颈动脉狭窄支架成形术并发症的预防及处理

目的探讨颈动脉狭窄支架成形术并发症的预防及处理。方法对48例病人行颈动脉支架成形术(CAS)，共安置支架52个，其中颈总动脉分又部及颈内动脉起始部48个，颈内动脉C1段2个，大脑中动脉M1段2个。手术中使用保护伞2例。结果术中在扩张狭窄部位及安置支架时出现心率、血压下降34例，术后出现心率、血压下降12例；出现神经功能损害症状1例；术中出现右侧髂外动脉夹层动脉瘤1例，术后出现穿刺部位血肿1例，穿刺侧下肢动脉栓塞1例；术后3个月内出现病变血管再狭窄2例。以上并发症经过处理均未遗留明显神经损害症状。结论支架成形术治疗缺血性脑血管病具有一定的风险及并发症，应做好其防治措施。

Prevention and treatment of complications in carotid stenting for carotid artery stenosis

Objective To discuss the safety of carotid stenting for carotid artery stenosis. Methods Fifty-two stents were placed in 48 patients, with 25 stents in left carotid artery, 23 in right, 2 in C1 segment of right internal carotid, and 1 in M1 segment of left middle cerebral artery. Protection devices were used in 2 patients. Results Heart rate and blood pressure decreased in 34 patients during operation, and in 12 after operation. Nerve function decreased in 1 patient. Dissecting aneurysm of right external iliac artery and hematoma of puncture point, and arterial embolism of right lower limb in 1 patients. Restenosis emerged in 2 patients 3 months after operation. All of the complications were treated promptly without any severe residual lesion. Conclusion Carotid stenting is effective for carotid artery stenosis as long as taking correct methods to decrease the risk and complications.