血管内支架成形术治疗颈内动脉高度狭窄的临床研究

The clinical study of carotid angioplasty and stenting for stenosis of internal carotid artery

目的评价血管内支架成形术(CAS)治疗颈内动脉狭窄的临床应用价值。方法选择颈内动脉狭窄≥80％的患者38例,全部均行全脑血管造影(CAG)、颈部超声和经颅多普勒(TCD)检查,并采用3种不同支架治疗;6月后复查上述检查。结果 38例操作顺利,临床并发症少,3例(7.9％)发生短暂性脑缺血发作(TIA),1例(2.6％)发生脑栓塞,3例(7.9％)发生过度灌注综合征;所有病例影像学评价成功,TCD检查血流恢复正常或明显好转;33例(86.8％)临床症状完全消失,3例(7.9％)好转;6月后CAG显示仅2例(5.3％)发生血管再狭窄。结论 CAS技术治疗颈内动脉高度狭窄是一种安全有效的新方法,值得推广应用。

Objective To evaluate the application of carotid angioplasty and stenting ( CAS) for stenosis of internal carotid artery (ICA). Methods 38 patients of ICA stenosis greater than 80% were selected. All cases were underwent cerebral vascular angiography ( GAG) , cervical Doppler sonography and transcranial Doppler (TCD). Three kinds of different stents were used for ICA stenosis. 6 months later, the same tests above mentionted Were carried out. Results All of the 38 cases underwent operation smoothly with a fcompli-cation. 3 cases were transient ischemic attack (TIA) and 1 case thromboembolism and 3 cases excessive perfusion syndrome. All of cases were successful on radiological image. Cerebral blood flows (CBF) were normal or increased on sonography. Symptoms was disappeared in 33 cases and weakened on various degrees in 3 cases. 6 months later GAG and TCD showed that the CBF were unobstructed, but there were 2 cases with restenosis after CAS. Conclusion CAS was a safe and effective therapeutic method for ICA stenosis. It was worthy of promotion and application.