脳卒中の外科
Online ISSN : 1880-4683
Print ISSN : 0914-5508
ISSN-L : 0914-5508
内頸動脈起始部狭窄症に対する経皮的血管形成術の成績と追跡結果
桑山 直也遠藤 俊郎堀江 幸男久保 道也西嶌 美知春高久 晃
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1995 年 23 巻 2 号 p. 75-80

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Ten patients (9 men and 1 woman, ranging in age from 61 to 85 years) with severe carotid stenosis were treated with percutaneous transluminal angioplasty (PTA). The stenosis rate was 64% to 94% (mean; 86%). There were 2 patients with TIA, 3 with a minor stroke, and 2 with a major stroke. The other 3 patients were asymptomatic and single photon emission CT showed decreases in CBF at the ipsilateral cerebral hemisphere in all patients. PTA was successful in all but 1 patient. The stenosis rate was reduced to 44% (mean). Two patients had no more TIA and there was no patient whose symptoms worsened. The CBF recovered in 9 of 10 patients. There was no complication related to the procedure.
Debris was aspirated from the guiding catheter in one patient after the inflation of the PTA catheter while the internal carotid artery was occluded with a protective balloon catheter. Among 7 patients who underwent 3 months or later follow-up angiography, a severe re-stenosis was demonstrated in one and moderate re-stenosis in 2.
In conclusion, the PTA for the carotid stenosis was a safe and effective method with the use of the protective balloon to avoid distal embolism. The re-stenosis after the PTA remains a problem to be solved.

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