颈内动脉狭窄83例的血管内支架治疗

目的 探讨颈内动脉狭窄血管内支架治疗的方法。方法 选择颈内动脉狭窄大于85%的患者83例行血管内支架治疗，于围手术期进行抗血小板治疗，并行全脑血管造影及颈部超声检查。手术采用2类支架，分预扩与不预扩两种操作。结果 83例手术操作顺利，无临床并发症，影像学评价完全成功，超声波检查示脑血流恢复正常或好转。56例临床症状消失，27例临床症状不同程度好转。术后随访3～24个月，复查脑血管造影及超声波示支架形态良好，血液通畅，血管无再狭窄。结论 采用正确的围手术期治疗及手术方法对颈内动脉狭窄行血管内支架治疗是安全的，支架的选择与是否预扩尚待商榷。

Percutaneous transluminal stenting for stenosis of internal carotid artery: a report of 83 cases

ObjectiveTo evaluate the methodology of percutaneous transluminal stenting for stenosis of internal carotid artery(ICA).Methods83 patients with ICA stenosis greater than 85% received antiplatelate therapy perioperatively, and underwent cerebral vascular angiography as well as cervical Doppler sonography. Four kinds of stents were used with or without predilation.ResultsThere were not procedure related morbidities. All procedures were successful based on angiography. Cerebral blood flow (CBF) restored to normal or significantly improved. Symptoms disappeared in 56 cases and ameliorated in 27 cases. Follow up by angiography and sonography at 3 to 24 months showed no distortion of stents and restenosis. ConclusionsPercutaneous transluminal stenting combined with perioperative medical therapy is a safe therapeutic method for stenosis of internal carotid artery.