高危颈动脉狭窄患者的外科治疗(附24例报告)

Surgical Management of High-Risk Carotid Stenosis(Report of 24 Cases)

目的 总结对高危颈动脉狭窄患者的治疗经验。方法 回顾性分析我院 2 0 0 1年至今收治的 2 4例高危颈动脉狭窄患者的病变特点、治疗方式和疗效 ,重点讨论颈动脉支架和转流管的应用指征和注意事项。结果 2 4例患者均手术治疗 ,其中 11例行支架成形术 ,13例行转流管下的颈动脉内膜切除术。手术均获成功 ,术后30d内无死亡、致残性中风及缺血性神经损害。结论 对手术高危患者 ,选择性应用支架成形术和颈动脉转流管 ,可有效减少并发症 。

Objective To summarize our experience in treating high risk carotid stenosis. Methods We retrospectively analyzed the clinical characteristics, treatment, and outcomes of 24 patients with high risk carotid stenosis in our department from January 2001 with emphasis on the application of carotid stents and shunting tubes. Results All patients were successfully treated, with 11 patients undergoing carotid angioplasty and stenting (CAS) and 13 patients receiving carotid endarterectomy (CEA) and shunting. No death, stroke, and ischemic neurological deficit occurred in 30 days postoperatively. Conclusion Selective application of CAS and shunting in CEA can effectively reduce complications and improve therapeutic effects in patients with high risk carotid stenosis.