颈动脉术后再狭窄的支架置入疗效分析

目的评价颈动脉支架置入术(CAS)治疗颈动脉术后再狭窄病变的临床疗效。方法回顾性分析首都医科大学宣武医院神经外科支架置入治疗的颈动脉内膜切除术(CEA)或CAS后再狭窄的19例患者,均为男性,年龄为48~78岁,平均(61.5±8.6)岁。其中CAS后再狭窄9例,CEA后再狭窄10例,均经DSA确诊,并行CAS治疗再狭窄,术前及术后第2天均行颈动脉彩色多普勒血流显像检查,术后1、3、6、12个月门诊随访。结果对19例患者均成功置入支架,未出现并发症,残余狭窄率均20%。术后患者自觉神经缺损症状消失。术后各时间点随访均未发现心肌梗死、卒中及死亡事件。随访终点时患者均无临床症状,复查颈动脉彩色多普勒血流显像均未显示再狭窄。结论 CAS治疗颈动脉术后再狭窄可能是一种安全有效的方法。

Efficacy analysis of stenting for carotid restenotic lesions

Objective To evaluate the clinical efficacy of carotid artery stenting （CAS） for carotid restenotic lesions. Methods Nineteen patients with carotid restenosis after carotid endarterectomy （CEA） or CAS at the Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively.All the patients were males,aged 48 to 78 （mean 61.5±8.6） years.9 patients had restenosis after CAS,and 10 had restenosis after CEA.They were all diagnosed by DSA,and their restenoses were treated with CAS.Two days before and after procedure,they underwent color Doppler ultrasound examination.At 1,3,6,and 12 months after procedure,they were followed up at the outpatient department. Results The stents of all the 19 patients were implanted successfully.No complications occurred.The residual stenosis rate was ＜20%.The patients felt that their neurological deficit symptoms disappeared after procedure,and did not have any clinical symptoms at the follow-up period.No myocardial infarction,stroke and death were found during the follow up at each time point after the procedure.The reexamination of carotid artery with color Doppler flow imaging did not reveal restenosis. Conclusion Carotid artery restenosis treated with CAS may be the safe and effective procedure.