徳島大学 教育・研究者情報データベース(EDB)

1. 山本 伸昭

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2. 山本 雄貴([徳島大学.病院.診療科.内科.脳神経内科])

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3. 山口 泉

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4. 曽我部 周

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5. 宮本 健志([徳島大学.大学院医歯薬学研究部.医学域.先端医学教育研究プロジェクト]/[徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.脳神経外科学])

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6. 島田 健司([徳島大学.病院.先端医科医療開発研究プロジェクト]/[徳島大学.病院.診療科.脳·神経·精神科.脳神経外科])

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7. 兼松 康久

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8. 森垣 龍馬([徳島大学.大学院医歯薬学研究部.医学域.共同研究講座.先端脳機能研究開発]/[徳島大学.病院.診療科.脳·神経·精神科.脳神経外科])

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9. 和泉 唯信([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.内科系.臨床神経科学]/[徳島大学.病院.診療科.内科.脳神経内科])

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10. 髙木 康志([徳島大学.大学院医歯薬学研究部.医学域.医科学部門.外科系.脳神経外科学])

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(英) Percutaneous Transluminal Angioplasty and Stenting Using an Aspiration Catheter

(英) <p><b>Objective</b>: During percutaneous transluminal angioplasty (PTA) for the vertebral artery, occlusion of the subclavian artery using a balloon guiding catheter may be useful to prevent embolism of clots and/or debris distal to an atherosclerotic lesion. However, when placing a balloon guiding catheter at the intended vessels is difficult, it may be useful to use an aspiration catheter (AC) for mechanical thrombectomy as an intermediate catheter to suction way clots and/or debris. We report two cases in which PTA was performed for an atherosclerotic lesion at the intracranial vertebral artery using an AC, which ended without complications.</p><p><b>Case Presentations</b>: Case 1: A 74-year-old man presented with dysarthria and was admitted to our hospital. MRI revealed severe left vertebral artery stenosis and diffuse cerebral infarct areas at the territory of the posterior circulation. The patient had an abdominal aortic aneurysm and abnormally shaped left tortuous subclavian artery. Therefore, we performed PTA and stenting via the left brachial artery. We guided a 6-Fr long sheath to the left subclavian artery, and a 6-Fr AC for thrombectomy was guided through the long sheath to the V4 portion of the left vertebral artery. Thereafter, PTA was carried out under manual aspiration from the AC. As restenosis at the atherosclerotic lesion occurred after PTA, we performed stenting using a coronary stent system for this lesion under manual aspiration from the AC. No new infarct areas were observed on post-procedural MRI. Case 2: A 74-year-old woman presented with dysarthria and was admitted to our hospital. MRI demonstrated basilar artery occlusion and diffuse cerebral infarct areas at the territory of the posterior circulation. As her symptom worsened after admission, we performed urgent mechanical thrombectomy. We first performed thrombectomy using a stent retriever and then performed PTA and stenting (PTAS) for residual basilar artery stenosis via the AC under manual aspiration.</p><p><b>Conclusion</b>: When it is difficult to place a guiding catheter at the intended vessels during PTA, an AC may be useful to prevent distal embolization.</p>

1. (英) percutaneous transluminal angioplasty
2. (英) aspiration catheter