MoMa脑保护装置在颈动脉狭窄支架置入术中的作用

Preliminary application of the INVATEC Mo. Ma proximal cerebral protection device during carotid artery stenting

目的探讨颈动脉狭窄支架置人术中使用MoMa脑保护装置的作用。方法回顾性分析2008年12月—2010年5月,对6例颈内动脉重度狭窄的患者行颈动脉支架置人术并使用MoMa脑保护装置的临床资料。结果①6例患者的临床症状均获得改善,NIHSS评分较术前提高1～2分。②保护装置的滤网中均可见捕获的小斑块,无一例患者发生栓子脱落事件,颈内动脉重度狭窄均得到改善(残余狭窄率均<30%)。③术后3 d及3个月复查头部MRI,均未发现新发的缺血病灶。有1例存使用MoMa脑保护装置过程中,血液从颈外动脉逆流而加用远端脑保护装置;1例术后出现急性冠状动脉综合征,经积极治疗后好转。6例患者术后3个月复查颈部血管彩超均未发现再狭窄。结论对颈动脉重度狭窄的患者行支架置入术时,使用MoMa脑保护装置是相对安全、有效的,但尚需大样本病例的进一步研究。

Objective To investigate the safety and effectiveness of the Mo. Ma proximal cerebral protection device during carotid artery stenting. Methods The clinical data of 6 patients with severe internal carotid artery stenosis diagnosed by the Department of Interventional Radiology, Xuanwu Hospital, Capital Medical University from December 2008 to May 2010 were analyzed retrospectively. They were underwent carotid artery stenting and used Mo. Ma cerebral protection device. Neurological and head MRI examinations were performed before and 3 months after the procedure. Results The clinical symptoms of the 6 patients were improved. The captured small plaques were found in the filter protection device. No patients had dislodgement of emboli. The severe internal carotid artery stenosis were improved significantly after the procedure（ residual stenosis rate of 〈 30% ）. No new ischemic lesions were found in intraoperative and postoperative MRI reexamination. During the use of Mo. Ma cerebral protection device, one patient had the upstream of external carotid blood and the distal cerebral protection device was added. One patient had acute coronary syndrome after surgery and improved after active treatment. Conclusion In patients with severe carotid artery stenosis who performed stenting, the using of INVATEC Mo. Ma proximal cerebral protection device is relatively safe and effective, but further studies with larger sample is necessary.