颈动脉狭窄的介入治疗(附40例报告)

Interventional therapy for carotid artery stenosis: Report of 40 cases

目的 总结我科 4 0例颈动脉支架置入术治疗颈动脉狭窄的经验。 方法 2 0 0 0年 10月～ 2 0 0 2年 7月 4 0例颈动脉狭窄行腔内成形、支架置入术 ,共放支架 4 3个 ,其中Wallstent支架 39个 ,Smart支架 4个。应用脑保护装置 5例。 结果所有病人都完成支架置入 ,颈内动脉口都恢复到 4mm以上。术中出现轻度卒中 2例 ,较重卒中 2例 :1例术中出现左眼视野缺损 ,3月后仍有残余症状 ;1例术中出现意识丧失、右侧肢体偏瘫 ,经救治神志恢复。并发症发生率 10 % (4 4 0 ) ,严重卒中发生率 5 % (2 4 0 ) ,应用脑保护装置的病人无并发症发生。 结论 颈动脉支架置入术是治疗颈动脉狭窄的有效手段 ,用脑保护装置时安全保证更高。

Objective To summarize the experience of 40 patients with carotid artery stenosis treated by carotid artery stenting (CAS). Methods Endovascular plasty and stent placement were performed in 40 patients with carotid artery stenosis from October 2000 to July 2002. A total of 43 stents were placed into, comprising 39 WALLSTENT stents and 4 SMART stents. Out of the 40 cases, cerebral protection devices were used in 5 cases. Results The stent placement was completed successively in all the patients.Diameters of carotid artery all returned to 4mm or above.Mild intraoperative ischemic stroke occurred in 2 cases, and severe intraoperative ischemic stroke was found in other 2 cases: visual field loss of the left eye in 1 case, with after-effects even 3 months after surgery; loss of consciousness and right hemiplegia in 1 case, whom was cured to full consciousness subsequently. The complication rate was 10% (4 of 40) and the rate of severe ischemic stroke was 5% (2 of 40). No complications were seen in patients with cerebral protection devices. Conclusions CAS is effective in the treatment of carotid artery stenosis. Carotid stenting with cerebral protection devices may further ensure the patients' safety.