脑保护装置下的颈动脉狭窄支架成形术:28例短期随访脑缺血事件再发生率

Endovascular stenting of carotid stenosis under cerebral protection device: short-term follow-up of the incidence of cerebral ischemia in 28 patients

目的:观察脑保护装置下颈动脉狭窄支架成形术对脑缺血事件发生的二级康复干预作用。方法:解放军第三军医大学第一附属医院神经内科2003-01/2004-06收治28例症状性颈动脉狭窄患者,在进行颈动脉狭窄支架成形术中采用过滤伞装置,将脑保护装置(保护伞)小心通过狭窄部位放置于颈动脉狭窄的远端并释放,然后进行狭窄的血管内支架成形术,观察手术期脑栓塞发生的情况及其他并发症。结果:28例保护伞放置及支架成形术均成功实施。支架释放前颈动脉的平均直径狭窄率为(87.6±6.8)%,支架释放后颈动脉的平均直径狭窄率为(18.9±10.8)%。释放后颈动脉的平均直径狭窄率明显的降低(P<0.01)。操作过程中未发生栓塞等并发症。结论:脑保护装置能提高颈动脉狭窄支架成形术的安全性,同时,临床短期随访无脑缺血事件发生。

AIM:To observe the effect of endovascular stenting of carotid stenosis under cerebral protection as the second rehabilitative prevention in preventing cerebral ischemia events. METHODS:Angioguard was used in the treatment of 28 patients with carotid artery stenosis selected from the Department of Neurology,First Affiliated Hospital of Third Military Medical University of Chinese PLA from January 2003 to June 2004,during endovascular stenting of carotid stenosis.The angiogurad was placed distally to the stenoses and deployed before endovascular stenting of carotid stenosis.Cerebral embolism events and complications during endovascular stenting were observed. RESULTS:The angioguard placed and endovascular stenting were successfully administered in all 28 patients.The mean diameter rate was(87.6± 6.8)% before endovascular stenting,and(18.9± 10.8)% after endovascular stenting.The mean diameter rate after endovascular stenting was reduced significantly(P< 0.01).There were no embolism events and other complications during the procedure.Meanwhile,there was no cerebral ischemia event during short- term follow- up.CONCLUSION:Cerebral protection device can improve the safety of endovascular stenting of carotid stenosis;meanwhile, no cerebral ischemia events occurs in clinic.