Ohshima Tomotaka, Bishnori Ishu, Ishikawa Kojiro, Goto Shunsaku, Yamamoto Taiki, Kato Yoko
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan.
Department of Neurosurgery, Maharaja Agarsen Medical College, Agroha, Hisar, Haryana, India; Department of Neurosurgery, Fujita Health University, Banbuntane Hotokukai Hospital, Nagoya, Japan.
World Neurosurg. 2017 Jun;102:235-239. doi: 10.1016/j.wneu.2017.03.027. Epub 2017 Mar 16.
The treatment strategy for bilateral carotid stenosis (BCS) is not clear. We report our experience of treating 12 patients with BCS using separate carotid artery stenting (CAS) using the restrict protective method. The order of treatment site and the protective method are also discussed.
Between April 2012 and November 2016, 24 lesions in 12 patients (range, 44-83 years; mean, 71 years; 1 woman) underwent CAS at Kariya Toyota General Hospital. These cases were reviewed retrospectively. In all cases, CAS was first performed on the more severely stenosed site. All procedures were performed using the proximal protective method involving balloons and a filter device. We took into consideration adverse events including death from any cause, major stroke within 30 days, and death between 30 days and 1 year later from any stroke.
All procedures were successfully performed under local anesthesia. There was not a single case that showed intolerance during flow arrest to prevent distal embolisms. We observed no adverse events, restenosis, or recurrent symptoms during follow-up.
Good outcomes can be achieved in patients with BCS when attempting separate CAS using the restrict protective method.
双侧颈动脉狭窄（BCS）的治疗策略尚不清楚。我们报告了采用限流保护法对12例BCS患者行颈动脉支架置入术（CAS）的经验。同时也讨论了治疗部位的顺序及保护方法。
2012年4月至2016年11月，12例患者（年龄44 - 83岁，平均71岁；1例女性）的24处病变在刈谷丰田综合医院接受了CAS治疗。对这些病例进行回顾性分析。所有病例均首先对狭窄更严重的部位进行CAS。所有手术均采用涉及球囊和滤器装置的近端保护法。我们考虑了包括任何原因导致的死亡、30天内的严重卒中以及30天至1年后因任何卒中导致的死亡等不良事件。
所有手术均在局部麻醉下成功完成。在防止远端栓塞的血流阻断过程中，没有一例出现不耐受情况。随访期间未观察到不良事件、再狭窄或复发症状。
采用限流保护法对BCS患者行单独CAS治疗可取得良好疗效。
