闭环自膨式支架结合后扩张技术治疗颈动脉严重钙化病变研究报告

Combined Closed-cell Self-expanding Stents and Postdilatation in Patients with Severe Calcified Carotid Lesions

目的评估自膨式闭环支架结合后扩张技术治疗颈动脉粥样硬化伴钙化的安全性和有效性。方法 2011年4月21日至11月17日以自膨式闭环支架结合后扩张技术治疗颈动脉粥样硬化伴钙化患者4例,术前经颈部血管超声诊断狭窄率为90%～99%,观察术后残余狭窄率、神经系统症状及循环的稳定性,并进行术后随访。结果术后所有病例保护装置内均未见脱落斑块,残余狭窄率约为1 0%～20%。术后神经系统评分同术前,无神经功能缺失病例。全部4例患者循环稳定,支架植入及球囊扩张未造成严重的血流动力学紊乱。随访无治疗侧的卒中事件及支架内再狭窄。结论在颈动脉粥样硬化斑块伴钙化的支架成形术中,自膨式闭环支架结合后扩张技术是一种有效的治疗方案。

Objective To assess the efficacy and safety of carotid artery stenting（CAS） with closed-cell self- expanding stents and postdilatation for calcified carotid atherosclerotic lesions. Methods Between April 21 and November 17, 2011, CAS by using combined closed-cell self- expanding stents and postdilatation was performed in 4 patients with carotid artery atherosclerosis accompanied by plaque calcification. The stenosis degree of the responsible carotid arteries in the 4 patients ranged from 90% to 99% before CAS. The angiographic outcomes immediately after CAS, and the intra- and postoperative neurological symptoms and circulation status were recorded. Short- term follow-up was conducted. Results There were no shedding plaques in the emlgollc protecuve uewtce in all 4caes successful in all 4 patients, with residual stenosis ranging from 10% to 20%. No patient developed a neurological deficit during the perioperative period of CAS. The hemodynamic status during the procedure was stable in all 4 cases. During the short-term follow-up, no patient experienced stroke or in-stent restenosis. Conclusion CAS with closed-cell self-expanding stents and postdilatation is an effective and safe alternative treatment in severely calcified carotid atherosclerosis.