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因无名动脉狭窄斑块导致颈内动脉闭塞行机械取栓术后的颈-颈交叉搭桥术

Carotid-carotid crossover bypass after mechanical thrombectomy for internal carotid artery occlusion due to plaque from stenosed innominate artery.

作者信息

Murakami Tomoaki, Toyota Shingo, Suematsu Takuya, Wada Yuki, Shimizu Takeshi, Taki Takuyu

机构信息

Department of Neurosurgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.

出版信息

Surg Neurol Int. 2021 Sep 30;12:480. doi: 10.25259/SNI_749_2021. eCollection 2021.

DOI:10.25259/SNI_749_2021
PMID:34754530
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8571319/
Abstract

BACKGROUND

The treatment for internal carotid artery occlusion (ICAO) due to innominate artery stenosis is not well established. We herein describe a case of carotid-carotid crossover bypass and common carotid artery (CCA) ligation after mechanical thrombectomy for ICAO due to a plaque from the stenosed innominate artery.

CASE DESCRIPTION

A 70-year-old man was transferred to our hospital because of left-sided hemiparalysis. Head magnetic resonance imaging/angiography showed a cerebral infarction in the right middle cerebral artery area and the right ICAO due to a plaque from the stenosed innominate artery. Immediately, we performed mechanical thrombectomy and successfully attained partial revascularization (Thrombolysis in Cerebral Infarction Grade 2B). After a conference with cardiovascular group, we performed carotid-carotid crossover bypass and the right CCA ligation. The treatment was successful, and no complications occurred.

CONCLUSION

Carotid-carotid crossover bypass and CCA ligation may be a better option for innominate artery stenosis in selected patients.

摘要

背景

无名动脉狭窄所致颈内动脉闭塞（ICAO）的治疗方法尚未完全确立。我们在此描述一例因无名动脉狭窄斑块导致ICAO，在机械取栓术后行颈动脉 - 颈动脉交叉搭桥术及颈总动脉（CCA）结扎的病例。

病例描述

一名70岁男性因左侧偏瘫被转至我院。头部磁共振成像/血管造影显示右侧大脑中动脉区域脑梗死及因无名动脉狭窄斑块导致的右侧ICAO。我们立即进行了机械取栓术，并成功实现了部分血管再通（脑梗死溶栓分级2B级）。在与心血管团队会诊后，我们进行了颈动脉 - 颈动脉交叉搭桥术及右侧CCA结扎。治疗成功，未发生并发症。

结论

对于部分选定患者，颈动脉 - 颈动脉交叉搭桥术及CCA结扎可能是无名动脉狭窄的更好选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3da/8571319/e92ce51e09a0/SNI-12-480-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3da/8571319/9d384b0c6678/SNI-12-480-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3da/8571319/97f755b61ed1/SNI-12-480-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3da/8571319/b14d0b4e947c/SNI-12-480-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3da/8571319/e92ce51e09a0/SNI-12-480-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3da/8571319/9d384b0c6678/SNI-12-480-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3da/8571319/97f755b61ed1/SNI-12-480-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3da/8571319/b14d0b4e947c/SNI-12-480-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3da/8571319/e92ce51e09a0/SNI-12-480-g004.jpg

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Carotid-Carotid Bypass for a Carotid Artery Aneurysm.颈动脉-颈动脉旁路术治疗颈动脉动脉瘤。
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Management of tandem occlusions in acute ischemic stroke - intracranial versus extracranial first and extracranial stenting versus angioplasty alone: a systematic review and meta-analysis.
急性缺血性脑卒中串联病变的处理 - 颅内与颅外血管开通的优先选择及单纯血管内支架成形术与单纯血管内球囊扩张术的比较：一项系统评价和荟萃分析。
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Carotid-Carotid Artery Crossover Bypass with a Synthetic Vascular Graft for Symptomatic Type 1A Common Carotid Artery Occlusion.采用人工血管行颈-颈动脉交叉旁路移植术治疗有症状的1A型颈总动脉闭塞
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