著者

Takayuki Ishikawa Takashi Yamanouchi Ryusuke Kabeya

出版者

The Japanese Society for Neuroendovascular Therapy

雑誌

Journal of Neuroendovascular Therapy (ISSN:18824072)

巻号頁・発行日

pp.cr.2023-0004, (Released:2023-04-20)

参考文献数

24

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Objective: Carotid artery stenting (CAS) is common procedure for carotid stenosis, but sometimes acute in-stent thrombosis or plaque protrusion after CAS leads to postoperative stroke. There are few reports of aspiration of in-stent plaque protrusion. This paper reports a case of acute in-stent mobile plaque aspirated with a distal access catheter.Case Presentation: A 74-year-old male underwent CAS for symptomatic internal carotid artery stenosis and postoperative course was thought to be good, but in-stent mobile plaque was detected by carotid duplex at postoperative day 6. As mobile plaque is a high risk for stroke, we performed plaque aspiration with a distal access catheter, without neurological deficit or a new cerebral lesion in magnetic resonance imaging. We present a case report, including a literature review, of acute thrombosis or in-stent plaque protrusion.Conclusion: Aspiration removal may be effective for in-stent mobile plaque, which is expected to be fragile, avoiding the disadvantages of increasing stents.

著者

Takayuki ISHIKAWA Kazuhito TAKEUCHI Yuichi NAGATA Keishi ITO Taiki YAMAMOTO Ryusuke KABEYA

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.9, pp.77-82, 2022-12-31 (Released:2022-04-21)

参考文献数

19

被引用文献数

5

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Here we report a rare case of capillary hemangioma (CH) in a 28-year-old woman suffering from gradual worsening diplopia at 28 weeks of pregnancy. Magnetic resonance imaging (MRI) showed a mass lesion (about 3 cm in diameter) in the right parasellar region. We decided to observe as she was pregnant, and had no symptoms other than right abducent nerve palsy. Fortunately, her symptoms did not worsen until delivery. Computed tomography, enhanced MRI, and angiography after delivery revealed that the lesion was highly calcified and vascularized. A dorsum sellae meningioma or highly calcified pituitary adenoma was suspected and the endoscopic transsphenoidal approach was used for tumor removal.The postoperative course was uneventful. The histological diagnosis was CH.Intracranial CHs or CHs of skull are rare vascular tumors. These tumors are reportedly more common in female patients and may change in size in adults according to menstrual cycle and pregnancy. Only six cases, including that of the present study, were diagnosed during the perinatal period. Some of them experienced rapid symptom progression and tumor growth in their course; thus, we should pay further attention to pregnant or peripartum patients with brain tumor, suspected hemangiomas.