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经颈动脉逆行支架置入术治疗颈总动脉开口狭窄：我的操作方法。

Transcarotid retrograde stenting for common carotid artery ostial stenosis: how I do it.

作者信息

Sasaki Nozomi, Egashira Yusuke, Enomoto Yukiko, Izumo Tsuyoshi

机构信息

Department of Neurosurgery, Gifu University Graduate School of Medicine, 1-1 Yanagido, 501-1194, Gifu, Japan.

出版信息

Acta Neurochir (Wien). 2025 Mar 4;167(1):57. doi: 10.1007/s00701-025-06463-1.

DOI:10.1007/s00701-025-06463-1
PMID:40035888
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11880150/
Abstract

BACKGROUND

We present a surgical technique for retrograde stenting of ostial stenosis of the common carotid artery (CCA) in a 74-year-old male patient.

METHOD

The carotid bifurcation was widely exposed. A 9-French (Fr) balloon guide catheter (BGC) was inserted via a small arteriotomy of the CCA and fixed using balloon inflation. The BGC was curved and placed toward the leg side. Transluminal angioplasty followed by stent deployment was then performed. The contrast medium injected via a diagnostic 4-Fr catheter was aspirated through the BGC.

CONCLUSION

Our modified transcarotid retrograde stenting technique appears to be a feasible approach for managing ostial stenosis of the CCA.

摘要

背景

我们介绍了一种针对一名74岁男性患者颈总动脉（CCA）开口处狭窄进行逆行支架置入的手术技术。

方法

广泛暴露颈动脉分叉处。通过CCA的一个小动脉切口插入一根9法国（Fr）的球囊引导导管（BGC），并通过球囊充盈将其固定。将BGC弯曲并朝向腿部一侧放置。然后进行腔内血管成形术，随后置入支架。通过诊断性4Fr导管注入的造影剂通过BGC吸出。

结论

我们改良的经颈动脉逆行支架置入技术似乎是治疗CCA开口处狭窄的一种可行方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13eb/11880150/0c67957bd211/701_2025_6463_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13eb/11880150/47daea2ef3fc/701_2025_6463_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13eb/11880150/935c5d98cb7e/701_2025_6463_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13eb/11880150/8a1579ce8a0b/701_2025_6463_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13eb/11880150/0c67957bd211/701_2025_6463_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13eb/11880150/47daea2ef3fc/701_2025_6463_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13eb/11880150/935c5d98cb7e/701_2025_6463_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13eb/11880150/8a1579ce8a0b/701_2025_6463_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13eb/11880150/0c67957bd211/701_2025_6463_Fig5_HTML.jpg

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本文引用的文献

1
Open Retrograde Stenting with a Sheathless Method Using a Balloon-guiding Catheter for Proximal Common Carotid Artery Stenosis.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。
J Neuroendovasc Ther. 2020;14(8):331-335. doi: 10.5797/jnet.tn.2020-0035. Epub 2020 May 29.
2
Hybrid treatment of tandem, common carotid/innominate artery and ipsilateral carotid bifurcation stenoses by simultaneous, retrograde proximal stenting and eversion carotid endarterectomy: Preliminary results of a case series.同期逆行近端支架置入术联合外翻颈动脉内膜切除术治疗串联、颈总/无名动脉及同侧颈动脉分叉狭窄的杂交治疗：病例系列的初步结果。
Int J Surg. 2018 Apr;52:329-333. doi: 10.1016/j.ijsu.2018.02.062. Epub 2018 Mar 10.
3
Transcarotid Approach for Retrograde Stenting of Proximal Innominate and Common Carotid Artery Stenosis.
经颈动脉途径逆行支架置入术治疗无名动脉和颈总动脉近端狭窄
Ann Vasc Surg. 2017 Aug;43:242-248. doi: 10.1016/j.avsg.2017.02.009. Epub 2017 May 3.
4
Transfemoral endovascular treatment of proximal common carotid artery lesions: a single-center experience on 153 lesions.经股动脉血管内治疗颈总动脉近端病变：153例病变的单中心经验
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Diagnosis and treatment of proximal carotid lesions.近端颈动脉病变的诊断与治疗。
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Transthoracic repair of innominate and common carotid artery disease: immediate and long-term outcome for 100 consecutive surgical reconstructions.经胸修复无名动脉和颈总动脉疾病：100例连续手术重建的近期和长期结果
J Vasc Surg. 1998 Jan;27(1):34-41; discussion 42. doi: 10.1016/s0741-5214(98)70289-7.