Urgent stenting for patients with acute stroke due to atherosclerotic occlusive lesions of the cervical internal carotid artery
Urgent stenting for patients with acute stroke due to atherosclerotic occlusive lesions of the cervical internal carotid artery
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DOI：
10.2176/nmc.48.49
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发表时间：
2008-02-01
影响因子：
1.9
通讯作者：
Shimaguchi, Hidetoshi
中科院分区：
文献类型：
--
作者：
Miyamoto, Naoko;Naito, Isao;Shimaguchi, Hidetoshi
颈内动脉（ICA）的急性症状闭塞可以通过静脉注射组织纤溶酶原激活剂、经皮腔内血管成形术和颈动脉内膜切除术来治疗。颈动脉支架置入术 (CAS) 目前适用于颈内动脉狭窄，但紧急 CAS 的安全性和有效性尚未确定。我们回顾性分析了 10 例因颈内动脉粥样硬化闭塞性病变合并急性卒中而接受紧急 CAS 治疗的患者。五名患者完全闭塞，五名患者接近完全闭塞。 10 名患者中有 5 名患有颅内串联闭塞。紧急 CAS 的指征是通过弥散加权和灌注加权磁共振成像结果的不匹配来确定的。支架已成功部署在所有病变中。五名伴有颅内串联闭塞的患者中的三名在 CAS 后接受了额外的动脉内纤溶治疗。一名患者的颅内动脉闭塞完全再通，两名患者通过纤溶作用部分再通。所有患者均未出现过度灌注综合征。良好的结果（改良兰金量表
Acute symptomatic occlusion of the cervical internal carotid artery (ICA) can be treated by intravenous administration of tissue plasminogen activator, percutaneous transluminal angioplasty, and carotid endarterectomy. Carotid artery stenting (CAS) is now indicated for cervical ICA stenosis, but the safety and the efficacy of urgent CAS have not been established. We retrospectively reviewed 10 patients treated by urgent CAS for atherosclerotic occlusive lesions of cervical ICA with acute stroke. Five patients had complete occlusions and five had near total occlusions. Five of the 10 patients had intracranial tandem occlusions. Indication for urgent CAS was determined by mismatch of diffusion-weighted and perfusion-weighted magnetic resonance imaging findings. Stents were successfully deployed in all lesions. Three of five patients with concomitant intracranial tandem occlusions were treated by additional intraarterial fibrinolysis after the CAS. Intracranial artery occlusions were completely recanalized in one patient, and partially recanalized in two by fibrinolysis. Hyperperfusion syndrome did not occur in any of the patients. A favorable outcome (modified Rankin Scale