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颅外颈动脉狭窄支架成形术治疗体会
引用本文:杨继党,傅贤,殷建瑞.颅外颈动脉狭窄支架成形术治疗体会[J].国际医药卫生导报,2013,19(1):82-85.
作者姓名:杨继党  傅贤  殷建瑞
作者单位:510260,广州医学院第二附属医院神经内科
摘    要:目的总结经皮血管内支架成形术治疗颅外颈动脉狭窄的临床应用体会。方法回顾性研究2009年1月至2011年12月在我院行经皮血管内支架成形术治疗颅外颈动脉狭窄的52例患者的临床资料,分析狭窄血管特点和手术成功率、评价血管狭窄纠正情况、症状改善情况和并发症情况。结果血管狭窄程度为极重度5例、重度36例、中度11例,狭窄部位颈内动脉40例、颈总动脉3例、分叉部5例、高于颈2水平的颅外段狭窄4例;共对52例患者放置56枚自膨胀式支架,手术成功率为96.2%(50/52);术中造影见血管狭窄程度均明显改善,残余狭窄程度〈20%;围手术期患者症状消失和改善的有49例,症状改善率为94.2%;术后发生并发症3例,占5.8%。结论根据颈动脉狭窄程度、血管解剖条件和全身耐受手术情况等适应症选择支架成形术治疗颅外颈动脉狭窄,可有效对血管扩张成形、纠正颈动脉管腔狭窄、改善临床症状,具有手术成功率高、并发症发生率低、术后缺血性卒中发生率较低等优点,是一种安全、有效的治疗方法。

关 键 词:颅外颈动脉狭窄  支架成形术

Experience in stent angioplasty for extracranial carotid stenosis
YANG Ji-dang , FU Xian , YIN Jian-rui.Experience in stent angioplasty for extracranial carotid stenosis[J].International Medicine & Health Guidance News,2013,19(1):82-85.
Authors:YANG Ji-dang  FU Xian  YIN Jian-rui
Institution:. (Department of Neurology, Second Amliated Hospital, Guangzhou Medical Univemity , Guangzhou 510260, China)
Abstract:Objective To summarize the experience in clinical application of percutaneous transluminal stent angioplasty in the treatment of extracranial carotid stenosis. Methods The clinical data on 52 patients with extracranial carotid stenosis who had undergone percutaneous transluminal stent angioplasty in our hospital dur- ing January 2009 to December 2011 were retrospectively reviewed. The characteristics of the narrowing vessels and the success rate of surgery were analyzed ; correction of vascular stenosis, improvement in clinical symp- toms, and incidence of complications were assessed. Results Vascular stenosis was extremely severe in 5 pa- tients, severe in 36, and moderate in 11. Stenosis at internal carotid artery was found in 40 patients, stenosis at common carotid artery in, stenosis at furcation in 5, and stenosis at extracranial carotid artery higher than cervi-cal 2 in 4. 56 self-expandable metallic stents were implanted in 52 patients, with a success rate of 96.2% (50/52). Intraoperative angiography showed the stenotic degree was significantly improved and the percentage of residual stenosis was less than 20%. Symptoms disappeared or improved in 49 patients during the perioperative period, with a rate of 94.2%. Compheations occurred postoperatively in 3 patients (5.8%). Conclusions Selec- tion of self-expandable stent therapy for extracranial carotid stenosis according to the surgical indications includ- ing degree of carotid artery stenosis, vascular anatomy and body tolerance to surgery can effectively expand ves- sels, correct of vascular stenosis, and relieve clinical symptoms. The procedure has a higher success rate, lower incidence rates of complications and postoperative ischemic stroke, being an effective and safe therapeutic method for extracranial carotid stenosis.
Keywords:Extracranial carotid stenosis  Stent angioplasty
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