影响颈动脉支架置入术安全性的因素分析

Therapeutic efficacy and postoperative complications for carotid artery stenting

目的探讨颈动脉支架置入术后并发症发生的机制及防治效果,以提高手术的安全性。方法2003年4月至2004年9月间,72例颈动脉狭窄患者进行了经皮腔内血管成形和支架植入术治疗。结果72例患者中有2例出现可逆性小卒中,3例出现术中球囊扩张时对侧肢体局灶性癫痫发作;3例血管痉挛;25例出现低血压、心动过缓;1例出现术后高灌注综合征;5例其他部位的出血。经积极处理后,均未留下严重后果。结论血管内支架成形术治疗是一种治疗颈动脉狭窄安全有效的方法,提高术者操作技巧及围手术期监护可以降低手术并发症和死亡率,提高安全性。

Objective To evaluate the therapeutic effects, prevention of complications after carotid artery stenting （CAS）. Methods From April 2003 to September 2004, 72 patients with the carotid stenosis underwent CAS in our hospital. Results The operations for all patients were technically successful. The immediate angiography after operation showed that the carotid artery stenosis in 40 cases recovered to normal, 20 relieved by 90%, and 12 relieved by 70%. The postoperative complications included minor stroke in 2 cases, transient cerebral ischemia symptoms after balloon dilation in 3, vasospasm in 3, hypotension and bradycardia in 25, hyperperfusion syndrome in 1, hemorrhage in other regions in 5. Conclusion CAS in the management of the carotid stenosis is a safe and effective method. The operation skill and the accumulated knowledge of complications can enhance the safety of CAS.