進行性脳梗塞に対する急性期頚動脈内膜剝離術の臨床的検討

森﨑 雄大; 米澤 泰司; 明田 秀太; 井上 美里; 新 靖史; 鄭 倫成; 輪島 大介; 古家一 洋平; 岡本 愛; 角谷 美帆; 古田 隆徳; 佐々木 弘光

doi:10.2335/scs.45.28

Original Articles

Clinical Features in Patients with Stroke-in-Evolution Undergoing Carotid Endarterectomy

Yudai MORISAKI, Taiji YONEZAWA, Shuta AKETA, Misato INOUE, Yasushi SHIN, Rinsei TEI, Daisuke WAJIMA, Youhei KOGEICHI, Ai OKAMOTO, Miho KAKUTANI, Takanori FURUTA, Hiromitsu SASAKI

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Keywords: acute carotid endarterectomy, stroke-in-evolution, plaque imaging, recurrence

JOURNAL FREE ACCESS

2017 Volume 45 Issue 1 Pages 28-34

DOI https://doi.org/10.2335/scs.45.28

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Abstract

The efficacy of and indications for acute carotid endarterectomy (CEA) in patients with stroke-in-evolution are still unclear. Here, we discuss the safety and plaque features of five patients undergoing acute CEA.
We studied five male patients (mean age of 70.6 years) with thromboembolism from cervical plaques. The preoperative median value of the National Institutes of Health Stroke Scale (NIHSS) score was 1 (0-10).
Preoperative plaque imaging studies showed three cases with low intensity, one with ulceration, and one with a floating atheroma. All five patients had undergone CEA within a week of onset between March 2011 and March 2014. None had postoperative recurrence.
We believe that CEA is more beneficial for patients with thromboembolic diseases such as carotid atheroma and stroke-in-evolution than management with medication alone.

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