Kinkingによる頸部内頸動脈狭窄に対し手術治療を行った2症例

Abstract

We report on two cases of the stenotic kinking of the internal carotid artery (ICA). One case is a 63-year-old female who experienced a transient ischemic attack of the right hemiparesis. Magnetic resonance imaging (MRI) showed lacunar infarction at the left basal ganglia and angiography showed a stenotic kinking of the left ICA. Since there was a localized atheromatous plaque in the ICA as an operative finding, and considering that it was the cause of kinking, we performed carotid endarterectomy and primary closure. After the operation, the stenotic kinking was improved. Another case is a 65-year-old man who had progressive mild weakness of the right upper extremity. MRI showed a spotty infarction at the parietal lobe and angiography showed a severe stenotic kinking of the left ICA. Although atherosclerotic change was slight, the kinking caused by elongation and the narrowing of the ICA were severe as operative findings. Angioplasty using synthetic patch improved the stenotic kinking.Pathophysiological findings of the kinking of the ICA are various and may cause hemodynamic or thromboembolic events. Meanwhile, there are several surgical methods of treating kinking. The status of the kinking of each case must be considered and the most adequate surgical method selected.