脑保护装置下高龄重度颈动脉狭窄患者颈动脉支架成形术的有效性和安全性评价

目的评价脑保护装置下高龄重度颈动脉狭窄患者颈动脉支架成形术(CAS)的有效性及安全性。方法选择2009年1月—2012年1月在青岛大学医学院附属医院行CAS的高龄重度颈动脉狭窄患者37例,术中均应用脑保护装置,观察患者狭窄改善情况、围术期并发症发生情况、回收脑保护装置内脱落栓子情况,随访1年观察患者缺血性脑血管事件发生情况。结果 36例患者脑保护伞均一次性顺利通过狭窄段放置到位成功释放;术后残余狭窄率均30%,平均狭窄程度从(83.0±6.7)%降至(13.0±6.1)%;回收的脑保护装置中有26个发现脱落的组织碎片;围术期均未出现脑出血、症状性脑梗死、支架内血栓形成等严重并发症;37例患者随访1年,无短暂性脑缺血发作(TIA)、卒中、死亡发生。结论脑保护装置下对高龄重度颈动脉狭窄患者行CAS成功率和安全性较高。

Efficacy and Safety of Carotid Artery Stenting Assisted by Cerebral Embolic Protection Devices in Aged Patients with Se- vere Carotid Stenosis

Objective To evaluate the efficacy and safety of carotid artery stenting assisted by cerebral embolic protec- tion devices in aged patients with severe carotid stenosis. Methods A total of 37 aged patients with severe carotid stenosis were selected in the Affiliated Hospital of Medical College,Qingdao University from January 2009 to January 2012,all of them under- went carotid artery stenting assisted by cerebral embolic protection devices. The improvement of carotid stenosis,incidence of complications during perioperative period,embolus in the embolic protection devices were observed;and incidence of ischemic cerebrovascular events during the one year fellow - up were recorded. Results Out of the 37 patients,36 patients successfully completed the carotid artery stenting,the remnant stenosis rate was less than 30% ,and the average degree of stenosis was （13. 0 ± 6. 1）% ,falled down from（83. 0 ± 6. 7）% ;26 cases found fragment of tissue in the embolic protection devices;no one occurred cerebral hemorrhage,symptomatic cerebral infarction or symptomatic cerebral infarction;no one occurred transient ischemic attack,stroke or death during the one year follow - up. Conclusion Carotid artery stenting assisted by cerebral embol- ic protection devices has high successful rate in aged patients with severe carotid stenosis,and high safety.