颈动脉支架成形术治疗颈动脉蹼的安全性及疗效观察

Carotid artery stenting for the treatment of carotid web: observation of its safety and efficacy

目的探讨颈动脉支架成形术治疗颈动脉蹼的安全性及疗效观察。方法以2014年1月至2016年10月收治的28例患有颈动脉蹼患者作为研究对象,并给予颈动脉支架成形术。术后随访12个月,观察血管事件[颈内动脉短暂性脑缺血发作(TIA)、新发脑梗死、心肌梗死]及死亡的发生率。结果 28例患者均成功植入自膨支架,手术成功率100%。术前狭窄率50%～70%,平均(60.0±6.9)%。术后狭窄率0～20%,平均4.6%。其中2例(7.14%)患者术中出现颈动脉窦迷走反射,引起血压下降及心率减慢。无其他手术并发症。术后随访12个月,无颈内动脉TIA、新发脑梗死、心肌梗死等血管事件的发生。无患者死亡。术后12个月随访时复查头颈部CTA。所有患者住院期间及随访期间均未发现责任血管颈动脉蹼的发生。结论颈动脉支架成形术治疗颈动脉蹼安全、有效,围手术期并发症发生率低,短期效果显著。

Objective To investigate the safety and efficacy of carotid artery stenting in the treatment of carotid web.Methods A total of 28 patients with carotid web,who were admitted to authors'hospital during the period from January 2014 to October 2016,were enrolled in this study.Carotid artery stenting was performed for all patients.The patients were followed up for 12 months.The incidence of vascular events,including internal carotid artery transient ischemic attack(TIA),newly-developed cerebral infarction,myocardial infarction,etc.,and the incidence of death were documented.Results Self-expanding stent was successfully implanted in all 28 patients,the success rate of operation was 100%.Preoperative stenosis rate was 50%-70%,with an average of(60.0±6.9)%.Postoperative stenosis rate was 0%-20%,with an average of 4.6%.Among the 28 patients,2 patients developed carotid sinus vagal reflex during the operation,causing the blood pressure to drop and heart rate to slow down.No other operation-related complications occurred.During the follow-up period of 12 months,no internal carotid artery TIA,newly-developed cerebral infarction,or myocardial infarction was observed.No death occurred.Twelve months after the treatment,follow-up CT angiography(GTA)of head and neck was performed.During hospitalization and follow-up period,no occurrence of responsible vascular carotid web was observed in all patients.Conclusion For the treatment of carotid web,carotid artery stenting is safe and efiective with low incidence of perioperative complications and satisfactory short-term effect.