摘要
目的探讨应用颈动脉支架成形术(earotid artery stenting,CAS)治疗症状性颈动脉狭窄患者的可行性、安全性及疗效。方法对51例症状性颈动脉狭窄患者(其中颈动脉起始段狭窄48例,颅外段狭窄3例;狭窄程度50%～70%12例,70%～90%24例,≥90%15例)予以CAS治疗,共释放51枚支架,37例应用保护伞。结果全组技术成功率100%,术前平均狭窄率为79.8%,术后残余狭窄率<20%,18例保护伞中有碎屑。所有患者术后1周内症状及神经功能缺损体征有所改善。术中及术后发生心率减慢25例,血压下降17例,血管痉挛5例。随访2年,对糖尿病和高血脂患者3个月随访1次,51例患者均行颈动脉B超观察支架血管,每6个月1次,有6例复查了全脑血管造影,有3例出现轻度再狭窄,1例出现重度再狭窄;未发现支架移位、缺血性脑卒中。结论 CAS是治疗症状性颈动脉狭窄安全、有效的方法,严格掌握手术适应证和熟练操作可降低手术风险。术后及时随诊根据病情调整药物治疗方案是远期疗效的保证。
Objective To assess the feasibility, the safety, the effect of carotid artery stenting （CAS） in patients with symptomatic carotid artery stenosis. Methods A total of 51 patients with symptomatic carotid artery stenosis were treated with carotid artery stenting, and the umbrella -like filter was used in 37 of 51 patients. Results The achievement ratio of stent placement was 100%. The mean stenosis before treatment was 79.8% , and the mean residual stenosis after stent placement was 20%. Neurologic impairment had been improved in all treated patients within a week of treatment. Heart rate stepped down in 25 patients, and blood preasure dropped in 17 patients, and vasospasm occurred in 5 patients after or in treatment. The follow -up period was 2 years. The patients with diabetes or hyperlipemia were followed up per 3 months. The stent - placed artery was examined by Doppler ultrasound per 6 months in all of the 51 patients. Follow - up digital subtraction angiography performed in 6 patients showed light restenosis in 3 patients, and severe restenosis in one patient, and no stent shift. Conclusion CAS is a safe and effective technique for symptomatic carotid artery stenosis. Strict operation indication and skilled handling can cut down operation risk. To adjust promptly drug treatment on the basis of reexamination after operation is the guarantee of prostecdtive efficacy.
出处
《河北医科大学学报》
CAS
2010年第8期900-902,共3页
Journal of Hebei Medical University
关键词
颈动脉狭窄
支架
治疗结果
carotid artery stenosis, Stenting,Therapeutic effieaey
