Key result
Carotid artery stenting for radiation-induced carotid stenosis in a 71-year-old man was complicated by repeated plaque protrusion and in-stent restenosis requiring additional stenting and angioplasty.
Case Report (n=1)
No
Carotid artery stenting for radiation-induced carotid artery stenosis may be complicated by repeated plaque protrusion, highlighting the need for strict observation and early intervention.
Alerts to stenting complications in radiation-induced stenosis; leaves open optimal strategies and comparative trials.
放射線誘発性頸動脈狭窄症に対して頸動脈ステント留置術（CAS）を行った場合，術後のステント内狭窄が多いとの報告がある．今回喉頭癌術後，放射線治療後11 年の経過で内頸動脈狭窄を来しCAS 施行後にplaque protrusion を繰り返した症例を経験した．症例は71 歳男性で糖尿病，高血圧，高脂血症の既往があった．右上下肢麻痺で発症した脳梗塞で左内頸動脈狭窄NASCET 50％を認め，右内頸動脈狭窄NASCET 80％も指摘された．両側内頸動脈狭窄に対してCAS 施行したが，plaque protrusion を繰り返し複数回の治療が必要であった．放射線治療後の頸動脈狭窄症はアテローム性頸動脈狭窄症に比較し虚血性脳卒中が起こる割合が有意に高く，特にアテローム性変化のリスクを合併している場合には厳重な経過観察を行い，soft plaque の蓄積が起こる前に早期の治療介入を検討する必要がある．
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Torikoshi et al. (2015) conducted a case report in Radiation-induced carotid artery stenosis (n=1). Carotid artery stenting was evaluated on Repeated plaque protrusion and in-stent restenosis. Carotid artery stenting for radiation-induced carotid stenosis in a 71-year-old man was complicated by repeated plaque protrusion and in-stent restenosis requiring additional stenting and angioplasty.
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