颈动脉支架置入术治疗症状性颈动脉中重度狭窄78例

摘要

目的:探讨颈动脉支架置入术治疗症状性颈动脉中重度狭窄患者的中远期疗效.方法:回顾性分析经颈动脉血管内支架植入术(CAS)治疗的78例症状性颈动脉中重度狭窄患者的临床资料,观察患者治疗前后的NIHSS评分和前向血流,随访治疗1年后的患者主要症状和颈动脉狭窄变化以及死亡、心脑血管事件的发生率.结果:在78例CAS中,3例CAS失败转做颈动脉内膜剥脱术(CEA),1例术后并发脑出血死亡,2例支架内血栓形成经治疗后恢复.74例CAS治疗前后的NIHSS评分和前向血流差异有统计学意义(P＜0.05);1年后随访,死亡2例、脑卒中再发3例,严重心肌梗死发作3例,经冠脉支架治疗康复.36例经颈动脉超声复查,1例手术侧并发了再狭窄.结论:CAS是安全有效地治疗症状性颈动脉中重度狭窄、防治缺血性脑血管病的方法之一,但治疗效果与术者的手术操作技巧有着很大的关系.%Objective: To study medium long term efficacy of carotid artery stenosis in Symptomatic se-vere carotid stenosis.Methods:rnRetrospective analysis of the carotid artery stenting (CAS) for treatment of 78 patients with symptomatic severe carotid artery stenosis, observation of patients with NIHSS score and forward flow, follow-up 1 years after treatment with primary symptoms and carotid artery stenosis changes and death , cardiovascu-lar and cerebrovascular events incidence rate. Results: In 78 cases of CAS, 3 cases failed to carotid endarterectomy (CEA) ,1 cases complicated with postoperative death of cerebral hemorrhage,2 cases of stent thrombosis and treat-ment recovery. In 74 cases,with NIHSS score and forward flow difference was statistically significant Before and af-ter CAS treatment (P<0. 05) ; after 1 years follow-up, 2 cases of death, stroke recurrence in 3 cases, severe myo-cardial infarction 3 cases and its rehabilitation in the treatment of coronary stent. In 36 cases of carotid artery ultra-sound review, 1 cases with operation side restenosis. Conclusion:CAS is safe and effective methods in the treatment of symptomatic carotid artery stenosis and ischemic cerebrovascular disease, the treatment effect and operation skill of operation has a great relationship. CAS is worthy of clinical application in the reasonable selection of indications.