title: [Case of two-stage carotid artery stenting managed with ultrasound-guided carotid sinus nerve block].
abstract: We report the use of ultrasound-guided carotid sinus nerve block for circulatory management during two-stage carotid artery stenting (CAS) in a patient with symptomatic carotid stenosis complicated with decreased cerebral perfusion reserve. The patient was a 70-year-old man with symptoms of ocular ischemia and markedly decreased perfusion of the left cerebral hemisphere observed in single photon emission computed tomography. Ultrasound-guided carotid sinus nerve block was conducted to prevent CAS perioperative circulatory fluctuations caused by carotid sinus reaction (CSR). We did not observe any hemodynamic instability during CAS. There were no complications associated with the nerve block. Although further research is required, the present findings suggest that ultrasoundguided carotid sinus nerve block may safely and effectively prevent CSR in CAS.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo 113-8431.
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Morita
authors.forename: Atsuko
authors.initials: A
authors.lastname: Hara
authors.forename: Keisuke
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Munetaka
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ootshi
authors.forename: Masako
authors.initials: M
authors.lastname: Iseki
authors.forename: Eiichi
authors.initials: E
authors.lastname: Inada
mesh_terms: D000368:Aged; D017130:Angioplasty; D002343:Carotid Artery, Internal; D002346:Carotid Sinus / Q000000981:diagnostic imaging* / Q000294:innervation*; D016893:Carotid Stenosis / Q000628:therapy*; D006801:Humans; D007022:Hypotension / Q000517:prevention & control; D008297:Male; D009407:Nerve Block / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D015607:Stents / Q000009:adverse effects; D013610:Tachycardia / Q000517:prevention & control; D014463:Ultrasonography