支架置入术治疗颈动脉狭窄

Endovascular Stenting for Carotid Artery Stenosis

目的 :总结血管内支架置入治疗颈动脉狭窄的安全性和疗效。方法 :收治颈动脉狭窄患者 16例 ,其中 3例进行狭窄预扩 ,3例使用脑保护装置 ,共放置自膨式支架 18枚。结果 :18枚支架均成功置入 ,术中无严重并发症 ,1例 (6 3% )术后第 3天发生非处理血管供血区脑梗死。随访 1～ 8个月 ,无新发短暂性脑缺血发作 (TIA)和脑梗死 ,末次改良Rankin量表评分平均 0 75 (0～ 2 )分 ,所有患者生活均自理。 10例患者术后 3个月颈动脉彩超复查 ,均未见再狭窄。结论 :支架置入治疗颈动脉狭窄是一种比较安全和可能有效的方法 ,但亟需设计随机对照临床试验观察其长期疗效和不良反应。

Objectives: To summarize the safety and efficacy in endovascular stenting and cerebral protection device. Methods: Sixteen patients with carotid stenosis were treated from July 2003 to May 2004. Among the patients only 3 with serious stenotic carotid were pre-expanded, and 3 were treated with brain protection device. Eighteen self-expanding stents were implanted altogether. Results: Eighteen stent implantations were successful. None of the patients had a serious complication during the procedures. One patient (6.3%) had a cerebral infarction on the third day after the procedure, which originated from another untreated artery. All the patients were followed up for 1 to 8 months. No new transient ischemia attack or stroke was found. The last mean MRS was 0.75 (0-2) points. No patients depended on others in their daily life. Ten patients were re-examined with color Doppler 3 month after stenting, and no restenosis was found. Conclusion: Endovascular stenting is a safer and probably effective method in the treatment of carotid. The design of a randomized, controlled trial for observing its efficacy and side effects is badly need.