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支架折叠变形致颈动脉支架置入术后迟发性脑梗死

Delayed cerebral infarction due to stent folding deformation following carotid artery stenting.

机构信息

Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720, Korea.

Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720, Korea. ; Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul 135-720, Korea.

出版信息

Korean J Radiol. 2014 Nov-Dec;15(6):858-61. doi: 10.3348/kjr.2014.15.6.858. Epub 2014 Nov 7.

DOI:10.3348/kjr.2014.15.6.858
PMID:25469100
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4248644/
Abstract

We report a case of delayed cerebral infarction due to stent longitudinal folding deformation following carotid artery stenting using a self-expandable stent with an open-cell design. The stented segment of the left common carotid artery was divided into two different lumens by this folding deformation, and the separated lumens became restricted with in-stent thrombosis. Although no established method of managing this rare complication exists, a conservative approach was taken with administration of anticoagulant and dual antiplatelet therapy. No neurological symptoms were observed during several months of clinical follow-up after discharge.

摘要

我们报告了一例使用具有开孔设计的自膨式支架行颈动脉支架置入术后因支架纵向折叠变形导致的迟发性脑梗死。这种折叠变形将左颈总动脉支架段分隔成两个不同的管腔，分隔的管腔因支架内血栓形成而受限。尽管对于这种罕见的并发症尚无既定的处理方法，但我们采取了保守的方法，给予抗凝和双联抗血小板治疗。出院后数月的临床随访中，未观察到神经症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0879/4248644/f03fa86cab12/kjr-15-858-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0879/4248644/f03fa86cab12/kjr-15-858-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0879/4248644/f03fa86cab12/kjr-15-858-g001.jpg

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本文引用的文献

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Prevalence and clinical significance of stent fracture and deformation following carotid artery stenting.颈动脉支架置入术后支架断裂和变形的发生率及临床意义。
J Vasc Surg. 2011 Sep;54(3):685-90. doi: 10.1016/j.jvs.2011.03.257.
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Stenting versus endarterectomy for treatment of carotid-artery stenosis.颈动脉狭窄的血管内支架成形术与颈动脉内膜切除术治疗的比较。
N Engl J Med. 2010 Jul 1;363(1):11-23. doi: 10.1056/NEJMoa0912321. Epub 2010 May 26.
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Carotid artery stent fracture identification and clinical relevance.颈动脉支架断裂的识别及其临床相关性。
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Biomechanical response of stented carotid arteries to swallowing and neck motion.置入支架的颈动脉对吞咽和颈部运动的生物力学反应。
J Endovasc Ther. 2008 Dec;15(6):663-71. doi: 10.1583/08-2528.1.
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Prevalence of carotid stent fractures in a single-center experience.单中心经验中颈动脉支架骨折的患病率。
J Endovasc Ther. 2008 Aug;15(4):485-9. doi: 10.1583/08-2420R.1.
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J Vasc Surg. 2008 Jun;47(6):1220-6; discussion 1226. doi: 10.1016/j.jvs.2008.01.043. Epub 2008 Apr 28.
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