A Case of Acute Ischemic Stroke due to Tandem Lesions Treated by Mean of Carotid Artery Stenting and Revascularization Devices

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  • tandem lesions を有する急性脳虚血に対し頚動脈ステント留置と脳血栓回収を施行した1 例
  • 症例報告 tandem lesionsを有する急性脳虚血に対し頚動脈ステント留置と脳血栓回収を施行した1例
  • ショウレイ ホウコク tandem lesions オ ユウスル キュウセイ ノウキョケツ ニ タイシ ケイドウミャク ステント リュウチ ト ノウ ケッセン カイシュウ オ シコウ シタ 1レイ

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Abstract

<p>Objective: A case of acute ischemic stroke involving intracranial middle cerebral artery and extracranial internal carotid artery (tandem lesions) requires some ingenuity to select appropriate revascularization devices in treatment. A case of tandem lesions treated by means of carotid artery stenting and revascularization devices was reported.</p><p>Case Presentation: A 66-year-old man was found lying on the floor, and was transferred to our hospital. The scores of neurological evaluation were as follows: Japan Coma Scale (JCS) 100, Glasgow Come Scale (GCS) 9 (E1V3M5) and National Institute of Health Stroke Scale (NIHSS) 31. The patient presented with left hemiparesis (Manual Muscle Test [MMT] 0/5). CT revealed no intracranial hemorrhage and cerebral infarction. MRI revealed no acute cerebral infarction, however, MRA revealed an occlusion of the right internal carotid artery (ICA). Within two hours after the onset of stroke, rt-PA was administered. NIHSS was improved to 11. Angiogram revealed an occlusion of the origin of the right ICA and the right middle cerebral artery. Recanalization (TICI IIb) was achieved by means of carotid artery stenting (CAS) and revascularization devices. Although the patient presented with dysarthria and left incomplete hemiparesis (MMT 3/5~4/5) after treatment, he could complete personal care. A modified Rankin Scale at the time of discharge was two.</p><p>Conclusion: Recanalization for an ischemic stroke due to tandem lesions by means of CAS and revascularization devices was useful, however, appropriate selection of patient and appropriate selection of revascularization devices were required.</p>

Journal

  • No Kekkannai Chiryo

    No Kekkannai Chiryo 2 (1), 31-35, 2017

    The Japanese Society for Neuroendovascular Therapy

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