Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Preliminary Report of Carotid Artery Stenting Using a Tapered Stent

Tapered Stent를 사용한 경동맥 스텐트 설치술에 대한 예비 보고

  • Jeong, Chang-Woo (Department of Radiology, Chosun University College of Medicine) ;
  • Kim, Dong-Hyun (Department of Radiology, Chosun University College of Medicine) ;
  • Ahn, Seong-Hwan (Department of Neurology, Chosun University College of Medicine) ;
  • Kim, Dong-Uk (Department of Neurology, Chosun University College of Medicine) ;
  • Hong, Seung-Jeong (Department of Radiology, Chosun University College of Medicine) ;
  • Kim, Young-Suk (Department of Radiology, Chosun University College of Medicine) ;
  • Byun, Joo-Nam (Department of Radiology, Chosun University College of Medicine) ;
  • Oh, Jae-Hee (Department of Radiology, Chosun University College of Medicine)
  • 정창우 (조선대학교 의과대학 영상의학과학교실) ;
  • 김동현 (조선대학교 의과대학 영상의학과학교실) ;
  • 안성환 (조선대학교 의과대학 신경과학교실) ;
  • 김동욱 (조선대학교 의과대학 신경과학교실) ;
  • 홍승정 (조선대학교 의과대학 영상의학과학교실) ;
  • 김영숙 (조선대학교 의과대학 영상의학과학교실) ;
  • 변주남 (조선대학교 의과대학 영상의학과학교실) ;
  • 오재희 (조선대학교 의과대학 영상의학과학교실)
  • Published : 2011.10.01
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Abstract

Purpose: To analyze the results of carotid artery stenting using a tapered stent and to evaluate the effectiveness of the tapered stent compared to previously reported studies using non-tapered stents. Materials and Methods: From October 2008 to August 2010, elective carotid artery stenting using a tapered stent was attempted in 39 lesions from 36 consecutive patients. Post-procedural complications were evaluated by neurologic symptoms and magnetic resonance imaging. Restenosis or occlusion was evaluated by carotid Doppler ultrasound and computerized tomography with angiography. Newly developed neurologic symptoms were evaluated clinically. Results: The self-expandable tapered stent was placed across the carotid artery stenosis. A total stroke was noted in 3 patients, while a major stroke was noted in 1 patient. On diffusion weighted imaging, new lesions were observed in 15 patients, but 13 patients were clinically silent. Follow-up imaging studies were performed in the 13 clinically silent lesions, and no evidence of restenosis or occlusion was found any of the 13 lesions. During clinical follow-up in 34 lesions from 31 patients, there were newly developed neurological symptoms in only 1 patient. Conclusion: Carotid artery stenting using a tapered stent may be safe and useful for the treatment of carotid artery stenosis.

목적: 본 연구는 내경동맥 팽대부의 협착을 가진 환자에서 tapered stent를 이용한 치료 결과를 분석하고 기존에 보고된 연구를 통해 non-tapered stent의 치료성적과 비교해 보고자 하였다. 대상과 방법: 2008년 10월부터 2010년 8월까지 tapered stent를 이용한 36명의 환자에서 39개 병변에 대해 분석하였다. 시술 후 환자의 임상증상, 자기공명영상을 통해 합병증을 평가하였다. 경동맥 도플러 초음파 및 혈관촬영술을 포함하는 전산화단층촬영을 통해 재협착에 대한 평가를 하였으며, 임상적인 무증상 기간을 평가하였다. 결과: 모든 39예에서 자가팽창성의 tapered stent를 총경동맥 분지부에 설치하였다. 총 3예에서 뇌졸중이 발생하였으며, 이 중 1예에서는 중증 뇌졸중이 발생하였다. 시술 후 확산강조 자기공명영상에서 15예에서 새로운 병변이 관찰되었으나 13예에서 임상증상은 없었다. 13예에서 시행한 추적검사에서 모두 재협착 소견을 보이지 않았다. 임상적인 추적관찰 기간 동안 총 31명 중 1명에서 신경학적 증상이 새롭게 발생하였다. 결론: Tapered stent를 이용한 경동맥 협착의 치료는 안전하고 효과적인 치료법이며, 향후 더 많은 환자를 대상으로 한 추적검사가 필요할 것으로 생각된다.

Keywords

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