日本颈动脉支架植入术中使用过滤器保护装置的初步经验。

Radiation medicine Pub Date : 2008-07-01 Epub Date: 2008-08-03 DOI:10.1007/s11604-008-0239-6
Katsutoshi Takayama, Hiroyuki Nakagawa, Satoru Iwasaki, Toshiaki Taoka, Toshiteru Miyasaka, Kaoru Myouchin, Takeshi Wada, Masahiko Sakamoto, Akio Fukusumi, Ichiro Nakagawa, Shinichiro Kurokawa, Kimihiko Kichikawa
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引用次数: 7

摘要

目的:日本尚未正式批准使用颈动脉支架(CAS)过滤器保护装置;然而,在2008年4月,Angioguard XP (AGXP)获得批准。这篇文章描述了我们在CAS中使用AGXP治疗颈动脉狭窄的初步结果。材料与方法:15例患者(男性14例),平均年龄72.3岁(53 ~ 81岁),采用AGXP进行CAS治疗。其中有症状者10例,颈总动脉或颈内动脉狭窄>50%,无症状者5例,狭窄>70%。评估技术成功率、术中卒中、ICA血流损伤、滤过器移动和扩散加权成像(DWI)上新缺血性病变的发展。结果:所有病例采用AGXP的CAS均成功。有1例轻微中风,6例患者出现血流障碍。滤波器平均移动1.9个椎体。DWI显示8例患者出现新的同侧缺血性病变。结论:使用AGXP治疗CAS的初步临床经验总体上是充分的。但是,在使用AGXP时必须注意三个问题:过滤器放置后可能会移动;过滤器可能会干扰ICA的血液流动;碎片可能会绕过过滤器。
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Initial experience of using the filter protection device during carotid artery stenting in Japan.

Purpose: No filter protection devices for carotid artery stenting (CAS) have been formally approved for use in Japan; however, as of April 2008, the Angioguard XP (AGXP) was approved. This article describes our initial results using the AGXP during CAS for the treatment of carotid artery stenosis.

Material and methods: A group of 15 patients (14 men) with a mean age of 72.3 years (range 53-81 years) were treated by CAS using the AGXP. Among them, 10 were symptomatic with >50% stenosis of the common or internal carotid artery (ICA), and 5 were asymptomatic with >70% stenosis. The rates of technical success, periprocedural stroke, ICA flow impairment, filter movement, and development of new ischemic lesions on diffusion-weighted imaging (DWI) were assessed.

Results: CAS using the AGXP was successful in all cases. There was one minor stroke, and flow impairment occurred in six patients. Filter movement averaged 1.9 vertebral bodies. DWI showed new ipsilateral ischemic lesions in eight of the patients.

Conclusion: Initial clinical experience using the AGXP for CAS has been generally sufficient. However, attention must be paid to three problems when using the AGXP: the filter may move after placement; the filter may disturb blood flow in the ICA; and debris may pass around the filter.

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