颈动脉狭窄支架成形术的长期疗效

Long-term outcomes of stent-assisted angioplasty in patients with carotid artery stenosis

目的总结颅外颈动脉狭窄支架成形治疗的长期疗效,以分析其安全性及有效性。方法收集采用自膨胀支架进行血管成形治疗并进行1年以上长期随访的颈动脉狭窄患者168例的临床和影像学资料,分析再卒中率和再狭窄率。结果168例患者共行颈动脉支架成形术179次(其中11例为双侧颈动脉狭窄),支架置入均获得成功,血管狭窄程度从治疗前的平均(76.4±12.5)%降低到(11.2±7.8)%。术后临床随访(12-56个月,平均24.5个月),其中5例发生治疗侧的TIA或小卒中(2.6%),1例为非治疗侧的小卒中,1例非卒中死亡(0.6%)。12个月以上的DSA随访中无症状性再狭窄2例(1.2%),63例有明显内膜增生(<50%)。结论血管内支架成形术治疗颈动脉狭窄是安全、可行的,长期随访结果显示能显著降低卒中发生率及残死率。

Objective To evaluate safety and efficacy of stent-assisted angioplasty in patients with carotid artery stenosis. Methods One hundred and sixty-eight patients with extracranial carotid stenosis treated by self-expandable stent placement and angioplasty, were followed-up for more than 12 months. We retrospectively studied their clinical and radiographic data. Results Stent placement and angioplasty was successful in all patients （179 vessels in 168 patients）. The average stenosis rate was reduced from （76.4 ±12.5） % before treatment to （ 11.2 ± 7.8） % after stent-assisted angioplasty. During the clinical follow- up for a period of 12-56 months with an average of 24.5 months, there were one nonstroke death （0.6%） , one contralateral minor stroke （0.6%） and five ipsilateral TIA or minor stroke （2.6%）. DSA follow-up showed only two asymptomatic restenosis （ 1. 2% ） and apparent intimal hyperplasia （ 〈 50% ） in 63 petients. Conclusion Endovascular stent-assisted angioplasty for extracranial stenosis is safe and effective with considerable good immediate and late outcomes.