颈动脉狭窄血管内支架治疗并发症的临床探析

Clinical Research of Using Endovascular Stent to Treat Carotid Artery Stenosis Complications

目的:分析血管内支架形成术治疗颈动脉狭窄术中及术后的并发症及其预防、治疗措施。方法:对我院经造影或MRA确诊的颈动脉狭窄98例患者采用血管内支架形成术进行治疗,以股动脉入路,应用球囊预扩张狭窄部位,然后释放自膨式支架,部分患者采用脑保护装置,统计术中以及术后的并发症并进行记录,对所有患者随访半年。结果:患者支架置入成功率100%,治疗有效率87.76%,术后因颅内出血死亡1例,脑卒中死亡1例,随访半年再狭窄3例(3.06%)。并发症发病率最高的为血管痉挛(25例,25.51%)和心动过缓(37例,37.76%),还有脑过度灌注综合症(6例,6.12%)、术中血栓形成并脱落(9例,9.18%)、缺血性脑卒中(3例,3.06%)等并发症,所有并发症经干预治疗后大部分均恢复或好转。结论:血管内支架形成术治疗颈动脉狭窄效果好,有效的预防、规范的操作以及及时的干预治疗可有效减少并发症。

Objective：To discuss and analyse using endovascular stents formation operation to treat carotid artery stenosis intraoperative and postoperative complications and its prevention, treatment measures. Methods：Adopted endovascular stents formation operation as treatment to 98 cases of thosecarotid artery stenosis patients who have been diagnosed by radiography and MRA at our hospital, regarded arteria femoralis as entrance, adopted sacculus to expand narrow sites, then release self- expandable supporter, used cerebral protection device to part of the patients, recorded intraoperative and postoperative complications, and proceeded half a year of follow-up visit to all the patients. Results： Patients＇ stent placement successful rate was 100%, treatment effective rate was 87.76%, there was one case of death because of intracranial hemorrhage after the operation, one case of stroke death, three cases of restenosis after half a year of follow - up visit（3.06% ）. The highest incidence of complications were vasospasm （ 25 cases, 25.51% ）, bradycardia （ 37 cases, 37.76% ） and brain excessive perfusion syndrome（6 cases,3.06% ） ,etc. Most of the complications have been recovered or improved after the intervention treatment. Conclusious ： Adopted endovascular stents formation operation to treat carotid artery stenosis can have good effect; What＇s more, effective prevention, standard operation and timely intervention treatment can reduce the happening of complications effectively.