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全块辅助经皮颈动脉血管重建术:一种增强神经保护的新方法。

FullBlock-Assisted Percutaneous Carotid Artery Revascularization: A Novel Approach for Enhanced Neuroprotection.

作者信息

Yu Bo, Kwan Kristine J S, Zhou Jiong, Tong Jin-Dong, Jiang Shuai, Tan Jin-Yun, Shi Wei-Hao, Tang Jing-Dong

机构信息

Department of Vascular Surgery, Fudan University Pudong Medical Center, Shanghai, China; Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling, Shanghai, China; Vascular Surgery Division, General Surgery Department, Huashan Hospital Affiliated to Fudan University, Shanghai, China.

Department of Vascular Surgery, Fudan University Pudong Medical Center, Shanghai, China; Shanghai Key Laboratory of Vascular Lesions Regulation and Remodeling, Shanghai, China.

出版信息

JACC Case Rep. 2025 May 14;30(10):103629. doi: 10.1016/j.jaccas.2025.103629.

Abstract

This report describes a first-in-human case of percutaneous carotid artery revascularization (PCAR) using FullBlock, a neuroprotective system that consists of a dual-occlusion balloon and reverse-flow neuroprotective system. The patient was a 77-year-old woman with severe left internal carotid artery stenosis and multiple cardiovascular comorbidities. She was deemed unsuitable for carotid endarterectomy. PCAR with stenting was performed successfully with general anesthesia. Neuroprotection depended on controllable reverse hemodynamics established with the femoral vein and communicating intracranial arteries. Atherosclerotic plaques were filtered in the extra-anatomic reverse flow tube. One-month follow-up was favorable. This case demonstrates the feasibility of FullBlock-assisted PCAR with stenting as a promising alternative for high-risk patients. Transradial and femoral access can be avoided, adding potential benefits of reduced operative complexity and enhanced neuroprotection.

摘要

本报告描述了首例使用FullBlock进行经皮颈动脉血管重建术(PCAR)的人体病例,FullBlock是一种神经保护系统,由双球囊阻断装置和逆向血流神经保护系统组成。患者为一名77岁女性,患有严重的左颈内动脉狭窄和多种心血管合并症。她被认为不适合进行颈动脉内膜切除术。在全身麻醉下成功进行了带支架的PCAR。神经保护依赖于通过股静脉和颅内交通动脉建立的可控逆向血流动力学。动脉粥样硬化斑块在解剖外逆向血流管中被过滤。1个月的随访结果良好。该病例证明了FullBlock辅助带支架PCAR作为高危患者一种有前景的替代方案的可行性。可避免经桡动脉和股动脉入路,增加了降低手术复杂性和增强神经保护的潜在益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0663/12144978/1801950e90d2/ga1.jpg

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