Tresukosol Damras, Wongpraparut Nattawut, Lirdvilai Tippayawan
Her Majesty's Cardiac Center, Department of Medicine, Siriraj Hospital, Bangkok, Thailand.
J Invasive Cardiol. 2007 Jul;19(7):E203-6.
Percutaneous transluminal carotid artery stenting (CAS) is a promising new treatment option for carotid artery stenosis. These procedures are currently performed in high-risk patients and have demonstrated favorable outcomes. We described the use of intravascular ultrasound (IVUS) to facilitate internal carotid artery stenting in a patient with heavily calcified and ambiguous common carotid artery stenosis. The common carotid artery angiogram revealed 50% stenosis, but IVUS of the common carotid demonstrated a 90% stenosis with complex superficial calcification. Protrusion of the superficial calcification inside the common carotid artery which was demonstrated by IVUS has not only created a difficulty to deliver the stent to the internal carotid artery, but also left the common carotid artery lesion untreated, which is not likely to achieve clinical the benefit of internal carotid stenting. IVUS was an indispensable tool for a procedural success in this case.
经皮腔内颈动脉支架置入术（CAS）是治疗颈动脉狭窄一种很有前景的新方法。目前这些手术是在高危患者中进行的，并且已显示出良好的效果。我们描述了在一名患有严重钙化且颈总动脉狭窄情况不明的患者中使用血管内超声（IVUS）辅助进行颈内动脉支架置入术。颈总动脉血管造影显示有50%的狭窄，但颈总动脉的IVUS显示有90%的狭窄且伴有复杂的浅表钙化。IVUS显示颈总动脉内浅表钙化的突出不仅给将支架输送至颈内动脉造成困难，而且颈总动脉病变未得到治疗，这不大可能实现颈内动脉支架置入术的临床益处。在这种情况下，IVUS是手术成功不可或缺的工具。
