颈动脉内膜切除术联合支架取出术治疗复发性支架内再狭窄：病例报告及文献综述
Carotid endarterectomy with stent removal for recurring in-stent restenosis: A case report and literature review.
作者信息
Takahashi Yuichi, Higashida Tetsuhiro, Uchida Takanori, Watanabe Saiko, Kanazawa Ryuzaburo
机构信息
Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama City, Japan.
出版信息
Surg Neurol Int. 2022 May 6;13:192. doi: 10.25259/SNI_1222_2021. eCollection 2022.
BACKGROUND
Percutaneous transcatheter angioplasty (PTA) and carotid artery stenting (CAS) are often performed repeatedly for in-stent restenosis (ISR) after CAS. Only a few reports describe the treatment for repeated ISR. Furthermore, only a few reports describe carotid endarterectomy (CEA) after CAS; thus, the evidence for this procedure is insufficient.
CASE DESCRIPTION
Herein, we describe a case in which CEA with stent removal was performed in a patient with repeated ISR after CAS. A 78-year-old man presented with dysarthria and slight left limb weakness. CAS was performed for the right internal carotid artery stenosis. ISR occurred again and PTA and stenting were performed. After the second CAS, ISR occurred again. CEA with stent removal was performed. After the CEA with stent removal, the patient experienced no restenosis or other complications.
CONCLUSION
CEA with stent removal can be a good option for treating repeated ISR after CAS.
背景
经皮腔内血管成形术（PTA）和颈动脉支架置入术（CAS）常因CAS术后支架内再狭窄（ISR）而反复进行。仅有少数报告描述了对反复ISR的治疗。此外，仅有少数报告描述了CAS术后的颈动脉内膜切除术（CEA）；因此，该手术的证据不足。
病例描述
在此，我们描述了1例在CAS术后反复出现ISR的患者接受CEA并取出支架的病例。一名78岁男性出现构音障碍和轻度左下肢无力。对右侧颈内动脉狭窄进行了CAS。再次发生ISR，遂进行了PTA和支架置入术。第二次CAS后，再次发生ISR。进行了CEA并取出支架。在CEA并取出支架后，患者未出现再狭窄或其他并发症。
结论
CEA并取出支架可能是治疗CAS术后反复ISR的一个良好选择。
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