急诊颈动脉支架植入术治疗症状性颈动脉狭窄患者的安全性和有效性研究  

Safety and efficacy of symptomatic carotid artery stenting performed in an emergency setting

作　　者：邓鹏飞[1] 李递通[1] 陈锦俭[1] Deng Pengfei;Li Ditong;Chen Jinjian(Department of Neurology,Yulin Second People's Hospital Guangxi 537000,China)

机构地区：[1]玉林市第二人民医院神经内科,广西537000

出　　处：《脑与神经疾病杂志》2023年第7期414-419,共6页Journal of Brain and Nervous Diseases

基　　金：广西玉林市科学研究与技术开发计划项目(20220641)。

摘　　要：目的分析并探讨急诊情况下行颈动脉支架植入术(CAS)的安全性和有效性。方法玉林市第二人民医院2019年5月至2022年5月期间因症状性颈动脉闭塞或显著狭窄而进行CAS的患者,根据进行手术的时间分为急诊CAS与择期CAS组。于术后3个月进行随访,记录患者围手术期并发症、再狭窄/闭塞率,记录手术相关卒中、心肌梗死或死亡情况。采用Logistic回归分析评估影响预后的因素。结果75例急诊和104例择期CAS患者纳入本研究。与择期CAS相比,急诊CAS患者同侧颈动脉闭塞的比率(17.3%vs.1.9%,P<0.001)及术前颈动脉狭窄程度(90,IQR 75~99vs.85,IQR 70~90,P<0.024)明显更高,但两组患者围手术期并发症(9.3%vs.4.8%,P=0.232)、术后3个月内发生卒中、心肌梗死或死亡事件(5.7%vs.1.0%,P=0.161)的风险均差异无统计学意义。结论本研究表明,症状性颈动脉狭窄患者进行急诊CAS的安全性和有效性与择期CAS相似。Objective To analyze and investigate the safety and efficacy of carotid artery stenting(CAS)in emergency situations.Methods Patients undergoing CAS for symptomatic carotid artery occlusion or significant stenosis between May 2019 and May 2022 at our institution were prospectively included and divided into emergency CAS and elective CAS groups according to the time of performing the procedure.Patients were recorded for perioperative complications,restenosis/occlusion rates,and were followed up for procedure-related stroke,myocardial infarction,or death at 3 months postoperatively.Logistic regression analysis was used to assess the factors affecting prognosis.Results Seventy-five patients with emergency and 104 patients with elective CAS were included in this study.Compared with elective CAS,the rate of ipsilateral carotid occlusion(17.3%vs.1.9%,P<0.001)and preoperative carotid stenosis(90,IQR 75-99 us.85,IQR 70-90,P<0.024)were significantly higher in patients with emergency CAS,but patients in both groups had significantly higher perioperative complications(9.3%us.4.8%,P=0.232),and the risk of stroke,myocardial infarction,or death within 3 months afer surgery(5.7%us.1.0%,P=0.161)were not significantly different between the two groups.Conclusions This study demonstrates that the safety and efficacy of emergency CAS in patients with symptomatic carotid stenosis is similar to that of elective CAS.

关 键 词：症状性颈动脉狭窄 机械取栓 颈动脉支架植入术 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]