coronary stent angioplast 를 통한 mca stenosis 의 치료
DESCRIPTION
Coronary Stent Angioplast 를 통한 MCA Stenosis 의 치료. 부산대학교 병원 진단 방사선과. 새로운 치료법으로 신중히 선택 안전성과 유효성에 대한 지속적 평가. PATIENT SELECTION. 대상 ; 2002 년 9 월 - 12 월 사이의 환자 연령 ; 48 세 – 74 세 남녀 비율 ; 8 명 : 4 명. 선택 - 50% 이상의 Stenosis - 빈발의 TIA 또는 Infarction - Poor Collateral - PowerPoint PPT PresentationTRANSCRIPT
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Coronary Stent AngioplastCoronary Stent Angioplast 를 를
통한 통한 MCA StenosisMCA Stenosis 의 치료의 치료
부산대학교 병원 진단 방사선과
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새로운 치료법으로 신중히 선택
안전성과 유효성에 대한 지속적 평가
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PATIENT SELECTION SELECTION
대상 ; 2002 년 9 월 - 12 월 사이의 환자연령 ; 48 세 – 74 세남녀 비율 ; 8 명 : 4 명
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선택 - 50% 이상의 Stenosis - 빈발의 TIA 또는 Infarction - Poor Collateral - Severe Stenosis 를 동반한 TIA 또는 Infarction
- CABG
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INSURANCE
비보험
Vertebral Artery Stenosis 에 대한
Coronary 재료 사용은 인정
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LESION CHARACTERISTICSNo Sex Age History Lesion Stenosis Rate(%)
1 M 48 Infarction Proximal M1 632 M 51 Infarction Distal M1 743 M 71 Infarction Middle M1 674 M 67 Infarction Proximal M1 805 F 74 TIA Middle M1 686 F 58 Infarction Total M1 907 M 66 Infarction Distal M1 608 M 60 Infarction Proximal M1 659 F 52 Infarction Proximal M1 7010 M 60 TIA,
InfarctionMiddle M1 72
11 F 49 TIA, Infarction
Proximal M1 50
12 M 67 TIA Proximal M1 72
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METHODStenosis 에 대한 평가 및 Premedication - 신경학적 검사 - MRI, MRA - DSA - SPECT - 항응고제 및 항혈소판 제제 투여
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Procedure - 7F Sheath - 6F Guiding Catheter 를 Distal ICA 에 거치 - Pre Angio - Heparin Inject.(ACT 250 이상 유지 ) - 014 G/W 를 Distal MCA 까지 위치 - Stent 를 Stenosis Lesion 까지 위치 - Ballooning( 순차적 ) - Reopro Inject.(AT 발생시 ) - Post Angio - 8F Angio-Seal
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RESULTSNo Stent
DiameterStenting Complication Neurologic Results Angiographic
Results
1 2.5 Fail None - -2 3.0 Fail Death Death -3 2.5 Success None Excellent 6Mons , No Resten
osis
4 2.5 Success AT Excellent 10Mons , 20%Restenosis
5 2.5 Success None Excellent None6 2.5 Success Rupture, AT Good 15Days , No Resten
osis
7 2.5 Success None Excellent None8 2.5 Success None Excellent None
9 2.5 Success AT Good None10 2.75 Success SAT Fair None11 2.5 Success Stent Migration
ATFair 10Days , No Resten
osis
12 2.5 Success AT Good None
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63/M
Recurrent Right MCA TIA
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Pre Stent MRAPre Stent MRA
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Pre Stent InsertionPre Stent Insertion
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2.5mm Stent2.5mm Stent
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Post Stent Insertion ATPost Stent Insertion AT
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Post Reopro 16mg InjectionPost Reopro 16mg Injection
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67/M
TIA(Sudden Left Weakness)
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Pre Stent Insertion DSAPre Stent Insertion DSA
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Pre Stent Other ViewPre Stent Other View
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2.5mm Stent AT
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Reopro 20mg Injection
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Final