颈动脉支架成形术治疗高危颈动脉狭窄

Carotid angioplasty and stenting for high-risk carotid stenosis

目的 探讨颈动脉支架成形术治疗高危颈动脉狭窄的可行性、安全性及短期疗效。方法 自 2 0 0 1年8月至 2 0 0 3年 7月 ,共采用颈动脉支架成形术治疗高危颈动脉狭窄 8例 ,术前平均狭窄程度分别为 (74 13±13 38) % ,均为症状性病人。结果 狭窄位于颈内动脉 6例 ,位于颈总动脉 2例 ,所有病人均成功地植入支架。术后狭窄程度均≤ 10 %。全部病人无临床并发症 ,5例临床症状消失 ,3例临床症状不同程度好转。随访 3～ 2 7个月 ,无短暂性脑缺血发作 (TIA)等缺血性神经损害发生 ;影像学检查无显著再狭窄。结论 颈动脉支架成形术治疗颈动脉狭窄安全有效 ,尤其适合于颈动脉内膜切除术高危的病人 ,脑保护装置可以有效减少因硬化斑块或血栓引起的并发症。

ObjectiveTo evaluate the feasibility, safety and short-term outcome of carotid angioplasty and stenting(CAS) in high risk patients with carotid stenosis. MethodsFrom Aug 2001 to July 2003, 8 patients considered to be at high risk of carotid stenosis were treated with CAS. The mean degree of residual stenosis before the procedure were (74.13±13.38)%. All those were symptomatic. ResultsThe stenosis was located at internal carotid artery in 6 cases, and common carotid artery in 2 cases. The procedures were technically successful in all patients. All the degrees of stenosis after CAS were less than 10%. None of them experienced clinical complications. Clinical symptoms disappeared in 5 patients, and different improvement was achieved in 3 patients. Following up 3 to 27 months , there was no TIA or other ischemic neurological defect. And there was no significant restenosis in follow-up angiography. ConclusionCarotid angioplasty and stenting are safe and feasible in treatment of carotid stenosis , particularly in patitents at high risk of carotid endarterectony. Brain protection can efficaciously minimize the complication due to the atherosclerotic plaque or thrombus.