经皮血管内支架成形术治疗颈动脉狭窄

目的　探讨经皮血管内支架成形术治疗颈动脉狭窄的手术方法、适应证及操作技巧。方法　本组 2 2例颈动脉狭窄患者均采用经股动脉入路 ,对颈动脉颈段狭窄者应用自膨式支架进行血管成形 ,对位于颈动脉海绵窦段的狭窄则使用管状支架治疗。结果　 2 0例患者术后的颈动脉狭窄段直径较术前扩大 ,达到正常管径的 6 0 %以上 ,2例达到 30 %。 2 2例患者临床缺血体征术后明显改善 ,没有发生并发症。随访 2～ 2 4个月未见脑缺血发作。结论　经皮血管内支架成形术是治疗颈动脉狭窄的简便安全方式之一。但是缓慢及准确的操作仍是手术成功的关键。

Endovascular angioplasty with stent for the treatment of stenosis in carotid artery

Objective To investigate the operation method,indication and technique of endovascular angioplasty with stent for treatment of stenosis of carotid artery in 22 cases.Methods The stenosis over 50% of the caliber of carotid artery with ischemia attacks was selected as the angioplasty indication in this group.Angioplasty with self-expand stent (WALLSTENT or SMART) for the stenosis in carotid segment and BX-stent for the stenosis in cavernous segment of carotid artery were used.Results The caliber of stenotic segment in carotid artery was widened to over 60% of normal in 20 cases and 30% in 2 cases.All clinical ischemia signs and symptoms in this group were remarkably improved and no any complication occurred during and after angioplasty.No attack of cerebral ischemia occurred during follow-up for 2～24 months.Conclusion Endovascular angioplasty with stent is one of the easy and safe therapies for stenosis in carotid artery,but the correct and slow manipulation is still the key of success of the operation.