颈动脉狭窄行支架成形术治疗的临床疗效

Clinical Effect of Stent Angioplasty in the Treatment of Carotid Artery Stenosis

目的本文旨在总结颈动脉狭窄行支架成形术治疗的临床疗效,以分析其安全性及有效性。方法对36例颈动脉狭窄患者行支架成形术治疗,其中男性32例,女性4例;平均年龄为68岁。术前3天详细体格检查,常规行临床化验和头颅CT检查。根据CREATE前瞻性研究结果,采用Protege自膨式支架和Spider保护装置。结果 36例患者颈动脉支架成形术全部成功。颈动脉管腔狭窄率由术前的(85.24±11.54)%降至(8.13±4.37)%。术后临床随访,其中2例在支架释放时出现心率减慢、血压下降等迷走反射,反复给阿托品处理后恢复正常。2例患者术后3天内出现了病灶侧新发梗死灶,临床症状加重并有肢体活动障碍,经治疗后恢复。无死亡、无支架移位、无严重缺血和出血性卒中发生。结论颈动脉支架成形术治疗是安全、有效的,随着介入材料的不断进步,技术操作水平的不断提高,这项技术会为更多的颈动脉狭窄患者提供更好的治疗,从而降低卒中的发生率及残死率。

Objective The purpose of this article is to summarize the clinical effect of stent angioplasty in the treatment of carotid stenosis so as to analyze the safety and efficacy. Methods Of 36 patients with carotid artery stenosis accepting the treatment of stent angioplasty,32 were male and 4 were female. The average age was 68 years. In preoperative 3 days detailed physical examination, routine clinical test and head CT examination were taken.According to the results of CREATE prospective study, the Protege self expanding stent and Spider protection device were used. Results Carotid artery stent angioplasty all success in 36 patients. The rate of carotid stenosis was reduced from(85.24 + 11.54)% to(8.13 + 4.37)%. Postoperative clinical follow-up, of which 2 cases in the stent release vagal reflex occurs when the heart rate slows down, and blood pressure decline, after repeated atropine treatment return to normal. Lesions appeared within three days of 2 cases of patients with postoperative side new infarcts, clinical symptom aggravating and limb movement disorder, recovering after the treatment. No death, no stent displacement, no severe ischemic stroke and hemorrhagic stroke occurred. Conclusion Carotid artery stent angioplasty is a safe and effective treatment method. With the continuous progress of interventional materials, the continuous improvement of the level of technical operation, this technology will provide better treatment for more patients with carotid stenosis, thereby reducing the incidence of stroke and death rate.