The Present Circumstances Related to the Use of Stenting for Cervical Internal Carotid Artery Stenosis at Kanmon Medical Center in the Absence of Full-time Neuroendovascular Specialists

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  • IZUMIHARA Akifumi
    Department of Neurosurgery, National Hospital Organization Kanmon Medical Center
  • YAMASHITA Katsuhiro
    Department of Neurosurgery, National Hospital Organization Kanmon Medical Center

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  • 関門医療センターにおける頸部内頸動脈狭窄症に対するステント留置術の現況
  • カンモン イリョウ センター ニオケル ケイブ ナイ ケイドウミャク キョウサクショウ ニ タイスル ステント リュウチジュツ ノ ゲンキョウ

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Abstract

<p>The aim of the present study was to clarify the current circumstances related to the use of stenting for cervical internal carotid artery stenosis in neurosurgical facilities where there are no full-time neuroendovascular specialists．A total of 82 patients（68 men and 14 women；mean age of 72.4 years）with cervical internal carotid artery stenosis treated surgically during a 13-year period from April 2002 to March 2015 at Kanmon Medical Center were identified, and their medical records were reviewed. Seventy-six carotid endarterectomies（47 symptomatic lesions and 29 asymptomatic lesions）and 16 carotid artery stentings（9 symptomatic lesions and 7 asymptomatic lesions）were performed in 68 and 15 patients, respectively. The main reasons for performing stenting were a high location of the stenotic lesion and serious previous disease. Cerebral ischemia as a complication occurred in 4 patients who had undergone stenting and had an adverse influence on outcome in none of them. Although currently few patients undergo stenting for carotid artery stenosis, this results support its validity and safety in neurosurgical facilities where there are no full-time neuroendovascular specialists. In view of its relative simplicity, the proportion of stenting relative to endarterectomy will likely increase in future, especially in neurosurgical facilities lacking manpower.</p>

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