支架置入术治疗颈动脉狭窄的临床疗效

目的 探讨支架置入术治疗颈动脉狭窄的近期临床疗效。方法 将临床经颈部B超、TCD、DSA脑血管造影确诊的颈动脉狭窄患者48例，实施狭窄段置入自膨式支架(WALISTENT或SMART)，12例行后扩张，11例使用滤器装置，围手术期给予抗血小板聚集等治疗。观察患者临床症状体征的改变以及影像学的改变。结果 2例手术失败未能成功置入支架；术后并发脑出血1例，脑栓塞1例，支架内血栓形成1例，除1例脑出血死亡外，其余2例治疗后恢复；其余43例患者均取得很好的临床效果，1～6个月的随访中，无1例出现复发。手术并发症和后遗症发生率低，近期疗效满意。结论 CAS治疗颈动脉狭窄可行性好，近期疗效肯定，是临床上有推广潜力的治疗颈动脉狭窄的方法，但远期疗效尚需进一步观察。

Treatment of carotid artery stenosis by stent placement

Objective To investigate the short term effect of stent placement for the treatment of carotid artery stenosis. Methods Self expandable stents (WALLSTENT or SMART) were placed in the stenotic sections in 48 patients with carotid artery stenosis confirmed by B mode ultrasonography or transcranial Doppler ultrasonography (TCD) or digital subtraction angiography (DSA). Postoperative dilation was performed in 12 cases and filter system used in 11 cases. During the perioperation period, anti coagulation medication was used in all patients. Results The operation was successful in most cases except in 2 cases. The postoperative complications included cerebral embolism in 1 case, thrombosis following stent placement in 1 case, death due to cerebral hemorrhage in 1 case. The left 2 patients recovered after treatment. Favorable clinical outcomes were found in all the left 43 patients. After a follow up for 1~6 months, no recurrence of carotid artery stenosis was found. The short term effect was satisfactory. Conclusion Stent placement is a potential valuable clinical way for the treatment of carotid artery stenosis. However, the long term effect needs to be further studied.