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使用球囊扩张式冠状动脉支架进行颈动脉支架置入术:用于分期血管成形术的意向性应用。

Carotid Artery Stenting Using Balloon-Expandable Coronary Stent: Intentional Use for Staged Angioplasty.

作者信息

Ezura Masayuki, Kimura Naoto, Sakata Hiroyuki, Ishida Tomohisa, Inoue Takashi, Uenohara Hiroshi

机构信息

Department of Neurosurgery, NHO Sendai Medical Center, Sendai, Miyagi, Japan.

Department of Neurosurgery, Iwate Prefectural Central Hospital, Morioka, Iwate, Japan.

出版信息

J Neuroendovasc Ther. 2021;15(9):621-628. doi: 10.5797/jnet.tn.2020-0154. Epub 2021 Jan 14.

Abstract

OBJECTIVE

We report carotid artery stenting (CAS) using balloon-expandable coronary (BECo) stent. The materials in this study consist of 15 cases of high-grade stenosis in internal carotid artery (ICA) in which self-expanding carotid (SECa) stent was not utilized. There were two groups why BECo stent was used instead of SECa stent: alternative group and intentional group. The alternative group was subdivided into two groups: access difficulty of guiding catheter and access difficulty of SECa stent.

CASE PRESENTATION

The alternative group included 11 cases (access difficulty of guiding catheter in 10 and access difficulty of SECa stent in 1), and the intentional group included 4 cases. There were four cases using transbrachial approach. All the intentional group cases were the first stage of staged angioplasty (SAP). The second stage of SAP was PTA in two and SECa stent over the BECo stent in two. There was no complication related to CAS.

CONCLUSION

CAS using BECo stent is one of the choices for the first stage of SAP, if stent placement instead of PTA is required at the first stage. It is also the useful alternative for the patient having difficulty of SECa stent.

摘要

目的

我们报告使用球囊扩张式冠状动脉(BECo)支架进行颈动脉支架置入术(CAS)。本研究中的材料包括15例颈内动脉(ICA)重度狭窄病例,这些病例未使用自膨式颈动脉(SECa)支架。使用BECo支架而非SECa支架有两组原因:替代组和意向组。替代组又细分为两组:引导导管进入困难组和SECa支架进入困难组。

病例介绍

替代组包括11例(引导导管进入困难10例,SECa支架进入困难1例),意向组包括4例。有4例采用经肱动脉途径。所有意向组病例均为分期血管成形术(SAP)的第一阶段。SAP的第二阶段,2例行经皮腔内血管成形术(PTA),2例行在BECo支架上置入SECa支架。未发生与CAS相关的并发症。

结论

如果在第一阶段需要置入支架而非进行PTA,那么使用BECo支架进行CAS是SAP第一阶段的选择之一。对于SECa支架置入困难的患者,它也是一种有用的替代方法。

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