颈动脉支架置入术后3年随访结果分析

Three-year follow-up of patients after carotid angioplasty and stenting

目的探讨颈动脉支架置入术(CAS)在预防脑梗死方面的远期效果。方法选择接受颅外段CAS患者55例,定期随访3年。根据CAS后发生缺血性脑血管事件(4例)和未发生缺血性脑血管事件(51例)进行比较。并分析CAS后血管再狭窄情况。结果在55例完成3年随访的CAS患者中,4例(7.3%)出现了终点事件的患者均为脑梗死。其中3例患者缺血事件对应的脑梗死在支架置入同侧,1例患者缺血事件对应的脑梗死在支架置入对侧。单因素分析发现,年龄>75岁、高血压史、有两个以上脑血管病危险因素、术后未系统服用抗血小板药物、术前有多次脑梗死病史的患者术后容易发生缺血性脑血管事件(P<0.05)。3年随访观察,有3例(5.5%)发生了再狭窄。结论 CAS能有效降低动脉粥样硬化性颈动脉狭窄患者脑卒中发生风险。CAS后中远期再狭窄率较低。

Objective To analyze long-term outcome of carotid artery stenting（CAS） in patients with atheroselerotie diseases. Methods Fifty-five patients who had received CAS and finished 3 years follow-up in a general hospital were enrolled as subjects. Patients were grouped into with（4） and without（51） recurrence of ischemic cerebral events. The restenosis after CAS was analyzed. Results During the 3 years follow-up,4 patients（7.3%0） had recurrent ischemic events. Of the 4 recurrent patients,3 had infarctions ipsilateral as the CAS; and 1 had infarction contralateral to the CAS. Univariate analysis indicated that age 〉75 years,history of multiple risk factors for cerebrovascular diseases, absence of systematic anti-platelet treatment after CAS, multiple infarctions before CAS were associated with cerebral ischemic events after CAS. Three（5.5%） patients developed restenosis after CAS. Conclusion CAS can efficaciously decrease stroke morbidity in patients with atherosclerotic diseases. Restenosis rate is relatively low during the medium-term follow-up.