Dhall Anil, Malani S K, Chadha Davinder S
Department of Cardiology, Artemis Health Institute, Gurgaon, India.
J Invasive Cardiol. 2010 Aug;22(8):E144-6.
Carotid endarterectomy in the presence of an occluded contralateral artery is associated with a high risk of perioperative stroke. Carotid stenting with neuroprotection devices has emerged as a safe procedure for revascularization in this circumstance. We performed high-risk carotid angioplasty in a patient with a history of recurrent transient ischemic attacks and 90% stenosis of left internal carotid artery with other occluded cerebral vessels. The final follow-up angiogram revealed thrombotic obstruction of the stent without any evidence of vasospasm, stent deformation or dissection. Direct thrombosuction was performed with the guiding sheath. Multiple suction passes yielded complete restoration of vascular patency and intracranial flows. A control angiogram performed 10 days later revealed no residual stenosis or thrombus. Thrombosuction using a guiding sheath leads to rapid revascularization in a patient with acute carotid stent thrombosis.
在对侧动脉闭塞的情况下进行颈动脉内膜切除术与围手术期中风的高风险相关。在这种情况下，使用神经保护装置的颈动脉支架置入术已成为一种安全的血管重建手术。我们对一名有复发性短暂性脑缺血发作病史、左颈内动脉狭窄90%且其他脑血管闭塞的患者进行了高风险颈动脉血管成形术。最终的随访血管造影显示支架血栓形成阻塞，没有任何血管痉挛、支架变形或夹层的迹象。使用引导鞘进行直接血栓抽吸。多次抽吸使血管通畅和颅内血流完全恢复。10天后进行的对照血管造影显示没有残余狭窄或血栓。对于急性颈动脉支架血栓形成的患者，使用引导鞘进行血栓抽吸可实现快速血管重建。
