頸部内頸動脈狭窄症に対するステント留置術 : 治療手技での工夫と治療成績  [in Japanese] Carotid Stenting for Carotid Artery Stenosis : Procedural Technique and Clinical Results  [in Japanese]

We have performed CAS for 239 patients with ICA stenosis in our institute using various protection devices since 1997. In this paper, we report our initial results (perioperative complication, morbidity/mortality 30 days after the procedure, change of stenosis ratio), rate of re-stenosis, and midterm results in the cases more than 3 years after CAS. The mean preoperative stenosis ratio, 79.6%, remarkably decreased to 6.2% after CAS. The morbidity/mortality rate at 30 days after CAS was 2.1% (5/239 cases). Five of 179 cases showed restenosis 6 months after CAS (3.2%). In 4 of these cases, in-stent PTA was performed. None of the cases showed new neurological deficits. In 62 cases, followed up more than 3 years after CAS, no ipsilateral ischemic stroke was encountered. Carotid artery stenting (CAS) for internal carotid artery (ICA) stenosis is an effective and safe treatment to alleviate stenosis and prevent future ischemic stroke as well as carotid endarterectomy (CEA). However, it is necessary to learn several technical methods and optional procedures for successful CAS in all carotid stenoses.