抄録
Disruption of an atherosclerotic plaque with resultant intraluminal thrombosis is an important mechanism of plaque development and progression, and also plays a fundamental part in the development of the acute coronary syndromes. The same mechanism contributes a development of ischemic cerebral symptom in the territory of carotid artery. We retrospectively analyzed 62 cases with symptomatic high grade carotid artery stenosis. In these 62 cases, contributing mechanism of ischemic symptoms were considered as hemodynamic ischemia due to acute progression of atheromatous plaque in 5 cases, artery to artery embolism originating from carotid stenosis in 37 cases, unclassified in 20 cases. In 5 cases, 4 cases with hemodynamic ischemia and 1 case with a floating thrombus just distal to the carotid stenosis, emergency treatments including 4 percutaneous transluminal angioplasty with/without stenting and a EC-IC bypass were performed. All cases made a rapid recovery from the ischemic symptoms. Emergent treatments of acute carotid syndrome due to rapid progression of atheromatous plaque produced dramatic effect, although candidates for emergency treatment were less than 10% of all symptomatic high grade carotid artery stenosis.
