重度颈动脉狭窄患者斑块最大厚度与颈动脉支架成形术后并发症的相关性研究

Correlation between maximum thickness of carotid plaque and postoperative complications of CAS in patients with severe carotid stenosis

目的探究重度颈动脉狭窄患者动脉粥样硬化斑块最大厚度与颈动脉支架成形术(CAS)后并发症发生率之间的关系。方法收集85例接受CAS的重度颈内动脉狭窄患者的影像学及临床病理资料,根据超声影像学资料评估颈动脉斑块最大厚度,根据ROC曲线斑块厚度的最佳临界值0.435mm将患者分为A、B两组并统计CAS术后两年内各类并发症发生情况。结果85例患者发生支架术后再狭窄12例,发生率14.1%,与动脉粥样硬化斑块最大厚度显著相关(P=0.002);术后再狭窄发生情况:A组2例(3.70%),B组10例(32.26%),B组较A组发生率明显上升(P<0.001);B组3例(9.68%)患者术后再发脑梗,两组差异有统计学意义(P=0.020)。结论颈动脉斑块厚度越大,患者CAS术后出现再狭窄的概率越高,特别是斑块最大厚度在0.435 mm以上的患者,再狭窄发生率明显增加。

Objective To investigate the relationship between the maximum thickness of carotid atherosclerotic plaque and the incidence of complications after carotid stenting in patients with severe carotid stenosis.Methods The clinical data of 85 patients with severe carotid stenosis undergoing CAS were analyzed.The maximum thickness of carotid plaque was evaluated according to ultrasound imaging data.Patients were divided into two groups according to the optimal threshold value:0.435 mm,which calculated in the ROC curve of plaque thickness.The incidence of complications within two years after CAS was analyzed.Results 85 patients were followed up for 2 years:restenosis occurred in 12 cases,the incidence rate was 14.1%,which was significantly correlated with the maximum thickness of atherosclerotic plaque(P=0.002).Postoperative restenosis occurred in 2 cases(3.70%)in group A and 10 cases(32.26%)in group B(P<0.001);Three cases(9.68%)suffered from relapsing cerebral infarction in group B compared to none in group A(P=0.020).Conclusion With the carotid plaque growing thicker,the incidence of restenosis after CAS in patients with carotid stenosis increases.Especially in patients whose maximum plaque thickness is more than 0.435 mm,the incidence of restenosis postoperative increases remarkably.