Yamada Miho, Tsugawa Jun, Nii Kouhei, Inoue Ritsurou, Tsuboi Yoshio, Higashi Toshio
Stroke center, Fukuoka University Chikushi Hospital.
Department of Neurosurgery, Fukuoka University Chikushi Hospital.
Rinsho Shinkeigaku. 2022 Oct 22;62(10):801-804. doi: 10.5692/clinicalneurol.cn-001772. Epub 2022 Sep 30.
A 79-year-old-man with a clinical history of type 2 diabetes and hypertension was admitted to our hospital for recurrent right hemiparesis. He was referred to our department with left internal carotid artery stenosis. Cerebral angiography with a slight contrast agent revealed NASCET 86% stenosis at the left internal carotid bifurcation. Although no neurological deficit was observed, he had a renal dysfunction with an estimated glomerular filtration rate of 32.2 ml/min/1.73 m. We used a 3D fusion image obtained from the initial angiography with B-mode and intravascular ultrasound to avoid aggravating renal function instead of using a contrast medium. Following the procedure, favorable expansion of the stenotic region was achieved, and no evidence of recurrence was seen during the follow-up period. 3D fusion imaging is a valuable and safe method for endovascular treatment of carotid artery stenosis for patients with renal dysfunction.
一名患有2型糖尿病和高血压病史的79岁男性因反复出现右侧偏瘫入住我院。他因左颈内动脉狭窄被转诊至我科。使用少量造影剂进行的脑血管造影显示,左颈内动脉分叉处NASCET狭窄率为86%。尽管未观察到神经功能缺损,但他存在肾功能不全,估计肾小球滤过率为32.2 ml/min/1.73m²。我们使用了从初始血管造影结合B超和血管内超声获得的三维融合图像,以避免加重肾功能,而不是使用造影剂。手术后,狭窄区域实现了良好的扩张,随访期间未发现复发迹象。三维融合成像对于肾功能不全患者的颈动脉狭窄血管内治疗是一种有价值且安全的方法。