PDF(Pubmed)
Abstract：
UNASSIGNED: Stent fractures may be a risk factor for delayed restenosis, but it is difficult to diagnose asymptomatic stent fractures in the subclavian artery (SCA). We report a rare case of percutaneous transluminal angioplasty and stenting (PTAS) for SCA stenosis with asymptomatic severe stent fracture that showed progressive in-stent stenosis in the early postoperative period.
UNASSIGNED: A 70-year-old woman presented with left arm claudication. Magnetic resonance imaging at the time of admission showed SCA stenosis with severe calcification. Because of the left subclavian steal phenomenon on ultrasonography of the left vertebral artery, she underwent PTAS using a balloon-expandable stainless stent. Ultrasonography the day after treatment showed appropriate stent placement. Computed tomography angiography (CTA) 30 days after PTAS showed an asymptomatic complete spiral stent fracture at the mid-portion of the stent. The in-stent stenosis then gradually progressed on follow-up ultrasonography at the site of the stent fracture. Nine months after the first PTAS, a second PTAS using a self-expandable nitinol stent was performed because the peak systolic velocity exceeded 300 cm/s on Doppler ultrasound. Two years after the second PTAS, no neurological symptoms and no stent deformation were observed.
UNASSIGNED: PTAS with a balloon-expandable stainless stent for SCA stenosis with severe calcification may lead to stent fracture. In the case of severe stent fracture, careful follow-up may be needed for the detection of asymptomatic in-stent stenosis in the early postoperative period.
UNASSIGNED: A 70-year-old woman presented with left arm claudication. Magnetic resonance imaging at the time of admission showed SCA stenosis with severe calcification. Because of the left subclavian steal phenomenon on ultrasonography of the left vertebral artery, she underwent PTAS using a balloon-expandable stainless stent. Ultrasonography the day after treatment showed appropriate stent placement. Computed tomography angiography (CTA) 30 days after PTAS showed an asymptomatic complete spiral stent fracture at the mid-portion of the stent. The in-stent stenosis then gradually progressed on follow-up ultrasonography at the site of the stent fracture. Nine months after the first PTAS, a second PTAS using a self-expandable nitinol stent was performed because the peak systolic velocity exceeded 300 cm/s on Doppler ultrasound. Two years after the second PTAS, no neurological symptoms and no stent deformation were observed.
UNASSIGNED: PTAS with a balloon-expandable stainless stent for SCA stenosis with severe calcification may lead to stent fracture. In the case of severe stent fracture, careful follow-up may be needed for the detection of asymptomatic in-stent stenosis in the early postoperative period.
摘要：
■支架骨折可能是延迟再狭窄的危险因素，但难以诊断锁骨下动脉（SCA）无症状支架骨折。我们报告了一例罕见的经皮腔内血管成形术和支架置入术（PTAS）治疗SCA狭窄并无症状的严重支架骨折，在术后早期显示出进行性支架内狭窄。
■一名70岁的妇女出现左臂跛行。入院时的磁共振成像显示SCA狭窄并伴有严重钙化。由于左椎动脉超声检查存在左锁骨下动脉盗血现象，她使用球囊扩张型不锈钢支架接受了PTAS治疗.治疗后第二天的超声检查显示支架放置适当。PTAS后30天，计算机断层扫描血管造影（CTA）显示支架中部无症状的完全螺旋支架骨折。然后，在支架骨折部位的随访超声检查中，支架内狭窄逐渐发展。第一次PTAS后九个月，我们使用自膨胀型镍钛诺支架进行了第二次PTAS,因为多普勒超声显示收缩期峰值速度超过300cm/s.第二次PTAS两年后，未观察到神经症状和支架变形。
■使用球囊可扩张的不锈钢支架治疗SCA狭窄伴严重钙化的PTAS可能导致支架骨折。在支架严重骨折的情况下，在术后早期发现无症状的支架内狭窄可能需要仔细随访.
■一名70岁的妇女出现左臂跛行。入院时的磁共振成像显示SCA狭窄并伴有严重钙化。由于左椎动脉超声检查存在左锁骨下动脉盗血现象，她使用球囊扩张型不锈钢支架接受了PTAS治疗.治疗后第二天的超声检查显示支架放置适当。PTAS后30天，计算机断层扫描血管造影（CTA）显示支架中部无症状的完全螺旋支架骨折。然后，在支架骨折部位的随访超声检查中，支架内狭窄逐渐发展。第一次PTAS后九个月，我们使用自膨胀型镍钛诺支架进行了第二次PTAS,因为多普勒超声显示收缩期峰值速度超过300cm/s.第二次PTAS两年后，未观察到神经症状和支架变形。
■使用球囊可扩张的不锈钢支架治疗SCA狭窄伴严重钙化的PTAS可能导致支架骨折。在支架严重骨折的情况下，在术后早期发现无症状的支架内狭窄可能需要仔细随访.
