Henry Christopher L, Hansen Spencer K, Gable Cara E, Grimsley Bradley R, Gable Dennis R
Department of Vascular Surgery, Baylor Scott & White Heart and Vascular Hospital, Dallas, Tex.
Department of Vascular and Endovascular Surgery, Baylor Scott & White Heart Hospital Plano, Plano, Tex.
J Vasc Surg Cases Innov Tech. 2020 Nov 5;7(1):68-73. doi: 10.1016/j.jvscit.2020.10.018. eCollection 2021 Mar.
Transcarotid arterial revascularization (TCAR) with flow reversal offers a less invasive option for carotid revascularization in high-risk surgical patients. TCAR has been shown to have similar complication rates for stroke and mortality compared with carotid endarterectomy and lower complication rates compared with transfemoral carotid artery stenting. A relative contraindication for carotid stenting includes heavily calcified lesions. Intravascular lithotripsy has been approved for use in other vascular beds for endovascular treatment of heavily calcified lesions. In the present report, we have demonstrated the application of intravascular lithotripsy for heavily calcified carotid lesions, enabling treatment with TCAR for those who otherwise might be at high risk of transfemoral carotid artery stenting or carotid endarterectomy.
采用血流逆转的经颈动脉血管重建术（TCAR）为高危手术患者的颈动脉血管重建提供了一种侵入性较小的选择。与颈动脉内膜切除术相比，TCAR已被证明在中风和死亡率方面具有相似的并发症发生率，与经股动脉颈动脉支架置入术相比，并发症发生率更低。颈动脉支架置入术的一个相对禁忌症包括严重钙化病变。血管内碎石术已被批准用于其他血管床，以治疗严重钙化病变。在本报告中，我们展示了血管内碎石术在严重钙化颈动脉病变中的应用，使那些原本可能面临经股动脉颈动脉支架置入术或颈动脉内膜切除术高风险的患者能够接受TCAR治疗。
