9 : , cutting balloon 9 : , PTA cutting balloon. bruit. 4 cutting balloon. WBC 5300 µl CRP 0.1 ESR. Hb 11.8 A G. X CT Fig.
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1 9 : , cutting balloon 29 bruit angiography 4 cutting balloon cutting balloon 9 : , 2000 PTA cutting balloon 4 cutting balloon bruit WBC 5300 µl CRP 0.1 ESR Hb 11.8 A G A G 1.89 X CT Fig. 1 Fig. 2 45
2 9 6 Fig. 1 CT of the neck shows the hypertrophic change and stenosis of the rt. carotid artery (arrow) percutaneous transluminal angioplasty PTA power flex 4 mm 10 Fig. 3A Palmaz stent 5 mm 2 cm Fig. 3B power flex 4 mm 10 Fig. 4A Palmaz stent 4 mm 4 cm Fig. 4B stent Fig. 2 Selective angiography of the brachiocephalic artery (A), lt. carotid artery (B), and rt. subclavian artery (C) shows the long segment stenosis of bil. subclavian arteries and carotid arteries. Fig. 3 Angiogram obtained after PTA shows the dissection of lt. carotid artery (arrow) (A). Palmaz stent was implanted into the dissected lesion (B). 46
3 cutting balloon InterVentional Technologies Inc. 4 mm 15 mm 6 cutting balloon PTA cutting balloon omnipass 3 mm 20 mm 6 PTA Fig. 5 1~3 1 cutting balloon 4,5 6 5 Fig. 4 Angiogram obtained after PTA shows the dissection of lt. subclavian artery (A). Palmaz stent was implanted into the dissected lesion (B). Fig. 5 Selective angiography of the rt. subclavian artery before PTA(A). Angiogram obtained after PTA using cutting balloon shows the satisfactory dilatation of the rt. subclavian artery, vertebral artery (B), and rt. carotid artery (C). 47
4 9 6 short segment PTA balloon PTA balloon balloon 2 PTA cutting balloon cutting balloon 1 2 elastic recoil mm 3 7 PTA cutting balloon overperfusion syndrome subclavian steal 8 Ando 9 overperfusion syndrome PTA Tyagi % 60% 21% Joseph % 57.1% 28% 26 1 long segment long segment PTA stent 3 2 PTA stent PTA 7 PTA long segment cutting balloon 3 long segment 1) Miyata, T., Sato, O., Deguchi, J. et al. : Anastomotic aneurysms after surgical treatment of Takayasu's arteritis : a 40-year experience. J. Vasc. Surg., 27 (3) : , ) Tada, Y., Sato, O., Ohshima, A. et al. : Surgical treatment of Takayasu arteritis. Heart Vessels Suppl., 7 : , ) Takagi, A., Tada, Y., Sato et al : Surgical treatment for Takayasu's arteritis. A long-term follow-up study. J. Cardiovasc. Surg. (Torino), 30 : , ) Tyagi, S., Verma, P. K., Gambhir, D. S. et al. : Early and long-term results of subclavian angioplasty in aortoarteritis (Takayasu disease) : comparison with atherosclerosis. Cardiovasc. Intervent. Radiol., 21 : , ) Tyagi, S., Gambhir, D. S., Kaul, U. A. et al. : A decade of subclavian angioplasty: aortoarteritis versus atherosclerosis. Indian Heart J., 48 : , ) :., 41 : , ) Inoue, T., Sakai, Y., Hoshi, K. et al. : Lower expression of neutrophil adhesion molecule indicates less vessel wall injury and might explain lower restenosis rate after cutting balloon angioplasty. Circulation, 97 (25) : , ) :.., 52 (8) : , ) Ando, M., Sasako, Y., Okita, Y. et al. : Surgical 48
5 considerations of occlusive lesions associated with Takayasu's arteritis. Jpn. J. Thorac. Cardiovasc. Surg., 48 (3) : , ) Joseph, S., Mandalam, K. R., Rao, V. R. et al. : Percutaneous transluminal angioplasty of the subclavian artery in nonspecific aortoarteritis : Results of long-term follow-up. J. Vasc. Interv. Radiol., 5 : , A Case of Percutaneous Transluminal Angioplasty for the Takayasu's Aortitis Using a Cutting Balloon Masashi Kano, Yoshio Fukata, Kazuya Horike, Atsushi Kurushima and Etsuki Fujimoto Department of Cardiovascular Surgery, National Zentsuji Hospital Key words : Takayasu's aortitis, PTA, Cutting balloon, Carotid stenosis A 29-year-old woman was admitted to our hospital to examine the cause of headache and vertigo. Takayasu's aortitis was diagnosed and she underwent PTA using a cutting balloon for the stenotic lesions of bilateral common carotid arteries, subclavian arteries and vertebral arteries. PTA was successful and she now has no symptoms. The cutting balloon was useful to dilatate the stenotic lesions and did not require a high balloon pressure. However recent reports suggest that restenosis was often observed in the diffuse arterial stenosis therefore careful follow up is needed after PTA. (Jpn. J. Vasc. Surg., 9 : ,
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