Tsujimoto Yoshitaka, Ikeda Hiroyuki, Otsuka Ryotaro, Kawauchi Takeshi, Sano Noritaka, Hayase Makoto, Toda Hiroki
Department of Neurosurgery, Fukui Red Cross Hospital, Fukui, Japan.
J Neuroendovasc Ther. 2020;14(6):222-230. doi: 10.5797/jnet.cr.2019-0062. Epub 2020 Apr 1.
Iatrogenic artery dissection during reperfusion therapy is one of the complications causing a poor prognosis. We report two cases of emergent stent placement for iatrogenic cervical carotid artery dissection during reperfusion therapy for acute ischemic stroke.
Two patients, a 77-year-old woman and a 77-year-old man, were diagnosed with acute major cerebral artery occlusion, and underwent reperfusion therapy. The iatrogenic internal carotid artery dissection was caused by derivation of a 6-Fr catheter and 0.014-inch wire in the tortuous cervical internal carotid artery, and emergent stent placement was performed. Recanalization was confirmed and no deterioration caused by the iatrogenic dissection was found.
In patients in whom cerebral infarction is localized on MRI, additional stent placement may be effective for preventing adverse events caused by iatrogenic cervical internal carotid artery dissection during reperfusion therapy for intracranial cerebral artery occlusion related to atherosclerotic change.
再灌注治疗期间的医源性动脉夹层是导致预后不良的并发症之一。我们报告两例在急性缺血性脑卒中再灌注治疗期间因医源性颈内动脉夹层而紧急置入支架的病例。
两名患者,一名77岁女性和一名77岁男性,被诊断为急性大脑中动脉闭塞,并接受了再灌注治疗。医源性颈内动脉夹层是由6F导管和0.014英寸导丝在迂曲的颈内动脉中操作引起的,随后进行了紧急支架置入。血管再通得到确认,未发现医源性夹层导致的病情恶化。
对于MRI显示脑梗死局限的患者,在对与动脉粥样硬化改变相关的颅内脑动脉闭塞进行再灌注治疗期间,额外置入支架可能有助于预防医源性颈内动脉夹层引起的不良事件。