血管内支架成形术治疗颅外颈动脉狭窄

Endovascular stenting for extracranial carotid stenosis

目的 评价颅外颈动脉狭窄支架成形术的安全性及近期疗效。 方法 2 0 0 0年 10月～ 2 0 0 2年 12月共收治颈动脉狭窄 16 4例 ,其中颅外分叉部颈内动脉狭窄 14 6例 ,单纯颅外段颈内动脉狭窄 13例 ,单纯颈总动脉狭窄 5例 ,采用自膨胀支架进行血管成形治疗。 结果 16 4例支架植入均获得成功 ,血管狭窄程度从治疗前 (78 8± 13 6 ) %降低到 (10 2± 7 5 ) % ,围手术期无死亡及大卒中发生 ,1例出现短暂性脑缺血发作 (Transientischemicattack ,TIA) (0 6 % ) ,1例出现小卒中 (0 6 % )。14 5例获得随访 ,时间 3月～ 30月 (平均 8 9月 ) ,随访期间无TIA及卒中发生 ,无死亡。术后 6月数字减影脑血管造影随访 4 5例 ,再狭窄 1例 (2 2 % ) ,但无临床症状。 结论 血管内支架成形术是治疗颈动脉狭窄安全而有效的方法 ,短中期结果令人满意。

ObjectiveTo assess the value of stent-assisted angiopl asty in the treatment of extracranial carotid stenosis.Methods A total o f 164 cases of ex tracranial carotid stenosis from October 2000 to December 2002, including 146 ca ses of carotid bifurcation stenosis, 13 cases of extracranial internal carotid s tenosis, and 5 cases of common carotid stenosis, were treated by self-expandable stent placement and angioplasty.ResultsStent placement and angioplasty was successfully accomplished in all the 164 patients. The degree of stenosis was re duced from (78 8±13 6)% before the treatment to (10 2±7 5)% after the oper atio n. There were 1 case of transient ischemic attack (TIA) (0 6%) and 1 case of mi n or stroke (0 6%) during the peri-operative period, but no death or major stroke took place. Follow-up for 3～30 months (mean, 8 9 months) in 145 cases found no T IA, cerebral apoplexy or death. Forty-five patients were followed by digital sub traction angiography (DSA) 6 months after the treatment, and asymptomatic re-ste nosis occurred in 1 case (2 2%).ConclusionsEndovascular ste nt-assisted angio plasty for extracranial stenosis is safe and effective, with favorable short-ter m outcomes.