双侧颈动脉重度狭窄患者介入干预后再发脑卒中的短中期随访(英文)  

A follow-up:stroke in patients with bilateral severe carotid stenosis after intervention treatment

作　　者：赵筱玲[1] 贾建平[1] 吉训明[2] 彭茂[1] 凌峰[2] 

机构地区：[1]首都医科大学宣武医院神经内科,北京市100053 [2]首都医科大学宣武医院神经外科,北京市100053

出　　处：《中国临床康复》2003年第19期2714-2715,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的评价介入颈动脉血管内支架置入术和内科药物治疗双侧重度颈动脉狭窄患者的效果,观察干预后再发脑卒中的中短期随访结果。方法21例双侧重度颈动脉狭窄患者,按随机数字表分成两组:A组8例患者接受颈动脉血管内支架置入术治疗,B组13例患者接受内科药物治疗;1年半后分别随访临床和超声波检查。结果A组8例手术患者支架放置成功,术前颈动脉狭窄程度为70%～98%,术后狭窄程度小于10%,除1例偶发1次短暂性脑缺血发作(TIA)外,其他患者未出现脑血管病发作;B组9例(9/13)患者再次发生脑卒中(其中4例患者出现TIA发作,2例死亡),另4例(4/13)患者病情无变化,超声波检查发现7例(7/11)患者颈动脉内中膜增厚、动脉粥样斑块增多增大,管腔进一步狭窄。结论颈动脉狭窄血管内支架置入术中短期疗效优于内科药物治疗。Aim To evaluate the effectiveness of endovascular stent therapy and drugs for 21 patients with bilateral severe carotid stenosis,and to observe the middle and short term follow up results of stroke after intervention treatment.Methods 21 patients with bilateral severe carotid stenosis were divided into two groups randomly. Group A (8 patients) were treated with endovascular stent approach, and Group B (13 patients) were treated with drugs.All patients were examined physically and checked by duplex ultrasound of carotid in a follow up way in 18 months.Results Group A: all 8 procedures succeeded, the stenotic degree of the lesions before procedures was 70% - 98% ,and the residual stenosis after procedures were less than 10% .Except one patient had TIA once,neither new stroke nor TIA had happened.Group B: Stroke had happened in 9 patients (4 patients had TIA, 2 patients died ).Other (4 patients) had not changed.Results of carotid ultrasound in 7 patients (7/11)showed that the carotid inner middle membrane thickness was significantly increased, the size and rank of carotid artery atheromatous plaque was significantly increased,carotid stenosis extent deteriorated.Conclusion Endovascular stenting approach is more effective than drug treatment for patients with bilateral severe carotid stenosis in a short or middle term.

关 键 词：双侧颈动脉重度狭窄 介入治疗 再发脑卒中 短中期随访 颈动脉血管内支架置入术 药物治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]