颈动脉支架治疗缺血性脑血管病的疗效分析及并发症探讨

Analysis of effects and complications of carotid angioplasty and stenting for treatment of cerebrovascular diseases

目的总结颈动脉狭窄支架成形术的经验,评价其疗效,分析其并发症。方法对62例颈动脉中重度狭窄患者在脑保护装置下使用自膨式支架行颈动脉支架成形术,总结手术经验,观察其疗效,分析其近期及远期并发症。结果手术成功率100%,术后残余狭窄<20%。13例术中出现血压心率明显降低,3例术后出现低血压、心动过缓,5例出现穿刺处皮下血肿,1例出现股动脉假性动脉瘤,1例出现脑栓塞,1例出现脑出血,2例分别在3个月及半年后复查发现支架内再狭窄。结论颈动脉支架成形术是治疗颈动脉狭窄相对安全、有效的方法,但其并发症仍值得我们警惕及预防。

Objective To summarize the experience, evaluate the effect, and analyze the complications of carotid angioplasty and stenting. Methods Sixty-two patients with moderate-to-severe carotid stenosis were chosen as subjects, and under- went carotid angioplasty and stenting with self-expanding stents and embolic protection device. Then we summarized the experi- ence, evaluated the effect, and analyzed the recent and long-term complications. Results The success rate of the surgery was 100%, and the residual stenosis after surgery was less than 20%. Thirteen patients had distinct decline of blood pressure and heart rate during the surgery, while 3 patients ~ad continuous decline after surgery. Subcutaneous hematoma in the puncture ar- ea was found in 5 patients and a pseudoaneurysm of femoral artery was found in 1 patient. 1 patient had intracranial hemorrhage in the perioperative period, and 1 patient had cerebral embolism during the surgery. In-stent restenosis was found in 2 patients after 3 months or 6 months reexamination. Conclusion Carotid angioplasty and stenting is a relatively safe and effective method in the treatment of carotid stenosis. But we should notice and try to prevent the complications.