頸部頸動脈狭窄に対するステント留置術 : Balloon angioplastyとの比較  [in Japanese] Stenting for Stenosis of Cervical Internal Carotid Artery: Comparative Study with Percutaneous Transluminal Angioplasty  [in Japanese]

We present the results of percutaneous transluminal angioplasty (PTA) with/without stenting for cervical internal carotid artery (ICA) stenosis. A total of 36 high-grade stenoses (>70%) in 31 patients were treated, in which 25 lesions in 20 patients were treated with PTA and 11 lesions in 11 patients were treated with stenting. All patients were successfully treated and no adverse events occurred during procedures. Postprocedural angiography showed that significantly larger diameters were obtained in stenting group than in PTA group. Dissection occurred in 6 (24%) patients in the PTA group, whom 1 patient was subsequently treated with carotid endarterectomy and 2 with stenting. In contrast, no dissection was observed in the stenting group. Restenosis occurred in 4 (16%) in the PTA group, but not in the stenting group. As postoperative complications, ischemic neurological deterioration was observed in 1 patient in the PTA group, and 1 ipsilateral subcortical hemorrhage and 1 myocardial infarction were observed in the stenting group. No stent deformation was observed during follow-up period. These results suggest that stenting provides a lower rate of dissection and restenosis than conventional PTA as a treatment for cervical ICA stenosis. Stenting may be a promising method to treat these lesions. Appropriate stents for carotid stenosis and brain protection system should be developed.