脑保护装置下支架成形术治疗颈动脉狭窄的临床疗效观察  

Clinical investigation of self-expendable stenting for the treatment of carotid stenosis under cerebral protected device

作　　者：冯敬东[1] 苏秀琴[2] 于世平[2] 乔建军[2] 卫丹[2] 

机构地区：[1]山西医科大学,山西太原030001 [2]山西医科大学第二医院介入治疗科

出　　处：《实用医学影像杂志》2011年第2期122-125,共4页Journal of Practical Medical Imaging

摘　　要：目的探讨脑保护装置下支架成形术治疗颈动脉狭窄的技术及疗效。方法 12例颈动脉狭窄患者,其中颅外分叉部颈内动脉狭窄8例,单纯颅外段颈内动脉狭窄3例,单纯颈总动脉狭窄1例;所有患者动脉狭窄程度均大于70%,其中9例狭窄程度大于90%,狭窄长度在1.5～4.5 cm,平均2.35±1.25 cm。在滤网型脑保护装置下使用自膨式支架行颈动脉支架成形术(CAS)治疗。结果 12例全部技术成功,共放置支架13枚,脑保护装置全部顺利收回,颈动脉病变残余狭窄小于等于20%,临床症状完全缓解。术中3例患者出现短暂性心率减慢和低血压,1例患者回收脑保护装置后出现对侧肢体麻木、肌力下降,即刻溶栓,20 min后症状缓解,其余无病死及症状性脑梗死并发症发生,术后临床近期随访无脑缺血发生。结论脑保护装置下支架成形术治疗颈动脉狭窄是一种安全有效的方法,但其长期疗效仍需进一步观察。Objective To investigate the technique and efficacy of carotid angioplasty and stenting（CAS）with self-expandable stenting for treatment of carotid stenosis under cerebral protected device.Methods There were twelve cases of carotid stenosis,including 8 cases of carotid bifurcation stenosis,3 cases of extracranial internal carotid stenosis,and 1 case of common carotid stenosis.All the rates of stenosis were more than 70%,there were 9 cases of the degrees of stenosis were more than 90%;the length of stenosis ranged between 1.5 and 4.5 cm,means length 2.35±1.25 cm.All patients were treated by CAS with self-expandable stenting under cerebral protected filter devices.Results The treatment successed in all 12 cases and 13 self-expandable stenting were successfully implanted,and all cerebral protected filter devices were successfully taken back.All the degrees of stenosis after CAS were less than 20%.Clinical symptoms disappeared.During the treatment,3 patients had transient bradycardia and blood pressure decrease.1 case occurred transient ischemia attack（TIA） after cerebral protected filter devices taken back and relieved after 20 minutes.No death or symptomatic cerebral thromboembolic events.No symptom related to thrombosis occurred during clinic short-term follow-up period.Conclusion CAS with self-expandable stenting under cerebral protected filter devices is a safe and effective method to treat carotid stenosis.However the long-term effect needs to be proved by following up.

关 键 词：颈动脉狭窄 自膨式支架 脑保护装置 

分 类 号：R743.3[医药卫生—神经病学与精神病学]