颈动脉支架置入术中保留远端保护装置而需行颈动脉内膜切除术：一种并发症及处理考量
Retained distal protection device during carotid artery stenting necessitating carotid endarterectomy: A complication and management considerations.
作者信息
Page Paul, Niemann David, Son Colin, Li Yiping
机构信息
Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
出版信息
Surg Neurol Int. 2018 Jun 19;9:123. doi: 10.4103/sni.sni_32_18. eCollection 2018.
BACKGROUND
Neuroendovascular techniques have significantly altered the treatment paradigm of cerebrovascular diseases. Since the introduction of distal cerebral protection devices (DCPD), the incidence of embolic strokes during carotid artery stenting (CAS) has been significantly reduced. Treatment guidelines for retained foreign bodies in the cerebral vasculature do not exist.
CASE DESCRIPTION
Here, we present the case of an 88-year-old male who, during carotid artery angioplasty and stenting for symptomatic carotid artery stenosis, suffered from a retained distal protection device ultimately requiring open surgical carotid endarterectomy including removal of the retained device and stent.
CONCLUSIONS
Carotid artery angioplasty and stenting utilizing distal protection devices is a commonly employed technique that may rarely result in retained devices. Knowledge of how to retrieve foreign bodies and the salvage techniques are essential to prevent complications from CAS.
背景
神经血管内技术显著改变了脑血管疾病的治疗模式。自从远端脑保护装置（DCPD）问世以来，颈动脉支架置入术（CAS）期间栓塞性卒中的发生率已显著降低。目前尚无关于脑血管系统中残留异物的治疗指南。
病例描述
在此，我们报告一例88岁男性病例，该患者在因症状性颈动脉狭窄行颈动脉血管成形术和支架置入术期间，远端保护装置残留，最终需要行开放性颈动脉内膜切除术，包括取出残留装置和支架。
结论
使用远端保护装置的颈动脉血管成形术和支架置入术是一种常用技术，但可能很少导致装置残留。了解如何取出异物及挽救技术对于预防CAS并发症至关重要。
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