超声在狭窄颈部动脉支架植入术后随访中的应用

Ultrasonographic Evaluation of Endovascular Therapy of Carotid Artery Vertebral or Subclavian Arterial Stenosis with Stent

目的评价超声在颈部动脉(颈动脉、锁骨下动脉及椎动脉)狭窄血管支架成形术后随访中的应用价值。方法应用超声随访观察47例患者的15枚颈内动脉(ICA)支架、9枚锁骨下动脉(SCA)支架及26枚椎动脉(VA)支架术后1～12个月,观察狭窄血管处支架位置、支架内及远端的收缩期峰值流速(PSV)、支架内有无血栓及再狭窄等情况,判断其疗效。结果支架置入术后超声示狭窄ICA、VA及SCA内径较术前明显增宽,内径分别由术前(2．90±0．76)mm、(2．0±0．38)mm及(4．00±1．46)mm增宽至术后的(4．20±1．78)mm、(3．4±0．51)mm、(6．15±0．98)mm;PSV分别由术前(115±15)cm/s、(181．4±32．5)cm/s、(257．67±66．41)cm/s减低至术后的(75±24)cm/s、(47．15±12．44)cm/s及(98．87±48．63)cm/s。随访中发现2例患者颈内动脉支架狭窄,1例颈内动脉支架闭塞。结论超声是评价颈部动脉狭窄血管支架成形术后疗效的无创、安全可靠的影像学检查方法。

Objective To evaluate the role of color Doppler ultrasonography in endovascular therapy of carotid,verte- bral or subclavian arterial stenosis with stents.Methods Forty-seven patients with Cartiod,vertebral or subclavian arterial stenosis were investigated by color Doppler ultrasound 1～12 months after stent treatment,including 15 ICA stents,9 SCA stent and 26 VA stents.The location of stents,peak systolic velocity(PSV)inside and distant place of stents were measured.In- stent thrombosis or restenosis were noted.Results The stent treatment of symptomatic atherosclerotic stenosis in the cartiod ar- tery,or original segment of vertebral or subcalvian artery were satisfied.The diameter of stenosis artery increased from(2.90±0.76)mm,(2.0±0.38)mm and(4.00±1.46)mm separatly to(4.20±1.78)mm,(3.4±0.51)mm,(6.15±0.98)mm.The PSV decreased from(115±15)cm/s,(181.4±32.5)cm/s and(257.67±66.41)cm/s to(75±24) cm/s,(47.15±12.44)cm/s and(98.87±48.63)cm/s.Stents restenosis occurred in two patients and occulusion happened in one patient during the procedure.Occlusion happened in one patient.Conclusion Color Doppler ultrasonography is a safe method in assessing the therapeutic effect of cartiod,vertebral or subclavian artery after stent therapy and it's available to follow- up in the long-term.