颅外动脉狭窄支架置入术治疗的临床研究

目的　观察支架置入 (SP)术治疗颅外动脉狭窄的疗效及其并发症 ,探讨其安全性与可行性。方法　 2 2例 (平均年龄 6 6岁 )因颅外动脉 (颈内动脉颅外段、椎动脉、锁骨下动脉 )狭窄 >70 %患者行SP术治疗。术前术后行脑血管造影、颈动脉双功能彩超检查。术中术后给予抗凝治疗。术后每 3个月复诊。结果　术后立即行脑血管造影 ,狭窄血管均开通 5 0 %以上。术后 3～ 12个月临床随诊仅 1例出现短暂性脑缺血发作 (TIA) ;颈动脉双功能彩超检查 ,1例出现舒张期短流。本组患者术后 5d内主要并发症有 :1例脑出血合并金黄色葡萄球菌感染死亡 ,1例上消化道出血伴右下肢体无力 ,5例出现TIA。结论　SP为脑血管严重狭窄者提供了新的、有前途的治疗手段 ,但必须严格的掌握适应证与禁忌证。

Clinical study on the stent placement therapy for stenoses of the extracranial artery

Objective To study the safety and feasibility of stent placement(SP) therapy for extracranial arterial stenosis and to observe its efficacy and complication.Methods Twenty-two patients (mean age 66 years old) were treated with stent placement for >70% stenoses of extracranial arteries(internal carotid arteries,vertebral arteries,subclavian arteries).Cerebrovascular angiography and carotid artery Doppler ultrasound were performed before and after the operation. Anticoagulant was taken during and after the operation. Follow-up was carried out every 3 monthes.Results It was confirmed that all stenosed extracranial arteries were opened >50% measured by cerebrovascular angiography immediately after the operation.During 3-12 months of clinical follow-up after the operation,only 1 case suffered from transient ischemic attack and 1 case suffered from flow break of blood during diastole detected by the Doppler ultrasound.Chief complications in 5 days after the operation were:1 case died of cerebral hemorrhage and Staphylococcus aureus infection, 1case suffered from hemorrhage of upper digestive tract and asthenia of right lower extremity, 5 cases suffered from transient ischemic attack.Conclusions SP provides a new and hopeful therapy for the patients suffering from serious cerebrovascular stenosis. However, the risk is fairly considerable;therefore, indications and contraindications should be considered.