頚動脈ステント留置術後に脳血管攣縮を生じた2症例
頚動脈ステント留置術（carotid artery stenting: CAS）の術後に，患側のびまん性脳血管攣縮を認めた2症例を報告する．症例1は症候性高度狭窄であった．症例2は脳循環予備能低下のない中等度狭窄であり，CAS直後のsingle-photon emission computed tomographyにて患側大脳の広範な血流低下を認めた．脳血管攣縮は過灌流症候群とともに血行動態の変化を来す病態であり，その治療方法は異なるため，速やかな鑑別を要する．CAS後の虚血性合併症では，血栓塞栓症だけでなく，本病態を念頭に置くことも重要と考えられる．...
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| Published in | 脳卒中 Vol. 45; no. 3; pp. 257 - 263 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本脳卒中学会
2023
日本脳卒中学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0912-0726 1883-1923 |
| DOI | 10.3995/jstroke.11103 |
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| Abstract | 頚動脈ステント留置術（carotid artery stenting: CAS）の術後に，患側のびまん性脳血管攣縮を認めた2症例を報告する．症例1は症候性高度狭窄であった．症例2は脳循環予備能低下のない中等度狭窄であり，CAS直後のsingle-photon emission computed tomographyにて患側大脳の広範な血流低下を認めた．脳血管攣縮は過灌流症候群とともに血行動態の変化を来す病態であり，その治療方法は異なるため，速やかな鑑別を要する．CAS後の虚血性合併症では，血栓塞栓症だけでなく，本病態を念頭に置くことも重要と考えられる． |
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| AbstractList | 「要旨」: 頚動脈ステント留置術(carotid artery stenting: CAS)の術後に, 患側のびまん性脳血管攣縮を認めた2症例を報告する. 症例1は症候性高度狭窄であった. 症例2は脳循環予備能低下のない中等度狭窄であり, CAS直後のsingle-photon emission computed tomographyにて患側大脳の広範な血流低下を認めた. 脳血管攣縮は過灌流症候群とともに血行動態の変化を来す病態であり, その治療方法は異なるため, 速やかな鑑別を要する. CAS後の虚血性合併症では, 血栓塞栓症だけでなく, 本病態を念頭に置くことも重要と考えられる. 頚動脈ステント留置術（carotid artery stenting: CAS）の術後に，患側のびまん性脳血管攣縮を認めた2症例を報告する．症例1は症候性高度狭窄であった．症例2は脳循環予備能低下のない中等度狭窄であり，CAS直後のsingle-photon emission computed tomographyにて患側大脳の広範な血流低下を認めた．脳血管攣縮は過灌流症候群とともに血行動態の変化を来す病態であり，その治療方法は異なるため，速やかな鑑別を要する．CAS後の虚血性合併症では，血栓塞栓症だけでなく，本病態を念頭に置くことも重要と考えられる． |
| Author | 内田, 貴範 東田, 哲博 金澤, 隆三郎 |
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| DOI | 10.3995/jstroke.11103 |
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| References | 6） Sztriha LK, Vörös E, Sas K, et al.: Favorable early outcome of carotid artery stenting without protection devices. Stroke 35: 2862–2866, 2004 14） Watanabe Y, Takechi A, Kajiwara Y, et al.: [Reversible cerebral vasoconstriction syndrome following carotid artery stenting: a case report]. Jpn J Stroke 39: 299–303, 2017 (in Japanese) 9） Wu TY, Frith RW, Barber PA: Reversible cerebral vasoconstriction following carotid endarterectomy. J Clin Neurosci 18: 1725–1728, 2011 5） Ishibashi T, Murayama Y, Saguchi T, et al.: [Relation between plaque characteristics on MR imaging and distal protection device in predicting risks of thromboembolic events during carotid artery stenting]. JNET J Neuroendovasc Ther 3: 3–9, 2009 (in Japanese) 10） Soltanolkotabi M, Ansari S, Patel B, et al.: Reversible cerebral vasoconstriction syndrome following carotid artery stenting. J Neurointerv Surg 4 Suppl 1: A49–A50, 2012 17） Dagher HN, Shum MK, Campellone JV: Delayed intracranial vasospasm following carotid endarterectomy. Cerebrovasc Dis 20: 205–206, 2005 8） Rosenbloom MH, Singhal AB: CT angiography and diffusion-perfusion MR imaging in a patient with ipsilateral reversible cerebral vasoconstriction after carotid endarterectomy. AJNR Am J Neuroradiol 28: 