Kasakura Shigen, Mori Takahisa, Iwata Tomonori, Tanno Yuhei, Aoyagi Yoshinori, Yoshioka Kazuhiro
Department of Stroke Treatment, Shonan Kamakura General Hospital Stroke Center.
No Shinkei Geka. 2015 Oct;43(10):913-8. doi: 10.11477/mf.1436203148.
The transfemoral approach is a common technique for carotid artery stenting(CAS)and involves the risk of distal embolism when a high-grade stenosis occurs at the common carotid artery(CCA). In this study, to minimize the risk of thromboembolic complications, we used a guide sheath that was specifically designed for direct cannulation to the CCA without the use of a guidewire or coaxial catheter. This study included 5 patients who underwent CAS of the CCA by using a guide sheath. Of these patients, 2 had right CCA stenosis and the other 3 had left CCA lesions. In all cases, direct cannulation to the target CCA by using the guide sheath was achieved, and CAS was performed safely. The median time from puncture to the end of the procedure was 61 min(interquartile range: 53-63). No periprocedural complications or cardiovascular events occurred within 30 days after CAS. CAS was safely and successfully performed for CCA stenosis by using the transbrachial guide sheath that was specifically designed for direct cannulation to the CCA.
经股动脉途径是颈动脉支架置入术（CAS）的常用技术，当颈总动脉（CCA）出现重度狭窄时，该途径存在远端栓塞风险。在本研究中，为将血栓栓塞并发症风险降至最低，我们使用了一种专门设计的引导鞘管，无需使用导丝或同轴导管即可直接插入CCA。本研究纳入了5例使用引导鞘管进行CCA的CAS患者。其中，2例为右侧CCA狭窄，另外3例为左侧CCA病变。在所有病例中，均成功使用引导鞘管直接插入目标CCA，并安全地进行了CAS。从穿刺到手术结束的中位时间为61分钟（四分位间距：53 - 63）。CAS术后30天内未发生围手术期并发症或心血管事件。通过使用专门设计用于直接插入CCA的经肱动脉引导鞘管，CCA狭窄的CAS得以安全、成功地实施。
