A Case of Ischemic Stroke With Congenital Protein C Deficiency and Carotid Web Successfully Treated by Anticoagulant and Carotid Stenting

被引：5

作者：

Watanabe, Sadayoshi ^{[1
]}

Matsumoto, Shoji ^{[1
]}

Nakahara, Ichiro ^{[1
]}

Ishii, Akira ^{[2
]}

Hatano, Taketo ^{[3
]}

Mori, Minako ^{[4
]}

Morishita, Eriko ^{[5
]}

Nagata, Izumi ^{[3
]}

机构：

[1] Fujita Hlth Univ, Sch Med, Dept Comprehens Strokol, Toyoake, Aichi, Japan

[2] Kyoto Univ, Grad Sch Med, Dept Neurosurg, Kyoto, Japan

[3] Kokura Mem Hosp, Stroke Ctr, Dept Neurosurg, Fukuoka, Japan

[4] Kyoto Univ, Grad Sch Med, Dept Hematol & Oncol, Kyoto, Japan

[5] Kanazawa Univ, Dept Clin Lab Sci, Grad Sch Med Sci, Kanazawa, Ishikawa, Japan

来源：

FRONTIERS IN NEUROLOGY | 2020年 / 11卷

基金：

日本学术振兴会;

关键词：

protein C deficiency; thrombus formation; carotid web; cerebral infarction; carotid artery stenting; AFRO-CARIBBEAN PATIENTS; FIBROMUSCULAR DYSPLASIA; INCREASED RISK; THROMBOEMBOLISM; THROMBOSIS;

D O I：

10.3389/fneur.2020.00099

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: A rare case of thromboembolic cerebral infarction due to carotid web in a patient with congenital protein C deficiency is reported. Case Presentation: A patient in her 40's with left-side hemiparesis was transferred to our hospital under continuous intravenous injection of heparin. Magnetic resonance angiography demonstrated occlusion of the right middle cerebral artery (MCA). Conventional angiography revealed recanalization of the right MCA and a carotid web at the origin of the right internal carotid artery. Ultrasound scan of the carotid artery on the 19th day revealed thrombus formation on the distal portion of the carotid web. We performed carotid artery stenting to prevent thrombus formation by suppressing the carotid web to the vessel wall and by regulating the turbulent flow. The patient had no recurrence of stroke under-anticoagulation with warfarin during the 2-year follow-up period. Conclusion: To our knowledge, this is the first report in which an immediate thrombus formation on the carotid web was observed in a patient with congenital protein C deficiency. In a case of acute ischemic stroke with carotid web, especially when congenital coagulopathy such as protein C deficiency is suspected, careful follow-up with ultrasound imaging should be performed.

引用

页数：4

共 15 条

[1] INCREASED RISK OF VENOUS THROMBOSIS IN CARRIERS OF HEREDITARY PROTEIN-C DEFICIENCY DEFECT [J].

ALLAART, CF ;

POORT, SR ;

ROSENDAAL, FR ;

REITSMA, PH ;

BERTINA, RM ;

BRIET, E .

LANCET, 1993, 341 (8838) :134-138

[2] Carotid Webs and Recurrent Ischemic Strokes in the Era of CT Angiography [J].

Choi, P. M. C. ;

Singh, D. ;

Trivedi, A. ;

Qazi, E. ;

George, D. ;

Wong, J. ;

Demchuk, A. M. ;

Goyal, M. ;

Hill, M. D. ;

Menon, B. K. .

AMERICAN JOURNAL OF NEURORADIOLOGY, 2015, 36 (11) :2134-2139

[3] Carotid artery web and ischemic stroke A case-control study [J].

Coutinho, Jonathan M. ;

Derkatch, Sheldon ;

Potvin, Alphonse R. J. ;

Tomlinson, George ;

Casaubon, Leanne K. ;

Silver, Frank L. ;

Mandell, Daniel M. .

NEUROLOGY, 2017, 88 (01) :65-69

[4] ARTERIAL THROMBOSIS AS CLINICAL MANIFESTATION OF CONGENITAL PROTEIN-C DEFICIENCY [J].

DESTEFANO, V ;

LEONE, G ;

MICALIZZI, P ;

TEOFILI, L ;

FALAPPA, PG ;

POLLARI, G ;

BIZZI, B .

ANNALS OF HEMATOLOGY, 1991, 62 (05) :180-183

[5] Carotid Web (Intimal Fibromuscular Dysplasia) Has High Stroke Recurrence Risk and Is Amenable to Stenting [J].

Haussen, Diogo C. ;

Grossberg, Jonathan A. ;

Bouslama, Mehdi ;

Pradilla, Gustavo ;

Belagaje, Samir ;

Bianchi, Nicolas ;

Allen, Jason W. ;

Frankel, Michael ;

Nogueira, Raul G. .

STROKE, 2017, 48 (11) :3134-+

[6] In-stent thrombosis after carotid artery stenting in a patient with protein C deficiency [J].

Iwamoto, Yuichirou ;

Kitano, Takaya ;

Matsubara, Shunji ;

Uno, Masaaki ;

Yagita, Yoshiki .

NEUROLOGICAL SCIENCES, 2018, 39 (12) :2229-2230

[7] Association Between Carotid Bulb Diaphragm and Ischemic Stroke in Young Afro-Caribbean Patients: A Population-Based Case-Control Study [J].

Joux, Julien ;

Boulanger, Marion ;

Jeannin, Severine ;

Chausson, Nicolas ;

Hennequin, Jean-Luc ;

Molinie, Vincent ;

Smadja, Didier ;

Touze, Emmanuel ;

Olindo, Stephane .

STROKE, 2016, 47 (10) :2641-2644

[8] Carotid-Bulb Atypical Fibromuscular Dysplasia in Young Afro-Caribbean Patients With Stroke [J].

Joux, Julien ;

Chausson, Nicolas ;

Jeannin, Severine ;

Saint-Vil, Martine ;

Mejdoubi, Mehdi ;

Hennequin, Jean-Luc ;

Deschamps, Lydia ;

Smadja, Didier ;

Olindo, Stephane .

STROKE, 2014, 45 (12) :3711-3713

[9] Current Understanding and Gaps in Research of Carotid Webs in Ischemic Strokes A Review [J].

Kim, Song J. ;

Nogueira, Raul G. ;

Haussen, Diogo C. .

JAMA NEUROLOGY, 2019, 76 (03) :355-361

[10] Hereditary deficiency of protein C or protein S confers increased risk of arterial thromboembolic events at a young age - Results from a large family cohort study [J].

Mahmoodi, Bakhtawar K. ;

Brouwer, Jan-Leendert P. ;

Veeger, Nic J. G. M. ;

van der Meer, Jan .

CIRCULATION, 2008, 118 (16) :1659-1667

← 1 2 →