80歳以上の頚動脈狭窄症に対する外科的治療

抄録

The treatment strategy for carotid stenosis in patients >80 years has been changing following many clinical trials. We retrospectively examined the surgical results of carotid stenosis in octogenarians in our hospital. Between January 2004 and November 2010, 223 patients underwent 143 carotid endarterectomies (CEA) and 80 carotid angioplasties with stentings (CAS) in our hospital. We regarded MRI plaque imaging using black-blood T1 sequence as important to select the treatment strategy.
Nineteen octogenarian patients underwent nine CEA and 10 CAS. MRI plaque imaging revealed that relative overall signal intensity of carotid plaque was significantly higher in the CEA cases than in CAS cases. Perioperative and long-term stroke, myocardial infarction and death rates did not differ significantly between the two treatment groups.
Our strategy using MRI plaque imaging for carotid stenosis in octogenarians is useful.