緊急頸動脈ステント留置術を施行した特発性頭蓋外内頸動脈解離の1例

抄録

Objective: We report a case in which urgent carotid artery stenting was performed for spontaneous dissection of the extracranial internal carotid artery (ICA).
Case: A 46-year-old male presented to our hospital with the weakness of left upper limb and dysarthria. Cerebral angiography revealed irregularities of the carotid wall and severe stenosis of ICA, stasis of the contrast agent, and delayed cerebral blood flow in the right extracranial ICA. Based on these observations, ICA dissection was diagnosed. Although our intensive medical treatment, including blood pressure control and administration of antiplatelet drug, thirteen days after onset, his neurological symptoms were suddenly worsened and increased cerebral infarctions on magnetic resonance imaging (MRI). We performed urgent carotid artery stenting. ICA morphology and cerebral blood flow were improved. The patient was transferred to a rehabilitation hospital on day 33.
Conclusion: Percutaneous carotid artery stenting is useful for dissection of the extracranial ICA that exhibit resistance to medical treatment.