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颈总动脉血管内再通术 完全闭塞:两例报告及文献综述

Endovascular recanalization of common carotid artery Total occlusion: two case reports and literature review.

作者信息

Hsu Jung-Chi, Tsai Han-Lin

机构信息

Department of Internal Medicine, Division of Cardiology, Saint Mary's Hospital Luodong, Yilan, 26546, Taiwan.

Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, 100, Taiwan.

出版信息

CVIR Endovasc. 2020 Jan 13;3(1):6. doi: 10.1186/s42155-020-0097-6.

DOI:10.1186/s42155-020-0097-6
PMID:32027013
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6966340/
Abstract

BACKGROUND

Common carotid artery total occlusion is rare but can be associated with a variety of neurological symptoms due to inadequate cerebral perfusion. The treatment includes bypass surgery, endarterectomy, and endovascular revascularization.

CASE PRESENTATION

Herein, we report two cases of common carotid artery total occlusion treated by percutaneous transluminal angioplasty, and review the literature.

CONCLUSION

Both of our cases were successfully treated with endovascular revascularization for common carotid artery total stenosis. Endovascular therapy provided an alternative treatment. Further large clinical study for comparing the safety and efficiency in surgical and endovascular treatment may be required.

LEVEL OF EVIDENCE

Level 4, Case Series.

摘要

背景

颈总动脉完全闭塞较为罕见,但由于脑灌注不足可伴有多种神经症状。治疗方法包括搭桥手术、动脉内膜切除术和血管内血运重建术。

病例报告

在此,我们报告两例经皮腔内血管成形术治疗颈总动脉完全闭塞的病例,并对文献进行综述。

结论

我们的两例病例均通过血管内血运重建术成功治疗颈总动脉完全狭窄。血管内治疗提供了一种替代治疗方法。可能需要进一步开展大型临床研究以比较手术治疗和血管内治疗的安全性和有效性。

证据级别

4级,病例系列。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5982/6966340/c2e2b454c649/42155_2020_97_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5982/6966340/f88d72d0fe2e/42155_2020_97_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5982/6966340/c2e2b454c649/42155_2020_97_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5982/6966340/f88d72d0fe2e/42155_2020_97_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5982/6966340/c2e2b454c649/42155_2020_97_Fig2_HTML.jpg

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本文引用的文献

1
Predictors for Successful Endovascular Intervention in Chronic Carotid Artery Total Occlusion.慢性颈动脉完全闭塞血管内介入治疗成功的预测因素。
JACC Cardiovasc Interv. 2016 Sep 12;9(17):1825-32. doi: 10.1016/j.jcin.2016.06.015.
2
Stenosis or Occlusion of the Right Subclavian and Common Carotid Arteries Is More Common than That of the Innominate Artery in Takayasu Arteritis.在高安动脉炎中,右锁骨下动脉和颈总动脉的狭窄或闭塞比无名动脉更为常见。
Vasc Specialist Int. 2015 Dec;31(4):120-4. doi: 10.5758/vsi.2015.31.4.120. Epub 2015 Dec 31.
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Common carotid artery occlusion: a case series.
Surgical procedures including carotid-carotid crossover bypass and ring-stripping hybrid operation for Rile's type 1A common carotid artery occlusion: an experience of 6 cases.
针对赖尔1A型颈总动脉闭塞的手术方法,包括颈-颈交叉搭桥术和剥脱环混合手术:6例经验
Ann Transl Med. 2020 Apr;8(7):439. doi: 10.21037/atm.2020.03.177.
颈总动脉闭塞:病例系列
ISRN Neurol. 2013 Sep 16;2013:198595. doi: 10.1155/2013/198595. eCollection 2013.
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Isolated oculomotor nerve palsy due to common carotid artery occlusion.因颈总动脉闭塞导致的孤立性动眼神经麻痹。
BMJ Case Rep. 2013 Sep 23;2013:bcr2013201338. doi: 10.1136/bcr-2013-201338.
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Common carotid artery occlusion treatment: revealing a gap in the current guidelines.颈总动脉闭塞的治疗:揭示当前指南中的空白。
Eur J Vasc Endovasc Surg. 2013 Sep;46(3):291-8. doi: 10.1016/j.ejvs.2013.06.006. Epub 2013 Jul 17.
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An original technique for the treatment of symptomatic common carotid artery occlusion and concomitant ipsilateral internal carotid artery stenosis.一种治疗有症状的颈总动脉闭塞并伴有同侧颈内动脉狭窄的原创技术。
J Cardiovasc Surg (Torino). 2013 Feb;54(1):145-9.
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Total occlusion of the common carotid artery: a modified classification and its relation to clinical status.
Ultrasound Med Biol. 2008 Jun;34(6):867-73. doi: 10.1016/j.ultrasmedbio.2007.11.015. Epub 2008 Apr 18.
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Common carotid artery occlusion with patent internal and external carotid arteries: diagnosis and surgical management.颈总动脉闭塞伴颈内、外动脉通畅:诊断与外科治疗
J Vasc Surg. 1993 Jun;17(6):1019-27; discussion 1027-8.
9
Common carotid artery occlusion: evaluation with duplex sonography.颈总动脉闭塞:双功超声评估
AJNR Am J Neuroradiol. 1995 May;16(5):1099-105.