Mouawad Nicolas J
Vascular and Endovascular Surgery, McLaren Health System - Bay Region, Bay City, MI.
Ann Vasc Surg. 2020 Nov;69:449.e1-449.e6. doi: 10.1016/j.avsg.2020.05.016. Epub 2020 May 27.
The use of transcarotid artery revascularization (TCAR) technique for carotid atherosclerotic disease has become increasingly popular as the endovascular alternative to traditional carotid endarterectomy. TCAR does offer a minimally invasive approach to carotid lesions, however, several technical and anatomic considerations, such as extensive calcification, limit its widespread applicability. Both orbital and rotational atherectomy are commonly used for extensively calcified lesions in the peripheral vasculature with satisfactory results for luminal gain. Herein, we describe the use of orbital atherectomy of a severely calcified ostial carotid lesion using reverse flow technique for neuroprotection during TCAR in a patient considered high risk for carotid endarterectomy.
经颈动脉血管重建术（TCAR）用于治疗颈动脉粥样硬化疾病，作为传统颈动脉内膜切除术的血管内替代方法，其应用越来越广泛。TCAR确实为颈动脉病变提供了一种微创方法，然而，一些技术和解剖学因素，如广泛钙化，限制了其广泛应用。轨道旋切术和 rotational atherectomy 通常用于外周血管系统中广泛钙化的病变，在管腔增益方面取得了令人满意的效果。在此，我们描述了一名被认为进行颈动脉内膜切除术风险较高的患者，在TCAR期间使用逆流技术对严重钙化的颈动脉开口病变进行轨道旋切术以实现神经保护的情况。 （注：原文中 rotational atherectomy 未找到确切对应中文，保留英文）
