使用球囊引导导管的无鞘方法对颈总动脉近端狭窄进行开放式逆行支架置入术。
Open Retrograde Stenting with a Sheathless Method Using a Balloon-guiding Catheter for Proximal Common Carotid Artery Stenosis.
作者信息
Yamauchi Keita, Kumagai Masaki, Itazu Takaaki, Sakai Hideki
机构信息
Department of Neurosurgery, National Hospital Organization Toyohashi Medical Center, Toyohashi, Aichi, Japan.
出版信息
J Neuroendovasc Ther. 2020;14(8):331-335. doi: 10.5797/jnet.tn.2020-0035. Epub 2020 May 29.
OBJECTIVE
Carotid artery stenting (CAS) and carotid endarterectomy are relatively difficult for proximal common carotid artery (CCA) stenosis because of the difficulty in anatomical approach. We treated proximal CCA stenosis by retrograde stenting using a 9Fr Optimo for peripheral intervention with a sheathless method.
CASE PRESENTATION
A 60-year-old woman was scheduled for total arch replacement (TAR) for an aortic arch aneurysm. Preoperative cervical MRI incidentally revealed tandem stenosis in the left CCA. We intended to treat CCA stenosis prior to aortic arch replacement. Under general anesthesia, distal left CCA was exposed. A 9Fr Optimo was introduced into CCA by retrograde with a sheathless method. The retrograde CAS was performed under distal balloon protection. Her postoperative course was uneventful.
CONCLUSION
Retrograde stenting using a 9Fr Optimo for peripheral intervention with a sheathless method was safe and useful for proximal CCA stenosis.
目的
由于解剖入路困难，对于颈总动脉（CCA）近端狭窄，颈动脉支架置入术（CAS）和颈动脉内膜切除术相对困难。我们采用9Fr Optimo进行外周介入的逆行支架置入术并使用无鞘方法治疗CCA近端狭窄。
病例介绍
一名60岁女性计划因主动脉弓动脉瘤行全弓置换术（TAR）。术前颈椎MRI偶然发现左CCA串联狭窄。我们打算在主动脉弓置换术前治疗CCA狭窄。在全身麻醉下，暴露左CCA远端。采用无鞘方法将9Fr Optimo逆行引入CCA。在远端球囊保护下进行逆行CAS。她的术后过程顺利。
结论
采用9Fr Optimo进行外周介入的逆行支架置入术并使用无鞘方法治疗CCA近端狭窄是安全有效的。
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