降低颈动脉支架置入术后缺血性脑损伤措施的研究进展

Advances in the measures to reduce ischemic brain injury after carotid artery stenting

颈动脉支架置入术(CAS)后缺血性脑损伤是认知功能下降及临床缺血事件的有效预测指标。目前,降低CAS术后缺血性脑损伤发生的措施包括选择合适的患者、控制危险因素以及应用抗血小板聚集及他汀类降脂药、神经保护药物和非药物神经保护措施、根据患者情况个体化选择合适的支架类型及栓塞保护装置等,对术者进行规范化培训也是降低手术并发症的重要措施之一。尽管如此,CAS术后缺血性脑损伤的发生率仍较高。因此,作者将该类治疗措施进行综述,以期降低CAS并发症的发生率。

Ischemic brain injury after carotid artery stenting(CAS) is a predictor of cognitive decline and clinical events of cerebral ischemia. Nowadays, the methods to reduce the incidence of ischemic brain injury after CAS include choosing the eligible patients, controlling the risk factors, using the antiplatelet aggregation drugs and statins, combining neuroprotective drugs, or non-pharmaceutical therapies, and selecting the appropriate type of stents and embolic protection devices individually. The standardized training of the operator is also important for reducing procedure-related complications. However, ischemic brain injury after CAS is still a common phenomenon. Further study is needed to develop a safe, economical and effective treatment to reduce the prevalence of CAS complications.