颈总动脉及颅外段颈内动脉狭窄的血管内支架成形治疗及随访研究

The Research for Percutaneous Transluminal Angioplasty and Stenting of Carotid (Common Carotid Artery and Extracranial Segment of Internal Carotid Artery) Stenosis and Follow-up

目的:探讨颈总动脉及颅外段颈内动脉狭窄的经皮血管内支架成形术的治疗及术后随访效果。材料和方法:96例颈总动脉及颅外段颈内动脉狭窄患者经全脑数字减影血管造影检查诊断后,均采用自膨式支架经股动脉入路行血管内支架成形术治疗。结果:96例颈动脉(颈总动脉/颅外段颈内动脉)狭窄术后狭窄段的直径均较术前扩大,其中87例达到正常管径的6 0 %以上,9例达到4 0 % ,有症状的90例术后临床脑缺血症状和体征均明显改善。全部患者无并发症发生。电话随访2～35个月,均未再发生脑缺血,其中超声复查颈动脉2 2例( 2 7次) ,DSA复查1 0例,无再狭窄发生。结论:经皮血管内支架成形术是治疗颈动脉(颈总动脉/颅外段颈内动脉)狭窄的简便、安全、有效的方法之一,3年内随访效果较好,大宗病例的更长时间的随访结果有待进一步观察。

Purpose: To study the treatment and follow-up of percutaneous transluminal angioplasty and stenting of carotid(common carotid artery and extracranial segment of internal carotid artery)stenosis. Materials and Methods: 96 cases with carotid(common carotid artery and extracranial segment of internal carotid artery)stenosis were diagnosed by digital subtraction angiography(DSA), and performed PTAS with self-expand stent by the approach of femoral artery. Results: The postoperative caliber of stenotic segment was widened in all the cases that was recovered over 60% of the normal diameter in 87 cases and over 40% in 9 cases. The clinical symptoms and signs of ischemia were improved obviously after PTAS in 90 cases with ischemia. No any complication was occurred in this group. During the follow-up for 2～35 months no cerebral ischemia attacked in all cases and no restenosis was found by DSA in 10 cases and Doppler in 22 cases. Conclusion: PTAS is an easy, safe and effective therapy for patients with carotid stenosis. The treatment results are well during the 3 year follow-up, but that will be much more investigated in the long period follow-up of a great number of patients.