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タイトル別表記
Stent retrieval for FFT with carotid stenosis
著者
Matsuda, Tomohiro Tokushima University
Kuroda, Kazutaka Tokushima University
曽我部, 周 Tokushima University
キーワード
Carotid artery stenting
Free-floating thrombus
Mechanical thrombectomy
Stent retriever
資料タイプ
学術雑誌論文
抄録
Background: We report two cases who underwent mechanical thrombectomy using a stent retriever in advance of urgent carotid artery stenting (CAS) for carotid artery stenosis with free-floating thrombus (FFT).
Case Description: Two patients showing symptomatic carotid artery stenosis with FFT underwent urgent endovascular surgery due to progressive neurological symptoms. The first case showed an FFT with 70% internal carotid artery (ICA) stenosis. After the completion of the common and external carotid artery balloon and distal ICA filter protection, we deployed a 6-mm-diameter stent retriever in the distal part of the stenosis. The white thrombus was retrieved; the angiographic shadow of the FFT disappeared; and CAS was performed. In the second case, due to a 90% severe stenosis lesion with FFT, balloon angioplasty was performed on the lesion using the push wire of the stent retriever. After angioplasty, the stent retriever was smoothly retrieved, and CAS was performed. Postoperative magnetic resonance imaging showed an increase in cerebral embolism in the first case; however, the patient’s neurological symptoms improved. The second case showed in-stent plaque protrusion and required two additional stent placements; the patient showed no worsening of his neurological symptoms.
Conclusion: In cases of carotid artery stenosis with FFT, it is technically possible to retrieve a thrombus with a stent retriever. Although thrombus removal may help reduce the risk of ischemic complications in a series of urgent CAS procedures, there are concerns such as mechanical irritation to the carotid artery plaque, and its indications and alternative treatments should be carefully considered.
掲載誌名
Surgical Neurology International
ISSN
21527806
出版者
Surgical Neurology International|Scientific Scholar
14
開始ページ
274
発行日
2023-08-04
権利情報
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License (https://creativecommons.org/licenses/by-nc-sa/4.0/), which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
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言語
eng
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出版社版
部局
医学系
病院