双侧颈动脉狭窄不同血运重建方式疗效的对比分析

Treatment for carotid artery sterosis combined with contralateral carotid artery disease

目的:探讨合并对侧颈动脉病变的颈动脉狭窄的治疗方法。方法:对2011年7月至2014年12月,收治的105例合并对侧颈动脉病变的颈动脉狭窄患者的临床资料进行回顾性分析。50例实施颈动脉内膜剥脱术(CEA),55例实施颈动脉支架置入术(CAS),对围手术期结果进行对比分析。结果:CEA组围手术期并发症发生率为14%(7/50),包括局灶性脑梗塞、TIA发作、声音嘶哑、刀口血肿及泌尿系感染。CAS组围手术期并发症发生率为20%(11/55),包括局灶性脑梗塞、颈动脉窦综合征、颈内静脉血栓、肾功能不全及肺部感染。所有患者均顺利出院,围手术期无患者死亡。2组患者并发症发生率比较差异无统计学意义(P=0.415)。结论:CAS和CEA均为治疗合并对侧颈动脉病变的颈动脉狭窄的安全、有效的方法。

Objective：To investigate the treatment for carotid artery sterosis combined with contralateral carotid artery disease. Methods：Between July 2011 and December 2014, CEA or CAS were performed in 105 patients with bilateral carotid artery stenosis, the perioperative outcomes were analyzed. Results： In CEA group, the perioperative complication rates were 14% （7/50）. The complications included cerebral infarction, hoarse, Urinary tract infection and Incision hematoma. In CAS group, the perioperative complication rates were 20% （11/55）. The complications included cerebral infarction, carotid sinus syndrome, Internal jugular vein thrombosis, Renal insufficiency and pneumonia. The complication rates have no significant difference between the two groups. Conclusion：CAS and CEA are both the safe and effective treatments in patients with carotid ar- tery sterosis combined with contralateral carotid artery disease.