滤网保护下支架置入术治疗颈动脉狭窄的临床观察

Clinical Observation of Stenting with Filter Protection Devices for the Treatment of Carotid Stenosis

[目的]探讨颈动脉狭窄的病因及滤网保护下支架置入术治疗颈动脉狭窄的临床疗效.[方法]对26例颈动脉狭窄患者施行滤网保护下支架置入术,分析颈动脉狭窄的常见病因及颈动脉支架置入术的有效性和安全性.[结果]既往有高血压病8例,高血压病伴糖尿病9例,高血压病伴冠心病6例,2例有高脂血症.男性患者中有13例长期吸烟病史,女性患者均无吸烟史.支架放置均准确,21例颈动脉狭窄管径基本恢复到正常,4例仅遗留20%狭窄,1例遗留40%狭窄,6例术中术后出现血压下降、心动过缓,无其他并发症发生.[结论]男性、高血压病、长期吸烟（吸烟指数约800）可能是颈动脉狭窄的重要危险因素,滤网保护下血管内支架置入术治疗颈动脉狭窄是一种安全、有效的方法.

[Objective] To explore the etiology of carotid stenosis and the clinical efficacy of stent place-ment with filter protection devices for the treatment of carotid stenosis. [Methods] Carotid artery stenting （CAS） with filter protection devices was performed in 26 patients with carotid stenosis. The common etiology of carotid stenosis, the validity and safety of CAS were analyzed. [Results] Among all patients, there were 8 patients with the history of hypertensive disease, 9 patients with hypertensive disease and diabetes mellitus, 6 patients with hypertensive disease and coronary heart disease as well as 2 patients with hyperlipidemia. Thir-teen patients in male patients had long term history of smoking. Female patient had no history of smoking. All stents were accurately implanted. Stenosis disappeared in 21 patients. Residual stenosis was about 20% in 4 patients and 40% in 1 patient. Hypotension and bradycardia during and after operation occurred in 6 patients. There were no other complications. [Conclusion] Male, hypertensive disease as well as long term smoking which the smoking index is about 800 may be the important risk factors for carotid stenosis. Stent placement with filter protection devices for carotid stenosis is safe and effective.