Zacharias Soni J, Kalapura Thomachan, Abrantes-Pais Fatima, Hennebry Thomas A
Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
J Interv Cardiol. 2007 Jun;20(3):214-21. doi: 10.1111/j.1540-8183.2007.00254.x.
Carotid artery stenting (CAS) is emerging as a less invasive modality for treating atherosclerotic occlusive disease of the internal carotid artery (ICA). Randomized trials like the SAPPHIRE trial have demonstrated that CAS is not inferior to carotid endarterectomy (CEA) in the treatment of carotid artery stenosis, and maybe even superior in high-risk symptomatic patients. However, patients with subtotal ICA occlusions with thrombus are excluded from randomized CAS trials and CAS registries. To our knowledge, carotid angioplasty with stenting has not been attempted in these cases. We present three cases of symptomatic subtotal ICA occlusions successfully treated with CAS without any periprocedural complications. With careful patient selection and technical expertise, endovascular management could be considered as a treatment option in subtotal carotid occlusions.
颈动脉支架置入术（CAS）正逐渐成为一种治疗颈内动脉（ICA）粥样硬化闭塞性疾病的侵入性较小的方式。像蓝宝石试验这样的随机试验表明，在治疗颈动脉狭窄方面，CAS并不逊色于颈动脉内膜切除术（CEA），甚至在高危症状性患者中可能更具优势。然而，有血栓形成的颈内动脉次全闭塞患者被排除在随机CAS试验和CAS登记之外。据我们所知，这些病例尚未尝试过颈动脉血管成形术加支架置入术。我们报告了3例有症状的颈内动脉次全闭塞患者成功接受CAS治疗且无任何围手术期并发症的病例。通过仔细的患者选择和技术专长，血管内治疗可被视为颈内动脉次全闭塞的一种治疗选择。
