Department of Interventional Neuroradiology, Baptist Cardiac and Vascular Institute, Miami, Florida 33176, USA.
J Neuroimaging. 2013 Apr;23(2):207-10. doi: 10.1111/j.1552-6569.2011.00657.x. Epub 2011 Nov 14.
To describe a case of successful intracranial angioplasty and stenting of a symptomatic middle cerebral artery (MCA) stenosis using a transcervical approach.
A 73-year-old woman presented with several ischemic strokes in the left MCA distribution. A diagnostic cerebral angiogram demonstrated more than 80% stenosis of her left MCA. Because the patient failed maximal medical therapy, it was decided to perform angioplasty and stenting. Given the patient's tortuous arch and rigid vessels, access was obtained through a transcutaneous puncture with direct visualization of the surgically exposed common carotid artery (CCA).
The patient tolerated well the procedure and after successful stenting her symptoms resolved.
Access of the intracranial circulation through direct CCA puncture may be a feasible alternative when the transfemoral access is not possible. The transcervical approach may be safe even with the use of antiplatelet medications and anticoagulation.
描述一例经颈途径成功治疗症状性大脑中动脉（MCA）狭窄的颅内血管成形术和支架置入术。
一位 73 岁女性因左侧 MCA 分布区多次缺血性卒中就诊。诊断性脑血管造影显示其左侧 MCA 狭窄超过 80%。由于患者对最大程度的药物治疗无效，决定进行血管成形术和支架置入术。鉴于患者的迂曲的弓和僵硬的血管，通过直接暴露手术中的颈总动脉（CCA）的经皮穿刺获得了入路。
患者耐受了手术过程，并且在成功支架置入后症状得到了缓解。
当经股动脉入路不可行时，直接 CCA 穿刺进入颅内循环可能是一种可行的替代方法。即使使用抗血小板药物和抗凝治疗，经颈途径也是安全的。
