颈动脉支架成形术治疗颅外段颈动脉夹层的疗效观察

Evaluation of endovascular stenting for extracranial carotid artery dissection

目的评价颈动脉支架成形术治疗颅外段颈动脉夹层的有效性及安全性。方法选择颅外段颈动脉夹层患者9例,均行颈动脉支架成形术,观察术后血管狭窄及夹层动脉瘤改善情况,围术期并发症的发生情况,对患者随访3个月到1年。结果手术技术成功率为100%,术后平均残余狭窄率均≤30%,患者颈动脉平均狭窄程度从(75.0±17.6)%降低至(15.8±9.2)%,夹层动脉瘤均消失,支架置入手术前后比较,差异有统计学意义(P<0.05)。患者术后缺血相关症状均有明显改善,围术期所有患者均未出现症状性脑卒中,无手术相关死亡事件发生,随访无缺血性脑血管事件发生,1例患者可见支架内再狭窄。结论颈动脉支架成形术治疗颅外段颈动脉夹层安全、有效。

Objective To evaluate the efficacy and safety of stenting for extracranial carotid artery dissection. Methods 9 patients with extracranial carotid artery dissection admitted in our center underwent stenting procedure, Post-operational stenosis, aneurysm obliteration and perioperative complications were evaluated. Clinical follow-ups were done within 3 to 12 months. Results Satisfactory stent deployment and aneurystn occlusion were achieved in all these 9 patients. The mean carotid artery stenosis was significantly reduced from （75.0 -＋ I7. 6） ~ to （15. 8 -＋ 9. 2） %, with the mean residual stenosis rate less than 30% （P^0. 05）. Ischemic symptoms were relieved after the procedure for all the patients. No perioperative symptomatic stroke, procedure-related death or isehemie eerebrovascular events were observed during the follow-up period. In-stent restenosis was observed in 1 patient. Conclusion It is safe and effective to treat extracranial carotid artery dissection by endovaseular stenting.