Silva Danilo Almeida, de Aguiar Guilherme Brasileiro, Jory Maurício, Conti Mario Luiz Marques, Veiga José Carlos Esteves
Department of Surgery, Santa Casa de Sao Paulo School of Medical Sciences, Rua Dr. Cesário Motta Júnior, São Paulo, Brazil.
Surg Neurol Int. 2020 Oct 8;11:329. doi: 10.25259/SNI_550_2020. eCollection 2020.
Angioplasty using a carotid stent is a treatment modality for carotid stenosis, with results similar to those obtained with endarterectomy, as demonstrated by important studies. The increasing use of this procedure has also led to a larger number of reports of complications, stent fractures among those. Stent fracture is a rare manifestation and hence needs further studying so that its actual prevalence can be determined, as well as its associated risk factors and proper clinical management. The current study reports the case of a patient who had previously undergone angioplasty with a carotid stent and, after an automobile accident, presented with a stent fracture and distal embolization of fragments thereof with neurological manifestation.
A male patient, 40 years old, presented with a history of previously stent carotid angioplasty. He had been involved in an automobile accident and suffered a stent fracture with distal fragment migration. As he was an asymptomatic patient (NIHSS 0, Rankin zero), we opted for a conservative treatment with oral anticoagulant.
Angioplasty is an effective treatment for extracranial atherosclerosis and, albeit rare, stent fractures can result in the migration of fragments thereof. This occurrence should be suspected in patients who have sustained severe neck injuries due to sudden deceleration and may be associated with thromboembolism.
使用颈动脉支架进行血管成形术是治疗颈动脉狭窄的一种方式，重要研究表明其结果与内膜切除术相似。该手术使用的增加也导致了更多并发症报告，其中包括支架断裂。支架断裂是一种罕见表现，因此需要进一步研究以确定其实际发生率、相关危险因素及合适的临床处理方法。本研究报告了一名此前接受过颈动脉支架血管成形术的患者，在一次汽车事故后出现支架断裂及其碎片远端栓塞并伴有神经学表现的病例。
一名40岁男性患者，有颈动脉支架血管成形术病史。他遭遇了一场汽车事故，发生了支架断裂及远端碎片移位。由于他是无症状患者（美国国立卫生研究院卒中量表评分为0，Rankin量表评分为0），我们选择了口服抗凝剂的保守治疗。
血管成形术是治疗颅外动脉粥样硬化的有效方法，尽管罕见，但支架断裂可导致其碎片移位。对于因突然减速而遭受严重颈部损伤的患者应怀疑有这种情况发生，且可能与血栓栓塞有关。
