血管内支架成形术治疗高危颈动脉狭窄

Stent-assisted Angioplasty Treatment for Patients with High-risk Carotid Stenosis

目的 探讨血管内支架成形术治疗高危颈动脉狭窄的可行性和安全性。资料与方法 自 2 0 0 0年 12月～ 2 0 0 1年 6月 ,共采用血管内支架植入术治疗不宜行颈动脉内膜切除术 (CEA)的高危颈动脉狭窄患者 14例 ,其中 3例为无症状者。结果 所有患者均成功地植入支架。术前、术后平均狭窄程度分别为 (82 .3± 5 .1) %、(17.0± 3.8) %。1例术中发生同侧颞叶梗死但恢复良好 ,无其他手术并发症。临床随访 1年以上无 1例缺血再发作 ,影像学检查无再狭窄。结论 血管内支架成形术治疗颈动脉狭窄是安全有效的 。

Objective To investigate the feasibility and safety of stent-assisted angioplasty treatment for patients with high-risk carotid stenosis.Materials and Methods During the period of Dec. 2000～Jun. 2001, 14 patients with high-risk carotid stenosis, who were unsuitable for CEA treatment, received carotid artery stenting (CAS) Three patients were free of clinical symptoms. Results The stenting procedures were technically successful in all patients. After the procedure, the mean stenotic degree was reduced from 82.3%±5.1% to 17.0%±3.8%. One patient had ipsilateral temporal infarction during the procedure, but well recovered in three months. No other procedure-related complications occurred. During a following-up period of one year, no ischemic attack was seen, and no restenosis was found on imaging exam.Conclusion Endovascular stent-assisted angioplasty is an effective and safe treatment for carotid stenosis, it is especially helpful for patients who are at high-risk for post-operative complications of CEA.