Accordion effect during carotid artery stenting: report of two cases and review of the literature.
Accordion effect during carotid artery stenting: report of two cases and review of the literature.
复制标题
颈动脉支架置入术中的手风琴效应：二例报告并文献复习。
作者：
M. Tsutsumi;K. Kazekawa;M. Onizuka;H. Aikawa;M. Iko;T. Kodama;K. Nii;S. Matsubara;H. Etou;A. Tanaka
介绍
术语“手风琴效应”用于描述迂曲动脉模仿痉挛或夹层的机械扭曲。在接受经皮冠状动脉介入治疗的患者中报告了这种现象。据我们所知，这是第一个文件的手风琴效应在颈动脉介入。
方法
两个病人谁开发的手风琴效应在颈动脉支架（CAS）的描述。
结果
CAS后即刻获得的血管造影片显示支架远端部分存在狭窄病变伴壁不规则。撤回导丝后，该病变消失，颈内动脉迂曲，直至其松软节段均匀地置于病变上。在另1例患者中，病变在导引导管撤回至颈总动脉近端部分后才完全消失。我们的结论是，这些狭窄病变反映了手风琴效应。
结论
必须将手风琴效应与夹层、痉挛和血栓形成区别开来，因为两者的治疗方法有很大的不同。我们报告我们的研究结果，并提出了文献综述。
INTRODUCTION
The term "accordion effect" is used to describe a mechanical distortion of tortuous arteries mimicking spasm or dissection. This phenomenon has been reported in patients undergoing percutaneous coronary intervention. To our knowledge, this is the first documentation of the accordion effect during carotid artery intervention.
METHODS
Two patients who developed the accordion effect during carotid artery stenting (CAS) are described.
RESULTS
Angiograms obtained just after CAS showed a stenosing lesion with wall irregularity at the distal part of the stent. This lesion disappeared and tortuosity of the internal carotid artery developed after withdrawing the guidewire until its floppy segment rested equally on the lesion. In another patient, the lesion did not disappear completely until the guiding catheter had been withdrawn to the proximal portion of the common carotid artery. We conclude that these stenosing lesions reflected the accordion effect.
CONCLUSION
It is essential to differentiate the accordion effect from dissection, spasm, and thrombosis because the management is importantly different. We report our findings and present a review of the literature.