高危颈动脉狭窄患者的血管内支架成形术治疗

Endovascular angioplasty and stenting for high-risk carotid stenosis

目的 :总结血管内支架成形术治疗高危颈动脉狭窄患者的可行性和安全性及短期疗效。 方法 :自 2 0 0 0年 10月至2 0 0 1年 12月 ,共采用血管内支架植入术治疗高危颈动脉狭窄患者 2 6例 ,其中 7例为无症状患者。结果 :所有患者均成功地植入支架。术前、术后平均狭窄程度分别为 (82 .3± 5 .1) %、(14 .0± 3.1) %。 1例出现同侧颞叶梗死 ,但恢复良好。其余无手术并发症发生。短期随访 10～ 2 2个月无 1例缺血再发作 ,影像学检查随访 6～ 18个月无再狭窄。结论 :血管内支架成形术治疗颈动脉狭窄安全有效 。

Objective:To investigate the feasibility,safety and short term outcome of carotid angioplasty and stenting (CAS) in high risk patients.Methods: From Oct 2000 to Dec 2001,twenty six consecutive patients considered to be at high risk of carotid endarterectomy (CEA) and excluded from the NASCET trial were treated with extracranial CAS.Seven patients were asymptomatic.Results: The stenting procedures were technically successful in all patients.The mean degree of residual stenosis before and after the procedure were (82.3±5.1)% and (14±3.1)% respectively.No one experienced procedure related complications,except one patient had ipsilateral temporal infarction and recovered well 3 months later.Short term follow up showed no clinical ischemic attack,and there was no restenosis in follow up angiography.Conclusion:Carotid artery angioplasty and stenting is safe and feasible in treatment of carotid stenosis,it produces satisfactory outcomes in patients who are at high risk of post operative complications of CEA.