Zusammenfassung
Eine hämodynamische Insuffizienz aufgrund von Pseudookklusionen oder Verschlüssen der A. carotis interna ist eine seltene Ursache des akuten Schlaganfalls. Eine akute Revaskularisation des Gefäßes kann die zerebrale Perfusion wieder herstellen.
Diese retrospektive Studie zeigt, dass eine akute Stentimplantation mit proximalen und distalen Protektionssystemen bei Patienten mit Verschluss oder Pseudookklusion der A. carotis interna und unzureichender Kollateralisation technisch möglich ist und weitere hämodynamisch bedingte Infarkte verhindern kann. Demgegenüber steht eine erhöhte Rate von Reperfusionssyndromen mit intrakraniellen Blutungen; eine periinterventionelle intensivmedizinische Überwachung und Einstellung des Blutdrucks auf normotone Werte wird empfohlen.
Abstract
Hemodynamic impairment caused by pseudo-occlusion or occlusion of the internal carotid artery (ICA) is a rare etiology of stroke. Acute revascularization of the vessel can restore the flow to the brain.
This retrospective study shows that ICA stenting with proximal and distal protection devices in patients with acute stroke and pseudo-occlusion or occlusion of the ICA is technically feasible and can prevent further hemodynamic strokes. In contrast, selected patients have a high risk of reperfusion syndrome with intracranial hemorrhage and peri-interventional monitoring of blood pressure in an ICU is recommended.
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du Mesnil de Rochemont, R., Sitzer, M., Zanella, F.E. et al. Stenting beim akuten Schlaganfall. Radiologe 45, 461–465 (2005). https://doi.org/10.1007/s00117-005-1204-3
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DOI: https://doi.org/10.1007/s00117-005-1204-3