腔内支架成形术治疗颈动脉狭窄(附64例报告)

目的：介绍颈动脉腔内支架成形术的基本方法，总结64例经验体会，探讨该术式治疗颈动脉狭窄的操作和并发症的预防。方法：64例颈动脉狭窄病人行腔内支架成形术，共放支架66个，其中Wallstent支架41个，Smart支架22个．OptiMed支架3个。应用脑保护装置26例。结果：术中出现较重卒中2例：1例术出现左眼视野缺损．3个月后仍有残余症状：1例术中出现意识丧失、右侧肢体偏瘫，经救治神志恢复。出现轻度卒中3例。10例出现一过性血压降低、心动过缓，其后逐渐恢复。1例术后出现原有神经系统症状加重。神经系统并发症发生率为7．88％，严重卒中是3.13％。循环系统并发症是15．63％。应用脑保护装置的病人仅有1例发生一过性神经系统并发症。结论：颈动脉腔内支架成形术是治疗颈动脉狭窄的有效手段，在有经验的医师操作下，治疗是安全的。使用脑保护装置可明显减少神经系统并发症。

Stenting to treat carotid artery stenosis:a report of 64 cases

Objective Introduc exactly the procedure of carotid stenting, and summary the experience of stenting in 64 patients with carotid artery stenosis. Methods Sixty-four patients with severe carotid atheromatous stenoses were treated by stent implantation and 66 stents were implanted. Of them, 41 were Wallstent, 22 Smart stents and 3 OptiMed stents. Tweenty-six of these patients were operated under cerebral protection. Results During periprocedure, Slight stroke occurred in 2 cases and major stroke in 2 cases, 1 patient suffered from left eye area deficit after 3 months. 1 case had consciousness loss and right acroparalysis and recoved in consciousness after salvage. The complication of nerval system was 7.88%, occurrence of serious stroke was 3.13%. The rate of complication in circular system was 15.63%. All the patients operated under cerebral protection device hasn't nerval complication except one patient had a transient ischemic attack. Conclusion Carotid stenting is effective technique in curing carotid artery stenoses. The experienced surgeon can make this procedure safely. The operation will be safer under cerebral protection device.