老年颈动脉支架成形术的随访分析

The follow-up analysis to carotid angioplasty and stenting in elderly patients with carotid artery stenosis

目的了解老年颈动脉狭窄病人经皮颈动脉成形术及支架植入术(carotidarterystenting,CAS)的有效性及安全性。方法行CAS,颅外段颈动脉狭窄老年患者39例:男28例,女11例;年龄55～81(64±10)岁。随访1年。术前及术后1年行颈动脉超声心动图检查。结果手术成功率为100%,发生微小脑梗死1例;高灌注综合征1例。围手术期及随访中未见死亡及卒中的事件发生,超声检查示狭窄程度明显改善(P<0.001),仅见50%的支架内再狭窄2例(4.9%)。结论老年颅外段颈动脉狭窄的病人CAS是一种简单、安全、可行的手术方式。

Objectives To investigate the feasibility and safety of carotid artery stenting （CAS） in the elderly patients with carotid stenosis. Methods From June 2002 to June 2004, 39 consecutive elderly patients with extracranial carotid stenosis were selected prospectively after under-going CAS procedures. Total 28 male and 11 female, mean age of patients was （64±10） years-ranged from 55-81 years, were selected to be a 1 year followup. The investigative data included death,stroke,minor stroke and echocardiography before the CAS and 1 year follow-up, and so on. Results All 39 CAS procedures were technically successful, and there were 1 minor stroke and 1 hyperperfusion syndrome in operative complications. No death and stroke incidences happened in perioperative and follow-up period. There were only 2 cases （4.9%）with 50% in-stent restenosis by echocardiography inspection. No restenosis was in long-term follow-up（14±6.5）months. Conclusions Carotid artery angioplasty and stenting are safe and feasible to the elderly patients with extracranial carotid stenosis. The result remains to be confirmed by further large-scale clinical reseach.