対側閉塞例に対して，術中モニタリング下に遠位バルーンプロテクションで CAS を施行した1 例

森下 雅博; 進藤 孝一郎; 荻野 達也; 遠藤 英樹; 立田 泰之; 櫻井 卓; 渕﨑 智紀; 石川 耕平; 岡村 尚泰; 石塚 智明; 大熊 理弘; 山口 陽平; 上山 憲司; 大里 俊明; 中村 博彦

doi:10.20626/nkc.cr.2021-0005

Case Reports

A Case of CAS Using Intraoperative Monitoring for Carotid Artery Stenosis with Contralateral Carotid Occlusion

Masahiro MORISHITA, Koichiro SHINDO, Tatsuya OGINO, Hideki ENDO, Yasuyuki TATSUTA, Suguru SAKURAI, Tomoki FUCHIZAKI, Kohei ISHIKAWA, Naoyasu OKAMURA, Tomoaki ISHIZUKA, Masahiro OKUMA, Youhei YAMAGUCHI, Kenji KAMIYAMA, Toshiaki OSATO, Hirohiko NAKAMURA

Author information

Masahiro MORISHITA
Department of Neurosurgery, Nakamura Memorial Hospital
Koichiro SHINDO
Department of Neurosurgery, Nakamura Memorial Hospital
Center for Endovascular Neurosurgery, Nakamura Memorial Hospital
Tatsuya OGINO
Department of Neurosurgery, Nakamura Memorial Hospital
Center for Endovascular Neurosurgery, Nakamura Memorial Hospital
Hideki ENDO
Department of Neurosurgery, Nakamura Memorial Hospital
Center for Endovascular Neurosurgery, Nakamura Memorial Hospital
Department of Neurosurgery, Nakamura Memorial South Hospital
Yasuyuki TATSUTA
Department of Neurosurgery, Nakamura Memorial Hospital
Center for Endovascular Neurosurgery, Nakamura Memorial Hospital
Suguru SAKURAI
Department of Neurosurgery, Nakamura Memorial Hospital
Center for Endovascular Neurosurgery, Nakamura Memorial Hospital
Tomoki FUCHIZAKI
Department of Neurosurgery, Nakamura Memorial Hospital
Kohei ISHIKAWA
Department of Neurosurgery, Nakamura Memorial Hospital
Naoyasu OKAMURA
Department of Neurosurgery, Nakamura Memorial Hospital
Tomoaki ISHIZUKA
Department of Neurosurgery, Nakamura Memorial Hospital
Masahiro OKUMA
Department of Neurosurgery, Nakamura Memorial Hospital
Youhei YAMAGUCHI
Department of Neurosurgery, Nakamura Memorial Hospital
Kenji KAMIYAMA
Department of Neurosurgery, Nakamura Memorial Hospital
Toshiaki OSATO
Department of Neurosurgery, Nakamura Memorial Hospital
Hirohiko NAKAMURA
Department of Neurosurgery, Nakamura Memorial Hospital

Keywords: carotid artery stenting, contralateral carotid occlusion, near-infrared spectroscopy, somatosensory evoked potentials

JOURNAL OPEN ACCESS

2021 Volume 6 Issue 3 Pages 141-147

DOI https://doi.org/10.20626/nkc.cr.2021-0005

Browse “Advance online publication” version

Details

Abstract

Objective: We report a case of carotid artery stenting (CAS) using intraoperative monitoring for carotid artery stenosis with contralateral carotid occlusion (CCO).

Case Presentation: A 68-year-old man underwent CAS for progressive left carotid artery stenosis with CCO, and the plaque images demonstrated plaque vulnerability. Therefore, we chose to perform a temporary carotid occlusion by distal balloon protection with monitoring (SEP and NIRS) before the procedure. If we did not confirm ischemic tolerance, we would have used a distal filter protection device. Monitoring demonstrated ischemic tolerance for a short time during the procedure with the occluded internal carotid artery at the cervical segment instead of the petrous segment. We performed CAS with distal balloon protection.

Conclusion: Monitoring may be useful for CAS in patients with CCO.

Corresponding author

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