颅外动脉狭窄支架成形术治疗的临床研究

Clinical study of angioplasty and stenting in treatment of extracranial artery stenosis.

目的观察颅外动脉狭窄支架成形术治疗及其短一中期疗效，探讨其有效性与安全性。方法收集病例进行回顾性分析及随访。分析病例特点；总结手术方法；制定手术技术成功标准、神经系统并发症评价标准及疗效评定指标；评价短期疗效。对病例进行随访，评价中期疗效。对患者术前、术后及随访时行NIHSS评分，进行统计学分析。结果36例患者手术技术成功率100％；术后症状改善34例，发生神经系统并发症2例。随访时症状改善34例，无改善者1例，死亡1例，所有患者均无新发缺血性脑血管病；影像学随访9例，1例发生再狭窄，1例支架内闭死。术前、术后及随访时的NIHSS评分依次降低，经统计学分析具有显著性差异。结论支架成形术可明显改善症状性颅外动脉狭窄患者的神经功能缺损程度，手术技术成功率高，并发症发生率低，是一种安全、有效的治疗方法。

Objective To study the angioplasty and stenting in treatment of extracranial artery stenosis and its short to mid - term outcomes. Study the efficiency and safety of the method. Methods Retrospective review and follow up the patients. Analyze the characteristics of all the cases. Summarize the method. Stipulate the metewand for operative technical success, nervous system complications and the guide lines to evaluate the curative effect. Estimate the short - term outcomes. Follow up all the patients. Estimate the mid - term outcomes. All the patients are graded with NIHSS when they were at preoperation, after operation and when are followed up. Analyze them by statistics. Results The technical successful rate of operation is 100% to the 36 patients. After operation, the symptoms ameliorated in 34 cases. Complications of nervous syste- moccurred in 2 eases. When followed up,the symptoms ameliorated in 34 cases. 1 case has no amelioration. 1 case died. No case attacked new ischemic eerebrovascular disease. 9 cases were examined with imaging. Restenosis occurred in 1 case. Stent obturated in 1 case. The NIHSS scores decrease in turn of preoperation, after operation and when followed up. There is significant difference analyzed by statistics. Conclusion PTAS can significantly ameliorate the nerval function defectiveness of the symptomatic patients with extracranial artery stenosis. The technical successful rate of operation is high,while the incidence of complications is low. It is a safe and effective method.