切迫脳卒中で発症した高齢者頸部頸動脈狭窄症の検討  [in Japanese] Analysis of Cervical Carotid Artery Stenosis in Elderly Patients Presenting with Impending Stroke  [in Japanese]

The treatment of carotid artery stenosis in elderly patients over 75 years old who present with impending stroke such as progressing or fluctuating stroke are still controversial. To confirm the efficacy of surgical revascularization, we analyzed the treatment outcome of surgical treatment and conservative medical treatment. Seven patients (mean age 78 y/o) were treated by carotid endoarterectomy (CEA : 3 cases) or carotid artery stenting (CAS : 4 cases), and 8 patients (mean age 84 y/o) were treated by anticoagulant or antiplatelet therapy. The outcomes of all surgically treated patients were favorable. But in medical group, 6 patients died and 1 was m-RS Grade 5. The median time between onset and complete stroke was 7 days. Four patients had a complete internal carotid artery occlusion in the medical group. Even though elderly patients presenting with hemodynamic impending stroke have a treatment high-risk, the emergency revascularization by CEA or CAS after careful evaluation of whole body seems to be a safe and effective strategy.