放射治疗后左侧常常 Carotid 动脉支架患者的斑块突出:一个病例报告
Yuki Hamada1, Mei Ikeda1, Shinju Shimotakahara1
1Department of Strokology, Stroke Center, National Hospital Organization Kagoshima Medical Center, Kagoshima, Kagoshima, Japan.
Journal of neuroendovascular therapy
|July 28, 2023
概括
本案例研究详细介绍了一名因斑块突起而经历动脉支架 (CAS) 后再次中风的患者. 额外的支架是成功的,突出需要个性化治疗策略的辐射诱导的动脉狭窄.
科学领域:
- 血管外科 血管外科
- 神经学 神经学
- 辐射疗法 辐射疗法
背景情况:
- 辐射诱导的常见动脉狭窄 (CCA) 是头癌的放射治疗后的一个已知的并发症.
- 照射血管中的加速动脉硬化会导致不稳定的斑块形成,并增加脑血管事件的风险.
- 动脉支架 (CAS) 是CCA狭窄的治疗选择,但可能会出现像斑块突起这样的并发症.
研究的目的:
- 报告在辐射诱导的CCA狭窄的初始CAS后发生的复发性脑栓塞病例.
- 描述后CAS.发生的斑块突起的管理.
- 强调在有放射治疗史的患者中治疗复杂的CCA狭窄症的挑战.
主要方法:
- 一名69岁的喉癌患者接受放射治疗,出现缺血性中风.
- 最初的CAS用于由于易受损伤的斑块导致的左CCA狭窄.
- 随访成像显示了斑块突起,需要额外的内血管治疗,包括静脉内超声波.
主要成果:
- 患者最初在CAS后改善,没有术后并发症.
- 在CAS后一个月发生了复发性脑栓塞.
- 对斑块突起的额外内血管治疗是成功的,没有并发症,并在3个月的随访中取得了良好的结果.
结论:
- 辐射诱导的CCA狭窄可以导致加速动脉样硬化和耐药性脑栓塞.
- 在CAS后的斑块突起是一种潜在的并发症,可能需要进一步的干预.
- 照射患者中CCA狭窄的治疗策略必须个性化,考虑潜在的疾病和斑块特征.
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