的使用正在增加，但其置入后复发性狭窄的处理方法尚无定论。作者报告了一名患者，该患者接受了两次左颈动脉内膜切除术，随后因复发性狭窄接受了左颈动脉血管成形术和支架置入术。第三次出现症状性复发后，通过将大隐静脉从颈总动脉移植至颈内动脉远端进行处理。在5个月的随访中，患者未出现半球或视网膜缺血。对于初次内膜切除术后和支架置入术后的颈动脉再狭窄，应考虑采用移植术作为一种治疗选择。
