老年颈动脉狭窄患者介入治疗的风险性分析

目的探讨老年颈动脉狭窄患者经皮血管内支架置入血管成形治疗术的方法及其风险。方法本组收集84例老年颈动脉狭窄患者经全脑数字减影血管造影检查诊断后,均采用经股动脉入路应用自膨式支架行经皮血管内支架置入术治疗。结果支架置入成功率98．8%(83/84),术后平均狭窄率由术前(77．0±15．3)%降至(8．2±8．7)%,临床脑缺血症状和体征明显改善。术后发生消化道出血1例,脑出血2例(1例治愈,1例死亡)。随访2个月～3年,无脑缺血再发,其中11例行数字减影血管造影复查,63例行多普勒超声复查,均无再狭窄发生。结论应用经皮血管内支架置入血管成形术治疗老年颈动脉狭窄具有简便、安全、有效的优点,老年患者围手术期须采取综合性措施以降低手术风险及防止手术并发症的发生。

Analysis of risk of endovascular interventional treatment for carotid stenosis in aged patients

Objective To explore the risk and operation method of percutaneous transluminal angioplasty and stenting(PTAS)in aged patients with carotid stenosis.Method Eighty-four cases were diagnosed by digital subtract angiography(DSA)and treated with PTAS with self-expand stent by the approach of femoral artery. Results The operation successful rate was 98.8%(83/84).The postoperative average rate of stenosis de- creased from(77.0±15.3)% before operation to(8.2±8.7)%.The clinical symptoms and signs of iseh- emia were improved obviously after PTAS in those with ischemia.Digestive hamorrhage occurred in lcase and cerebral hemorrhage in 2 cases(one was cured and the other died).During the follow-up for 2 to 36 months no cerebral isehemic attack occurred in all the cases and no restenosis was found in follow-up examination by DSA in 11 eases and Doppler uttrasonography in 63 cases.Conclusions PTAS is an easy,safe and effective thera- py for aged patients with carotid stenosis.Comprehensive measures should be taken to decrease the risk and prevent perioperative complications in aged patients with carotid stenosis.