920–922, 2007 3） Arai M, Kuwayama N, Koide K, et al.: [Transient right hemisphere hypoperfusion following right carotid artery stenting: a case report]. JNET J Neuroendovasc Ther 7: 119–126, 2013 (in Japanese) 12） Higashi E, Uwatoko T, Mizokami T, et al.: Reversible cerebral vasoconstriction complicated with brain infarction immediately after carotid artery stenting. Interv Neuroradiol 24: 688–692, 2018 7） Ducros A: Reversible cerebral vasoconstriction syndrome. Lancet Neurol 11: 906–917, 2012 11） Aghaebrahim A, Jadhav AP, Saeed Y, et al.: Reversible cerebral vasoconstriction syndrome following carotid stenting. Neurology 83: 570–571, 2014 18） Fitas D, Carvalho M, Castro P, et al.: Cerebral vasoconstriction after carotid endarterectomy. Pract Neurol 18: 378–381, 2018 13） Shiraga S, Akai T, Takata H, et al.: [Possible cerebral infarction due to multiple segmental cerebral vasospasms after carotid artery stenting: a case report]. No Shinkei Geka 43: 1081–1089, 2015 (in Japanese) 2） Kang CH, Roh J, Yeom JA, et al.: Asymptomatic cerebral vasoconstriction after carotid artery stenting. AJNR Am J Neuroradiol 41: 305–309, 2020 15） Brick JF, Dunker RO, Gutierrez AR: Cerebral vasoconstriction as a complication of carotid endarterectomy. J Neurosurg 73: 151–153, 1990 19） Asuzu DT, Kumar J, Capek S, et al.: Fulminant reversible cerebral vasoconstriction syndrome after carotid endarterectomy for asymptomatic stenosis. World Neurosurg 134: 423–426, 2020 4） Kuwabara M, Nakahara T, Mitsuhara T, et al.: Transient cerebral vasospasm after carotid artery stenting: a case report and literature review. World Neurosurg 135: 107–111, 2020 1） Qureshi AI, Luft AR, Janardhan V, et al.: Identification of patients at risk for periprocedural neurological deficits associated with carotid angioplasty and stenting. Stroke 31: 376–382, 2000 16） Lopez-Valdes E, Chang HM, Pessin MS, et al.: Cerebral vasoconstriction after carotid surgery. Neurology 49: 303–304, 1997 |
| References_xml | – reference: 5） Ishibashi T, Murayama Y, Saguchi T, et al.: [Relation between plaque characteristics on MR imaging and distal protection device in predicting risks of thromboembolic events during carotid artery stenting]. JNET J Neuroendovasc Ther 3: 3–9, 2009 (in Japanese) – reference: 14） Watanabe Y, Takechi A, Kajiwara Y, et al.: [Reversible cerebral vasoconstriction syndrome following carotid artery stenting: a case report]. Jpn J Stroke 39: 299–303, 2017 (in Japanese) – reference: 19） Asuzu DT, Kumar J, Capek S, et al.: Fulminant reversible cerebral vasoconstriction syndrome after carotid endarterectomy for asymptomatic stenosis. World Neurosurg 134: 423–426, 2020 – reference: 6） Sztriha LK, Vörös E, Sas K, et al.: Favorable early outcome of carotid artery stenting without protection devices. Stroke 35: 2862–2866, 2004 – reference: 17） Dagher HN, Shum MK, Campellone JV: Delayed intracranial vasospasm following carotid endarterectomy. Cerebrovasc Dis 20: 205–206, 2005 – reference: 7） Ducros A: Reversible cerebral vasoconstriction