Neurological Surgery 脳神経外科48巻7号

2020年07月発行

症例

屈曲病変へのcarotid artery stenting後に高度狭窄を来しステント除去を必要とした1例

著者： 西尾雅実¹ 矢野喜寛¹ 江村拓人¹ 高野浩司¹

所属機関： ¹市立豊中病院脳神経外科

ページ範囲：P.615 - P.620

Ⅰ．はじめに
　屈曲病変に対するステント留置術後，血管走行が変化し，屈曲部が移動することはしばしば経験される．今回，屈曲病変への頚動脈ステント留置術（carotid artery stenting：CAS）後に血管走行が変化してステント端が血管壁に当たり，ストラットの間から遠位へ血流が流れる状態になった結果，留置2年後に高度狭窄を来し，再治療を要した症例を経験した．

参考文献

1) Arhuidese IJ, Nejim B, Chavali S, Locham S, Obeid T, Hicks CW, Malas MB：Endarterectomy versus stenting in patients with prior ipsilateral carotid artery stenting. J Vasc Surg 65：1418-1428, 2017

2) de Borst GJ, Vos JA, Reichmann B, Hellings WE, de Vries JP, Suttorp MJ, Moll FL, Ackerstaff RG；Antonius Carotid Endarterectomy, Angioplasty, and Stenting Study Group：The fate of the external carotid artery after carotid artery stenting. Follow-up study with duplex ultrasonography. Eur J Vasc Endovasc Surg 33：657-663, 2007

3) Brown K, Itum DS, Preiss J, Duwayri Y, Veeraswamy RK, Salam A, Dodson TF, Brewster LP：Carotid artery stenting has increased risk of external carotid artery occlusion compared with carotid endarterectomy. J Vasc Surg 61：119-124, 2015

4) Casey K, Zhou W, Tedesco MM, Al-Khatib WK, Hernandez-Boussard T, Bech F：Fate of external carotid artery following carotid interventions. Int J Angiol 18：173-176, 2009

5) Chakhtoura EY, Hobson RW 2nd, Goldstein J, Simonian GT, Lal BK, Haser PB, Silva MB Jr, Padberg FT Jr, Pappas PJ, Jamil Z：In-stent restenosis after carotid angioplasty-stenting：incidence and management. J Vasc Surg 33：220-225, 2001

6) Gomes WJ, Buffolo E：Coronary stenting and inflammation：implications for further surgical and medical treatment. Ann Thorac Surg 81：1918-1925, 2006

7) Kamenskiy AV, Pipinos Ⅱ, Dzenis YA, Bikhchandani J, Gupta PK, Philips N, Kazmi SA, MacTaggart JN：Effects of carotid artery stenting on arterial geometry. J Am Coll Surg 217：251-262, 2013

8) Malek AM, Alper SL, Izumo S：Hemodynamics share stress and its role in atherosclerosis. JAMA 282：2035-2042, 1999

9) Reichmann BL, Hellings WE, van der Worp HB, Algra A, Brown MM, Mali WP, de Borst GJ：Flow velocities in the external carotid artery following carotid revascularization. Eur J Vasc Endovasc Surg 46：411-417, 2013

10) Siracuse JJ, Epelboym I, Li B, Hoque R, Catz D, Morrissey NJ：External carotid artery stenosis after internal and common carotid stenting. Ann Vasc Surg 29：443-446, 2015

11) Tanigawa J, Barlis P, Di Mario C：Do unapposed stent struts endothelialise? In vivo demonstration with optical coherence tomography. BMJ Case Rep 2009：bcr2006091876, 2009

12) Vale FL, Fisher WS 3rd, Jordan WD Jr, Palmer CA, Vitek J：Carotid endarterectomy performed after progressive carotid stenosis following angioplasty and stent placement. Case report. J Neurosurg 87：940-943, 1997

13) Zheng J, Liu L, Cao Y, Zhang D, Wang R, Zhao J：Carotid endarterectomy with stent removal in management of in-stent restenosis：a safe, feasible, and effective technique. Eur J Vasc Endovasc Surg 47：8-12, 2014