Yamamura A, Shibata K, Okuyama T, Hirai H
Department of Neurosurgery, Hakodate Municipal Hospital.
No Shinkei Geka. 1993 Mar;21(3):251-6.
We encountered one case of right cervical internal carotid artery (ICA) stenosis with ulcerative plaque. The patient was treated using percutaneous transluminal angioplasty (PTA). A 70 year-old man complained of left motor weakness and left hemidysesthesia. CT scan on the day of admission showed no abnormal findings. Angiographical findings revealed a severe right ICA stenosis with ulcerative plaque. We first treated the patient conservatively because of high-positioned carotid bifurcation, bronchial asthma and hypertension. 20 hours after the stroke, left motor weakness gradually worsened and CT scan revealed multiple low-density areas in the right fronto-parieto-occipital watershed region. Because of this, we treated the stenosed ICA by PTCA balloon dilatation catheter, and successfully obtained adequate dilatation with no complications. We propose that PTA of ICA stenosis, as well as PTA of the vertebral region, is a useful method for patients who have conditions which would make surgical operations risky.
我们遇到一例右侧颈内动脉（ICA）狭窄伴溃疡性斑块的病例。该患者接受了经皮腔内血管成形术（PTA）治疗。一名70岁男性主诉左侧肢体运动无力和左侧半身感觉障碍。入院当天的CT扫描未发现异常。血管造影结果显示右侧ICA严重狭窄伴溃疡性斑块。由于颈动脉分叉位置高、支气管哮喘和高血压，我们首先对患者进行了保守治疗。中风后20小时，左侧肢体运动无力逐渐加重，CT扫描显示右侧额顶枕交界区有多个低密度区。因此，我们使用PTCA球囊扩张导管对狭窄的ICA进行了治疗，并成功获得了充分扩张，且无并发症。我们认为，ICA狭窄的PTA以及椎动脉区域的PTA，对于那些存在手术风险情况的患者来说是一种有用的方法。
