血管内支架成形术治疗老年症状性颈内动脉开口狭窄患者的研究

摘要

Objective To evaluate the safety, performability and long-term clinical efficacy of stenting angioplasty for treating symptomatic internal carotid artery (ICA) stenosis in the origin part in elderly patients. Methods Stenting angioplasty was performed on 29 patients with symptomatic ICA stenosis in the origin part. Results 29 stents were placed in 29 patients. Operations were performed 100%successfully. After an average 24 months of follow-up visits, restenoses were detected in 2cases reexamined by DSA 6 months after stenting, both presented with less than 50% stenoses. 1 case was found not regularly taking statins and antiplatelet drugs after stenting, severe restenosis occurred 6 months later, stent implantation performed again, no recurrence of transient ischemic attack (TIA) was noted during 2 years′follow-up visit. Cerebral ischemic strokes occurred in 2 cases , and both of them had balloon dilatation after stenting. 1 case was completely recovered after treatment and 1 was left with weakness in right extremities, unabling to walk. No cases of posterior circulation ischemia, death and myocardial infarction were detected. Conclusions Stenting angioplasty can be performed in treating symptomatic internal carotid artery stenosis in elderly patients. It showed a relatively good mid-long-term clinical effects and can be a secondary prevention option.%目的：评估老年症状性颈内动脉开口狭窄患者支架成形术的安全性、可行性和远期疗效。方法：29例颈动脉开口狭窄患者接受了球囊扩张支架成形手术治疗。结果：29例患者共置入支架29枚，技术成功率100％。平均随访24个月，其中2例在半年后行DSA复查时出现再狭窄，狭窄率均小于50％。1例术后未规律服用他汀类药物及抗血小板药物，半年后出现严重再狭窄，再次行支架植入术，随访2年TIA未再复发。2例术后出现缺血性脑卒中，均为行囊后扩者，其中1例经治疗完全恢复，1例遗留右侧肢体无力，不能行走。所有患者未发生后循环缺血、死亡及心肌梗死。结论：球囊扩张支架成形术治疗老年症状性颈动脉狭窄技术可行，预后较好，可作为其二级预防的选择。