颈动脉狭窄支架治疗前后的超声检测结果分析

Analysis of ultrasonic detection for the patients with carotid artery stenosis underwent carotid stent

目的应用彩色多普勒影像(CDFI)和经颅多普勒超声(TCD)技术结合,评价随访颈动脉支架术疗效。 方法对53例颈动脉狭窄患者血管内支架治疗前后血管内径、狭窄率及颅内外血流动力学检测结果对比分析。 结果 术前颈动脉狭窄患者的血管内径为(1.644±0.817)mm,术后支架内径为(4.150±0.642)mm(P=0.000)。支架术前后血管造影和CDFI狭窄率分别为(84.24±12.17)％、(85.72±11.44)％和(26.00±8.25)％、(29.00±9.74)％(P=0.000、P=0.000)。术后MCA流速提高(20-189)％,平均(63±34)％,支架术前后MCA的血管搏动指数明显改善(0.76±0.17和1.04±0.14;P=0.000),侧支循环开放类型与患侧MCA、PCA血流变化密切相关。 结论 CDFI和TCD结果均能提示血管内支架治疗效果的客观血流变化依据,二者结合是准确评价和随访颈动脉支架术疗效的重要手段。

Objective In order to evaluate and follow the effect of carotid stent used by the combined result of color duplex flow imaging (CDFI) and transcranial Doppler (TCD). Methods 53cases (47 male, 6female, aged from 41 - 83 years, mean (64. 26±9. 63)years) with carotid artery stenosis were investigated pre-post stent treatment 1 to 24 month. . The diameter of vessels, percent of stenosis, index of hemodynamicsintra-extracranial artery were recorded and compared respectively. Results 53 cases with carotid artery stenosis were successfully managed by carotid aetery stent. None of these patients happened is-chemic symptoms again after procedure. The diameter of carotid artery was increased from (1. 644±0. 817) mm to(4. 150±0. 642) mm( P = 0. 000) by means of CDFI. The percent of stenosis of vessels were reduced significantly. Angiography and CDFI showed the stenosis of percent from (84. 63±11. 41)% to (14. 37±6.6. 1)% and (84. 84 ±10. 09)% to (14. 85±8. 4)% (P = 0. 000) respectively. The velocity of MCA improved 20% -189% was detected by TCD, mean value was (63±34)% after carotid artery stent, pulsatilty index (PI) of MCA were changed from 0. 76±0. 17 to 1. 04±0. 14(P = 0. 000) . Intracranial collateral circulation was opened before stent placement; while it was closed post procedure. The changes of velocity of MCA and PCA were mutually related to the intracranial collateral circulation. Conclusion According to the result of combing CDFI and TCD clued on the really gist of hemodynamics extra-intracranial pre-postoperation, it is very important method for assessing and following the curative effect of carotid artery stent.