颈动脉支架置入术治疗高危颈动脉狭窄患者的随访研究

Carotid artery stenting for patients with high-risk carotid stenosis： a follow-up observational study

目的 评估颈动脉支架置入术治疗高危颈动脉狭窄患者的安全性和有效性.方法 回顾性分析2012年6月到2014年5月新疆医科大学第一附属医院59例行颈动脉支架置入术高危颈动脉狭窄的患者的病历资料,随访观察术后1周,术后30 d以及术后1年患者不良事件发生率并行神经功能评价,比较患者术前和术后的差别.结果 本项研究共纳入患者59例,平均年龄（67±8）岁,其中男49例（83％）.术前颈动脉造影平均狭窄程度为（87±6）％,术后平均狭窄程度（9±6）％,差异有统计学意义（P＜0.05）.在术后1周和术后30 d内不良事件的发生5例.其中卒中3例,短暂脑缺血发作2例,1例患者因术后缺血再灌注脑损伤致颅内出血导致死亡.随访1年,1例患者因脑梗死发生大卒中,其他患者术前和术后神经功能评价均有所好转或保持相同水平（P＜0.05）.结论 颈动脉支架置入术是对高危颈动脉狭窄的患者是安全有效的治疗方式.

Objective To evaluate the effectiveness and safety of carotid artery stenting for the treatment of patients with high-risk carotid stenosis through this study.Methods From June 2012 to May 2014,the medical data of 59 patients with high-risk carotid stenosis performed carotid artery stenting at the First Affiliated Hospital of Xinjiang Medical University were analyzed retrospectively.The incidence of adverse events and neurological evaluation of the patients were conducted during the follow-up observation at 1 week,day 30,and 1 year after procedure.The preoperative and postoperative differences of the patients were compared.Results A total of 59 patients were enrolled.Their average age was 67 ± 8 years old,and 49 of them （83%） are males.The average degree of stenosis of the preoperative carotid angiography was 87 ± 6%.The average degree of stenosis was 9 ± 6% after procedure.There was significant difference （P 〈 0.05）.Five patients had adverse events within 1 week after procedure and at day 30 after procedure,including 3 strokes and 2 transient ischemic attacks.One patient died because of cerebral ischemiareperfusion injury caused intracranial hemorrhage after procedure.They were followed up for 1 year.One patient had major stroke because of cerebral infarction.The preoperative and postoperative neurological evaluation of the other patients were all improved or maintained at the same level （P 〈 0.05）.Conclusion Carotid artery stenting is a safe and effective treatment for patients with high-risk carotid stenosis.