颈动脉近闭塞伴管腔完全塌陷患者的血运重建治疗效果

The Effect of Carotid Revascularization in Patients with Carotid Near-Occlusion and Full Collapse

目的:比较颈动脉内膜剥脱术(Caotid Endarterectomy, CEA)与颈动脉支架置入术(Carotid Artery Stenting, CAS)治疗颈动脉近闭塞伴完全塌陷患者的疗效。方法:选取2021年1月至2024年3月接受颈动脉血运重建治疗的颈动脉近闭塞伴完全塌陷患者45例,其中CEA组20例,CAS组25例,比较两组患者的围手术期并发症、术后1年缺血性脑卒中复发率、再狭窄率及死亡率。结果:两组患者的围术期并发症比较无统计学意义(P > 0.05),CEA组的再狭窄率小于CAS组差异有统计学意义(P 0.05)。结论:CEA和CAS均可用于治疗颈动脉近闭塞伴完全塌陷,两者且有相似的围术期并发症发生率、短暂性脑缺血发作/脑卒中的发生率、长期存活率,随访中CAS的再狭窄率高于CEA。

Objective: To compare the efficacy of carotid endarterectomy and carotid artery stenting in the treatment of carotid near-occlusion with full collapse. Methods: From January 2021 to March 2024, 45 patients with carotid near-occlusion and full collapse were selected, including 20 cases in CEA group and 25 cases in CAS group. The recurrence rate, restenosis rate and mortality of ischemic stroke in one year after operation were compared between the two groups. Results: There was no significant difference in perioperative complications between the two groups (P > 0.05). The restenosis rate in CEA group was lower than that in CAS group (P 0.05). Conclusion: Both CEA and CAS can be used to treat carotid near-occlusion with full collapse and have similar incidence of perioperative complications;incidence of transient ischemic attack/stroke;survival rate;restenosis rate of CAS is higher than that of CEA at follow-up.