血管内支架成形治疗颅外段颈动脉狭窄临床观察  

The clinical effect of endovascular stent-angioplasty in extracranial carotid stenosis

作　　者：李郁芳[1] 蒋初明[2] 李冬华[2] 叶容臻[1] 李宇东[1] 李燕[1] 张静[1] 缪中荣[3] 

机构地区：[1]北京航天总医院影像中心,100076 [2]北京航天总医院神经内科,100076 [3]首都医科大学宣武医院介入放射诊疗中心

出　　处：《中国现代医药杂志》2008年第6期1-4,共4页Modern Medicine Journal of China

基　　金：北京市首都医学发展科研基金(课题编号2005-3028)

摘　　要：目的评价血管内支架成形术治疗颅外段颈动脉狭窄的安全性、有效性和中短期疗效。方法对2005年3月至2007年10月收治的24例颅外段颈内动脉狭窄患者,在颈动脉保护伞下采用自膨支架进行血管成形治疗。结果24例患者成功置入27枚自膨支架、26个颈动脉保护伞,其中3例双侧颈内动脉狭窄患者分别于双侧颈内动脉各置入1枚支架。血管平均狭窄程度从治疗前的87.2%(70%～99%)降低到4.3(0%～15%)。回收的过滤伞中12个发现组织碎片(46.2%)。8例患者(33.3%)在球囊扩张及支架置入后出现迷走兴奋引发低血压及心动过缓,其中2例患者持续3～5天,经对症处理全部缓解。1～31个月临床中短期随访21例,平均随访22个月,2例失访。1例患者手术后26小时死于急性心梗;1例患者手术后36小时出现一过性意识丧失1小时,经对症处理缓解;1例患者出现小卒中;1例患者出现一过性脑缺血发作。随访21例患者中19例症状明显缓解或消失,占90.5%,2例部分缓解。随访21例支架全部开通良好,未出现再狭窄。结论保护伞下血管内支架成形治疗颅外段颈动脉狭窄是安全、有效的方法,中短期效果令人满意。Objective To evaluate the clinical effects and safety of endovascular stent-angioplasty in extracranial carotid stenosis. Methods From March 2005 to Oct 2007, 24 patients with extracranial carotid stenosis were treated by selfexpandable stents and cerebral protection filter devices. Results 27 self-expandable stents and 26 cerebral protection filter devices were placed successfully in all 24 patients, clinical success was achieved in all patients （100%）. The average stenosis rate was reduced from 87.2% （70%-99%） before treatment to 4.3 （0%-15%）after stent-assisted angioplasty. Debris could be found macroscopically in 12 out of 26 retrieved fihers（46.2%）. 21 patients had 1 to 31 months follow-up, 1 patient died of acute myocardical infarction after the procedure 25 hours later, 1 patient suffered from transient unconsciousness after the procedure 36 hours later, there were only 1 case of TIA and 1 case of minor stroke. The clinical symptoms were improved significantly or disappeared in 19 patients after the proeedure （90.5%）, partial reeuperation in 3, and no restenosis oeeured. Conclusion Endovaseular stent-angioplasty in extraeranial earotid stenosis is safe and effeetive with eonsiderable good middle term and short term outcome.

关 键 词：血管成形术 颈动脉狭窄 支架 保护伞 

分 类 号：R743.3[医药卫生—神经病学与精神病学]