高危颈动脉狭窄的球囊扩张和支架植入术治疗  

Carotid angioplasty and stenting in patients with high-risk carotid stenosis

作　　者：漆君[1] 刘建仁[1] 晁明[1] 丁美萍[1] 黄鉴政[1] 武建军[1] 张广强[1] 孙继红[1] 宋水江[1] 张宝荣[1] 陈伟[1] 李慎茂[2] 

机构地区：[1]浙江大学医学院附属第二医院,浙江杭州310009 [2]首都医科大学宣武医院,北京100053

出　　处：《浙江大学学报（医学版）》2007年第4期401-405,共5页Journal of Zhejiang University(Medical Sciences)

基　　金：国家自然科学基金资助项目(30600193);浙江省科技厅科研计划资助项目(021103023);浙江省卫生厅优秀青年科技人才专项基金资助项目(2004QN012)

摘　　要：目的：探讨用球囊扩张和支架植入术（Carotid angioplasty and stenting，CAS）治疗高危颈动脉狭窄患者的疗效和并发症。方法：从2003年3月到2006年4月对8例高危的颈动脉狭窄患者进行CAS治疗，观察CAS的疗效和并发症。结果：对8例症状性颈动脉狭窄患者的9根颈动脉进行了CAS治疗。CAS术后9根颈动脉的平均狭窄率从75．49／5显著减少到28．89／5（P〈0．001，配对t检验）。所有的患者都使用了脑保护装置。全部使用自膨式支架，其中大部分是Precise镍钛合金支架（77．8％）。术中5例患者发生了一过性心率减慢和血压下降。经过21．5±14．2（4～41）月的随访，所有患者没有再发卒中，除1例患者仍有轻度头晕外，其余患者头晕、眩晕症状全部消失。6例（75％）患者通过颈动脉超声和／或CTA随访发现支架通畅，无再狭窄。结论：采用脑保护装置的CAS是治疗高危颈动脉狭窄的安全可行的方法，但其疗效和安全性需要作进一步观察。Objective： To investigate the efficacy and complication of carotid angioplasty and stenting （CAS） in patients with high-rlsk carotid stenosis. Methods： Eight cases with high-risk carotid stenosis underwent CAS with cerebral protective devices from March 2003 to April 2006, the efficacy and complications of CAS were reviewed. Results： Nine stenotic carotid arteries of 8 cases were treated with CAS. Stenotic rate was significantly reduced from 75.4% to 28.8% （P〈 0. 001,paired t-Test） immediately after CAS. All stents used were self-expanding and most of them （77.8%） were precise nitinol stents. Five patients had mild and reversible low heart rate and blood pressure. During follow-up for 4-41 months （21.5±14.2）,no case had stroke again,all except one had no dizziness or vertigo again. Uhrasonography and/or computed tomographic angiography showed no re-stenosis in six cases （75%） when they were followed up. Conclusion： CAS with cerebral protection device is a safe and feasible procedure to treat high-risk carotid stenosis. However,its long-term efficacy and safety need to be further studied.

关 键 词：颈动脉狭窄/治疗 血管成形术/副作用 支架 气囊扩张术 随访研究 颈动脉球囊扩 张和支架植入术 脑保护装置 血管内治疗 疗效 安全性 

分 类 号：R543.4[医药卫生—心血管疾病]