Ogata Atsushi, Sonobe Makoto, Kato Noriyuki, Yamazaki Tomosato, Kasuya Hiromichi, Ikeda Go, Miki Shunichiro, Matsushima Toshio
Department of Neurosurgery, National Hospital Organization, Mito Medical Center, Ibaraki, Japan Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan.
Department of Neurosurgery, National Hospital Organization, Mito Medical Center, Ibaraki, Japan.
J Neurointerv Surg. 2014 Sep;6(7):517-20. doi: 10.1136/neurintsurg-2013-010873. Epub 2013 Sep 7.
To evaluate the clinical outcome and MRI findings after carotid artery stenting (CAS) without post-dilatation.
Between May 2005 and April 2012, a total of 169 consecutive patients (61.4% symptomatic) underwent 176 CAS procedures performed with an embolic protection device (GuardWire, n=116; FilterWire EZ, n=60). All stents were deployed without post-dilatation. Periprocedural complications and mid-term outcomes were analyzed.
The stroke rate was 2.3% within 30 days post-CAS (asymptomatic patients 1.5%; symptomatic patients 2.8%). Cerebral infarction occurred in one asymptomatic patient (1.5%) and one symptomatic patient (0.9%). Intracranial hemorrhage occurred in two symptomatic patients (1.9%). Post-CAS diffusion-weighted imaging (DWI) revealed a high-intensity area in 26 of 176 procedures (14.8%). Ipsilateral stroke after 31 days occurred in two patients (1.1%) and restenosis occurred in six (3.4%). A post-CAS comparison of the embolic protection devices revealed no difference in stroke incidence within 30 days and in DWI high-intensity area.
Our CAS procedure without post-dilatation is feasible, safe and associated with a low incidence of stroke and restenosis.
评估未进行后扩张的颈动脉支架置入术（CAS）后的临床结局及磁共振成像（MRI）表现。
2005年5月至2012年4月期间，共有169例连续患者（61.4%有症状）接受了176例使用栓子保护装置的CAS手术（GuardWire，n = 116；FilterWire EZ，n = 60）。所有支架均未进行后扩张。分析围手术期并发症及中期结局。
CAS术后30天内的卒中发生率为2.3%（无症状患者为1.5%；有症状患者为2.8%）。1例无症状患者（1.5%）和1例有症状患者（0.9%）发生脑梗死。2例有症状患者（1.9%）发生颅内出血。CAS术后扩散加权成像（DWI）显示，176例手术中有26例（14.8%）出现高强度区域。31天后同侧卒中发生在2例患者（1.1%），再狭窄发生在6例患者（3.4%）。CAS术后栓子保护装置的比较显示，30天内的卒中发生率及DWI高强度区域无差异。
我们的未进行后扩张的CAS手术可行、安全，且卒中及再狭窄发生率低。
