Tanaka Kanta, Kitagawa Takamichi, Yamana Norikazu, Akiyama Yoshinori
Department of Neurology and Stroke Center, Tenri Hospital, Tenri, Japan.
Department of Clinical Pathology, Tenri Hospital, Tenri, Japan.
Med Ultrason. 2019 Feb 17;21(1):89-92. doi: 10.11152/mu-1539.
In-stent plaque protrusion (ISP) is a predictor for ischemic complications in carotid artery stenting (CAS). Because its mobility would further increase the distal embolization risk, the intraprocedural detection of mobility is important but has not yet been reported. We present an 87-year-old male with symptomatic right carotid artery stenosis who underwent CAS. Intravascular ultrasound (IVUS) after stent deployment revealed a small ISP, and simultaneous extravascular carotid duplex disclosed its mobility. After coverage of the ISP with stent-in-stent implantation, no remaining protrusion was observed with either IVUS or carotid duplex. The patient experienced no periprocedural strokes. Carotid duplex is suited to evaluate targets' movement because of its excellent temporal resolution. Carotid duplex has potential value for intraprocedural risk estimation of ISP.
支架内斑块突出（ISP）是颈动脉支架置入术（CAS）中缺血性并发症的一个预测指标。由于其活动性会进一步增加远端栓塞风险，因此术中对活动性的检测很重要，但尚未见报道。我们报告一例87岁有症状的右颈动脉狭窄男性患者接受了CAS。支架置入后血管内超声（IVUS）显示有一个小的ISP，同时血管外颈动脉双功超声显示了其活动性。在采用重叠支架植入术覆盖ISP后，IVUS或颈动脉双功超声均未观察到残留突出。该患者未发生围手术期卒中。由于颈动脉双功超声具有出色的时间分辨率，因此适合评估目标的移动情况。颈动脉双功超声在术中对ISP风险评估具有潜在价值。
