Yub Lee Sang, Won Youn Sung, Kyun Kim Ho, Kwon Younghoon
Department of Radiology, The Armed Forces Capital Hospital; Sungnam, Korea.
Department of Radiology, Catholic University of Daegu School of Medicine; Daegu, Korea
Neuroradiol J. 2015 Feb;28(1):62-6. doi: 10.15274/NRJ-2014-10114.
Inadvertent occlusion of an internal carotid artery (ICA) during stenting may be a catastrophic situation requiring a bailout operation to prevent permanent neurologic sequelae. The underlying mechanisms of ICA occlusion may include filter-related flow arrest, arterial dissection, vasospasm, and the accordion effect, and timely differential diagnosis is crucial for appropriate management. We present herein a case of stenting-related accordion effect that led to complete ICA occlusion, wherein temporary placement of a retrievable intracranial stent for rescue was successful in achieving flow restoration, but further complicated by engagement with the filter. The differential diagnosis, preventive measures, and management of the accordion effect are discussed.
在支架置入过程中意外闭塞颈内动脉（ICA）可能是一种灾难性情况，需要进行补救手术以防止永久性神经后遗症。ICA闭塞的潜在机制可能包括滤器相关的血流停滞、动脉夹层、血管痉挛和手风琴效应，及时进行鉴别诊断对于恰当的处理至关重要。我们在此报告一例因支架置入相关的手风琴效应导致ICA完全闭塞的病例，其中临时置入可回收颅内支架进行抢救成功恢复了血流，但因与滤器卡合而使情况进一步复杂化。本文还讨论了手风琴效应的鉴别诊断、预防措施及处理方法。
