脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
原  著
頚動脈内膜剝離術と頚動脈ステント留置術の使い分けと問題点
永田 崇三橋 豊川上 太一郎鶴田 慎井上 剛大畑 建治
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2019 年 47 巻 4 号 p. 266-271

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Carotid endarterectomy (CEA) is a standard surgical procedure used to treat carotid artery stenosis and the associated peri-procedural stroke rate is lower than that associated with carotid artery stenting (CAS). However, the latter is preferred as it is comparatively less invasive. We compared the efficacy of CEA for symptomatic stenosis and CAS for asymptomatic or transient ischemic attack, while considering other factors such as anatomy, renal function, and general status before selecting the final procedure. We operated on 5 lesions using CEA and 14 lesions using CAS. One patient with symptomatic stenosis who was treated using CEA developed symptomatic postoperative stroke. Symptomatic stenosis, vulnerable plaque, and hazardous anastomosis were associated with an increased risk of stenting. A higher location of internal carotid artery stenosis and other anatomical factors should be considered before selecting endarterectomy.

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© 2019 一般社団法人 日本脳卒中の外科学会
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