经皮颈动脉狭窄血管内支架成形140例临床分析

目的分析总结我院140例经皮血管内支架治疗颈动脉狭窄的手术方法、适应证选择和并发症的预防。方法本组140例患者均经MRA或造影确诊,采用经股动脉入路,应用自膨式支架对颈动脉颅外段狭窄进行治疗。结果140例手术均获得成功,颈动脉狭窄得到有效改善,临床缺血症状术后得到明显改善,全脑循环时间缩短,脑组织血管染色好转,术后早期4例出现并发症,经治疗均获得较满意效果;随访5-24个月,未发现明显脑缺血发作,无发现支架内再狭窄病例。结论经皮血管内支架治疗颈动脉狭窄的手术方法逐渐成熟,适应证的选择和围手术期的专业处理以及娴熟的操作技巧是手术成功的关键。

Percutaneous transluminal angioplasty and stenting for 140 cases with stenosis of carotid artery

Objective To evaluate the operation method, indications and prevention from complication in 140 cases with stenosis of carotid artery by percutaneous transluminal angioplasty and stenting. Methods The procedures of percutaneous transluminal angioplasty and stenting of carotid arteries were performed after the diagnosis of 140 cases with carotid artery stenosis which were confirmed by MRA and DSA. Results All 140 carotid stents were successfully accomplished. DSA showed that the diameter of stenosed segment of carotid artery was markedly enlarged, all clinical ischemia signs were improved remarkably, Circulating time and dyeing of ipsilateral intracranial cerebral vessels recovered to normal. Four cases suffered from early stage postoperative complications, and recovered well after therapy within one month; Follow up ranged between 5-24 months, no ischemia attack occurred in all cases by clinical observation and no restenosis was found in stenting angioplasty segment of carotid artery by ultrasonic examination. Conclusion The satisfactory effect and safety were achieved in the therapy of carotid stenosis by percutaneous transluminal angioplasty and stenting. But the selection for indication, special treatment during operation period and skillful technique were the keys of success.