syndrome. Lancet Neurol 11: 906–917, 2012 – reference: 13） Shiraga S, Akai T, Takata H, et al.: [Possible cerebral infarction due to multiple segmental cerebral vasospasms after carotid artery stenting: a case report]. No Shinkei Geka 43: 1081–1089, 2015 (in Japanese) – reference: 11） Aghaebrahim A, Jadhav AP, Saeed Y, et al.: Reversible cerebral vasoconstriction syndrome following carotid stenting. Neurology 83: 570–571, 2014 – reference: 3） Arai M, Kuwayama N, Koide K, et al.: [Transient right hemisphere hypoperfusion following right carotid artery stenting: a case report]. JNET J Neuroendovasc Ther 7: 119–126, 2013 (in Japanese) – reference: 15） Brick JF, Dunker RO, Gutierrez AR: Cerebral vasoconstriction as a complication of carotid endarterectomy. J Neurosurg 73: 151–153, 1990 – reference: 1） Qureshi AI, Luft AR, Janardhan V, et al.: Identification of patients at risk for periprocedural neurological deficits associated with carotid angioplasty and stenting. Stroke 31: 376–382, 2000 – reference: 4） Kuwabara M, Nakahara T, Mitsuhara T, et al.: Transient cerebral vasospasm after carotid artery stenting: a case report and literature review. World Neurosurg 135: 107–111, 2020 – reference: 2） Kang CH, Roh J, Yeom JA, et al.: Asymptomatic cerebral vasoconstriction after carotid artery stenting. AJNR Am J Neuroradiol 41: 305–309, 2020 – reference: 16） Lopez-Valdes E, Chang HM, Pessin MS, et al.: Cerebral vasoconstriction after carotid surgery. Neurology 49: 303–304, 1997 – reference: 8） Rosenbloom MH, Singhal AB: CT angiography and diffusion-perfusion MR imaging in a patient with ipsilateral reversible cerebral vasoconstriction after carotid endarterectomy. AJNR Am J Neuroradiol 28: 920–922, 2007 – reference: 10） Soltanolkotabi M, Ansari S, Patel B, et al.: Reversible cerebral vasoconstriction syndrome following carotid artery stenting. J Neurointerv Surg 4 Suppl 1: A49–A50, 2012 – reference: 12） Higashi E, Uwatoko T, Mizokami T, et al.: Reversible cerebral vasoconstriction complicated with brain infarction immediately after carotid artery stenting. Interv Neuroradiol 24: 688–692, 2018 – reference: 18） Fitas D, Carvalho M, Castro P, et al.: Cerebral vasoconstriction after carotid endarterectomy. Pract Neurol 18: 378–381, 2018 – reference: 9） Wu TY, Frith RW, Barber PA: Reversible cerebral vasoconstriction following carotid endarterectomy. J Clin Neurosci 18: 1725–1728, 2011 |
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| Snippet | 頚動脈ステント留置術（carotid artery stenting: CAS）の術後に，患側のびまん性脳血管攣縮を認めた2症例を報告する．症例1は症候性高度狭窄であった．症例2は脳循環予備能低下のない中等度狭窄であり，CAS直後のsingle-photon emission computed... 「要旨」: 頚動脈ステント留置術(carotid artery stenting: CAS)の術後に, 患側のびまん性脳血管攣縮を認めた2症例を報告する. 症例1は症候性高度狭窄であった. 症例2は脳循環予備能低下のない中等度狭窄であり, CAS直後のsingle-photon emission computed... |
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| SubjectTerms | carotid artery stenting cerebral vasospasm ischemic complication |
| Title | 頚動脈ステント留置術後に脳血管攣縮を生じた2症例 |
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