Takayama Katsutoshi, Nakagawa Hiroyuki, Iwasaki Satoru, Taoka Toshiaki, Miyasaka Toshiteru, Myouchin Kaoru, Wada Takeshi, Sakamoto Masahiko, Fukusumi Akio, Nakagawa Ichiro, Kurokawa Shinichiro, Kichikawa Kimihiko
Department of Interventional Neuroradiology, Ishinkai Yao General Hospital, 1-41 Numa, Yao 581-0036, Japan,
Radiat Med. 2008 Jul;26(6):348-54. doi: 10.1007/s11604-008-0239-6. Epub 2008 Aug 3.
No filter protection devices for carotid artery stenting (CAS) have been formally approved for use in Japan; however, as of April 2008, the Angioguard XP (AGXP) was approved. This article describes our initial results using the AGXP during CAS for the treatment of carotid artery stenosis.
A group of 15 patients (14 men) with a mean age of 72.3 years (range 53-81 years) were treated by CAS using the AGXP. Among them, 10 were symptomatic with >50% stenosis of the common or internal carotid artery (ICA), and 5 were asymptomatic with >70% stenosis. The rates of technical success, periprocedural stroke, ICA flow impairment, filter movement, and development of new ischemic lesions on diffusion-weighted imaging (DWI) were assessed.
CAS using the AGXP was successful in all cases. There was one minor stroke, and flow impairment occurred in six patients. Filter movement averaged 1.9 vertebral bodies. DWI showed new ipsilateral ischemic lesions in eight of the patients.
Initial clinical experience using the AGXP for CAS has been generally sufficient. However, attention must be paid to three problems when using the AGXP: the filter may move after placement; the filter may disturb blood flow in the ICA; and debris may pass around the filter.
在日本，尚无用于颈动脉支架置入术（CAS）的滤器保护装置获得正式批准；然而，截至2008年4月，Angioguard XP（AGXP）已获批准。本文介绍了我们在CAS治疗颈动脉狭窄过程中使用AGXP的初步结果。
一组15例患者（14例男性），平均年龄72.3岁（范围53 - 81岁），采用AGXP进行CAS治疗。其中，10例有症状，颈总动脉或颈内动脉（ICA）狭窄>50%，5例无症状，狭窄>70%。评估技术成功率、围手术期卒中、ICA血流受损、滤器移动以及弥散加权成像（DWI）上新发缺血性病变的发生率。
所有病例使用AGXP进行CAS均获成功。发生1例轻度卒中，6例出现血流受损。滤器移动平均为1.9个椎体节段。DWI显示8例患者同侧出现新发缺血性病变。
使用AGXP进行CAS的初步临床经验总体上是充分的。然而，使用AGXP时必须注意三个问题：滤器放置后可能移动；滤器可能干扰ICA血流；碎片可能绕过滤器。
