颈动脉狭窄的诊断与治疗

Diagnosis and Treatment of Carotid Artery Stenosis

目的 研究颈动脉狭窄的诊断与治疗方法。方法 选择短暂性脑缺血性发作(TIA)患者行全脑血管造影,了解血管病变部位和狭窄程度。颈动脉狭窄<50％者行颈动脉注射尿激酶治疗;颈动脉狭窄>50％者行颈动脉内膜剥脱手术或血管内支架置入治疗。结果 4年来58例TIA患者中,发现颈动脉狭窄16例,其中狭窄<50％者8例经尿激酶颈动脉注射治疗后,TIA终止;狭窄>70%者8例,其中1例动脉粥样硬化斑块性狭窄行颈动脉内膜剥脱术,5例动脉粥样硬化斑块性狭窄、1例多发性大动脉炎及1例颈动脉夹层动脉瘤均行自膨式支架置入治疗。7例患者8处病变共置入自膨式支架12枚,治疗效果良好,随访3～20个月无再狭窄发生。结论 颈动脉狭窄是TIA发作的重要原因,而颈动脉内膜剥脱术和支架置入是治疗颈动脉狭窄的有效手段。

Objective To study the diagnostic method and therapeutic strategy of carotid artery stenosis. Methods The different stenosis in degree was detected by cerebral angiography in 16 of 58 patients with transient ischemic attacks (TIA). The injection oi urokinase into the carotid arteries were performed in the 8 patients with slight stenosis (<50%) of carotid arteries. Of 8 patients with serve stenosis (>70%) of carotid arteries, 1 underwent endarterectomy and 7 were treated by placing the stents into the arteries. Result The data of follow-up for 3-20 months showed that no TIA occurred again in all the 16 patients, of whom, 8 treated by carotid endarterectomy or placing the stents did not suffer from restenosis oi the carotid. Conclusion Carotid Artery stenosis is important reason for TIA and effectively treated by carotid endarterectomy or placing the stents.