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血管内血栓切除术和支架置入术治疗伴严重缺血性卒中的颈动脉纤维肌发育不良

Endovascular thrombectomy and stenting in the management of carotid fibromuscular dysplasia presenting with major ischemic stroke.

作者信息

Cohen José E, Itshayek Eyal, Keigler Galina, Eichel Roni, Leker Ronen R

机构信息

Department of Neurosurgery, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel; Department of Endovascular Neurosurgery and Interventional Neuroradiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

Department of Neurosurgery, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem 91120, Israel.

出版信息

J Clin Neurosci. 2014 Nov;21(11):2021-3. doi: 10.1016/j.jocn.2014.07.008. Epub 2014 Sep 1.

Abstract

Fibromuscular dysplasia (FMD) affecting the internal carotid artery (ICA) is considered a benign condition; however, retinal and cerebral ischemic events may occur. We present a patient with carotid FMD presenting with a major ischemic stroke due to major embolic occlusion of the ICA in conjunction with a hemodynamic component caused by narrowing and beading of the lumen associated with FMD. The patient was successfully treated with intracranial stent-assisted thrombectomy followed by cervical ICA stenting that aimed to reconstruct and angioplasty the FMD-affected arterial segment. Recently, stent-based thrombectomy has emerged as the most effective endovascular option for the rapid revascularization of major intracranial occlusions; however, to our knowledge, its use in a rare case of FMD-associated major stroke has not yet been reported.

摘要

影响颈内动脉(ICA)的纤维肌发育不良(FMD)被认为是一种良性疾病;然而,可能会发生视网膜和脑缺血事件。我们报告一名患有颈动脉FMD的患者,该患者因ICA的主要栓塞性闭塞以及由FMD相关的管腔狭窄和串珠样改变引起的血流动力学因素而出现严重缺血性中风。该患者成功接受了颅内支架辅助血栓切除术,随后进行了颈内动脉支架置入术,旨在重建并对受FMD影响的动脉段进行血管成形术。最近,基于支架的血栓切除术已成为主要颅内闭塞快速再血管化的最有效血管内选择;然而,据我们所知,其在罕见的FMD相关严重中风病例中的应用尚未见报道。

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