经皮血管内支架术治疗颈动脉狭窄九例报告

Transcutaneous endovascular placement of self-expandable stent in the treatment of carotid artery stenosis: report of nine cases

目的介绍并探讨支架治疗颈动脉病变的程序及有效性、安全性。方法2004年1月至2005年6月颈动脉狭窄大于或等于70%(NASCET标准)的患者9例行11枚自膨胀支架置入治疗,皆应用保护伞,于围手术期进行抗血小板治疗,并行全脑血管造影及颈部超声检查,临床随访5.5月(1￣12月)。结果9例手术操作完全成功,术后残余狭窄小于20%,无死亡病例;无症状脑梗死1例;2例术后出现低血压,心动过缓,静脉持续给药24h后恢复正常。结论应用支架内置入是治疗颈动脉狭窄的一种可行、安全、有效的方法。

Objective To introduce the procedure of carotid stenting, and to investigate the effectiveness, safety, and practicability of carotid stenting for carotid artery stenosis. Methods From January, 2004 to June, 2005, 9 patients （3 women and 6 men; mean age, 65.4 years; age range, 45-75 years） with symptomatic internal carotid artery stenosis （≥70% according to the NASCET）, underwent 11 extracranial carotid angioplasty and stenting （CAS） procedures with the self-expanding stents. Cerebral protection device was furnished for all patients. Antiplatelet therapy and cerebral angiography as well as cervical Doppler sonography were performed perioperatively, followed by clinical follow-up of 5.5 months （I-12）. Results Extracranial CAS was successful in all patients, with average residual stenosis of less than 20%. There were no deaths. Asymptomatic cerebral infarction was found in 1 case, hypotension and bradycardia in 2 cases that required continuous intravenous medication and inotropic support for 24 h. Conclusion Carotid stenting is considered to be a feasible and safe procedure for the treatment of carotid artery stenosis.