颈动脉狭窄的血管内支架治疗  

Percutaneous transluminal stenting for stenosis of internal carotid artery

作　　者：李慎茂[1] 朱凤水[1] 缪中荣[1] 王默力[2] 华扬[3] 凌锋[1] 

机构地区：[1]北京市脑血管病中心首都医科大学宣武医院介入放射诊断治疗中心,北京100053 [2]北京市脑血管病中心首都医科大学宣武医院神经内科,北京100053 [3]北京市脑血管病中心首都医科大学宣武医院超声科,北京100053

出　　处：《中国介入影像与治疗学》2004年第1期14-18,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：首都科学技术发展基金 (2 0 0 2 1 0 1 8) ;国家"九五"科研攻关课题 (96 60 7 0 2 0 3) ;国家"十五"科研攻关课题 (2 0 0 1BA70 3B1 8)。

摘　　要：目的　总结颈内动脉狭窄血管内支架治疗的经验与并发症。方法　颈内动脉狭窄患者 417例 ,全部患者行全脑血管造影及颈部超声检查。 13 4例患者使用脑保护装置 ;2 83患者未使用保护装置 ,对其中 2 0 2例 (71.3 8% )进行预扩张 ,66例 (2 3 .3 2 % )采取后扩张 ,3例未扩张。结果　 417例患者术中 ,心率下降者 10 5例 (2 5 .18% ) ;术中微栓子脱落 5例 ,其中 2例治疗后好转 ,2例留有一侧肢体运动障碍 ,术后颅内出血死亡 1例。 3 2 2例随诊 ,占 77.2 2 % ,其中再狭窄 15例 ,再狭窄发生率为 3 .6%。 3 2 5例有临床症状的患者中 ,2 5 6例症状消失或好转 ,占 78.77% ;结论　采用正确的围手术期治疗及手术方法 ,颈内动脉狭窄的血管内支架治疗是安全的 。Objective To discuss the benefits and complicat ions of percutaneous transluminal stenting for stenosis of internal carotid artery ( ICA). Methods Total 417 patients with ICA stenosis treated fro m Oct 1997 to May 2004, underwent periprocedual anticoagulation treatment, cereb ral vascular angiograpgy and cervical Doppler sonography, 134 of them with cereb ral protection of filter devices. Among the 283 patients without cerebral protec tion, 202 patients (71.38%) underwent predilation, 66 (23.32%) underwent postdil ation, and 3 underwent neither. Results Decreased heart rat e (less than 50 beat/min) was found in 105 patients (25.18%). Dislocation of mic roembolus happened in 5 patients, 2 of them mended after treatment, 2 got dyskin esias of one side, 1 (0.24%) died of intracerebral hemorrhage (ICH). After the t reatment, 322 patients (77.22%) were followed up, restenosis occurred in 15 pati ents (3.6%), and in 325 patients with transcient ischemic attack symptoms, 256 p atients (78.77%) mended well. Conclusion Percutaneous translumi nal stenting is safe for stenosis of ICA if adopting proper periprocedual treatm ent and operative procedure. However, enough attention should be paid to the occ urrence of ICH resulting from over-flow after operation.[

关 键 词：颈动脉狭窄 支架 介入 并发症 

分 类 号：R743.3[医药卫生—神经病学与精神病学]