Clin Neuroradiol. 2013 Sep;23(3):225-9. doi: 10.1007/s00062-012-0172-z. Epub 2012 Sep 8.
While acute internal carotid artery (ICA) occlusions are increasingly being treated with carotid angioplasty and stenting (CAS), the utility of CAS in subacute stages is unclear.
A 65-year-old patient with an acute left ICA occlusion and pre-existing occlusion on the right side presented with dysarthria and central right-sided facial palsy. Carbon dioxide (CO) reactivity within the left hemisphere was markedly reduced. Due to acute deterioration despite maximal conservative therapy CAS was performed 8 days after the initial event with an excellent result and symptoms subsided.
CAS in subacute ICA occlusion is possible. Patients should be selected carefully. Assessment of cerebrovascular CO reactivity might provide valuable information.
尽管急性颈内动脉(ICA)闭塞越来越多地采用颈动脉血管成形术和支架置入术(CAS)治疗,但在亚急性期使用 CAS 的效果尚不清楚。
一名 65 岁患者,左侧 ICA 急性闭塞,右侧先前闭塞,表现为构音障碍和右侧中枢性面瘫。左侧半球内的二氧化碳(CO)反应性明显降低。尽管进行了最大程度的保守治疗,但仍出现急性恶化,因此在初始事件发生后 8 天进行了 CAS,结果非常好,症状得到缓解。
在亚急性 ICA 闭塞中可以进行 CAS。应仔细选择患者。评估脑血管 CO 反应性可能提供有价值的信息。