经皮颈动脉支架植入术的临床应用及效果-18例报告  

Clinical Outcome of Carotid Artery Stenting - 18 cases report

作　　者：罗建方 陈纪言[1] 周颖玲[1] 黄文辉[1] 李瑜辉[1] 李光[1] 王硕[2] 王丽娟[2] 詹国华[2] 

机构地区：[1]广东省心血管病研究所心内科,广州510100 [2]广东省人民医院神经内科,广州510100

出　　处：《海南医学》2002年第12期195-195,共1页Hainan Medical Journal

摘　　要：目的　通过有关的临床资料评价经皮颈动脉支架植入术对预防和治疗脑卒中以及远端滤网系统保护下的临床效果。方法　从 1998年 7月至 2 0 0 2年 11月间 ,共有 18例颈内动脉严重狭窄病例在本所行经皮颈动脉支架植入术。18例患者在术前行神经专科检查 ,颈动脉超声检查及行颈动脉及其颅内段血管造影 ,手术采用经皮穿刺血管成形术的方法 ,把自膨式支架植入并覆盖颈动脉病变 ,分别在术后 1,3 ,6,12及 2 4个月进行临床神经专科及颈动脉超声检查随访。结果　 18例均为 5 8岁以上的病人 (男性 17例 ,女性 1例 ) ,其中 11例曾患有脑卒中或反复一过性脑缺血 ;选择性颈动脉造影示 18个靶病变均有 >70 %的狭窄 ,其中 3例合并对侧颈内动脉完全闭塞 ,12例冠脉造影示为严重的三支冠脉血管病变 ,1例为单支冠脉血管病变 ;10例患有高血压 ,3例患有糖尿病。在以上 18个病变中 ,共植入自膨式支架 19个 ,其中Wallstent (BostonScientificCo .) 12个 ,Smart(Cordis) 7个 ,有 7例行直接支架植入 ;最后 7例采用了远端滤网保护系统 (AngioguardXP ,Cordis) ,在术后会收的滤网中均发现数十个直径为 3 0 0 -10 0 0微米的碎片 ;所有病变术后病变残余狭窄均 <10 % ,手术技术成功率为 10 0 % ;Objective To investigate the safety and feasibility of carotid artery stenting (CAS) and evaluate its clinical outcomes. Methods From July 1998 to N 2002, 16 consecutive patients underwent extracranial CAS procedures. Neurologic assessment, Carotid duplex ultrasound, carotid and intracranial angiography were done before CAS in all patients. Carotid duplex ultrasound, cardiac and neurologic elevation were performed at 24hours, 1, 3, 6, 12 and 24 months post procedure. Results 18 patients (17 male and 1 female) underwent a total of 18 CAS procedures. Self-expandable stents (12 Wallstent BSC and 7 Smart Cordis) were implanted in all cases. Direct stenting technique was applied in 7 cases. The last seven procedures were performed with distal filtration device (Angioguard XP, Cordis) supporting. All CAS procedures were technically successful. The particles were found in the filter baskets in all distal filtration device used cases, which were 300-1000 micron in diameter. One patient had contralateral cerebral hemorrhage during CAS and died three day later after CAS. There were not other operative and post-operative complications. There were not restenosis within long-term (16±6.5 months) follow-up study. Conclusions Carotid artery stenting is safe and feasible in preventing ischemic stroke, this new alternative has satisfied clinical outcomes in managing ischemic disease of cardiac and neurological as well.

关 键 词：经皮颈动脉支架植入术 临床应用 疗效 脑卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]