Coronary Stent Angioplast? ?? MCA Stenosis? ??

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Coronary Stent Angioplast? ?? MCA Stenosis? ??

• ????? ??
• ?? ????

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• ??? ????? ??? ??
• ???? ???? ?? ??? ??

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PATIENT SELECTION

• ?? 2002? 9? - 12? ??? ??
• ?? 48? 74?
• ?? ?? 8? 4?

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• ??
• - 50??? Stenosis
• - ??? TIA ?? Infarction
• - Poor Collateral
• - Severe Stenosis? ??? TIA ??
• Infarction
  
• - CABG

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INSURANCE

• ???
• Vertebral Artery Stenosis? ??
• Coronary ?? ??? ??

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LESION CHARACTERISTICS
No Sex Age History Lesion Stenosis Rate()
1 M 48 Infarction Proximal M1 63
2 M 51 Infarction Distal M1 74
3 M 71 Infarction Middle M1 67
4 M 67 Infarction Proximal M1 80
5 F 74 TIA Middle M1 68
6 F 58 Infarction Total M1 90
7 M 66 Infarction Distal M1 60
8 M 60 Infarction Proximal M1 65
9 F 52 Infarction Proximal M1 70
10 M 60 TIA, Infarction Middle M1 72
11 F 49 TIA, Infarction Proximal M1 50
12 M 67 TIA Proximal M1 72
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METHOD

• Stenosis? ?? ?? ? Premedication
• - ???? ??
• - MRI, MRA
• - DSA
• - SPECT
• - ???? ? ???? ?? ??

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• Procedure
• - 7F Sheath
• - 6F Guiding Catheter? Distal ICA?
• ??
• - Pre Angio
• - Heparin Inject.(ACT 250?? ??)
• - 014 G/W? Distal MCA?? ??
• - Stent? Stenosis Lesion?? ??
• - Ballooning(???)
• - Reopro Inject.(AT???)
• - Post Angio
• - 8F Angio-Seal

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RESULTS
No Stent Diameter Stenting Complication Neurologic Results Angiographic Results
1 2.5 Fail None - -
2 3.0 Fail Death Death -
3 2.5 Success None Excellent 6Mons , No Restenosis
4 2.5 Success AT Excellent 10Mons , 20Restenosis
5 2.5 Success None Excellent None
6 2.5 Success Rupture, AT Good 15Days , No Restenosis
7 2.5 Success None Excellent None
8 2.5 Success None Excellent None
9 2.5 Success AT Good None
10 2.75 Success SAT Fair None
11 2.5 Success Stent Migration AT Fair 10Days , No Restenosis
12 2.5 Success AT Good None
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• 63/M
• Recurrent Right MCA TIA

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Pre Stent MRA
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Pre Stent Insertion
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2.5mm Stent
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Post Stent Insertion AT
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Post Reopro 16mg Injection
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• 67/M
• TIA(Sudden Left Weakness)

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Pre Stent Insertion DSA
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Pre Stent Other View
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2.5mm Stent AT
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Reopro 20mg Injection
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Final