支架成形术治疗颈内动脉起始段狭窄的临床分析

A clinical analysis of endovascular stenting for carotid artery stenosis

目的探讨颈动脉血管内支架成形术(CAS)治疗颈内动脉起始段狭窄的疗效及并发症。方法回顾性分析87例颈内动脉起始段狭窄患者行87例次CAS的临床资料。结果 87例患者的手术成功率100%。术中51例出现血压下降、心动过缓,3例出现栓子脱落导致动脉到动脉栓塞,1例出现部分性癫痫发作,1例留下永久性神经功能障碍,永久性神经功能障碍并发症发生率为1.1%,暂时性神经功能障碍发生率为3.4%;术后对87例患者进行6个月至2年随访,1例出现有症状性再狭窄,6例出现无症状性再狭窄,1例出现再发卒中,再狭窄发生率为8.1%,卒中再发率为1.1%。结论 CAS治疗颈动脉狭窄是一种有效且相对安全的方法,但应重视术中及术后并发症的预防及处理。

Objective To evaluate the efficacy and complications of carotid artery stenting （CAS） in the treatment of carotid artery stenosis. Methods The clinical data of 87 patients with carotid stenosis, who were implanted 87 stents, was analyzed retrospectively. Results The procedural success rate was 100%. During the procedures, 51 patients suffered from descent of heart rate and blood pressure, 3 patients suffered from embolism caused by dislodgment of emboli, and 1 patient suffered from partial seizure. The permanent neural dysfunction rate was 1.1%, and temporal neural dysfunction rate was 3.4%. During the follow-up with 87 patients between 6 months and 2 years, symptomatic restenosis occurred in 1 patients, symptomless restenosis occurred in 6 patients, and minor stoke occurred in 1 patients. The restenosis rate was 8.1% and recurrent stoke rate was 1.1%. Conelsions CAS is a safe and effective method to treat carotid stenosis, however, we should pay attention to the prevention and treatment of its complications.